lOMoARcPSD|3013804
Chapter 63 notes
Care Management (Keiser
University)
, lOMoARcPSD|3013804
Test Bank for Medical Surgical Nursing 10th Edition Ignatavicius (Test Bank PDF Files)
Chapter 63: Concepts of Care for Patients with Acute Kidney Injury and Chronic
Kidney Disease
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. The nurse is assessing a client with a diagnosis of prerenal acute kidney injury (AKI). Which
condition would the nurse expect to find in the patient’s recent history?
a.
Pyelonephritis
b.
Dehydration
c.
Bladder cancer
d.
Kidney stones
ANS: B
Prerenal causes of AKI are related to a decrease in perfusion, such as in clients who have
prolonged dehydration. Pyelonephritis is an intrinsic or intrarenal cause of AKI related to
kidney damage. Bladder cancer and kidney stones are postrenal causes of AKI related to
urine flow obstruction.
DIF: Understanding TOP: Integrated Process: Nursing Process: Assessment
KEY: Acute kidney injury, Assessment
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
2. A marathon runner comes into the clinic and states “I have not urinated very much in the last
few days.” The nurse notes a heart rate of 110 beats/min and a blood pressure of 86/58 mm
Hg. Which action by the nurse is m o s t a p p ro p ri a te ?
G R A DE S L A B . C O M
a.
Give the client a bottle of water immediately.
b.
Start an intravenous line for fluids.
c.
Teach the patient to drink 2 to 3 L of water daily.
d.
Perform an electrocardiogram.
ANS: A
This athlete is mildly dehydrated as evidenced by the higher heart rate and lower blood
pressure. The nurse can start hydrating the client with a bottle of water first, followed by
teaching the patient to drink 2 to 3 L of water each day. An intravenous line may be needed
later, after the patient’s degree of dehydration is assessed. An electrocardiogram is not
necessary at this time.
DIF: Applying TOP: Integrated Process: Nursing Process: Planning and Implementation
KEY: Renal system, Dehydration
MSC: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
3. A client comes into the emergency department with a serum creatinine of 2.2 mg/dL (1944
mcmol/L) and a blood urea nitrogen (BUN) of 24 mL/dL (8.57 mmol/L). What question
would the nurse ask first when taking this client’s history?
a.
“Have you been taking any aspirin, ibuprofen, or naproxen recently?”
b.
“Do you have anyone in your family with renal failure?”
c.
“Have you had a diet that is low in protein recently?”
d.
“Has a relative had a kidney transplant lately?”
Chapter 63 notes
Care Management (Keiser
University)
, lOMoARcPSD|3013804
Test Bank for Medical Surgical Nursing 10th Edition Ignatavicius (Test Bank PDF Files)
Chapter 63: Concepts of Care for Patients with Acute Kidney Injury and Chronic
Kidney Disease
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. The nurse is assessing a client with a diagnosis of prerenal acute kidney injury (AKI). Which
condition would the nurse expect to find in the patient’s recent history?
a.
Pyelonephritis
b.
Dehydration
c.
Bladder cancer
d.
Kidney stones
ANS: B
Prerenal causes of AKI are related to a decrease in perfusion, such as in clients who have
prolonged dehydration. Pyelonephritis is an intrinsic or intrarenal cause of AKI related to
kidney damage. Bladder cancer and kidney stones are postrenal causes of AKI related to
urine flow obstruction.
DIF: Understanding TOP: Integrated Process: Nursing Process: Assessment
KEY: Acute kidney injury, Assessment
MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation
2. A marathon runner comes into the clinic and states “I have not urinated very much in the last
few days.” The nurse notes a heart rate of 110 beats/min and a blood pressure of 86/58 mm
Hg. Which action by the nurse is m o s t a p p ro p ri a te ?
G R A DE S L A B . C O M
a.
Give the client a bottle of water immediately.
b.
Start an intravenous line for fluids.
c.
Teach the patient to drink 2 to 3 L of water daily.
d.
Perform an electrocardiogram.
ANS: A
This athlete is mildly dehydrated as evidenced by the higher heart rate and lower blood
pressure. The nurse can start hydrating the client with a bottle of water first, followed by
teaching the patient to drink 2 to 3 L of water each day. An intravenous line may be needed
later, after the patient’s degree of dehydration is assessed. An electrocardiogram is not
necessary at this time.
DIF: Applying TOP: Integrated Process: Nursing Process: Planning and Implementation
KEY: Renal system, Dehydration
MSC: Client Needs Category: Physiological Integrity: Reduction of Risk Potential
3. A client comes into the emergency department with a serum creatinine of 2.2 mg/dL (1944
mcmol/L) and a blood urea nitrogen (BUN) of 24 mL/dL (8.57 mmol/L). What question
would the nurse ask first when taking this client’s history?
a.
“Have you been taking any aspirin, ibuprofen, or naproxen recently?”
b.
“Do you have anyone in your family with renal failure?”
c.
“Have you had a diet that is low in protein recently?”
d.
“Has a relative had a kidney transplant lately?”
