COMPLEX ADULT HEALTH NR 341 EXAM 3
PRACTICE EXAM QUESTIONS WITH
CORRECT ANSWERS TESTED AND APPROVED
NEWLY MODIFIED EXAM!!!
AKI prerenal causes -- ANSWER--Volume depletion
Decreased cardiac output
Vasodilation
AKI intrarenal causes -- ANSWER--Acute tubular necrosis (ATN)
Prolonged renal ischemia
Nephrotoxic agents
Infectious process
AKI postrenal causes -- ANSWER--Urinary tract obstruction
Tumors, calculus (stones)
AKI phases -- ANSWER--Onset - initial problem
, Page 2 of 85
Oliguria - urine output <400ml/24 hrs, accompanied by increase in serum
concentration of substances usually excreted by kidneys
Diuresis - gradual increase in urine output, daily urine output 1-3 L per day (due
to osmotic diuresis) signals that filtration has started to recover, kidneys have
recovered ability to excrete wastes but not to concentrate the urine, observe
closely for hyponatremia, hypokalemia, dehydration
Recovery - signals the improvement of renal function (increasing GFR), may
take 3-12 months
AKI symptoms -- ANSWER--Lethargic
Drowsiness
Headache
Muscle twitching
Seizures
AKI Assessment and Diagnostic Findings -- ANSWER--Laboratory findings -
decline in GFR, increase in Creatinine, increase in BUN
- ultrasound, CT, MRI (anatomical changes)
- high risk for hyperkalemia, metabolic acidosis
Page | 2
,Renal Failure -- ANSWER--Occurs when kidneys cannot remove the body's
metabolic wastes or perform regulatory functions.
Acute Kidney Injury -- ANSWER--rapid loss of renal function due to damage to
the kidneys
Causes of AKI -- ANSWER--Hypovolemia
Hypotension Infections decreased cardiac
output and heart failure
Obstruction of the kidney or lower urinary tract
Blood clot or renal stones (rare)
Obstruction of renal arteries or veins
Nephrotoxic agents
Types of AKI -- ANSWER--Prerenal - hypoperfusion of kidney, not enough
blood to kidney
Intrarenal - actual damage to glomeruli or kidney tubules
Postrenal - urinary obstruction that impedes forward flow (tumor, stone)
Pt has increased creatinine level and increased BUN, what is the issue? --
, Page 4 of 85
ANSWER--Problem with kidney perfusion
Pt has increased creatinine and increased BUN, what are the nursing priorities?
-- ANSWER--Check urine output
Check specific gravity - filtration/how concentrated
Fixed specific gravity -- ANSWER--Kidney damage - can't dilute
urine/accommodate
Specific gravity lab value -- ANSWER--1.005-1.030
Lab values to monitor for kidney function -- ANSWER--BUN, creatinine,
creatinine clearance, GFR, specific gravity, UA
Adult urine output -- ANSWER--30 mL/hr
What lab increases during dehydration? -- ANSWER--BUN
Normal Na levels -- ANSWER--135-145 mEq/L
Page | 4
PRACTICE EXAM QUESTIONS WITH
CORRECT ANSWERS TESTED AND APPROVED
NEWLY MODIFIED EXAM!!!
AKI prerenal causes -- ANSWER--Volume depletion
Decreased cardiac output
Vasodilation
AKI intrarenal causes -- ANSWER--Acute tubular necrosis (ATN)
Prolonged renal ischemia
Nephrotoxic agents
Infectious process
AKI postrenal causes -- ANSWER--Urinary tract obstruction
Tumors, calculus (stones)
AKI phases -- ANSWER--Onset - initial problem
, Page 2 of 85
Oliguria - urine output <400ml/24 hrs, accompanied by increase in serum
concentration of substances usually excreted by kidneys
Diuresis - gradual increase in urine output, daily urine output 1-3 L per day (due
to osmotic diuresis) signals that filtration has started to recover, kidneys have
recovered ability to excrete wastes but not to concentrate the urine, observe
closely for hyponatremia, hypokalemia, dehydration
Recovery - signals the improvement of renal function (increasing GFR), may
take 3-12 months
AKI symptoms -- ANSWER--Lethargic
Drowsiness
Headache
Muscle twitching
Seizures
AKI Assessment and Diagnostic Findings -- ANSWER--Laboratory findings -
decline in GFR, increase in Creatinine, increase in BUN
- ultrasound, CT, MRI (anatomical changes)
- high risk for hyperkalemia, metabolic acidosis
Page | 2
,Renal Failure -- ANSWER--Occurs when kidneys cannot remove the body's
metabolic wastes or perform regulatory functions.
Acute Kidney Injury -- ANSWER--rapid loss of renal function due to damage to
the kidneys
Causes of AKI -- ANSWER--Hypovolemia
Hypotension Infections decreased cardiac
output and heart failure
Obstruction of the kidney or lower urinary tract
Blood clot or renal stones (rare)
Obstruction of renal arteries or veins
Nephrotoxic agents
Types of AKI -- ANSWER--Prerenal - hypoperfusion of kidney, not enough
blood to kidney
Intrarenal - actual damage to glomeruli or kidney tubules
Postrenal - urinary obstruction that impedes forward flow (tumor, stone)
Pt has increased creatinine level and increased BUN, what is the issue? --
, Page 4 of 85
ANSWER--Problem with kidney perfusion
Pt has increased creatinine and increased BUN, what are the nursing priorities?
-- ANSWER--Check urine output
Check specific gravity - filtration/how concentrated
Fixed specific gravity -- ANSWER--Kidney damage - can't dilute
urine/accommodate
Specific gravity lab value -- ANSWER--1.005-1.030
Lab values to monitor for kidney function -- ANSWER--BUN, creatinine,
creatinine clearance, GFR, specific gravity, UA
Adult urine output -- ANSWER--30 mL/hr
What lab increases during dehydration? -- ANSWER--BUN
Normal Na levels -- ANSWER--135-145 mEq/L
Page | 4
