Final SATA Exam. 120 Multiple Choice Questions and
Correct Answers With Rationale. Complete Solution
2024.
ANS: A, B, C
Urine flow obstruction, such as prostate cancer, blood clots in the urinary tract, and kidney stones
(ureterolithiasis), causes post-renal AKI. Severe burns would be a pre-renal cause. Lupus would be an
intrarenal cause for AKI.
The nurse is caring for five clients on the medical-surgical unit. Which clients would the nurse consider to
be at risk for post-renal acute kidney injury (AKI)? (Select all that apply.)
a. Man with prostate cancer
b. Woman with blood clots in the urinary tract
c. Client with ureterolithiasis
d. Firefighter with severe burns
e. Young woman with lupus
ANS: A, C, E
The low urine output, sediment, and blood pressure should be reported to the provider.
Postoperatively, the nurse should measure intake and output, check the characteristics of the urine,
and report sediment, hematuria, and urine output of less than 0.5 mL/kg/hour for 3 to 4 hours. A
urine output of 100 mL is low, but a urine output of 500 mL in 12 hours should be within normal limits.
Perfusion to the kidneys is compromised with low blood pressure. The amber odorless urine is normal
A nurse is caring for a postoperative 70-kg client who had major blood loss during surgery. Which
findings by the nurse should prompt immediate action to prevent acute kidney injury? (Select all that
apply.)
a. Urine output of 100 mL in 4 hours
b. Urine output of 500 mL in 12 hours
c. Large amount of sediment in the urine
d. Amber, odorless urine
e. Blood pressure of 90/60 mm Hg
ANS: A, C, E
Many clients with AKI are too ill to meet caloric goals and require tube feedings with kidney-specific
formulas that are lower in sodium, potassium, and phosphorus, and higher in calories than are
standard formulas.
A client is hospitalized in the oliguric phase of acute kidney injury (AKI) and is receiving tube feedings.
The nurse is teaching the client's spouse about the kidney-specific formulation for the enteral solution
compared to standard formulas. What components should be discussed in the teaching plan? (Select all
that apply.)
a. Lower sodium
b. Higher calcium
,c. Lower potassium
d. Higher phosphorus
e. Higher calories
ANS: B, D, E
Weight should be maintained at a body mass index (BMI) of 22 to 25. A BMI of 30 indicates obesity.
The use of nonsteroidal anti-inflammatory drugs such as aspirin should be limited to the lowest time
at the lowest dose due to interference with kidney blood flow. The client should drink at least 2 liters
of water daily. Diet adjustments should be made by restricting sodium, cholesterol, and protein.
Smoking causes constriction of blood vessels and decreases kidney perfusion, so the client should stop
smoking.
The nurse is teaching a client with diabetes mellitus how to prevent or delay chronic kidney disease
(CKD). Which client statements indicate a lack of understanding of the teaching? (Select all that apply.)
a. "I need to decrease sodium, cholesterol, and protein in my diet."
b. "My weight should be maintained at a body mass index of 30."
c. "Smoking should be stopped as soon as I possibly can."
d. "I can continue to take an aspirin every 4 to 8 hours for my pain."
e. "I really only need to drink a couple of glasses of water each day."
ANS: B, C, D, E
In discharge teaching, the nurse must emphasize that the client needs to have an antibiotic
prophylactically before dental procedures to prevent infection. There may be a need for dose
reduction in medications if the kidney is not excreting them properly (antacids with magnesium,
antibiotics, antidiabetic drugs, insulin, opioids, and anticoagulants).
A nurse is giving discharge instructions to a client recently diagnosed with chronic kidney disease (CKD).
Which statements made by the client indicate a correct understanding of the teaching? (Select all that
apply.)
a. "I can continue to take antacids to relieve heartburn."
b. "I need to ask for an antibiotic when scheduling a dental appointment."
c. "I'll need to check my blood sugar often to prevent hypoglycemia."
d. "The dose of my pain medication may have to be adjusted."
e. "I should watch for bleeding when taking my anticoagulants."
ANS: A, B, D
Hypotension occurs often during hemodialysis treatments as a result of vasodilation from the warmed
dialysate. Modest decreases in blood pressure, as is the case with this client, can be maintained with
rate adjustment, Trendelenburg positioning, and a fluid bolus. If the blood pressure drops considerably
after two boluses and cooling dialysate, the hemodialysis can be stopped and the health care provider
contacted.
A client is undergoing hemodialysis. The client's blood pressure at the beginning of the procedure was
136/88 mm Hg, and now it is 110/54 mm Hg. What actions should the nurse perform to maintain blood
pressure? (Select all that apply.)
a. Adjust the rate of extracorporeal blood flow.
b. Place the client in the Trendelenburg position.
,c. Stop the hemodialysis treatment.
d. Administer a 250-mL bolus of normal saline.
e. Contact the health care provider for orders.
ANS: A, B, D
PD is based on exchanges of waste, fluid, and electrolytes in the peritoneal cavity. There is no need for
vascular access. Protein is lost in the exchange, which allows for more protein and fluid in the diet.
There is flexibility in the time for exchanges, but the treatment takes a longer period of time compared
to hemodialysis. There still is risk for infection with PD, especially peritonitis.
A client is unsure of the decision to undergo peritoneal dialysis (PD) and wishes to discuss the
advantages of this treatment with the nurse. Which statements by the nurse are accurate regarding PD?
(Select all that apply.)
a. "You will not need vascular access to perform PD."
b. "There is less restriction of protein and fluids."
c. "You will have no risk for infection with PD."
d. "You have flexible scheduling for the exchanges."
e. "It takes less time than hemodialysis treatments."
ANS:
66 mm Hg
MAP= 98+(2x50)/3=66
A client in the intensive care unit with acute kidney injury (AKI) must maintain a mean arterial pressure
(MAP) of 65 mm Hg to promote kidney perfusion. What is the client's MAP if the blood pressure is 98/50
mm Hg? (Record your answer using a whole number.) _____ mm Hg
Correct Responses
167 drops/min
20 gtt × 500 mL = 10,000/60 min = 167 drops/min
A client with acute kidney injury is receiving a fluid challenge of 500 mL of normal saline over 1 hour.
With a drop factor of 20 drops/mL, how many drops per minute does the nurse infuse?
_________
ABCEF
To prevent AKI, all people should be urged to avoid dehydration by drinking at least 2 to 3 liters of
fluids daily, especially during strenuous exercise or work associated with diaphoresis, or when
recovering from an illness that reduces kidney blood flow, such as influenza. Contrast media may
cause acute renal failure, especially in older clients with reduced kidney function. Recent surgery or
trauma, transfusions, or other factors that might lead to reduced kidney blood flow may cause AKI.
Certain antibiotics may cause nephrotoxicity. Diabetes may cause acute kidney failure superimposed
on chronic kidney failure.
Which clients are at risk for acute kidney injury (AKI)? (Select all that apply.)
, A) Football player in preseason practice
B) Client who underwent contrast dye radiology
C) Accident victim recovering from a severe hemorrhage
D) Accountant with diabetes
E) Client in the intensive care unit on high doses of antibiotics
F) Client recovering from gastrointestinal influenza
ACD
Breakdown of protein leads to azotemia and increased blood urea nitrogen. Fluid is restricted during
the oliguric stage. Potassium intoxication may occur, so dietary potassium is also restricted. Sodium is
restricted during AKI because oliguria causes fluid retention. Fats may be used for needed calories
when proteins are restricted.
The nurse assists a client with acute kidney injury (AKI) to modify the diet in which ways? (Select all that
apply.)
A) Restricted protein
B) Liberal sodium
C) Restricted fluids
D) Low potassium
E) Low fat
BCE
A bruit or swishing sound, and a thrill or buzzing sensation upon palpation should be present in this
client, indicating patency of the fistula. No blood pressure, venipuncture, or compression, such as lying
on the fistula, should occur. Distal pulses and capillary refill should be checked, and for a forearm
fistula, the radial pulse is checked—the brachial pulse is proximal. Elevating the arm increases venous
return, possibly collapsing the fistula.
When caring for a client with a left forearm arteriovenous fistula created for hemodialysis, which actions
must the nurse take? (Select all that apply.)
A) Check brachial pulses daily.
B) Auscultate for a bruit every 8 hours.
C) Teach the client to palpate for a thrill over the site.
D) Elevate the arm above heart level.
E) Ensure that no blood pressures are taken in that arm.
AC
Obtaining the client's weight and documenting oral fluid intake are routine tasks that can be
performed by UAP. Assessment skills (checking the AV fistula and auscultating lung sounds) and client
education (explaining special diet) require more education and are in the legal scope of practice of the
RN.
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