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Renal failure analyze quiz

Total questions: 20

Worksheet time: 10mins

Name
Class
Date
1.

A client with acute kidney injury has a serum potassium of 7.0 mEq/L. Which action should the nurse implement first?

a)

Administer IV insulin with dextrose

b)

Prepare for hemodialysis

c)

Place the client on a cardiac monitor

d)

Restrict dietary potassium

2.

A client with ESRD presents with dyspnea, crackles in the lungs, and 3+ peripheral edema. Which interventions should the nurse implement? Select all that apply.

a)

Administer prescribed diuretics

b)

Restrict oral fluids

c)

Elevate the head of the bed

d)

Encourage ambulation

3.

A client in the oliguric phase of AKI produces 200 mL of urine in 24 hours. Which is the priority nursing assessment?

a)

Assess for fluid overload

b)

Monitor potassium levels

c)

Evaluate for infection

d)

Administer diuretics immediately

4.

A client with AKI receives IV furosemide for oliguria. Which finding indicates treatment effectiveness?

a)

Urine output increases to 800 mL/24 hr

b)

Weight gain of 2 kg

c)

Persistent hyperkalemia

d)

Crackles in lungs increase

5.

A client with chronic kidney disease is prescribed sodium polystyrene sulfonate. Which finding indicates that the medication has been effective?

a)

Serum potassium decreases from 6.8 mEq/L to 5.2 mEq/L

b)

Serum sodium increases from 138 mEq/L to 145 mEq/L

c)

Urine output increases from 400 mL/day to 700 mL/day

d)

BUN decreases from 70 mg/dL to 50 mg/dL

6.

Which combination of foods would be most appropriate for this client?

a)

Baked chicken, white rice, strawberries, green beans

b)

Baked salmon, baked potato, orange juice, broccoli

c)

Yogurt, banana, tomato soup, whole wheat bread

d)

Spinach salad with avocado, milk, baked kidney beans

7.

A 58-year-old client with end-stage renal disease (ESRD) presents for routine lab monitoring. The nurse reviews the following results: • BUN: 78 mg/dL (normal 7–20 mg/dL) • Creatinine: 8.2 mg/dL (normal 0.6–1.3 mg/dL) • Potassium: 6.4 mEq/L (normal 3.5–5.0 mEq/L) • Calcium: 7.2 mg/dL (normal 8.5–10.5 mg/dL) • Phosphate: 7.8 mg/dL (normal 2.5–4.5 mg/dL) Which abnormality requires the nurse to take the highest-priority action?

a)

Elevated BUN

b)

Elevated creatinine

c)

Hyperkalemia

d)

Hypocalcemia

8.

A client with ESRD has a BUN of 92 mg/dL (normal 7–20 mg/dL). Which nursing action is most appropriate?

a)

Administer IV fluids immediately

b)

Monitor for signs of uremia, such as nausea and confusion

c)

Restrict dietary protein completely

d)

Notify provider for emergent dialysis

9.

A client’s creatinine increased from 5.0 mg/dL to 7.5 mg/dL over 48 hours. Which interpretation is correct?

a)

Normal variation

b)

Worsening renal function

c)

Recovery phase of ESRD

d)

Lab error

10.

A client with ESRD has sodium 128 mEq/L. Which assessment finding is consistent?

a)

Confusion and lethargy

b)

Muscle cramps from hypernatremia

c)

Increased urine output

d)

Hypertension

11.

A client with ESRD presents with: • Dyspnea at rest • O₂ saturation 85% • 3+ peripheral edema • Crackles bilaterally

a)

Impaired Gas Exchange related to pulmonary edema

b)

Risk for Infection related to dialysis catheter

c)

Activity Intolerance related to fatigue

d)

Imbalanced Nutrition related to protein restriction

12.

A client has just completed hemodialysis and is assessed with: • Blood pressure: 88/54 mmHg • Dizziness and lightheadedness • Pallor and diaphoresis Which nursing diagnosis is the highest priority?

a)

Risk for Injury related to dizziness

b)

Deficient Fluid Volume related to ultrafiltration

c)

Fatigue related to dialysis

d)

Ineffective Peripheral Tissue Perfusion related to hypotension

13.

A client has a peritoneal dialysis catheter. Which nursing diagnosis is priority to prevent complications?

a)

Risk for Infection related to vascular access

b)

Impaired Skin Integrity

c)

Anxiety related ot performing dialysis at home

d)

Activity Intolerance

14.

14. The priority nursing diagnosis for a client with ESRD experiencing bone pain from renal osteodystrophy is:

a)

Risk for Injury

b)

Impaired Gas Exchange

c)

Ineffective Airway Clearance

d)

Deficient Fluid Volume

15.

A client with ESRD has K+ 6.0 mEq/L and phosphate 7.5 mg/dL. Which dietary intervention is most appropriate?

a)

Provide low-potassium, low-phosphate meals

b)

Encourage fresh fruits for fiber

c)

Offer milk and cheese

d)

Allow unlimited protein on dialysis days

16.

A client has pH 7.28, HCO3− 16 mEq/L. Which nursing action is appropriate?

a)

Administer IV sodium bicarbonate as prescribed

b)

Restrict fluids

c)

Encourage high-potassium foods

d)

Provide IV calcium gluconate

17.

A client with chronic kidney disease (CKD) is experiencing Kussmaul respirations. Which acid-base imbalance should the nurse suspect the client is experiencing?

a)

Respiratory alkalosis

b)

Metabolic acidosis

c)

Respiratory acidosis

d)

Metabolic alkalosis

18.

A patient with stage 2 chronic kidney disease (CKD) is scheduled for an intravenous pyelogram (IVP). Which of these orders for the patient will the nurse question?

a)

NPO for 6 hours before IVP procedure

b)

Normal saline 500 mL IV before procedure

c)

Ibuprofen (Advil) 400 mg PO PRN for pain

d)

Dulcolax suppository 4 hours before IVP procedure

19.

Which statement by a patient with stage 5 chronic kidney disease (CKD) indicates that the nurses teaching about management of CKD has been effective?

a)

I need to try to get more protein from dairy products.

b)

I will try to increase my intake of fruits and vegetables.

c)

I will measure my urinary output each day.

d)

I need to take the erythropoietin to boost my immune system.

20.

Which action by a patient who is using peritoneal dialysis (PD) indicates that the nurse should provide more teaching about PD?

a)

The patient leaves the catheter exit site without a dressing.

b)

The patient plans 30 to 60 minutes for a dialysate exchange.

c)

the patient cleans the catheter while taking a bath each day.

d)

The patient slows the inflow rate when experiencing abdominal pain.