NR 118 CARE OF PATIENTS WITH LIFE
THREATENING CONDITIONS QUESTIONS WITH
ANSWERS 2022/2023 A+
ACUTE RENAL FAILURE
1. A patient admitted with severe dehydration has a urine output of 380 ml
over the next 24 hours and elevated blood urea nitrogen (BUN) and
creatinine levels. A finding that the nurse would expect when reviewing the
patient's urinalysis is
a. proteinuria.
b. bacteriuria.
c. high specific gravity.
d. tubular casts.
2. A patient with acute renal failure (ARF) has an arterial blood pH of 7.30. The nurse will
assess the patient for
a. tachycardia.
b. rapid respirations.
c. poor skin turgor.
d. vasodilation.
3. A patient with severe heart failure develops elevated BUN and
creatinine levels. The nurse plans care for the patient based on the
knowledge that collaborative care of the patient will be directed
toward the goal of
a. preventing hypertension.
b. replacing fluid volume.
c. diluting nephrotoxic substances.
, NR 118 CARE OF PATIENTS WITH LIFE
THREATENING CONDITIONS QUESTIONS WITH
ANSWERS 2022/2023 A+
d. maintaining output.
cardiac
4. When reviewing the laboratory values for a patient admitted with a
severe crushing injury after an industrial accident, the nurse will be
most concerned about levels of
a. creatinine.
b. potassium.
c. white blood cells (WBCs).
d. BUN.
4. A patient admitted with sepsis has had several episodes of severe
hypotension. Laboratory results indicate a BUN 50 mg/dl (10.7
mmol/L), serum creatinine 2.0 mg/dl (177 µmol/L), urine sodium 70
mEq/L (70 mmol/L), urine specific gravity 1.010, and cellular casts and
debris in the urine. The nurse knows these findings are consistent with
a. chronic renal insufficiency.
b. prerenal failure.
c. postrenal failure.
d. acute tubular necrosis.
6. A patient in the oliguric phase of acute renal failure has a 24-hour
fluid output of 150 ml emesis and 250 ml urine. The nurse plans a fluid
replacement for the
, NR 118 CARE OF PATIENTS WITH LIFE
THREATENING CONDITIONS QUESTIONS WITH
ANSWERS 2022/2023 A+
following day of
ml. a. 400
b. 800
c. 1000
d. 1400
7. The health care provider orders IV glucose and insulin to be given to a
patient in ARF whose serum potassium level is 6.3 mEq/L. To best
evaluate the effectiveness of the medications, the nurse will
a. monitor the patient's electrocardiograph (ECG).
b. check the blood glucose level.
c. obtain serum potassium levels.
d. assess BUN and creatinine levels.
8. A patient in ARF has a gradual increase in urinary output to 3400 ml a
day with a BUN of 92 mg/dl (33 mmol/L) and a serum creatinine of 4.2
mg (371 mol/L). The nurse should plan to
a. use a urine dipstick to monitor for proteinuria.
b. auscultate the lungs to assess for pulmonary
edema. c. take the blood pressure to check for
hypotension.
d. draw blood to monitor for hyperkalemia.
, NR 118 CARE OF PATIENTS WITH LIFE
THREATENING CONDITIONS QUESTIONS WITH
ANSWERS 2022/2023 A+
Rationale: During the diuretic phase of ARF, fluid and electrolyte losses
may cause hypovolemia, hypotension, hyponatremia, and hypokalemia.
Proteinuria, pulmonary edema, and hyperkalemia occur during the
oliguric phase.
9. After noting increasing QRS intervals in a patient with ARF, which
action should the nurse take first?
a. Notify the patient's health care provider.
b. Check the chart for the most recent blood potassium level.
c. Look at the patient's current BUN and creatinine levels.
d. Document the QRS interval.
Rationale: The increasing QRS interval is suggestive of hyperkalemia, so
the nurse should check the most recent potassium and then notify the
patient's health care provider. The BUN and creatinine will be elevated in
a patient with ARF, but these would not directly affect the ECG.
Documentation of the QRS interval is also appropriate, but interventions
to decrease the potassium level are needed to prevent life-threatening
bradycardia.
10.A patient with renal insufficiency is scheduled for an intravenous
pyelogram (IVP). Which of the following orders for the patient will the
nurse question?
THREATENING CONDITIONS QUESTIONS WITH
ANSWERS 2022/2023 A+
ACUTE RENAL FAILURE
1. A patient admitted with severe dehydration has a urine output of 380 ml
over the next 24 hours and elevated blood urea nitrogen (BUN) and
creatinine levels. A finding that the nurse would expect when reviewing the
patient's urinalysis is
a. proteinuria.
b. bacteriuria.
c. high specific gravity.
d. tubular casts.
2. A patient with acute renal failure (ARF) has an arterial blood pH of 7.30. The nurse will
assess the patient for
a. tachycardia.
b. rapid respirations.
c. poor skin turgor.
d. vasodilation.
3. A patient with severe heart failure develops elevated BUN and
creatinine levels. The nurse plans care for the patient based on the
knowledge that collaborative care of the patient will be directed
toward the goal of
a. preventing hypertension.
b. replacing fluid volume.
c. diluting nephrotoxic substances.
, NR 118 CARE OF PATIENTS WITH LIFE
THREATENING CONDITIONS QUESTIONS WITH
ANSWERS 2022/2023 A+
d. maintaining output.
cardiac
4. When reviewing the laboratory values for a patient admitted with a
severe crushing injury after an industrial accident, the nurse will be
most concerned about levels of
a. creatinine.
b. potassium.
c. white blood cells (WBCs).
d. BUN.
4. A patient admitted with sepsis has had several episodes of severe
hypotension. Laboratory results indicate a BUN 50 mg/dl (10.7
mmol/L), serum creatinine 2.0 mg/dl (177 µmol/L), urine sodium 70
mEq/L (70 mmol/L), urine specific gravity 1.010, and cellular casts and
debris in the urine. The nurse knows these findings are consistent with
a. chronic renal insufficiency.
b. prerenal failure.
c. postrenal failure.
d. acute tubular necrosis.
6. A patient in the oliguric phase of acute renal failure has a 24-hour
fluid output of 150 ml emesis and 250 ml urine. The nurse plans a fluid
replacement for the
, NR 118 CARE OF PATIENTS WITH LIFE
THREATENING CONDITIONS QUESTIONS WITH
ANSWERS 2022/2023 A+
following day of
ml. a. 400
b. 800
c. 1000
d. 1400
7. The health care provider orders IV glucose and insulin to be given to a
patient in ARF whose serum potassium level is 6.3 mEq/L. To best
evaluate the effectiveness of the medications, the nurse will
a. monitor the patient's electrocardiograph (ECG).
b. check the blood glucose level.
c. obtain serum potassium levels.
d. assess BUN and creatinine levels.
8. A patient in ARF has a gradual increase in urinary output to 3400 ml a
day with a BUN of 92 mg/dl (33 mmol/L) and a serum creatinine of 4.2
mg (371 mol/L). The nurse should plan to
a. use a urine dipstick to monitor for proteinuria.
b. auscultate the lungs to assess for pulmonary
edema. c. take the blood pressure to check for
hypotension.
d. draw blood to monitor for hyperkalemia.
, NR 118 CARE OF PATIENTS WITH LIFE
THREATENING CONDITIONS QUESTIONS WITH
ANSWERS 2022/2023 A+
Rationale: During the diuretic phase of ARF, fluid and electrolyte losses
may cause hypovolemia, hypotension, hyponatremia, and hypokalemia.
Proteinuria, pulmonary edema, and hyperkalemia occur during the
oliguric phase.
9. After noting increasing QRS intervals in a patient with ARF, which
action should the nurse take first?
a. Notify the patient's health care provider.
b. Check the chart for the most recent blood potassium level.
c. Look at the patient's current BUN and creatinine levels.
d. Document the QRS interval.
Rationale: The increasing QRS interval is suggestive of hyperkalemia, so
the nurse should check the most recent potassium and then notify the
patient's health care provider. The BUN and creatinine will be elevated in
a patient with ARF, but these would not directly affect the ECG.
Documentation of the QRS interval is also appropriate, but interventions
to decrease the potassium level are needed to prevent life-threatening
bradycardia.
10.A patient with renal insufficiency is scheduled for an intravenous
pyelogram (IVP). Which of the following orders for the patient will the
nurse question?
