Chapter 16: Acute Kidney Injury Questions And Answers, Exams of Nursing

Download Chapter 16: Acute Kidney Injury Questions And Answers and more Exams Nursing in PDF only on Docsity! Chapter 16: Acute Kidney Injury Questions And Answers With sudden cessation of renal function, all body systems are affected by the inability to maintain fluid and electrolyte balance and eliminate metabolic waste. In critically ill patients, what statement regarding renal dysfunction is true? a. It is a very rare problem. b. It affects nearly two thirds of patients. c. It has a low mortality once renal replacement therapy has been initiated. d. It has little effect on morbidity, mortality, or quality of life. - correct answer b. It affects nearly two thirds of patients. The nurse is caring for a patient who has sustained blunt trauma to the left flank area, and is evaluating the patient's urinalysis results. What related assessment finding should concern the nurse? a. Creatinine levels in the urine are similar to blood levels of creatinine. b. Sodium and chloride are found in the urine. c. Urine uric acid levels have the same values as serum levels. d. Red blood cells and albumin are found in the urine. - correct answer d. Red blood cells and albumin are found in the urine. What is a normal glomerular filtration rate? Chapter 16: Acute Kidney Injury Questions And Answers a. Less than 80 mL/min b. 80 to 125 mL/min c. 125 to 180 mL/min d. More than 189 mL/min - correct answer b. 80 to 125 mL/min What is a normal urine output? a. 80 to 125 mL/min b. 180 L/day c. 80 mL/min d. 1 to 2 L/day - correct answer d. 1 to 2 L/day Renin plays a role in blood pressure regulation by what process? a. Activation of the renin-angiotensin-aldosterone cascade. b. Suppression of angiotensin production. c. Decreasing of sodium reabsorption. d. Inhibition of aldosterone release. - correct answer a. Activation of the renin-angiotensin-aldosterone cascade. Chapter 16: Acute Kidney Injury Questions And Answers c. Hypovolemia or decreased cardiac output. d. Conditions that act directly on functioning kidney tissue. - correct answer a. Obstruction of the flow of urine. Conditions that produce acute kidney injury by directly acting on functioning kidney tissue are classified as intrarenal. What is the most common intrarenal condition that produces such a kidney injury? a. Prolonged ischemia. b. Exposure to nephrotoxic substances. c. Acute tubular necrosis (ATN). d. Hypotension for several hours. - correct answer c. Acute tubular necrosis (ATN). Which of the following patients is at the greatest risk of developing acute kidney injury? a. One who had a diagnostic test using a radiocontrast media 6 days. b. One with a history of controlled hypertension with a blood pressure of 138/88 mm Hg. c. One discharged 2 weeks earlier after aminoglycoside therapy of 2 weeks. Chapter 16: Acute Kidney Injury Questions And Answers d. One with a history of fluid overload as a result of heart failure. - correct answer c. One discharged 2 weeks earlier after aminoglycoside therapy of 2 weeks. The patient has elevated blood urea nitrogen (BUN) and serum creatinine levels with a normal BUN/creatinine ratio. What do these levels most likely indicate? a. Increased nitrogen intake b. Acute kidney injury, such as acute tubular necrosis (ATN) c. Hypovolemia d. Fluid resuscitation - correct answer b. Acute kidney injury, such as acute tubular necrosis (ATN) The patient's serum creatinine level is 0.7 mg/dL. The expected BUN level should be a. 1 to 2 mg/dL. b. 7 to 14 mg/dL. c. 10 to 20 mg/dL. d. 20 to 30 mg/dL. - correct answer b. 7 to 14 mg/dL. Chapter 16: Acute Kidney Injury Questions And Answers The patient reporting severe flank pain when urinating. has a urinalysis that shows sediment and crystals along with a few bacteria. This information suggestions what about the nature of the condition? a. It is prerenal. b. It is postrenal. c. It is intrarenal. d. It is not renal related - correct answer b. It is postrenal. The patient is a new postoperative patient. She weighs 75 kg. The nurse expects the minimal acceptable urine output to be what? a. Less than 30 mL/hour. b. 37 mL/hour. c. 80 mL/hour. d. 150 mL/hour. - correct answer b. 37 mL/hour. Daily weights are being recorded for a patient with urine output that has been less than intravenous and oral intake. The patient's weight yesterday was 97.5 kg and this morning it is 99 kg. The nurse understands that this corresponds to what? a. A fluid retention of 1.5 liters. Chapter 16: Acute Kidney Injury Questions And Answers a. Insertion of a percutaneous catheter at the bedside. b. Insertion a percutaneous tunneled catheter at the bedside. c. Creation of an arteriovenous fistula. d. Creation of an arteriovenous graft. - correct answer a. Insertion of a percutaneous catheter at the bedside. The patient has a temporary percutaneous catheter in place for treatment of acute kidney injury. The catheter has been in place for 5 days. What action should the nurse take? a. Prepare to assist with a routine dialysis catheter change to replace the existing catheter. b. Evaluate the patient for signs and symptoms of infection. c. Teach the patient that the catheter is designed for long-term use. d. Use one of the three lumens for fluid administration. - correct answer b. Evaluate the patient for signs and symptoms of infection. The patient has just returned from having an arteriovenous fistula placed. The patient asks, "When will they be able to use this and take this other catheter out?" The nurse should provide what response? a. "It can be used immediately so the catheter can come out anytime." b. "It will take 2 to 4 weeks to heal before it can be used." Chapter 16: Acute Kidney Injury Questions And Answers c. "The fistula will be usable in about 4 to 6 weeks." d. "The fistula was made using graft material so it depends on the manufacturer." - correct answer c. "The fistula will be usable in about 4 to 6 weeks." The patient in progressive care unit following arteriovenous fistula implantation in the left upper arm, is due to have blood drawn with the next set of vital signs and assessment. When the nurse assesses the patient, the nurse should take what action? a. Draw blood from the left arm. b. Take blood pressures from the left arm. c. Start a new intravenous line in the left lower arm. d. Auscultate the left arm for a bruit and palpate for a thrill. - correct answer d. Auscultate the left arm for a bruit and palpate for a thrill. The nurse assessing a patient with a new arteriovenous fistula, does not hear a bruit or feel a thrill. Pulses distal to the fistula are not palpable. The nurse should take what action? a. Reassess the patient in an hour. b. Raise the arm above the level of the patient's heart. c. Notify the primary health care provider immediately. Chapter 16: Acute Kidney Injury Questions And Answers d. Apply warm packs to the fistula site and reassess. - correct answer c. Notify the primary health care provider immediately. The nurse is caring for a patient who has a temporary percutaneous dialysis catheter in place. In caring for this patient, the nurse should take what action? a. Apply a sterile gauze dressing to maintain sterility. b. Replace the transparent dressing every 10 days to prevent manipulation. c. Assess the catheter site for redness and/or swelling. d. Use the catheter for drawing blood samples to reduce patient discomfort. - correct answer c. Assess the catheter site for redness and/or swelling. The patient getting hemodialysis for the second time reports a headache and nausea and, a little later, of becoming confused. The nurse realizes these are symptoms of what possible complication? a. Dialyzer membrane incompatibility b. A shift in potassium levels c. Dialysis disequilibrium syndrome d. Hypothermia - correct answer c. Dialysis disequilibrium syndrome Chapter 16: Acute Kidney Injury Questions And Answers How is peritoneal dialysis different from hemodialysis? a. It is more frequently used for acute kidney injury. b. It uses the patient's own semipermeable membrane (peritoneal membrane). c. It is not useful in cases of drug overdose or electrolyte imbalance. d. It is not indicated in cases of water intoxication. - correct answer b. It uses the patient's own semipermeable membrane (peritoneal membrane). What is an advantage of peritoneal dialysis? a. Peritoneal dialysis is time intensive. b. It has a decreased risk of peritonitis. c. Any biochemical disturbances are corrected rapidly. d. The danger of hemorrhage is minimal. - correct answer d. The danger of hemorrhage is minimal. The nurse is caring for a patient receiving peritoneal dialysis. The patient suddenly reports experiencing abdominal pain and chills. The patient's temperature is elevated. The nurse should take what action? Chapter 16: Acute Kidney Injury Questions And Answers a. Assess peritoneal dialysate return. b. Check the patient's blood sugar. c. Evaluate the patient's neurological status. d. Inform the provider of probable visceral perforation. - correct answer a. Assess peritoneal dialysate return. The patient is on intake and output (I&O) as well as daily weights. The nurse notes that output is considerably less than intake over the last shift, and daily weight is 1 kg more than yesterday. The nurse should take what action? a. Draw a trough level after the next dose of antibiotic. b. Obtain an order to place the patient on fluid restriction. c. Assess the patient's lungs. d. Insert an indwelling catheter. - correct answer c. Assess the patient's lungs. The patient has been admitted to the hospital with nausea and vomiting that started 5 days earlier with a blood pressure of 80/44 mm Hg and heart rate of 122 beats/min. The patient reports having not voided in 8 hours but there is no distention of the bladder. The nurse anticipates what "stat" order? Chapter 16: Acute Kidney Injury Questions And Answers A. A blood transfusion B. Fluid replacement with 0.45% saline C. Infusion of an inotropic agent D. An antiemetic - correct answer B. Fluid replacement with 0.45% saline Presence of which substances would indicate a problem with renal function. (Select all that apply.) a. Protein b. Sodium c. Creatinine d. Red blood cells e. Uric acid - correct answer a. Protein d. Red blood cells e. Uric acid The patient is admitted with acute kidney injury from a postrenal cause. Acceptable treatments for that diagnosis include what intervention? (Select all that apply.) a. Bladder catheterization