Renal Complex Exam 2-Renal||Latest
Exam With Correct Verified
Answers||Graded A+
For which complications would the nurse monitor a client hospitalized with end-stage
kidney disease? Select all that apply. One, some, or all responses may be correct.
Anemia
Dyspnea
Jaundice
Hyperexcitability
Hypophosphatemia -CORRECT ANSWER Anemia
Dyspnea
Rationale
Anemia results from decreased production of erythropoietin by the kidneys, which
causes decreased erythropoiesis by bone marrow. Dyspnea is a result of fluid overload,
which is associated with chronic kidney failure. Jaundice occurs with biliary obstruction
or liver disorders, not with kidney failure. Hyperphosphatemia occurs with kidney failure,
not hypophosphatemia. Hyperexcitability is not a feature of end-stage kidney disease.
Which information would the nurse include in response to a client's questioning a
protein-restricted dietary change required for acute kidney injury?
"A high-protein intake ensures an adequate daily supply of amino acids to compensate
for losses."
"Essential and nonessential amino acids are necessary in the diet to supply materials
for tissue protein synthesis."
"This diet supplies only essential amino acids, reducing the amount of metabolic waste
products, thus decreasing stress on the kidneys."
"Currently, your body is unable to synthesize amino acids, so the nitrogen for amino
acid synthesis must come from the dietary protein." -CORRECT ANSWER "This diet
supplies only essential amino acids, reducing the amount of metabolic waste products,
thus decreasing stress on the kidneys."
Rationale
The amount of protein permitted in the diet depends on the extent of kidney function;
excess protein causes an increase in urea concentration, excess metabolic waste, and
added stress on the kidneys. The restricted protein diet prevents overburdening the
client's kidneys at this time. When experiencing acute kidney injury, the kidneys are
unable to eliminate the waste products of a high-protein diet. The body is able to
,synthesize the nonessential amino acids. Urea is a waste product of protein
metabolism; the body is able to synthesize the nonessential amino acids.
Test-Taking Tip: Make educated guesses when necessary.
Which condition can be prevented when a client with chronic kidney disease receives
medication to manage anemia?
Uremic frost
Chronic fatigue
Tubular necrosis
Dependent edema -CORRECT ANSWER Chronic fatigue
Rationale
Kidney failure results in impaired erythropoietin production, which causes anemia and
chronic fatigue; treating the anemia will help in managing the fatigue. Uremic frost
results because urea compounds and other waste products of metabolism that are not
excreted by the kidneys are brought to the skin by small, superficial capillaries and are
excreted and deposited on the skin. Tubular necrosis is a pathological condition of the
kidneys that can lead to kidney failure. The anemia and dependent edema associated
with kidney failure are not interrelated.
Which abnormal finding would the nurse monitor for during the oliguric phase of acute
kidney injury?
Hypothermia
Hyperkalemia
Hypocalcemia
Hypernatremia -CORRECT ANSWER Hyperkalemia
Rationale
The kidneys retain potassium during the oliguric phase of acute kidney injury; an
elevated potassium level is one of the main indicators for placing a client on
hemodialysis when he or she is experiencing acute kidney injury. Hypothermia does not
occur with acute kidney injury. Serum levels of calcium decrease during the oliguric
phase of kidney failure. The retained fluids create a hemodilution effect and
hyponatremia occurs, not hypernatremia
Which statement would the nurse include in the preoperative teaching plan of a client
who, after receiving hemodialysis for several years, has a kidney transplant scheduled?
Select all that apply. One, some, or all responses may be correct
"The kidney may not function immediately."
"Precautions are needed to prevent infection."
"A urinary catheter will be present postoperatively."
"Immunosuppressive medications will be given preoperatively."
,"The arteriovenous fistula will be used for drawing blood specimens preoperatively." -
CORRECT ANSWER "The kidney may not function immediately."
"Precautions are needed to prevent infection."
"A urinary catheter will be present postoperatively."
Rationale
Because infection is a major complication of a kidney transplant, prevention begins with
the recognition of the earliest signs and symptoms. The transplanted kidney does not
always function immediately; the client should know that dialysis may have to be
continued. Just before surgery a urinary catheter is inserted and an antibiotic may be
instilled into the bladder to decrease the risk of infection. Immunosuppressive therapy
begins after the kidney transplant, not before surgery. The nurse should never use the
vascular access for drawing blood or instilling intravenous medications.
STUDY TIP: Becoming a nursing student automatically increases stress levels because
of the complexity of the information to be learned and applied and because of new
constraints on time. One way to decrease stress associated with school is to become
very organized so that assignment deadlines or tests do not come as sudden surprises.
By following a consistent plan for studying and completing assignments, you can stay
on top of requirements and thereby prevent added stress
Which response would the nurse give to a client with an acute kidney injury who has
peritoneal dialysis (PD) prescribed and asks why the procedure is necessary?
"PD prevents the development of serious heart problems by removing the damaged
tissues."
"PD helps perform some of the work usually performed by your kidneys."
"PD stabilizes the kidney damage and may 'restart' your kidneys to perform better than
before."
"PD speeds recovery because the kidneys are not responding to regulating hormones."
-CORRECT ANSWER "PD helps perform some of the work usually performed by your
kidneys."
Rationale
PD removes chemicals, wastes, and fluids usually removed from the body by the
kidneys. The mention of heart problems is a threatening response and may cause
increased fear or anxiety. Telling the patient that PD may 'restart' your kidneys so that
they perform better than before is misleading. PD helps maintain fluid and electrolytes;
in acute kidney injury, damage occurs in the nephrons, so the PD may or may not
speed recovery
Which test would the nurse monitor when determining whether a client's newly
transplanted kidney works effectively?
Renal scan
Serum creatinine
, 24-hour urine output
White blood cell (WBC) count -CORRECT ANSWER Serum creatinine
Rationale
Serum creatinine, a test of renal function, measures the kidneys' ability to excrete
metabolic wastes; creatinine, a nitrogenous product of protein breakdown, is elevated in
renal insufficiency. A renal scan will not provide information about the filtering ability of
the transplanted kidney. Although the nurse monitors the client's intake and output, this
information will not provide information about the ability of kidney to excrete metabolic
wastes. The WBC count will not reflect functioning of a transplanted kidney
Which symptom is indicative of the need for dialysis in the child with chronic kidney
disease?
Hypotension
Hypokalemia
Hypervolemia
Hypercalcemia -CORRECT ANSWER Hypervolemia
Rationale
Hypervolemia results when the kidneys have failed and are no longer able to maintain
homeostasis, the blood pressure is high, and cardiac overload is imminent.
Hypertension, not hypotension, is present when kidney failure occurs. Hyperkalemia,
not hypokalemia, occurs with kidney failure. Hypocalcemia, not hypercalcemia, is
present when kidney failure occurs
Which assessment finding is associated with rejection of a kidney transplant? Select all
that apply. One, some, or all responses may be correct.
Fever
Oliguria
Jaundice
Polydipsia
Weight gain -CORRECT ANSWER Fever
Oliguria
Weight gain
Rationale
Fever is a characteristic of the systemic inflammatory response to the antigen
(transplanted kidney). Oliguria or anuria occurs when the transplanted kidney is rejected
and fails to function. Weight gain can occur from fluid retention when the transplanted
kidney fails to function or as a result of steroid therapy; this response must be assessed
further. Jaundice is unrelated to rejection. Polydipsia is associated with diabetes
mellitus; it is not a clinical manifestation of rejection.
Exam With Correct Verified
Answers||Graded A+
For which complications would the nurse monitor a client hospitalized with end-stage
kidney disease? Select all that apply. One, some, or all responses may be correct.
Anemia
Dyspnea
Jaundice
Hyperexcitability
Hypophosphatemia -CORRECT ANSWER Anemia
Dyspnea
Rationale
Anemia results from decreased production of erythropoietin by the kidneys, which
causes decreased erythropoiesis by bone marrow. Dyspnea is a result of fluid overload,
which is associated with chronic kidney failure. Jaundice occurs with biliary obstruction
or liver disorders, not with kidney failure. Hyperphosphatemia occurs with kidney failure,
not hypophosphatemia. Hyperexcitability is not a feature of end-stage kidney disease.
Which information would the nurse include in response to a client's questioning a
protein-restricted dietary change required for acute kidney injury?
"A high-protein intake ensures an adequate daily supply of amino acids to compensate
for losses."
"Essential and nonessential amino acids are necessary in the diet to supply materials
for tissue protein synthesis."
"This diet supplies only essential amino acids, reducing the amount of metabolic waste
products, thus decreasing stress on the kidneys."
"Currently, your body is unable to synthesize amino acids, so the nitrogen for amino
acid synthesis must come from the dietary protein." -CORRECT ANSWER "This diet
supplies only essential amino acids, reducing the amount of metabolic waste products,
thus decreasing stress on the kidneys."
Rationale
The amount of protein permitted in the diet depends on the extent of kidney function;
excess protein causes an increase in urea concentration, excess metabolic waste, and
added stress on the kidneys. The restricted protein diet prevents overburdening the
client's kidneys at this time. When experiencing acute kidney injury, the kidneys are
unable to eliminate the waste products of a high-protein diet. The body is able to
,synthesize the nonessential amino acids. Urea is a waste product of protein
metabolism; the body is able to synthesize the nonessential amino acids.
Test-Taking Tip: Make educated guesses when necessary.
Which condition can be prevented when a client with chronic kidney disease receives
medication to manage anemia?
Uremic frost
Chronic fatigue
Tubular necrosis
Dependent edema -CORRECT ANSWER Chronic fatigue
Rationale
Kidney failure results in impaired erythropoietin production, which causes anemia and
chronic fatigue; treating the anemia will help in managing the fatigue. Uremic frost
results because urea compounds and other waste products of metabolism that are not
excreted by the kidneys are brought to the skin by small, superficial capillaries and are
excreted and deposited on the skin. Tubular necrosis is a pathological condition of the
kidneys that can lead to kidney failure. The anemia and dependent edema associated
with kidney failure are not interrelated.
Which abnormal finding would the nurse monitor for during the oliguric phase of acute
kidney injury?
Hypothermia
Hyperkalemia
Hypocalcemia
Hypernatremia -CORRECT ANSWER Hyperkalemia
Rationale
The kidneys retain potassium during the oliguric phase of acute kidney injury; an
elevated potassium level is one of the main indicators for placing a client on
hemodialysis when he or she is experiencing acute kidney injury. Hypothermia does not
occur with acute kidney injury. Serum levels of calcium decrease during the oliguric
phase of kidney failure. The retained fluids create a hemodilution effect and
hyponatremia occurs, not hypernatremia
Which statement would the nurse include in the preoperative teaching plan of a client
who, after receiving hemodialysis for several years, has a kidney transplant scheduled?
Select all that apply. One, some, or all responses may be correct
"The kidney may not function immediately."
"Precautions are needed to prevent infection."
"A urinary catheter will be present postoperatively."
"Immunosuppressive medications will be given preoperatively."
,"The arteriovenous fistula will be used for drawing blood specimens preoperatively." -
CORRECT ANSWER "The kidney may not function immediately."
"Precautions are needed to prevent infection."
"A urinary catheter will be present postoperatively."
Rationale
Because infection is a major complication of a kidney transplant, prevention begins with
the recognition of the earliest signs and symptoms. The transplanted kidney does not
always function immediately; the client should know that dialysis may have to be
continued. Just before surgery a urinary catheter is inserted and an antibiotic may be
instilled into the bladder to decrease the risk of infection. Immunosuppressive therapy
begins after the kidney transplant, not before surgery. The nurse should never use the
vascular access for drawing blood or instilling intravenous medications.
STUDY TIP: Becoming a nursing student automatically increases stress levels because
of the complexity of the information to be learned and applied and because of new
constraints on time. One way to decrease stress associated with school is to become
very organized so that assignment deadlines or tests do not come as sudden surprises.
By following a consistent plan for studying and completing assignments, you can stay
on top of requirements and thereby prevent added stress
Which response would the nurse give to a client with an acute kidney injury who has
peritoneal dialysis (PD) prescribed and asks why the procedure is necessary?
"PD prevents the development of serious heart problems by removing the damaged
tissues."
"PD helps perform some of the work usually performed by your kidneys."
"PD stabilizes the kidney damage and may 'restart' your kidneys to perform better than
before."
"PD speeds recovery because the kidneys are not responding to regulating hormones."
-CORRECT ANSWER "PD helps perform some of the work usually performed by your
kidneys."
Rationale
PD removes chemicals, wastes, and fluids usually removed from the body by the
kidneys. The mention of heart problems is a threatening response and may cause
increased fear or anxiety. Telling the patient that PD may 'restart' your kidneys so that
they perform better than before is misleading. PD helps maintain fluid and electrolytes;
in acute kidney injury, damage occurs in the nephrons, so the PD may or may not
speed recovery
Which test would the nurse monitor when determining whether a client's newly
transplanted kidney works effectively?
Renal scan
Serum creatinine
, 24-hour urine output
White blood cell (WBC) count -CORRECT ANSWER Serum creatinine
Rationale
Serum creatinine, a test of renal function, measures the kidneys' ability to excrete
metabolic wastes; creatinine, a nitrogenous product of protein breakdown, is elevated in
renal insufficiency. A renal scan will not provide information about the filtering ability of
the transplanted kidney. Although the nurse monitors the client's intake and output, this
information will not provide information about the ability of kidney to excrete metabolic
wastes. The WBC count will not reflect functioning of a transplanted kidney
Which symptom is indicative of the need for dialysis in the child with chronic kidney
disease?
Hypotension
Hypokalemia
Hypervolemia
Hypercalcemia -CORRECT ANSWER Hypervolemia
Rationale
Hypervolemia results when the kidneys have failed and are no longer able to maintain
homeostasis, the blood pressure is high, and cardiac overload is imminent.
Hypertension, not hypotension, is present when kidney failure occurs. Hyperkalemia,
not hypokalemia, occurs with kidney failure. Hypocalcemia, not hypercalcemia, is
present when kidney failure occurs
Which assessment finding is associated with rejection of a kidney transplant? Select all
that apply. One, some, or all responses may be correct.
Fever
Oliguria
Jaundice
Polydipsia
Weight gain -CORRECT ANSWER Fever
Oliguria
Weight gain
Rationale
Fever is a characteristic of the systemic inflammatory response to the antigen
(transplanted kidney). Oliguria or anuria occurs when the transplanted kidney is rejected
and fails to function. Weight gain can occur from fluid retention when the transplanted
kidney fails to function or as a result of steroid therapy; this response must be assessed
further. Jaundice is unrelated to rejection. Polydipsia is associated with diabetes
mellitus; it is not a clinical manifestation of rejection.
