Chapter 20: Renal Disorders and Therapeutic Management

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. An elderly patient is in a motor vehicle accident and incurs a significant internal hemorrhage. He is at greatest risk for which category of acute kidney injury (AKI)?

a.	Intrinsic
b.	Postrenal
c.	Prerenal
d.	Acute tubular necrosis

 

ANS:   C

Any condition that decreases blood flow, blood pressure (BP), or kidney perfusion before arterial blood reaches the renal artery that supplies the kidney may be anatomically described as prerenal AKI. When arterial hypoperfusion due to low cardiac output, hemorrhage, vasodilation, thrombosis, or other cause reduces the blood flow to the kidney, glomerular filtration decreases and consequently urine output decreases.

 

DIF:    Cognitive Level: Application REF:    Box 20-2

OBJ:    Nursing Process: Analysis      TOP:    Renal Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

2. Which of the following laboratory values is the most help in evaluating a patient for acute kidney injury?

a.	Serum sodium
b.	Serum creatinine
c.	Serum potassium
d.	Urine potassium

 

ANS:   B

Serum creatinine is the most reliable predictor of kidney function.

 

DIF:    Cognitive Level: Application REF:    404

OBJ:    Nursing Process: Assessment TOP:    Renal

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential

 

3. Which of the following intravenous solutions has been found to expedite renal recovery?

a.	Dextrose in water
b.	Normal saline
c.	Albumin
d.	Lactated Ringer’s

 

ANS:   B

Although the choice of fluid and the amount infused are based on the patient’s general condition and the patient’s ability to tolerate intervention, normal saline or “solute loading” in the prevention mode of treating pre-acute tubular necrosis has been found to expedite recovery.

 

DIF:    Cognitive Level: Comprehension       REF:    409

OBJ:    Nursing Process: Implementation       TOP:    Renal Disorders

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. The nurse is caring for a patient with acute kidney injury. Upon assessing the patient’s electrocardiogram the nurse notes peaked T-waves and a widening of the QRS interval. The nurse knows these are signs of:

a.	hypocalcemia.
b.	hyperphosphatemia.
c.	hyponatremia.
d.	hyperkalemia.

 

ANS:   D

Specific electrocardiographic changes are associated with hyperkalemia: peaked T-waves, a widening of the QRS interval, and ultimately, ventricular tachycardia or fibrillation.

 

DIF:    Cognitive Level: Analysis      REF:    408

OBJ:    Nursing Process: Assessment TOP:    Renal Disorders

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential

 

5. Which of the following nursing interventions is used in caring for the patient with acute kidney injury (AKI)?

a.	Encourage consumption of 1 to 2 L of fluids daily.
b.	Monitor for signs of hypokalemia and hypercalcemia.
c.	Test all stool, nasogastric drainage, and emesis for occult blood.
d.	Avoid the use of skin emollients.

 

ANS:   C

Anemia is an expected side effect of kidney failure that occurs because the kidney no longer produces the hormone erythropoietin. Irritation of the gastrointestinal tract from metabolic waste accumulation is expected, and stress ulcer prophylaxis must be prescribed. Stool, nasogastric drainage, and emesis are routinely tested for occult blood.

 

DIF:    Cognitive Level: Application REF:    414

OBJ:    Nursing Process: Implementation       TOP:    Renal Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation