MED SURG: AKI & CKD TEST 1-4 & STUDY GUIDE REVISIONS QUESTIONS AND ANSWERS NEW
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MED SURG: AKI & CKD
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MED SURG: AKI & CKD
MED SURG: AKI & CKD TEST 1-4 & STUDY GUIDE REVISIONS QUESTIONS AND ANSWERS NEW
TEST 1
1. The nurse is admitting a client diagnosed with acute renal failure (AKI). Which question is most important for the nurse to ask during the admission interview?
1. "Have you recently traveled outside the Un...
MED SURG: AKI & CKD TEST 1-4 &
STUDY GUIDE REVISIONS QUESTIONS
AND ANSWERS NEW 2024-2025
TEST 1
1. The nurse is admitting a client diagnosed with acute renal failure (AKI). Which
question is most important for the nurse to ask during the admission interview?
1. "Have you recently traveled outside the United States?"
2. "Did you recently begin a vigorous exercise program?"
3. "Is there a chance you have been exposed to a virus?"
4. "What over-the-counter medications do you take regularly?"
4. “What over-the-counter medications do you take regularly?”
Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and some
herbal remedies are nephrotoxic; therefore, asking about medications is
appropriate.
2. The nurse is caring for a client diagnosed with AKI. Which laboratory values
are most significant for diagnosing ARF?
1. BUN and creatinine.
2. WBC and hemoglobin.
3. Potassium and sodium.
4. Bilirubin and ammonia level.
1. BUN and creatinine.
Blood urea nitrogen (BUN) levels reflect the balance between the production and
excretion of urea from the kidneys. Creatinine is a by-product of the metab- olism
of the muscles and is excreted by the kidneys. Creatinine is the ideal sub- stance
for determining renal clearance because it is relatively constant in the body and
is the laboratory value most
3. The nurse is caring for a client diagnosed with rule-out AKI. Which condition
predisposes the client to developing prerenal failure?
,1. Diabetes mellitus.
2. Hypotension.
3. Aminoglycosides.
4. Benign prostatic hypertrophy.
2. Hypotension.
Hypotension, which causes a decreased blood supply to the kidney, is one of the
most common causes of prerenal failure (before the kidney).
4. The client is diagnosed with AKI. Which signs/symptoms indicate to the nurse
the client is in the recovery period? Select all that apply.
1. Increased alertness and no seizure activity.
2. Increase in hemoglobin and hematocrit.
3. Denial of nausea and vomiting.
4. Decreased urine-specific gravity. 5. Increased serum creatinine level.
1. Increased alertness and no seizure activity.
2. Increase in hemoglobin and hematocrit.
3. Denial of nausea and vomiting.
1. Renal failure affects almost every system in the body. Neurologically, the client
may have drowsiness, headache, muscle twitching, and seizures. In the recovery
period, the client is alert and has no seizure activity.
2. In renal failure, levels of erythropoietin are decreased, leading to anemia. An
increase in hemoglobin and hematocrit in- dicates the client is in the recovery
period.
3. Nausea, vomiting, and diarrhea are common in the client with ARF; there- fore,
an absence of these indicates the client is in the recovery period
5. The client diagnosed with AKI has a serum potassium level of 6.8 mEq/L.
Which collaborative treatment should the nurse anticipate for the client?
1. Administer a phosphate binder.
2. Type and crossmatch for whole blood.
3. Assess the client for leg cramps. 4. Prepare the client for dialysis.
4. Prepare the client for dialysis.
,Normal potassium level is 3.5 to5.5 mEq/L. A level of 6.8 mEq/L is life threatening
and could lead to cardiac dysrhythmias. Therefore, the client may be dialyzed to
decrease the potassium level quickly. This requires a health-care provider order,
so it is a collaborative intervention.
6. The nurse is developing a plan of care for a client diagnosed with AKI. Which
statement is an appropriate outcome for the client?1. Monitor intake and output
every shift.
2. Decrease of pain by 3 levels on a 1-10 scale.
3. Electrolytes are within normal limits.
4. Administer enemas to decrease hyperkalemia.
3. Electrolytes are within normal limits.
Renal failure causes an imbalance of electrolytes (potassium, sodium, calcium,
phosphorus). Therefore, the desired client outcome is electrolytes within normal
limits.
7. The client diagnosed with AKI is admitted to the intensive care unit and placed
on a therapeutic diet. Which diet is most appropriate for the client?
1. A high-potassium and low-calcium diet.
2. A low-fat and low-cholesterol diet.
3. A high-carbohydrate and restricted-protein diet.
4. A regular diet with six (6) small feedings a day.
3. A high-carbohydrate and restricted-protein diet.
Carbohydrates are increased to provide for the client’s caloric intake and protein
is restricted to minimize protein breakdown and to prevent accumulation of toxic
waste products.
8. The client diagnosed with AKI is placed on bedrest. The client asks the nurse,
"Why do I have to stay in bed? I don't feel bad." Which scientific rationale
supports the nurse's response?
1. Bedrest helps increase the blood return to the renal circulation.
2. Bedrest reduces the metabolic rate during the acute stage.
3. Bedrest decreases the workload of the left side of the heart.
4. Bedrest aids in reduction of peripheral and sacral edema.
, 2. Bedrest reduces the metabolic rate during the acute stage.
Bedrest reduces exertion and the metabolic rate, thereby reducing catabolism
and subsequent release of potassium and accumulation of endogenous waste
products (urea and creatinine).
9. The nurse and an unlicensed assistive personnel (UAP) are caring for clients
on a medical floor. Which nursing task is most appropriate for the nurse to
delegate?
1. Collect a clean voided midstream urine specimen.
2. Evaluate the client's 8-hour intake and output.
3. Assist in checking a unit of blood prior to hanging.
4. Administer a cation-exchange resin enema.
1. Collect a clean voided midstream urine specimen.
The UAP can collect specimens. Collecting a midstream urine specimen requires
the client to clean the perineal area, to urinate a little, and then collect the rest of
the urine output in a sterile container.
10. The client is admitted to the emergency department after a gunshot wound to
the abdomen. Which nursing intervention should the nurse implement first to
prevent AKI?
1. Administer normal saline IV.
2. Take vital signs.
3. Place client on telemetry.
4. Assess abdominal dressing.
1. Administer normal saline IV.
Preventing and treating shock with blood and fluid replacement will prevent acute
renal failure from hypoperfusion of the kidneys. Significant blood loss is
expected in the client with a gunshot wound.
11. The UAP tells the nurse the client with AKI has a white crystal-like layer on top
of the skin. Which intervention should the nurse implement?
1. Have the assistant apply a moisture barrier cream to the skin.
2. Instruct the UAP to bathe the client in cool water.
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