the nurse is conducting a post operative assessmen
the nurse assesses the client who has chronic rena
the client with chronic renal failure complains
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Med- Surg Final Exam Practice
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Updated 2024
The nurse is conducting a post-operative assessment of a client on the first day
after renal surgery. Which of the following findings would be most important for
the nurse to report to the physician?
a. Temperature= 99.8 F
b. Urine output 20 ml/hr
c. Absence of bowel sounds
d. A 2'2" inch area of serous sanguineous drainage on the flank dressing -
ANSWER✔✔b. Urine output 20 ml/hr
The nurse assesses the client who has chronic renal failure and notes the following:
crackles in the lung bases, elevated blood pressure and weight gain of 2 pounds in
1 day. Based on these data, which of the following nursing diagnoses is
appropriate?
a. Excess fluid volume related to the kidney's inability to maintain fluid balance
b. Increased cardiac output related to fluid overload
c. Ineffective tissue perfusion related to interrupted arterial blood flow
d. Ineffective therapeutic regimen management related to lack of knowledge about
therapy - ANSWER✔✔a. Excess fluid volume related to the kidney's inability to
maintain fluid balance
The client with chronic renal failure complains of feeling nauseated at least part of
every day. The nurse should explain that the nausea is the result of:
a. Acidosis caused by the medications
b. Accumulation of waste products in the blood
c. Chronic anemia and fatigue
d. Excess fluid load - ANSWER✔✔b. Accumulation of waste products in the
blood
,Which of the following nursing interventions should be included in the client's care
plan during dialysis therapy?
a. Limit the client's visitors
b. Monitor client's blood pressure
c. Pad the side rails of the bed
d. Keep the client NPO - ANSWER✔✔b. Monitor client's blood pressure
What is the most potentially dangerous complication of peritoneal dialysis?
a. Abdominal pain
b. Gastrointestinal bleeding
c. Peritonitis
d. Muscle cramps - ANSWER✔✔c. Peritonitis
The nurse helps the client with chronic renal failure develop a home diet plan with
the goal of helping the client maintain adequate nutritional intake. Which of the
following diets would be most appropriate for a client with chronic renal failure?
a. High carbohydrate, high protein
b. High calcium, high potassium, high protein
c. Low protein, low sodium, low potassium
d. Low protein, high potassium - ANSWER✔✔c. Low protein, low sodium, low
potassium
The client's with which of the following medical histories is at the greatest risk of
developing renal failure?
a. Polycystic kidney disease
b. DM with poorly controlled hypertension
c. Vascular disorders
d. Respiratory infections - ANSWER✔✔b. DM with poorly controlled
hypertension
A high- carbohydrate, low-protein diet is prescribed for the client with acute renal
failure. The rationale for the high- carbohydrate diet is that carbohydrate will:
a. Act as a diureetic
b. Reduce demands in the liver
,c. Helps maintains urine acidity
d. Prevent the development of ketosis - ANSWER✔✔d. Prevent the development
of ketosis
The client with acute renal failure asks thee nurse for a snack. Because the client's
potassium level is elevated, which of the following snacks would be most
appropriate?
a. A gelatin dessert
b. Yogurt
c. An orange
d. Peanuts - ANSWER✔✔a. A gelatin dessert
In the oliguric phase of acute renal failure, the nurse should anticipate the
development off which of the following complications?
a. Pulmonary edema
b. Metabolic alkalosis
c. Hypotension
d. Hypokalemia - ANSWER✔✔a. Pulmonary edema
The client in acute renal failure has an external cannula inserted in the forearm for
hemodialysis. Which of the following nursing measures is appropriate for the care
of the client?
a. Use the unaffected arm for blood pressure measurement
b. Draw blood from the cannula for routine laboratory work
c. Percuss the cannula for bruits each shift
d. Inject heparin into the cannula each shift - ANSWER✔✔a. Use the unaffected
arm for blood pressure measurement
The nurse initiates the client's first hemodialysis treatment. the client develops a
headache, confusion, and nausea. These symptoms indicate which of the following
potential complications?
a. Disequilibrium syndrome
b. Myocardial infarction
c. Air embolism
d. Peritonitis - ANSWER✔✔a. Disequilibrium syndrome
, The client with acute renal failure is recovering and asks the nurse, "will my
kidneys ever function normally again?" The nurse's response is based on
knowledge that the client's renal status will most likely:
a. Continue to improve over a period of weeks
b. Result in need for permanent hemodialysis
c. Improve only if the client receives a renal transplant
d. Result in end-stage renal failure - ANSWER✔✔a. Continue to improve over a
period of weeks
The transplant nurse is assessing a client during a post-transplant follow-up
appointment. Which of the following signs and symptoms may indicate organ
rejection?
a. Hypotension, polyuria, dramatic weight loss and tenderness over the
transplanted kidney
b. Polyuria, hypothermia, edema, and hypotension
c. Increasing blood pressure, oliguria, fever, and weight gain
d. Edema, hypothermia, oliguria, and numbness over the transplanted kidney -
ANSWER✔✔c. Increasing blood pressure, oliguria, fever, and weight gain
The client has returned from the PACU to the step down unit after a unilateral
nephrectomy related to cancer. The nurse is developing a care plan for this client.
What is the priority nursing diagnosis for thee client following a nephrectomy?
a. ineffective breathing pattern related to the surgical incision
b. acute pain related to abdominal distention and the surgical incision
c. urine retention related to anesthesia
d. Anxiety related to fear of kidney failure - ANSWER✔✔a. ineffective breathing
pattern related to the surgical incision
The critical care nurse is caring for a client with acute renal failure in the oliguric
phase. The nurse will closely monitor the client for which commonly experienced
electrolyte imbalance?
a. Hyperkalemia
b. Hypercalcemia
c. Hyperlipidemia
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