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WorksheetsUnit 5 Nursing 3 Anemia and Renal
Total questions: 48
Worksheet time: 48mins
Name
Class
Date
1.
A nurse is performing an admission assessment of a client who has acute glomerulonephritis. The nurse should expect which of the following findings?
a)
Low blood pressure
b)
Polyuria
c)
Dark-colored urine
d)
Weight loss
2.
A nurse is caring for a client following a lithotripsy for the treatment of calcium phosphate kidney stones. Which of the following actions should the nurse take?
a)
Monitor the client’s urine for ketones.
b)
Provide the client with an increases animal protein diet.
c)
Limit the client’s fluid intake to 1.5 L per day.
d)
Strain all of the client’s urine.
3.
A nurse is planning care for a client who has acute glomerulonephritis. The nurse should plan to provide which of the following interventions?
a)
Weigh the client daily.
b)
Encourage the client to drink 2 to 3 L of fluid daily.
c)
Instruct the client to ambulate every 2 hours.
d)
Check the client’s blood glucose level.
4.
A nurse in an ED department is caring for a client who reports costovertebral angle tenderness, nausea, and vomiting. Which of the following laboratory values should the nurse report to the provider?
a)
WBC 15,000/mm3
b)
BUN 15 mg/dL
c)
Urine specific gravity 1.020
d)
Urine pH 5.5
5.
A nurse is teaching a client who has a newly dx of acute pyelonephritis. Which of the following instructions should the nurse include in the teaching?
a)
Drink up to 1,500mL of fluid a day
b)
Avoid the use of NSAIDS.
c)
Check peripheral blood glucose levels twice per day
d)
Increase dietary protein intake.
6.
A nurse is providing teaching to a client who has CKD. Which of the following statements by the client indicates an understanding of the teaching?
a)
“I will check my BP once per week.”
b)
“I will take a magnesium antacid if I get constipated.”
c)
“I will weigh myself every morning.”
d)
“I will use a salt substitute in my diet.”
7.
A nurse is obtaining a urine specimen for culture and sensitivity from a client who has manifestations of a urinary tract infection. Which of the following actions should the nurse take?
a)
Collect the client’s urine in a clean specimen container.
b)
Instruct the client to start urinating than pass the container into the stream
c)
Obtain the client’s first morning urine of the day.
d)
Place the client’s urine specimen in a container with a preservative.
8.
A nurse is planning care for a group of clients. Which of the following clients should the nurse plan to monitor for signs of nephrotoxicity?
a)
A client who is receiving gentamicin for the treatment of a wound infection.
b)
A client who is receiving digoxin for the treatment of HF.
c)
A client who is receiving methylprednisolone for the treatment of asthma.
d)
A client who is receiving propanolol for the treatment of HTN
9.
A nurse in a women’s health clinic is caring for a client who reports urinary urgency and dysuria. Which of the following additional findings should the nurse identify as an indication of a urinary tract infection?
a)
Vaginal discharge
b)
Pyuria
c)
Glucosuria.
d)
Elevated creatine kinase-MB
10.
A nurse is caring for a postoperative client following a arteriovenous (AV) fistula in her left arm. Which of the following actions should the nurse take?
a)
Measure BP in the client’s arm every 4 hours.
b)
Keep the client’s arm in a dependent position.
c)
Auscultate for bruits and palpate for thrills in the client’s fistula every 4 hours.
d)
Instruct the client to sleep on the left side.
11.
A nurse is providing instructions for reducing the dietary intake of potassium to a client who has CKD. Which of the following food selections should the nurse recommend?
a)
One cup cubed cantaloupe
b)
One cup boiled spinach
c)
One medium baked potato
d)
One large raw apple.
12.
A nurse is assessing a client who has CKD and has completed her third peritoneal dialysis (PD) treatment. Which of the following findings should the nurse report to the provider?
a)
Greater outflow of dialysate than inflow
b)
Weight loss
c)
Cloudy Dialysate effluent.
d)
Report of pain during inflow.
13.
A nurse is providing discharge teaching for a client who has CKD. Which of the following statements should the nurse identify as an indication that the client understands the teaching?
a)
“I will consume foods that are high in protein.”
b)
“I will decrease my intake of foods that are high in phosphorus.
c)
“I will limit my intake of foods that are high in iron”
d)
“I will add salt to the foods I consume”
14.
A client with AKI has a serum potassium level of 7.0 mEq/L (7.0 mmol/L). The nurse should plan which actions as a priority? Select all that apply.
a)
Place the client on a cardiac monitor.
b)
Notify the health care provider (HCP)
c)
Put the client on NPO (nothing by mouth) status except for ice chips.
d)
Review the client’s medications to determine if any contain or retain potassium.
e)
Allow an extra 500ml of intravenous fluid intake to dilute the electrolyte concentration.
15.
The nurse is reviewing a client’s record and notes that the health care provider has documented that the client has chronic renal disease. On review of the laboratory results, the nurse most likely would expect to note which finding?
a)
Elevated creatinine.
b)
Decreased hemoglobin level
c)
Decreased red blood cell count
d)
Increased number of WBC cells in the urine.
16.
A nurse is teaching a client who has chronic kidney disease and a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances?
a)
Iron
b)
Potassium
c)
Protein
d)
Sodium
17.
A nurse is teaching a client who has acute kidney disease about fluid restrictions. Which of the following statements by the client should the nurse identify as understanding of the teaching?
a)
"I should consume most of the fluid during the evening.“
b)
“I will make a list of my favorite beverages”
c)
"I will put beverages in large containers to give the appearance of drinking a lot.“
d)
"I will not count ice cream to the amount of fluid intake."
18.
A nurse is caring for a female client who has recurrent kidney stones and is scheduled for an intravenous pyelogram. Which of the following statements by the client should the nurse report to the provider?
a)
"I drink at least 2 quarts of fluid every day.“
b)
"The last time I voided it was painful and red-tinged.“
c)
"My period ended 2 days ago.“
d)
"I don't eat shellfish because it gives me hives."
19.
A nurse is teaching a client who has chronic kidney disease about limiting foods that are high in potassium. Which of the following foods should the nurse instruct the client to avoid? (Select all that apply.)
a)
Green Beans
b)
Tomatoes
c)
Bananas
d)
Asparagus
e)
Raisins
20.
A nurse is caring for a client who has acute kidney injury (AKI). Which of the following arterial blood gas values would the nurse expect this client to have?
a)
pH 7.49, HCO3 24, PaCO2 30
b)
pH 7.49, HCO3 30, PaCO2 40
c)
pH 7.26, HCO3 24, PaCO2 46
d)
pH 7.26, HCO3 14, PaCO2 30
21.
A nurse is caring for a client 4 hr postoperative following a kidney biopsy. Which of the following interventions should the nurse take? (Select all that apply).
a)
Monitor for hematuria.
b)
Check for flank pain.
c)
Monitor for extravasation of tissue surrounding the biopsy site.
d)
Encourage ambulation.
e)
Administer aspirin PRN for pain.
22.
A nurse is reviewing the BUN and creatinine levels of an older adult client who has chronic kidney disease. The nurse should expect which of the following findings?
a)
BUN 10, Creatinine 0.4
b)
BUN 23, Creatinine 1
c)
BUN 8, Creatinine 0.7
d)
BUN 25 Creatinine 8
23.
A nurse is teaching a client who has acute kidney injury about the oliguric phase. Which of the following information should the nurse include in the teaching?
a)
Renal function is reestablished.
b)
BUN and creatinine levels decrease.
c)
Urine output is less than 400 mL per 24 hr.
d)
The glomerular filtration rate (GFR) recovers.
24.
A nurse is caring for a client who has polycystic kidney disease (PKD). Which of the following findings should the nurse expect?
a)
flank pain
b)
hypotention
c)
confusion
d)
urinary retention
25.
A nurse is assessing a client in the oliguric phase of acute kidney injury. Which of the following findings should the nurse expect?
a)
Decreased creatinine level
b)
hyperkalemia
c)
hypomagnesamia
d)
increased glomerular filtration rate
26.
A nurse is reviewing the medication record for a client who has chronic kidney disease. Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?
a)
Omeprazole
b)
vancomycin
c)
Ondansetron
d)
Diphenhydramine
27.
A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of acute kidney injury?
a)
BUN 15
b)
Creatinine 6
c)
Hemaglobin 16
d)
Potassium 4.5
28.
A nurse is teaching a client who has pre-dialysis end-stage kidney disease about diet. Which of the following instructions should the nurse include?
a)
"Increase intake of dietary phosphorous.“
b)
"Eliminate foods high in protein from your diet.“
c)
"Reduce intake of foods high in potassium.“
d)
"Increase intake of sodium-containing food."
29.
A nurse is assessing a client who has end-stage kidney disease and is receiving hemodialysis. Which of the following findings should the nurse identify as an indication the client is experiencing fluid overload?
a)
The client has a 5 lb weight gain since yesterday.
b)
Flattened neck veins
c)
O2 Saturation 92%
d)
Return of skin to previous position when the client’s shin is palpated
30.
A nurse is caring for a client who has end-stage kidney disease (ESKD) and reports having shortness of breath and swelling in his lower extremities. Upon assessment, the nurse notes the client has crackles in his lungs and an elevated blood pressure. The nurse should suspect which of the following based on the client's manifestations?
a)
hypovolemia
b)
hypervolemia
c)
hyperkalemia
d)
Hyponatremia
31.
The client diagnosed with menorrhagia complains to the nurse of feeling listless and tired all the time. Which scientific rationale would explain why these symptoms occur?
a)
The pain associated with the menorrhagia does not allow the client to rest.
b)
The client’s symptoms are unrelated to the diagnosis of menorrhagia.
c)
The client probably has been exposed to a virus that causes chronic fatigue.
d)
Menorrhagia has caused the client to have decreased levels of hemoglobin.
32.
The client’s CBC indicates: RBCs 6, Hb 14.2, Hct 42%, and platelets 69,000. Which intervention should the nurse implement?
a)
Teach the client to use a soft bristle tooth brush.
b)
Monitor the client for elevated temperature.
c)
Check the client’s blood pressure.
d)
Hold venipuncture sites for one minute.
33.
The client diagnosed with iron-deficiency anemia is prescribed ferrous gluconate orally. Which should the nurse teach the client?
a)
Take Imodium, an antidiarrheal, over-the-counter (OTC) for diarrhea.
b)
Limit exercise for several weeks until a tolerance is achieved.
c)
The stools may be very dark, and this can mask blood.
d)
Eat only red and organ meats for protein.
34.
After the nurse receives the change-of-shift report, which patient should be assessed first?
a)
A 20-year-old patient with possible acute myelogenous leukemia who has just arrived on the medical unit.
b)
A 38-year-old patient with aplastic anemia who needs teaching about decreasing infection risk before discharge.
c)
A 40-year-old patient with lymphedema who requests help in putting on compression sticking before getting out of bed.
d)
A 60-year-old patient with non-Hodgkin lymphoma who is refusing the prescribed chemotherapy regimen.
35.
The nurse is caring for a client diagnosed with aplastic anemia. Which interventions should be taught to the client? Select all that apply
a)
Avoid alcohol.
b)
Pace activities.
c)
Stop smoking
d)
Eat a balanced diet
e)
Use a safety razor
36.
The nurse and an unlicensed assistive personnel (UAP) are caring for clients on a medical unit. Which task should the nurse delegate to the UAP?
a)
Check on the bowel movement of a client diagnosed with melena.
b)
Take the vital signs of a client who received blood the day before.
c)
Evaluate the dietary intake of a client who has been noncompliant with eating.
d)
Shave the client diagnosed with severe hemolytic anemia.
37.
The nurse is reviewing the complete blood count for a patient who has been admitted for knee arthroscopy. Which value is most important to report to the health care provider before surgery?
a)
Hematocrit of 33%
b)
Hemoglobin of 10.9 g/dL
c)
Platelet count of 426,000/mm3
d)
White blood cell count of 16,000/mm3
38.
A nurse is providing teaching to a client who follows vegan dietary practices. The nurse should instruct the client to ensure he is consuming enough of which of the following nutrients? (Select all that apply)
a)
Vitamin D
b)
Fiber
c)
Calcium
d)
Vitamin B
e)
Whole grains
39.
The nurse is providing orientation to a new RN who is preparing to administer packed red blood cells (PRBCs) to a patient who had blood loss during surgery. Which action by the new RN requires that the nurse intervene immediately?
a)
Waiting 20minutes after obtaining the PRBCs before starting the infusion.
b)
Starting an IV line for the transfusion using a 22-guage catheter.
c)
Priming the transfusion set using 5% dextrose Lactated Ringer’s solution.
d)
Telling the patient that the PRBCs may cause a serious transfusion reaction.
40.
After the nurse receives a change-of-shift report, which patient should be seen first?
a)
A 26year-old patient with thalassemia who has a hemoglobin level of 8 g/dL and orders for a blood transfusion.
b)
A 44-year-old patient admitted 3 days previously for sickle cell crisis who is scheduled for a computed tomographic (CT) scan.
c)
A 50-year-old patient with stage IV non-Hodgkin lymphoma who is crying and saying, “I’m not ready to die.”
d)
A 69-year old patient with chemotherapy-induced neutropenia who has an oral temperature of 100.1 F.
41.
A patient with iron deficiency anemia who is taking oral iron supplements is evaluated by the nurse in the outpatient clinic. Which finding by the nurse is of most concern?
a)
The patient reports that stools are black.
b)
The patient complains of occasional constipation.
c)
The patient takes a multivitamin tablet everyday.
d)
The patient takes an antacid with the iron to avoid nausea.
42.
A nurse is educating a client who is taking iron supplements about foods which aid in iron absorption. Which of the following foods is the best choice for the client to make?
a)
1 baked potato
b)
½ cup orange juice
c)
½ cup low-fat milk
d)
2 cups boiled green beans
43.
The clients laboratory values are: RBCs 5.5, WBCs 8.9, and platelets 189,000. Which intervention should the nurse implement?
a)
Prepare to administer packed red blood cells.
b)
Continue to monitor the client.
c)
Request an order for Neupogen, a biologic response modifier.
d)
Institute bleeding precautions.
44.
The nurse is admitting a 24-year-old African American female client with a diagnosis of rule-out anemia. The client has a history of gastric bypass surgery four years ago. Current assessment findings include height 5’5”; weight 75 kg; P 110, R 27, BP 104/66; pale mucous membranes and dyspnea on exertion. Which type of anemia would the nurse suspect the client has developed?
a)
Vitamin B12 deficiency
b)
Folic acid deficiency
c)
Iron deficiency
d)
Sickle cell anemia
45.
The nurse writes a diagnosis of altered tissue perfusion for a client diagnosed with anemia. Which interventions should be included in the plan of care? Select all that apply
a)
Monitor the client’s hemoglobin and hematocrit.
b)
Move the client to a room near the nurse’s desk.
c)
Limit the client’s dietary intake of green vegetables.
d)
Assess the client for numbness and tingling.
e)
Allow for rest periods during the day for the client.
46.
The nurse is caring for clients on a medical floor. After the shift report, which client should be assessed first?
a)
The client who is two-thirds of the way through a blood transfusion and has had no complaints of dyspnea or hives.
b)
The client diagnosed with leukemia who has a hematocrit of 18% and petechiae covering the body.
c)
The client with peptic ulcer disease who called over the intercom to say that he is vomiting blood.
d)
The client diagnosed with Chron’s disease who is complaining of perineal discomfort.
47.
The client diagnosed with anemia has an Hb of 6.1 g/dL. Which complication should the nurse assess for?
a)
Decreased pulmonary functioning.
b)
Impaired muscle functioning.
c)
Congestive heart failure.
d)
Altered gastric secretions.
48.
What is cyanocobalamin?
(a)
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