Med Surg Exam II Practice Questions

A 15-year-old is admitted to the renal unit with a diagnosis of postinfectious glomerular disease. The nurse should recognize that this form of kidney disease may have been precipitated by what event?

• •  Streptococcal infection

• A urinary tract infection

• An episode of dehydration or heat exhaustion

• viral infection such as influenza or mononucleosis

A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client's risk of:

• • Hypokalemia

• Weight loss from dehydration

• •  water and sodium retention secondary to a severe decrease in the glomerular filtration rate.

• Metabolic alkalosis

The nurse cares for a client with a right-arm arteriovenous fistula (AVF) for hemodialysis treatments. Which nursing action is contraindicated?

• Encourage range of motion and gentle use of the arm

• •  Obtaining a blood pressure reading from the right arm

• Report absence of bruit/thrill immediately.

• • Teach the client to avoid sleeping on or carrying heavy objects with the fistula arm.

A client with a history of chronic renal failure receives hemodialysis treatments three times per week through an arteriovenous (AV) fistula in the left arm. Which intervention should the nurse include in the care plan?

• Apply a tourniquet to the left arm

• • Use tight bandages or restraints on the left arm

• Draw blood or start IV lines in the left arm

• • Assess the AV fistula for a bruit and thrill.

Diet modifications are part of nutritional therapy for the management of ARF. Select the high-potassium food that should be restricted.

• Citrus fruits

• • Apples

• White rice

• • Green Beans

Which of the following would the nurse expect to find when reviewing the laboratory test results of a client with renal failure?

• Increased calcium levels (hypercalcemia)

• • Decreased potassium (hypokalemia)

• •  Increased serum creatinine level

• • Low phosphate

A client has a decreased secretion of erythropoietin from the kidneys due to end-stage kidney disease. The nurse explains that the decrease in erythropoietin will have what effect?

• Polycythemia due to erythropoietin excess

• •  Anemia from the decrease in maturation of red blood cells

• Increased production of red blood cells

• Elevated hemoglobin levels

A client, aged 75, is diagnosed with a renal disease and administered nephrotoxic drugs in normal doses. The nurse is aware that it is important to observe the client closely for any changes in renal status. Which of the following measures may help a nurse determine a change in renal status?

• Check blood pressure once per shift

• • Assess skin turgor and mucous membranes

• Observe for ankle swelling

• •  Observing the client's urinary output.

A client is being treated for acute kidney injury (AKI) and daily weights have been ordered. The nurse notes a weight gain of 3 pounds over the past 48 hours. What is suggested by this assessment finding?

• The client’s nutritional status is improving.

• • Excess fluid volume

• The weight gain is not clinically significant.

• The client’s kidney function is improving.

The most accurate indicator of fluid loss or gain in an acutely ill client is:

• Blood pressure or pulse changes

• Skin turgor

• Intake and output (I&O) records

• weight