Renal Failure NCLEX Practice Questions (71-75)

Welcome to Renal Failure NCLEX Practice Questions. Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.


71. A client has received instructions on self-management of peritoneal dialysis. The nurse determines that the client needs further instruction if the client states to:

a) use a strong adhesive tape to anchor the catheter dressing
b) use meticulous aseptic technique for dialysate bag changes
c) take own vital signs daily
d) monitor own weight daily

72. A nurse has given a client with a nephrostomy tube instructions to follow after hospital discharge. The nurse determines that the client understands the instructions if the client states he or she should drink at least how many glasses of water per day?

a) 1 to 3
b) 6 to 8
c) 12 to 14
d) 16 to 18

73. Renal Failure NCLEX Practice Questions about a nurse who notes that a client's urinalysis report contains a notation of positive red blood cells (RBC). The nurse interprets that this finding is unrelated to which of the following items that is part of the client's medical record?

a) diabetes mellitus
b) concurrent anticoagulant therapy
c) history of kidney stones
d) history of recent blow to the right flank

74. A client with acute glomerulonephritis has had a urinalysis sent to the laboratory. The report reveals that there are hematuria and proteinuria in the urine. The nurse interprets that these results are:

a) consistent with glomerulonephritis
b) inconsistent with glomerulonephritis
c)unclear, and no conclusion can be drawn
d) indicative of impending renal failure

75. A young female client with acute pyelonephritis is scheduled for a voiding cystourethrogram. The nurse determines that this client would likely benefit from increased support and teaching about the procedure because:

a) radiopaque contrast is injected into the bloodstream with a syringe
b) radioactive material is injected into the bladder with a syringe
c) the client must lie on an x-ray table in a cold, barren room
d) the client must void while the micturition process is filmed






Renal Failure NCLEX Practice Questions
Answers and Rationale

71) A
- The client is at risk for impairment of skin integrity because of the presence of the catheter, exposure to moisture, and irritation from tape and cleansing solutions. The client should be instructed to use paper or nonallergenic tape to prevent skin irritation and breakdown. It is proper procedure for the client to use aseptic technique, and self-monitor vital signs and weight daily.

72) B
- The client with a nephrostomy tube needs to have adequate fluid intake to dilute urinary particles that could cause calculus and to provide good mechanical flushing of the kidney and tube. The nurse encourages the client to take in at least 2000 mL of fluid per day, which is roughly equivalent to 6 to 8 glasses of water. Options C and D represent high fluid volumes and could possibly place undue distention on the renal pelvis. Option A is an amount that is lower than recommended.

73) A
- Hematuria can be caused by trauma to the kidney, such as with blunt trauma to the lower posterior trunk or flank. Kidney stones can cause hematuria as they scrape the endothelial lining of the urinary system. Anticoagulant therapy can cause hematuria as a side effect. Diabetes mellitus does not cause hematuria, although it can lead to renal failure from prerenal causes.

74) A
- Gross hematuria and proteinuria are the cardinal signs of glomerulonephritis. The urine may be small in volume, dark or smoky in color from the hematuria, and foamy from the proteinuria. Concurrent serum studies would reveal elevated blood urea nitrogen, creatinine, C-reactive protein level, and antistreptolysin O titer.

75) D
- Having to void in the presence of others can be very embarrassing for clients, and may actually interfere with the client's ability to void. The nurse teaches the client about the procedure to try to minimize stress from lack of preparation, and gives the client encouragement and emotional support. Screens may be used in the radiology department to try to provide an element of privacy during this procedure.



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Renal Failure NCLEX Practice Questions (1-7)


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Renal Failure NCLEX Practice Questions (76-80)

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Renal NCLEX Questions (66-70)

Welcome to Renal NCLEX Questions. Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.


66. A nurse has administered a dose of epoetin alfa (Epogen) to a client with chronic renal failure. The nurse interprets that which of the following hemodynamic effects experienced by the client is a side effect of this medication?

a) bradycardia
b) tachycardia
c) hypotension
d) hypertension

67. A client with chronic renal failure who has just undergone repair of an umbilical hernia is complaining of postoperative pain. The nurse should call the physician if which of the following opioid analgesics is prescribed for this client?

a) meperidine hydrochloride (Demerol)
b) morphine sulfate
c) codeine sulfate
d) oxycodone (OxyContin, Roxicodone)

68. Renal NCLEX Questions about a client with chronic renal failure who did not receive any juice on the breakfast meal tray. The nurse asks the nursing assistant to give the client a cup of which of the following juices from the unit kitchen?

a) grape
b) grapefruit
c) orange
d) prune

69. A nurse is caring for a client with chronic renal failure whose daily fluid allotment is determined by calculating the previous day's output plus insensible losses through the lungs. If the client's urine output for the previous day was 300 ml, the nurse anticipates how many milliliters of fluid will be allotted for today?

a) 400 ml
b) 700 ml
c) 1000 ml
d) 1200 ml

70. A nurse has instructed a client about the procedure for continuous ambulatory peritoneal dialysis (CAPD). The nurse determines that the client needs further instruction if the client:

a) states that dwell times will vary depending on whether it is a daytime or nighttime
b) allows air to get into the dialysis tubing
c) warms the dialysate solution before infusion
d) plans on doing four exchanges per day




Renal NCLEX Questions
Answers and Rationale

66) D
- The client taking exogenous erythropoietin may develop or have an increase in the degree of hypertension. This probably results from increased blood viscosity and the hemodynamic changes that accompany it. The nurse monitors the client's blood pressure carefully and regularly. Options A, B, and C are not associated with the use of epoetin alfa.

67) A
- Although all of the medications listed in the options are metabolized by the liver, meperidine hydrochloride is metabolized partially to normeperidine, which must be excreted by the kidneys. Seizure activity can occur in the client with chronic renal failure from accumulation of normeperidine in the client's system. It is also generally true that dosages for all opioid analgesics will be reduced for the client with chronic renal failure.

68) A
- Apple juice and grape juice are lower in potassium and are the better choices of juice for the client with chronic renal failure. Prune, orange, and grapefruit juices are higher in potassium and should be used cautiously or avoided in these clients.

69) B
- The lungs expire about 400 mL of water per day. Therefore, if the client's urine output for the previous day was 300 mL, then 700 mL of fluid is to be allotted (400 mL from the lungs and 300 mL urine output).

70) B
- Peritoneal dialysis tubing is flushed to avoid introducing air into the peritoneal cavity. With CAPD, there are usually four exchanges planned per day, with dwell times varying, depending on whether it is a daytime or nighttime exchange. The dialysate solution should be slightly warmed (37° C) prior to use.


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Renal NCLEX Questions (1-7)


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Renal NCLEX Questions (71-75)

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Test for Kidneys (NCLEX 61-65)

Welcome to Test for Kidneys. Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck.


61. A client with chronic renal failure is scheduled to begin hemodialysis therapy. As part of general teaching about hemodialysis, the nurse tells the client to expect the typical dialysis schedule to be:

a) 2 to 3 hours treatment 5 days per week
b) 2 hours of treatment 6 days per week
c) 5 hours of treatment 2 days per week
d) 3 to 4 hours of treatment 3 days per week

62. A nurse is hemodialyzing a client. The client suddenly becomes short of breath and complains of chest pain. The nurse notes that the client is tachycardic, pale, and anxious. The nurse should take which action?

a) monitor vital signs every half hours for the next 2 hours
b) bolus the client with 500 ml normal saline
c) check the tubing for air and continue dialysis at a slower rate
d) discontinue dialysis and notify the physician

63. A nurse is teaching a hemodialysis client about self-monitoring between hemodialysis treatments. The nurse tells the client to record which of the following on a daily basis?

a) calorie count
b) activity log
c) pulse, respiratory rate
d) intake and output, weight

64. A nurse is providing home care instructions to a client who has a cystoscopy in the physician's office. The nurse gives the client which instruction?

a) take cold tub baths two or three times a day
b) expect small episodes of bright red bleeding
c) drink increased amounts of fluids
d) try to avoid taking analgesic medications

65. A nurse has taught a client with chronic renal failure about medication therapy used in its treatment. The nurse determines that the client needs additional teaching if the client states which medication is needed to enhance red blood cell (RBC) production?

a) calcium carbonate (Tums)
b) multivitamins (MVI)
c) ferrous sulfate (Feosol)
d) folic acid (Folvite)






Test for Kidneys
Answers and Rationale

61) D
- The typical schedule for hemodialysis is 3 to 4 hours of treatment 3 days per week. Individual adjustments may be made according to variables such as the size of the client, type of dialyzer, the rate of blood flow, personal client preferences, and others. Options A, B, and C do not represent the typical hemodialysis schedule.

62) D
- The signs and symptoms exhibited by the client are compatible with air embolism. If the client experiences air embolus during hemodialysis, the nurse should stop the dialysis immediately, notify the physician, and administer oxygen as needed. All of the other actions are incorrect.

63) D
- The client monitors his or her own status between dialysis procedures by measuring intake and output and daily weight. These measures will assist the client in preventing fluid volume excess. The other options do not need to be recorded by the client daily.

64) C
- Because clients may be discharged immediately after cystoscopy, clients must understand home care measures. Pink-tinged urine is common, but not bright red bleeding. Increased intake of fluids helps prevent this from occurring. Clients often experience bladder spasm and bladder pain, feelings of bladder fullness and burning, and burning on urination after this procedure. Mild analgesics and warm tub baths are recommended to relieve these discomforts.

65) A
- Calcium carbonate is a calcium salt that is used as a phosphate binder in the client with chronic renal failure. It has nothing to do with the treatment of anemia. Folic acid is a vitamin that is needed for RBC production, and it is usually deficient in the client with chronic renal failure. Iron supplements (ferrous sulfate) are needed to produce adequate hemoglobin. Multivitamins supplement dietary vitamins and minerals but do not specifically enhance RBC production.



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Test for Kidneys (NCLEX 1-7)


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Test for Kidneys (NCLEX 66-70)

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NCLEX Renal Questions (56-60)

Welcome to the NCLEX Renal Questions. Before you begin answering this questions, I recommend that you start from the beginning:

NCLEX Renal Questions (1-7)

Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck


56. A client who has a renal mass asks the nurse why an ultrasound has been scheduled, as opposed to other diagnostic tests that may be ordered. The nurse formulates a response based on the understanding that:

a) all other tests are more invasive than an ultrasound
b) all other tests require more elaborate postprocedure care
c) an ultrasound can differentiate a solid mass from a fluid-filled cyst
d) an ultrasound is much more cost effective than other diagnostic tests

57. A client has been admitted to the hospital with a diagnosis of acute glomerulonephritis. During history-taking the nurse first asks the client about a recent history of:

a) bleeding ulcer
b) deep vein thrombosis
c) myocardial infarction
d) streptococcal infection

58. A nurse is assigned to care for a client with nephrotic syndrome. The nurse assesses which important parameter on a daily basis?

a) weight
b) albumin levels
c) activity tolerance
d) blood urea nitrogen (BUN) level

59. A client is being admitted to the hospital with a diagnosis of urolithiasis and ureteral colic. The nurse assesses the client for pain that is:

a) dull and aching in the costovetebal area
b) aching and camplike throughout the abdomen
c) sharp and radiating posteriorly to the spinal column
d) excruciating, wavelike, and radiating toward the genitalia

60. A client with renal failure is receiving epoetin alfa (Epogen) to support erythropoiesis. The nurse questions the client about compliance with taking which of the following medications that supports red blood cell (RBC) production?

a) iron supplement
b) zinc supplement
c) calcium supplement
d) magnesium supplement




NCLEX Renal Questions:
Answers and Rationale

56) C

- A significant advantage of an ultrasound is that it can differentiate a solid mass from a fluid-filled cyst. It is noninvasive and does not require any special aftercare. Other diagnostic tests, such as magnetic resonance imaging and computed tomography scanning, are also noninvasive (unless contrast is used) and require no special aftercare, either. However, the ultrasound can discriminate between solid and fluid masses most optimally.

57) D

- The predominant cause of acute glomerulonephritis is infection with beta hemolytic Streptococcus 3 weeks before the onset of symptoms. In addition to bacteria, other infectious agents that could trigger the disorder include viruses, fungi, and parasites. Bleeding ulcer, deep vein thrombosis, and myocardial infarction are not precipitating causes.

58) A

- The client with nephrotic syndrome typically presents with edema, hypoalbuminemia, and proteinuria. The nurse carefully assesses the fluid balance of the client, which includes daily monitoring of weight, intake and output, edema, and girth measurements. Albumin levels are monitored as they are prescribed, as are the BUN and creatinine levels. The client's activity level is adjusted according to the amount of edema and water retention. As edema increases, the client's activity level should be restricted.

59) D

- The pain of ureteral colic is caused by movement of a stone through the ureter and is sharp, excruciating, and wavelike, radiating to the genitalia and thigh. The stone causes reduced flow of urine, and the urine also contains blood because of its abrasive action on urinary tract mucosa. Stones in the renal pelvis cause pain that is a deep ache in the costovertebral area. Renal colic is characterized by pain that is acute, with tenderness over the costovertebral area.

60) A

- Iron is needed for RBC production. Otherwise, the body cannot produce sufficient erythrocytes. In either case, the client is not receiving the full benefit of epoetin alfa therapy if iron is not taken. Options B, C, and D are not needed for RBC production.


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NCLEX Renal Questions (61-65)

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NCLEX Renal Questions (51-55)

Welcome to the NCLEX Renal Questions. Before you begin answering this questions, I recommend that you start from the beginning:

NCLEX Renal Questions (1-7)

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51. A client has an arteriovenous (AV) fistula in place in the right upper extremity for hemodialysis treatments. When planning care for this client, which of the following measures should the nurse implement to promote client safely?

a) take blood pressures only on the right arm to ensure accuracy
b) use the fistula for all venipunctures and intravenous infusions
c) ensure that small clamps are attached to the AV fistula dressing
d) assess the fistula for the presence of a bruit and thrill every 4 hours

52. A nurse is assessing a client who is diagnosed with cystitis. Which assessment finding is inconsistent with the typical clinical manifestations noted in this disorder?

a) hematuria
b) low back pain
c) urinary retention
d) burning on urination

53. A client with urolithiasis is scheduled for extracorporeal shock wave lithotripsy (ESWL). The nurse assesses to ensure that which of the following items are in place or maintained before sending the client for the procedure?

a) IV line and a foley catheter
b) NPO status and a foley catheter
c) signed informed consent, NPO status, and an IV line
d) signed informed consent and clear liquid restriction preprocedure

54. The home care nurse is making follow-up visits to a client following renal transplant. The nurse assesses the client for which signs of acute graft rejection?

a) hypotension, graft tenderness, and anemia
b) hypertension, oliguria, thirst, and hypothermia
c) fever, hypertension, graft tenderness, and malaise
d) fever, vomiting, hypotension, and copious amounts of dilute urine

55. A client is scheduled for computed tomography (CT) of the kidneys to rule out renal disease. As an essential preprocedure component of the nursing assessment, the nurse plans to ask the client about a history of:

a) familial renal disease
b) frequent antibiotic use
c) long-term diuretic therapy
d) allergy to shellfish or iodine





NCLEX Renal Questions:
Answers and Rationale

51) D

- Arteriovenous fistulas are created by anastomosis of an artery and a vein within the subcutaneous tissues to create access for hemodialysis. Fistulas should be evaluated for presence of thrills (palpate over the area) and bruits (auscultate with a stethoscope) as an assessment of patency.

52) C

- Clinical manifestations of cystitis usually include urinary frequency, urgency, dysuria, inability to void, or voiding only small amounts. The urine may be cloudy, with hematuria and bacteriuria. The client may complain of pain that is suprapubic or in the lower back. Nonspecific signs include fever, chills, malaise, and nausea and vomiting. Some clients may be asymptomatic, particularly the older client.

53) C

- ESWL is done with conscious sedation or general anesthesia. The client must sign an informed consent form for the procedure and must be NPO for the procedure. The client needs an IV line for the procedure as well. A Foley catheter is not needed.

54) C

- Acute rejection usually occurs within the first 3 months after transplant, although it can occur for up to 2 years posttransplant. The client exhibits fever, hypertension, malaise, and graft tenderness. Treatment is immediately begun with corticosteroids and possibly also with monoclonal antibodies and antilymphocyte agents.

55) D

- The client undergoing any type of diagnostic testing involving possible dye administration should be questioned about allergy to shellfish or iodine. This is essential to identify the risk for potential allergic reaction to contrast dye, which may be used. The other items are also useful as part of the assessment but are not as critical as the allergy determination in the preprocedure period.


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NCLEX Renal Questions (56-60)

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NCLEX Renal Questions (46-50)

Welcome to the NCLEX Renal Questions. Before you begin answering this questions, I recommend that you start from the beginning:

Online Nursing Practice Test about Renal Disorders (1-7)

Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. Good Luck


46. The client is admitted to the emergency department following a motor vehicle accident. The client was wearing a lap seat belt when the accident occurred and now the client has hematuria and lower abdominal pain. To assess further whether the pain is caused by bladder trauma, the nurse asks the client if the pain is referred to which of the following area?

a) hip
b) shoulder
c) umbilicus
d) costovertebral angle


47. The female client is admitted to the emergency department following a fall from a horse and the physician orders insertion of a foley catheter. While preparing for the procedure, the nurse notes blood at the urinary meatus. The nurse should:

a) notify the physician
b) use a smaller size of catheter
c) administer pain medication before inserting the catheter
d) use extra povidone-iodine solution in cleansing the meatus

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NCLEX Renal Questions (41-45)

NCLEX Renal Questions

41. The client with an external arteriovenous shunt in place for hemodialysis is at risk for bleeding. The priority nurse action would be to:

a) check the shunt for the presence of bruit and thrill
b) observe the site once as time permits during the shift
c) check the results of the prothrombin time as they are determined
d) ensure that small clamps are attached to the arteriovenous shunt dressing


42. The nurse develops a post-procedure plan of care for a client who had a renal biopsy. The nurse avoids documenting which intervention in the plan?

a) administering analgesics as needed
b) encouraging fluids to at least 3L in the first 24 hours
c) testing serial urine samples with dipstick for occult blood
d) ambulating the client in the room and hall for short distances

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Online Nursing Practice Test about Renal Disorders (36-40)

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36. The client with acute renal failure has a serum potassium of 6.0 mEq/L. The nurse would plan which of the following as a priority action?

a) check the sodium level
b) place the client on a cardiac monitor
c) encourage increased vegetables in the diet
d) allow an extra 500 ml of fluid intake to dilute the electrolyte concentration

37. The client with chronic renal failure who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril (Vasotec). The nurse should plan to administer this medication:

a) during dialysis
b) just before dialysis
c) the day after dialysis
d) on return form dialysis

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Online Nursing Practice Test about Renal Disorders (31-35)

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31. Which of the following should be considered in the diet of the client with end-stage-renal-disease (ESRD)?

a) limit fluid intake during anuric phase
b) limit phosphorus and vitamin D-rich food
c) limit calcium-rich food
d) limit carbohydrates



32. A client has been admitted to the hospital for urinary tract infection and dehydration. The nurse determines that the client has received adequate volume replacement if the blood urea nitrogen level drops to:

a) 3 mg/dL
b) 15 mg/dL
c) 29 mg/dL
d) 35 mg/dL

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NCLEX Kidneys 26-30

Let us try answering some NCLEX Kidneys Questions . . . 

28. The client with chronic renal failure is on chronic hemodialysis. Which of the following indicate improvement of the client's condition due to hemodialysis? Select all that apply

a) the client's BP is 130/90
b) the client's serum potassium is 4.8 mEq/L
c) the client's hemoglobin level is 10 g/dL
d) the client's serum calcium is 7.7 mg/dL
f) the client's serum sodium is 140 mEg/L
g) the client's serum magnesium is 4 mEq/L
h) the client's weight has increased from 60 kg to 63 kg

29. The client is in end-stage renal failure (ESRD). Which of the following foods may be allowed for the client?

a) banana
b) apple
c) carrot cake
d) cantaloupe

30. The client has end-stage renal disease. He had undergone kidney transplant 5 days ago. Which of the following is the most important intervention for the client to prevent infection?

a) observe sepsis
b) increase fluid intake
c) avoid clients with flu
d) avoid crowded places




NCLEX Kidneys 
ANSWERS AND RATIONALE

26) A
- cloudy diasylate indicates infection (peritonitis). Culture of the fluid must be done to determine the microorganism present.

27) D
- the client with renal failure should be given low potassium diet because of hyperkalemia. Apple contains very little potassium. So, it can be given to the client.

28) A, B, E
- these values have normalized; therefore they indicate improvement of client's condition on chronic hemodialysis. As edema fluids are removed from the body, there should be decrease in weight. Hemodialysis does not affect hemoglobin levels.

29) B
- the client with ESRD should have low potassium diet to prevent hyperkalemia. Apple has very minimal potassium. Banana, carrot, cantaloupe are rich in potassium.

30) A
- asepsis is the most effective measure to prevent infection.


Related Topics:

• Fundamentals of Nursing  Concepts
• Medical-Surgical Concepts
• Maternal and Child Concepts

• NCLEX Kidneys (31-35)
• Go back to NCLEX Kidneys (1-7) to start the test from the beginning.

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Online Nursing Practice Test about Renal Disorders (21-25)

21. Which of the following should the nurse include in the nursing care plan of the client who is diagnosed to have renal failure, whose BUN is 32 mg/dl, serum creatinine is 4 mg/dl, hematocrit is 38%. He is complaining of fatigue and edema.

a) low protein diet and fluid restriction
b) high protein diet and fluid restriction
c) low protein diet and increase in fiber
d) high protein diet and potassium restriction

22. The client in end-stage of renal failure had undergone kidney transplant. Which of the following assessment findings indicate kidney transplant rejection?

a) increased urinary output, BUN = 15 mg/dL
b) HCT = 50%, Hgb = 17 g/dl
c) decreased urinary output, sudden weight gain
d) decreased urinary output, sudden weight loss

23. Which of the following assessment findings indicates that pyridium is effective in a client with urinary tract infection?

a) the client's urine culture yields negative result
b) the client is able to void every 2 to 3 hours
c) the client verbalizes that she is relieved from pain
d) the client is able to void 30-60 ml/hour

24. Which of the following anti-hypertensive medications is contraindicated for clients with renal insufficiency?

a) beta-adrenergic blockers
b) calcium-channel blockers
c) direct-acting vasodilators
d) angiotensin-converting enzyme inhibitors

25. The client has been diagnosed to have glomerulonephritis. What should the nurse observe in the urine?

a) blood
b) pus
c) white blood cells
d) glucose



ANSWERS AND RATIONALE

21) A
- the diet for a client with elevated BUN and serum creatine should be low protein, to reduce urea and nitrogenous waste products. For edema, fluid restriction should be implemented.

22) C
- kidney transplant rejection is manifested by failure of renal functions like decreased urinary output and water retention, as manifested by weight gain.

23) C
- pyridium is a urinary analgesic. It will normally cause red-orange discoloration of the urine.

24) D
- ACE inhibitors may cause hyperkalemia. It should be used with great caution if it is prescribed for a client with renal insufficiency.

25) A
- glomerulonephritis causes gross hematuria. The urine appears dark, smoky, cola-colored, or red-brown.


Related Topics:

• Fundamentals of Nursing  Concepts
• Medical-Surgical Concepts
• Maternal and Child Concepts

• Online Nursing Practice Test about Renal Disorders (26-30)
• Go back to Online Nursing Practice Test about Renal Disorders (1-7) to start the test from the beginning.

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Online Nursing Practice Test about Renal Disorders (12-15)

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12. The client for intermittent self-catheterization is concerned with the cost of materials for the procedure. Which of the following is the most appropriate response by the nurse?

a) I will refer you to social welfare department
b) you should be more concerned with your health rather than the cost of materials
c) the materials can be reused if properly cleaned and safely kept
d) you better discuss your concern with your primary health care provider

13. A client has been diagnosed to have chronic renal failure. Sodium polysterene sulfonate (exchange resin kayexalate) is prescribed. The action of the medication is that it releases

a) bicarbonate in exchange for primarily sodium ions
b) sodium ions in exchange for primarily bicarbonate ions
c) sodium ions in exchange for primarily potassium ions
d) potassium ions in exchange for primarily sodium ions

14. Which of the following problems is expected in a client who is in end-stage renal failure?

a) anemia
b) thalassemia
c) renal calculi
d) hypotension

15. Which of the following client responses shows a correct understanding of continuous ambulatory peritoneal dialysis (CAPD)?

a) I am expected to perform the procedure at home
b) the procedure lasts for one hour
c) I have to sit and raise my legs during the procedure
d) I have to go to the hospital for this procedure


ANSWERS AND RATIONALE

12) C
- intermittent self-catheterization involves clean technique. The client should wash the catheter with warm soapy water. This catheter can be used repeatedly.

13) C
- as sodium is released from exchange resin kayexalate, potassium ions will be excreted. This will lower serum potassium levels.

14) A
- the damaged kidney are unable to secrete erythropoietin adequately. There is decreased production of RBC in the bone marrow which leads to severe anemia.

15) A
- CAPD is done by the client.


Related Topics:

• Fundamentals of Nursing  Concepts
• Medical-Surgical Concepts
• Maternal and Child Concepts

• Online Nursing Practice Test about Renal Disorders (16-20)
• Go back to Online Nursing Practice Test about Renal Disorders (1-7) to start the test from the beginning.

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Online Nursing Practice Test about Renal Disorders (16-20)

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16. The client with chronic renal failure is undergoing peritoneal dialysis. He asks why the nurse monitors his blood glucose levels. Which of the following will be the most appropriate response by the nurse?

a) I have to check if you have diabetes mellitus
b) the dialysate contains glucose
c) the procedure may lower your blood glucose levels
d) it is a routine procedure for every client who undergoes the treatment

17. Which of the following is an expected finding in the client with chronic renal failure?

a) anemia
b) polyuria
c) increased creatinine clearance
d) increased serum calcium levels

18. In the oliguric phase of renal failure, what is the most appropriate nursing diagnosis?

a) fluid volume deficit
b) activity intolerance
c) ineffective breathing pattern
d) fluid volume excess

19. Which of the following complaints is common in a client with pyelonephritis?

a) right upper quadrant pain
b) left upper quadrant pain
c) pain at the costovertebral region
d) pain at the suprapubic region

20. The client had been diagnosed to have chronic renal failure. He had undergone hemodialysis for the first time. What signs and symptoms when experienced by the client suggest that he is experiencing disequilibrium syndrome?

a) restlessness, hypotension, headache
b) nausea and vomiting, hypertension, dizziness
c) lethargy, hypotension, dizziness
d) thachycardia, hypotension, headache



ANSWERS AND RATIONALE

16) B
- the solution used for peritoneal dialysis contains glucose, to remove edema fluids from the body through the process of osmosis. Hyperglycemia may occur. Therefore, urine and blood glucose levels need to be monitored.

17) A
- in renal failure, the kidneys are unable to secrete erythropoietin. This results to decreased RBC production by the bone marrow. Severe anemia occurs.

18) D
- oliguric phase is characterized by water retention (edema) which leads to fluid volume excess.

19) C
- the kidneys are located at the costovertebral angle. Therefore the pain in pyelonephritis is located in this area.

20) B
- disequilibrium syndrome is caused by more rapid removal of waste products from the blood from the brain. This is due to the presence of blood-brain barrier. This causes increased intracranial pressure.


Related Topics:

• Fundamentals of Nursing  Concepts
• Medical-Surgical Concepts
• Maternal and Child Concepts

• Online Nursing Practice Test about Renal Disorders (21-25)
• Go back to Online Nursing Practice Test about Renal Disorders (1-7) to start the test from the beginning.

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Online Nursing Practice Test about Renal Disorders (8-11)

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Situation: Three year old Carlo has been admitted to the pediatric unit with a tentative diagnosis of nephrotic syndrome.

8. The diagnosis of Idiopathic Nephrotic Syndrome has been confirmed. Which unexpected finding would the nurse report?

a) proteinuria
b) distended abdomen
c) blood in the urine
d) elevated serum lipid levels

9. Carlo's potential for impairment of skin integrity is related to:

a) joint inflammation
b) drug therapy
c) edema
d) generalized body rash

10. Prednisone is prescribed for Carlo. The nurse evaluate its effectiveness by

a) checking his BP every 4 hours
b) checking his urine for protein
c) weighing him each morning before breakfast
d) observing him for behavioral changes

11. At Carlo's last check-up when he was 2 1/2 years old, his BP was 95/60, PR was 110/min and weight was 15 kg. Which unexpected assessment today would the nurse report to help the diagnosis?

a) BP: 95/60
b) weight: 20 kg
c) PR: 110
d) temp: 37 C


ANSWERS AND RATIONALE

8) C
- hematuria is rare in nephrotic syndrome but it is profuse is acute glomerulonephritis.

The manifestations of nephrotic syndrome are:

• Proteinuria - nephrosis is believed to be due to immunologic response that results in increased permeability of glomerular membrane to proteins resulting in massive protein losses in the urine -- proteinuria and albuminuria (+3 +4), the child losses 50-100 mg/kg weight/day from proteinuria.
• Hypoalbuminemia - loss of protein in blood results in hypoalbumenimia
• Edema - cardinal sign and appears first in the periorbital region followed by dependent edema and accompanied by pallor, fatigue and lethargy. Hypoalbuminemia leads to decreased oncotic pressure resulting in fluid shift from intravascular to interstitial causing generalized edema or anasarca.The child has lost appetite but gained weight -- puffiness of the eyes on awakening decreases during the day but appears on the legs and abdomen. Fluid shift causes decreased blood volume that leads to decreased blood supply to kidney. Decreased blood supply to kidney initiates release of aldosterone. Aldosterone causes sodium retention (in interstitial spaces so child will have hyponatremia) and water retention contributing to edema.
• Hypocholesteronemia and hyperlipidemia - triglycerides and fats are released by the liver in the blood to make up for the protein loss

9) C
- management: reduce protein excretion
Prevention of Skin Breakdown from Edema

• frequent turning
• keep nails short to prevent scratching
• meticulous skin care to dependent and edematous areas - sacrum, scrotum, labia, abdomen, legs
• loose clothing

Monitor Edema

• weigh daily and monitor I and O
• check for pulmonary edema manifested by crackles on auscultation
• ascites - measure abdominal girth

Prevention of Infection - pulmonary edema predisposes to respiratory infection and generalized edema predisposes to skin breakdown. Avoid contact with persons who have infection.

Diet - usually anorexic because of GI edema

• high protein diet
• sodium restriction if with severe edema
• fluid intake equal to output and insensible loss
• vitamin and iron supplements
• small feedings, give favorite foods

10) B
- prednisone is prescribed for CArlo to decrease protein excretion. Proteinuria disappears in one week after intiating treatment. The child is responding favorably to treatment if there is no proteinuria for 2 consecutive days. Steroid therapy is continued until urine is negative for protein and gradually reduced over a period of 1 to 3 weeks

Monitor side effect of prolonged steroid therapy

• Hyperglycemia - test urine
• monitor growth of child by checking height because steroid has growth suppressing effect by preventing calcium deposition in the bones
• Gastric Irritation - give milk or meals, test for occult blood, administer with antacids
• Avoid exposure to infection because child is immunosuppressed

11) B
- during the toddler period, the child gains 2.5 kg a year. Carlo has gained 5 kg in only 6 months. In nephrotic syndrome, this excessive weight gain is due to edema.


Related Topics:

• Fundamentals of Nursing  Concepts
• Medical-Surgical Concepts
• Maternal and Child Concepts

• Online Nursing Practice Test about Renal Disorders (12-15)
• Go back to Online Nursing Practice Test about Renal Disorders (1-7) to start the test from the beginning.

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Online Nursing Practice Test about Renal Disorders (1-7)

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Situation: Ms. Elsa Cruz has fever with severe flank pain was brought to the ER.

1. Urinalysis was ordered for her, with instruction about the examination, when can you collect urine specimen for culture?

a) noon time if specimen is available
b) evening before retiring
c) anytime as soon as there is specimen
d) A.M. only

2. Intravenous pyelography was ordered, your nursing preparation would include the following. Except:

a) enema on the morning of the test
b) check for history of allergies
c) hydrating Mrs. Cruz orally four hours before the procedure
d) NPO 8 hours before the test

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