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Renal Critical Care Exam – Questions & Answers
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Renal Critical Care Exam – Questions & AnswersA client with AKI has a serum potassium level of 7.0 mEq/L. The nurse should
plan which actions as a priority. Select all that apply.
1. Place the client on a cardiac monitor
2. Notify the HCP
3. Put the client on NPO status except for ice chips
4. Review the client's medications to determine if any contain or retain
potassium
5. Allow an extra 500 mL of intravenous fluid intake to dilute the electrolyte
concentration Ans -1, 2, 4
The potassium level is elevarted. The client is at risk for developing cardiac
dysrhythmias and cardiac arrest. Because of this the client should be placed
on a cardiac monitor. The nurse should notify the HCP and also review
medications to determine if any contain potassium or are potassium retaining.
The client does not need to be put on NPO status. Fluid intake is not increased
because it contributes to fluid overload and would not affect the serum
potassium level significantly.
The client being hemodialyzed suddenly becomes short of breath and
complains of chest pain. The client is tachycardic, pale, and anxious. The nurse
suspects air embolism. The priority action for the nurse is to: (Select all that
apply.)
1. Administer oxygen to the client.
2. Continue dialysis at a slower rate after checking the lines for air.
3. Notify the HCP and Rapid Response team.
4. Stop dialysis and turn the client on the left side with head lower than feet.
5. Bolus the client with 500 mL of normal saline to break up the air embolus.
Ans -1, 3, 4
If the client experiences air embolus during hemodialysis, the nurse should
terminate dialysis immediately, position the client so the air embolus is in the
right side of the heart, notify the HCP and Rapid Response Team, and
administer oxygen as needed. Slowing the dialysis treatment or giving an IV
bolus will not correct the air embolus or prevent complications.
,The client arrives at the ED with complaints of low abdominal pain and
hematuria. The client is afebrile. The nurse next assess the client to determine
a history of which condition?
1. Pyelonephritis
2. Glomerulonephritis
3. Trauma to the bladder or abdomen
4. Renal cancer in the clients family Ans -3
Bladder trauma or injury should be considered or suspected in the client with
low abdominal pain and hematuria. Glomerulonephritis and pyelonephritis
would be accompanied by fever and are thus not applicable to the client
described in the question. Renal cancer would not cause pain that is felt in the
low abdomen; rather, the pain would be in the flank area.
The nurse discusses plans for future treatment options with a client with
symptomatic polycystic kidney disease. Which treatment should be included
in this discussion? Select all that apply.
1. Hemodialysis
2. Peritoneal dialysis
3. Kidney transplant
4. Bilateral nephrectomy
5. Intense immunosuppression therapy Ans -1, 3, 4
Polycystic kidney disease is a genetic familial disease in which the kidneys
enlarge with cysts that rupture and scar the kidney, eventually resulting in
end-stage renal disease. Treatment options include hemodialysis or kidney
trasnplant. Clients usually undergo bilateral nephrectomy to remove the large,
painful, cyst-filled kidneys. Peritoneal dialysis is not an option due to the
infected cysts. The condition does not respond to immunosuppression.
A client is admitted to the ED following a fall from a horse and the HCP
prescribes insertion of a urinary catheter. While preparing for the procedure,
the nurse notes blood at the urinary meatus. The nurse should take which
action?
1. Notify the HCP before performing the catheterization.
,2. Use a small-sized catheter and an anesthetic gel as a lubricant.
3. Administer parenteral pain medication before inserting the catheter.
4. Clean the meatus with soap and water before opening the catheterization
kit. Ans -1
The presence of blood at the urinary meatus may indicate urethral trauma or
disruption. The nurse notifies the HCP, knowing that the client should not be
catheterized until the caues of the bleeding is determined by diagnostic
testing. The other options include performing the catheterization procedure
and therefore are incorrect.
The nurse is assessing the patency of a client's left arm arteriovenous fistula
prior to initiating hemodialysis. Which finding indicates that the fistula is
patent?
1. Palpation of a thrill over the fistula
2. Presence of a radial pulse in the left wrist
3. Visualization of enlarged blood vessels at the fistula site
4. Capillary refill less than 3 seconds in the nail beds of the fingers on the left
hand Ans -1
The nurse assesses the patency of the fistula by palpating for the presence of a
thrill or auscultating for a bruit. The presence of a thrill and bruit indicate
patency of the fistula. Enlarged visible blood vessels at the fistula site are a
normal observation but a not indicative of fistula patency. Although the
presence of a radial pulse in the left wrist and capillary refill less than 3
seconds in the nail beds of the fingers on the left hand indicate adequate
circulation to the hand, they do not assess fistula patency.
A male client has a tentative diagnosis of urethritis. The nurse should assess
the client for which manifestation of the disorder?
1. Hematuria and pyuria
2. Dysuria and proteinuria
3. Hematuria and urgency
4. Dysuria and penile discharge Ans -4
Urethritis in the male client often results from chalmydial infection and is
characterized by dysuria, which is accompanied by a clear to mucopurulent
, discharge. Because this disorder often coexists with gonorrhea, diagnostic
tests are done for both and include culture and rapid assays. Hematuria is not
associated with urethritis. Proteinuria is associated with kidney dysfunction.
The nurse is assessing a client with epididymitis. The nurse anticipates which
findings on physical examination?
1. Fever, diarrhea, groin pain, and ecchymosis
2. Nausea, painful scrotal edema, and ecchymosis
3. Fever, nausea, vomiting, and painful scrotal edema
4. Diarrhea, groin pain, testicular torsion, and scrotal edema Ans -3
Typical signs and symptoms of epididymitis include scrotal pain and edema,
which often are accompanied by fever, nausea and vomiting, and chills.
Epididymitis most often is caused by infection, although sometimes it can be
caused by trauma. The remaining options do not present all of the accurate
manifestations.
A client complains of fever, perineal pain, and urinary urgency, frequency, and
dysuria. To assess whether the client's problem is related to bacterial
prostatitis, the nurse reviews the results of the prostatic examination for
which characteristic of this disorder?
1. Soft and swollen prostate gland
2. Swollen and boggy prostate gland
3. Tender and edematous prostate gland
4. Tender, indurated prostate gland that is warm to the touch Ans -4
The client with bacterial prostatitis has a swollen and tender prostate gland
that is also warm to the touch, firm, and indurated. Systemic symptoms
include fever with chills, perineal and low back pain, and signs of urinary tract
infection, which often accompany the disorder.
The nurse is collecting data from a client. Which symptom described by the
client is a characteristic of an early symptom of benign prostatic hyperplasia?
1. Nocturia
2. Scrotal edema
3. Occasional constipation
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