Test Bank for Medical Genetics 5th Edition by Jorde - Ch. 1-8, 9780323188357, with Rationales

TEST BANK For Medical-
s s s


Surgical Nursing, Concepts and Practice, 5th Edition (Stromberg,
s s s s s s s s


2023), s




DuringsthesoliguricsphasesofsAKI,sthesnursesmonitorssthespatientsfors(selectsallsthatsappl
y)
a)shypotension.
b)sECGschanges.
c)shypernatremia.
d)spulmonarysedema.
e)surineswithshighsspecificsgravity. ANSWER:sbsandsd

WhensaspatientsissinsthesdiureticsphasesofsAKI,sthesnursesmustsmonitorsforswhichsserums
electrolytesimbalances?
a)sHyperkalemiasandshyponatremia
b)sHyperkalemiasandshypernatremia
c)sHypokalemiasandshyponatremia
d)sHypokalemiasandshypernatremia ANSWER:sc)sHypokalemiasandshyponatremia

Thesnursesassessessthespatientswithschronicskidneysdiseaseswithsthesunderstandingstha
tsthissconditionsisscharacterizedsby
a)sprogressivesirreversiblesdestructionsofstheskidneys.
b)sasrapidsdecreasesinsurinesoutputswithsanselevatedsBUN.
c)sansincreasingscreatininesclearanceswithsasdecreasesinsurinesoutput.
d)sprostration,ssomnolence,sandsconfusionswithscomasandsimminentsdeath.
ANSWER:sa)sprogressivesirreversiblesdestructionsofstheskidneys.

Nursesscansscreenspatientssatsrisksforsdevelopingschronicskidneysdisease.sThosesconside
redstosbesatsincreasedsrisksincludes(selectsallsthatsapply)
a)soldersBlackspatients.
b)spatientssmoresthans60syearssold.
c)sthoseswithsashistorysofspancreatitis.
d)sthoseswithsashistorysofshypertension.
e)sthoseswithsashistorysofstypes2sdiabetes. ANSWER:sa,b,sdandse

Whichspointssmuststhesnursesconsiderswhensplanningsnutritionssupportsforspatientsswit
hschronicskidneysdisease?s(selectsallsthatsapply)
a)sSodiumsmaysbesrestrictedsinssomeoneswithsadvancedsCKD.
b)sFluidsissnotsusuallysrestrictedsforspatientssonsperitonealsdialysis.
c)sDecreasedsfluidsintakesandsaslow-
potassiumsdietsaresneededsforsaspatientsonshemodialysis.
d)sDecreasedsfluidsintakesandsaslow-
potassiumsdietsaresneededsforsaspatientsonsperitonealsdialysis.
e)sDecreasedsfluidsintakesandsasdietsinsprotein-
richsfoodssarespartsofsasdietsforsaspatientsonshemodialysis ANSWER:sa,bsandsc

,Tosassesssthespatencysofsasnewlysplacedsarteriovenoussgraft,sthesnursesshoulds(selectsal
lsthatsapply)
a)smonitorsthesBPsinsthesaffectedsarm.
b)sirrigatesthesgraftsdailyswithslow-dosesheparin.
c)spalpatesthesareasofsthesgraftstosfeelsasnormalsthrill.
d)slistenswithsasstethoscopesoversthesgraftstosdetectsasbruit.
e)sassesssthespulsessandsneurovascularsstatussdistalstosthesgraft. ANSWER:scsdsandse

Duringshemodialysis,sthespatientsdevelopsslight-
headednesssandsnausea.sWhatswouldsthesnursesdosfirst?
a)Giveshypertonicssaline.
b)sInitiatesasbloodstransfusion.
c)sDecreasesthesratesofsfluidsremoval.
d)sAdministersantiemeticsmedications.
ANSWER:sc)sDecreasesthesratesofsfluidsremoval.
Thespatientsisshavingshypotensionsfromsasrapidsremovalsofsvascularsvolume.sThesratesan
dsvolumesofsfluidsremovalswillsbesdecreased,sands0.9%ssalinessolutionsmaysbesinfused.s
Hypertonicssalinesissnotsusedsbecausesofstheshighssodiumsload.sAsbloodstransfusionsissn
otsindicated.sAntiemeticsmedicationssmayshelpsthesnauseasbutswouldsnotshelpstheshyp
ovolemia.

Aspatientswithsstages2schronicskidneysdiseasesissscheduledsforsansoutpatientsdiagnostics
proceduresusingscontrastsmedia.sWhichsprioritysactionswouldsthesnursesperform?
a)Assesssthespatient'sshydrationsstatus.
b)sInsertsasurinaryscathetersforsthesexpectedsdiuresis.
c)sEvaluatesthespatient'sslowersextremitiessforsedema.
d)sChecksthespatient'ssurinesforsthespresencesofsketones.
ANSWER:sa)Assesssthespatient'sshydrationsstatus.
Preexistingskidneysdiseasesissthesmostsimportantsrisksfactorsforsthesdevelopmentsofscon
trast-
associatedsnephropathysandsnephrotoxicsinjury.sIfscontrastsmediasmustsbesadministere
dstosashigh-
riskspatient,sthespatientsneedsstoshavesoptimalshydration.sThesnursesshouldsassesssthes
hydrationsstatussofsthespatientsbeforesthesproceduresissperformed.sIndwellingscatheter
susesshouldsbesavoidedswheneverspossiblestosdecreasesthesrisksofsinfection.




Theshomescaresnursesvisitssaspatientsreceivingsperitonealsdialysis.sWhichsstatementsbyst
hespatientsindicatessasneedsforsimmediatesfollow-upsbysthesnurse?
a)s"DrainstimesissfastersifsIsrubsmysabdomen."
b)s"Thesfluidsdrainingsfromsthescathetersisscloudy."
c)"ThesdrainagesissbloodyswhensIshavesmysperiod."
d)s"Iswashsaroundsthescatheterswithssoapsandswater."
ANSWER:sb)s"Thesfluidsdrainingsfromsthescathetersisscloudy."
Thesprimarysmanifestationsofsperitonitississascloudysperitonealseffluent.sBloodsmaysbesp
resentsinstheseffluentsofswomenswhosaresmenstruating,sandsnosinterventionsissindicate

,d.sDailyscatheterscaresmaysincludeswashingsaroundsthescatheterswithssoapsandswater.sD
rainstimesmaysbesfacilitatedsbysgentlysmassagingsthesabdomen.

Whichspatientsdiagnosissorstreatmentsissmostsconsistentswithsprerenalsacuteskidneysinj
urys(AKI)?
a)sIVstobramycin
b)sIncompatiblesbloodstransfusion
c)sPoststreptococcalsglomerulonephritis
d)sDissectingsabdominalsaorticsaneurysm
ANSWER:sd)sDissectingsabdominalsaorticsaneurysm
AsdissectingsabdominalsaorticsaneurysmsissasprerenalscausesofsAKIsbecausesitscansdecre
asesrenalsarterysperfusionsandsthereforesthesglomerularsfiltratesrate.sAminoglycosidesa
ntibioticsadministration,sashemolyticsbloodstransfusionsreaction,sandspoststreptococca
lsglomerulonephritissaresintrarenalscausessofsAKI.

Whichsstatementsaboutscontinuoussambulatorysperitonealsdialysiss(CAPD)swouldsbesm
ostsimportantswhensteachingsaspatientsnewstosthestreatment?
a)"Maintainsasdailyswrittensrecordsofsbloodspressuresandsweight."
b)"Itsissessentialsthatsyousmaintainsasepticstechniquestospreventsperitonitis."
c)s"YouswillsbesallowedsasmoresliberalsproteinsdietsoncesyouscompletesCAPD."
d)s"Continuesregularsmedicalsandsnursingsfollow-upsvisitsswhilesperformingsCAPD.
ANSWER:sb)"Itsissessentialsthatsyousmaintainsasepticstechniquestospreventsperit
onitis."
Peritonitississaspotentiallysfatalscomplicationsofsperitonealsdialysis,sandsthussitsissimpera
tivestosteachsthespatientsmethodssofsprevention.sAlthoughsthesothersteachingsstateme
ntssaresaccurate,stheysdosnotshavesthespotentialsforsmorbiditysandsmortalitysthatsperito
nitissdoes.

Asfrailselderlyspatientswithsstages3schronicskidneysdiseasesisscaredsforsatshomesbystheirsf
amily.sThespatientshassashistorysofstakingsmanysover-the-
countersmedications.sWhichsover-the-
countersmedicationsswouldsthesnursesteachsthespatientstosavoid?
a)Aspirin
b)Acetaminophen
c)sDiphenhydramine
d)sAluminumshydroxide ANSWER:sd)sAluminumshydroxide
Antacidss(thatscontainsmagnesiumsandsaluminum)sshouldsbesavoidedsbecausespatientss
withskidneysdiseasesaresunablestosexcretesthesessubstances.sAlso,ssomesantacidsscontai
nshighslevelssofssodiumsthatsfurthersincreasesbloodspressure.sAcetaminophensandsaspir
ins(ifstakensforsasshortsperiodsofstime)saresusuallyssafesforspatientsswithskidneysdisease.s
Antihistaminessmaysbesused,sbutscombinationsdrugssthatscontainspseudoephedrinesma
ysincreasesbloodspressuresandsshouldsbesavoided.

Aspatientswithsas25-
yearshistorysofstypes1sdiabetessissreportingsfatigue,sedema,sandsansirregularsheartbeat.s
Onsassessment,sthesnursesnotessnewlysdevelopedshypertensionsandsuncontrolledsbloo

, dsglucoseslevels.sWhichsdiagnosticsstudysissmostsindicativesofschronicskidneysdiseases(C
KD)?
a)Serumscreatinine
b)Serumspotassium
c)sMicroalbuminuria
d)Calculatedsglomerularsfiltrationsrates(GFR)
ANSWER:sd)Calculatedsglomerularsfiltrationsrates(GFR)
ThesbestsstudystosdetermineskidneysfunctionsorsCKDsthatswouldsbesexpectedsinsthespati
entswithsdiabetessissthescalculatedsGFRsthatsissobtainedsfromsthespatient'ssage,sgender,s
race,sandsserumscreatinine.sItswouldsneedstosbesabnormalsfors3smonthsstosestablishsasdi
agnosissofsCKD.sAscreatininesclearancestestsdoneswithsasbloodssamplesandsas24-
hoursurinescollectionsissalsosimportant.sSerumscreatininesissnotsthesbeststestsforsCKDsbe
causestheslevelsvariesswithsdifferentspatients.sSerumspotassiumslevelsscouldsexplainswh
ysthespatientshassansirregularsheartbeat.sThesfindingsofsmicroalbuminuriascansalertsthes
patientswithsdiabetessaboutspotentialsrenalsinvolvementsandspotentiallysfailingskidneys
.sHowever,surinesalbuminslevelssaresnotsusedsforsdiagnosissofsCKD.

Thesnursesisscaringsforsaspatientswhosissinsthesoliguricsphasesofsacuteskidneysdisease.sW
hichsactionswouldsbesappropriatestosincludesinsthesplansofscare?
a)sProvidesfoodsshighsinspotassium.
b)sRestrictsfluidssbasedsonsurinesoutput.
c)sMonitorsoutputsfromsperitonealsdialysis.
d)sOffershigh-proteinssnackssbetweensmeals.
ANSWER:Restrictsfluidssbasedsonsurinesoutput.
Fluidsintakesissmonitoredsduringsthesoliguricsphase.sFluidsintakesissdeterminedsbysaddin
gsallslossessforsthespreviouss24shoursspluss600smL.sPotassiumsandsproteinsintakesmaysbe
slimitedsinsthesoliguricsphasestosavoidshyperkalemiasandselevatedsureasnitrogen.sHemo

dialysis,snotsperitonealsdialysis,sissindicatedsinsacuteskidneysinjurysifsdialysississneeded.

Whichsassessmentsfindingsswouldsalertsthesnursesthatsthespatientshassenteredsthesdiur
eticsphasesofsacuteskidneysinjurys(AKI)?s(Selectsallsthatsapply.)
a)sDehydration
b)sHypokalemia
c)sHypernatremia
d)sBUNsincreases
e)Urinesoutputsincreases
f)sSerumscreatininesincreases ANSWER:sa,bsandse
Theshallmarksofsenteringsthesdiureticsphasesissthesproductionsofscopioussamountssofsuri
ne.sDehydration,shypokalemia,sandshyponatremiasoccursinsthesdiureticsphasesofsAKIsbe
causesthesnephronsscansexcreteswastessbutsnotsconcentratesurine.sSerumsBUNsandsser
umscreatinineslevelssbeginstosdecrease.

Aspatientswithstypes2sdiabetessandschronicskidneysdiseaseshassasserumspotassiumslevels
ofs6.8smEq/L.sWhichsfindingswillsthesnursesmonitorsfor?
a)sFatigue
b)sDysrhythmias
c)sHypoglycemia