chapter 68

Which finding in the first 24 hours after kidney transplantation requires immediate intervention?
1. Abrupt decrease in urine output
2. Blood-tinged urine
3. Incisional pain
4. Increase in urine output

1

The nurse is assessing the key features of severe chronic kidney disease (CKD) in a client. What term does the nurse use to document the presence of black and tarry stools?
1. Tachypnea
2. Hyperpnea
3. Melena
4. Purpura

3

The nurse wishes to reduce the incidence of hospital-acquired acute kidney injury. Which question by the nurse to the interdisciplinary health care team will result in reducing client exposure?
1. "Should we filter air circulation?"
2. "Can we use less ra

2

When assisting with dietary protein needs for a client on peritoneal dialysis, the nurse recommends that the client select which food?
1. Eggs
2. Ham
3. Eggplant
4. Macaroni

1

The nurse is caring for a client with a peritoneal dialysis catheter. What action does the nurse take?
1. Remove the old dressing and assess the area for infection.
2. Use clean technique while cleaning the site.
3. Clean the site from the abdomen towards

1

A client is being treated for kidney failure. Which statement by the nurse encourages the client to express his or her feelings and concerns about the risk for death and the disruption of lifestyle?
1. "All of this is new. What can't you do?"
2. "Are you

4

The nurse teaches a client who is recovering from acute kidney disease to avoid which medication?
1. Nonsteroidal anti-inflammatory drugs (NSAIDs)
2. Angiotensin-converting enzyme (ACE) inhibitors
3. Opiates
4. Calcium channel blockers

1

A client is receiving a loop diuretic for chronic kidney disease. Which drug does the nurse recognize as a loop diuretic?
1. Digoxin (Lanoxin)
2. Folic acid (Folvite)
3. Epoetin alfa (Epogen)
4. Furosemide (Lasix)

4

A client is receiving immune-suppressive therapy after kidney transplantation. Which measure for infection control is most important for the nurse to implement?
1. Adherence to therapy
2. Handwashing
3. Monitoring for low-grade fever
4. Strict clean techn

2

While managing care for a client with chronic kidney disease, which actions does the registered nurse (RN) plan to delegate to the unlicensed assistive personnel (UAP)? Select all that apply.
1. Obtain the client's predialysis weight.
2. Check the arterio

1, 3,
Obtaining the client's weight and documenting oral fluid intake are routine tasks that can be performed by a UAP. Assessment skills (checking the AV fistula and auscultating lung sounds) and client education (explaining special diet) require more ed

The RN has just received change-of-shift report. Which of the assigned clients should be assessed first?
1. Client with chronic kidney failure who was just admitted with shortness of breath
2. Client with kidney insufficiency who is scheduled to have an a

1

When caring for a client with acute kidney injury and a temporary subclavian hemodialysis catheter, which assessment finding does the nurse report to the provider?
1. Mild discomfort at the insertion site
2. Temperature 100.8� F
3. +1 ankle edema
4. Anore

2

which signs and symptoms indicate rejection of transplanted kidney? select all that apply
1. BUN 21, creatinine 0.9
2. crackles in lung fields
3. temp. of 98.8
4. BP of 164/98
5. +3 edema of lower extremities

2, 4, 5

Which problem excludes a client hoping to receive a kidney transplant from undergoing the procedure?
1. History of hiatal hernia
2. Presence of diabetes and HbA1c of 6.8
3. History of basal cell carcinoma on the nose 5 years ago
4. Presence of tuberculosi

4

The nurse instructor is teaching a group of nursing students about acute rejection of kidney transplantation. What statement made by the nurse instructor is accurate?
1. "Acute rejection manifests as pain at the transplant site."
2. "Acute rejection can o

4

The nurse is caring for a client who has been prescribed digoxin (Lanoxin) for acute kidney injury (AKI). What manifestations are likely to be observed in the client experiencing digoxin toxicity? Select all that apply.
1. Color vision changes
2 .Halos ar

1, 2, 5

What term does the nurse use to document a condition where the ability to produce dilute urine is reduced, resulting in urine with a fixed osmolarity?
1. Azotemia
2. Isosthenuria
3. Uremia
4 .Hyponatremia

2

The caregiver of a client receiving dialysis reports increased fatigue in the client. What does the nurse suggest to the caregiver?
1. Avoid giving the client iron supplements.
2. Provide 0.55 to 0.60 g of protein per kg of body weight.
3. Administer subc

3

A client has chronic kidney disease (CKD) and pericarditis. What manifestations of pericarditis does the nurse find on assessment?
1. Mild chest pain
2. High fever
3. Decreased pulse rate
4. Pericardial friction rub

4

The nurse is caring for a client with prerenal failure. What is the cause of this AKI?
1. Damage to kidney tissue
2. Reduced perfusion
3. Obstruction of urine flow
4. Chronic kidney disease

2

What intervention is appropriate for the client with stage 4 chronic kidney disease (CKD)?
1. Managing complications and preparing for renal replacement
2. Implementing strategies to slow CKD progression
3. Focusing on reduction of risk factors
4. Impleme

1

Which medication is most effective in slowing the progression of kidney failure in a client with chronic kidney disease?
1. Diltiazem (Cardizem)
2. Lisinopril (Zestril)
3. Clonidine (Catapres)
4. Doxazosin (Cardura)

2

The nurse is teaching a client with acute kidney injury (AKI) how to take prescribed ferrous sulfate (Feosol). What statement made by the client indicates a need for further teaching?
1. "I have to take the drug after dialysis."
2. "The drug should be tak

4

A client is scheduled to undergo kidney transplant surgery. Which teaching point does the nurse include in the preoperative teaching session?
1. "Your diseased kidneys will be removed at the same time the transplant is performed."
2. "The new kidney will

3

Which nephrotoxic nonsteroidal anti-inflammatory drug (NSAID) can cause acute kidney injury (AKI) in clients?
1. Tolmetin (Tolectin)
2. Cisplatin (Platinol)
3. Rifampin (Rifadin)
4. Vancomycin (Vancocin)

1

the nurse is caring for a dialysis client with a very poor appetite. What action does the nurse take?
1. Administer total parenteral nutrition as prescribed.
2. Provide 40 g/day of prescribed protein in the diet.
3. Allow fluid intake equal to urine outpu

1

What does the nurse identify as a possible cause of postrenal acute kidney injury (AKI) in a client?
1. Urethral stricture
2. Exposure to nephrotoxins
3. Acute tubular necrosis
4. Pulmonary embolism

1

While assisting a client during peritoneal dialysis, the nurse observes the drainage discontinue after 200 mL of peritoneal effluent. What action should the nurse implement first?
1. Instruct the client to deep breathe and cough.
2. Document the effluent

3

Which assessment finding represents a positive response to erythropoietin (Epogen, Procrit) therapy?
1. Hematocrit of 26.7%
2. Potassium within normal range
3. Absence of spontaneous fractures
4. Less fatigue

4

client receiving hemodialysis is prescribed folic acid and ferrous sulfate orally. What does the nurse teach the client about folic acid therapy?
1. Avoid antacids within 2 hours of taking folic acid.
2. Report any change in the color of stool.
3. Take st

4

A client admitted to the medical unit with a history of vomiting and diarrhea and an increased blood urea nitrogen (BUN) requires 1 liter of normal saline infused over 2 hours. Which staff member should be assigned to care for the client?
1. RN who has fl

3

Discharge teaching has been provided for a client recovering from kidney transplantation. Which information indicates that the client understands the instructions?
1. "I can stop my medications when my kidney function returns to normal."
2. "If my urine o

3

A client with chronic kidney disease (CKD) has developed the Kussmaul pattern of respiration. What causes this breathing pattern?
1. Increased acid retention
2. Increased pH
3. Increased bicarbonate
4. Decreased rate and depth of breathing

1