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Med-Surg Renal Failure- Ch 17 test
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Med-Surg Renal Failure- Ch 17 testThe most accurate indicator of fluid loss or gain in an acutely ill patient is
blood pressure.
weight.
pulse rate.
edema. - ANS weight.
Explanation:
The most accurate indicator of fluid loss or gain in an acutely ill patient is weight. An accurate daily
weight must be obtained and recorded. Blood pressure, pulse rate, and edema are not the most
accurate indicator of fluid loss or gain.
Observing the client's urinary output.
Explanation:
Nephrotoxic drugs are not administered to a client with renal disease unless the client's life is in
danger and no other therapeutic agent is of value. Since the client is given nephrotoxic drugs in
normal doses, observing the client's urinary output can help the nurse determine a change in the
renal status. Observing the client's fluid intake and noting the color of skin and nail beds do not help
a nurse determine a change in the renal status. Checking for a thrill or a bruit daily is performed for a
client with a vascular access device. - ANS A client, aged 75, is diagnosed with a renal disease and
administered nephrotoxic drugs in normal doses. The nurse is aware that it is important to observe
the client closely for any changes in renal status. Which of the following measures may help a nurse
determine a change in renal status?
Observing the client's urinary output.
Observing the client's fluid intake.
Observing the skin color and nail beds.
Checking for a thrill or a bruit daily.
,Increased serum creatinine level
Explanation:
In renal failure, laboratory blood tests reveal elevations in BUN, creatinine, potassium, magnesium,
and phosphorus. Calcium levels are low. The RBC count, hematocrit, and hemoglobin are decreased.
- ANS Which of the following would the nurse expect to find when reviewing the laboratory test
results of a client with renal failure?
Decreased serum potassium level
Increased red blood cell count
Increased serum creatinine level
Increased serum calcium level
Anemia
Explanation:
Anemia develops as a result of inadequate erythropoietin production, the shortened lifespan of
RBCs, nutritional deficiencies, and the patient's tendency to bleed, particularly from the GI tract.
Erythropoietin, a substance normally produced by the kidneys, stimulates bone marrow to produce
RBCs (Murphy, Bennett, & Jenkins, 2010). In ESKD, erythropoietin production decreases and
profound anemia results, producing fatigue, angina, and shortness of breath. - ANS A patient with
chronic kidney failure experiences decreased levels of erythropoietin. What serious complication
related to those levels should the nurse assess for when caring for this patient?
Anemia
Acidosis
Hyperkalemia
Pericarditis
- ANS A client with a history of chronic renal failure receives hemodialysis treatments three times
per week through an arteriovenous (AV) fistula in the left arm. Which intervention should the nurse
include in the care plan?
, Keep the AV fistula site dry.
Keep the AV fistula wrapped in gauze.
Take the client's blood pressure in the left arm.
Assess the AV fistula for a bruit and thrill.
- ANS Which of the following is as integumentary manifestation of chronic renal failure?
Asterixis
Gray-brown skin color
Tremors
Seizures
- ANS The nurse is reviewing the potassium level of a patient with kidney disease. The results of the
test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention
does the nurse anticipate the physician will order to reduce the potassium level?
Administration of an insulin drip
Administration of a loop diuretic
Administration of sodium bicarbonate
Administration of sodium polystyrene sulfonate [Kayexalate])
- ANS A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this
disorder increases the client's risk of:
water and sodium retention secondary to a severe decrease in the glomerular filtration rate.
a decreased serum phosphate level secondary to kidney failure.
an increased serum calcium level secondary to kidney failure.
metabolic alkalosis secondary to retention of hydrogen ions.
- ANS Which of the following is used to decrease potassium level seen in acute renal failure?
Kayexalate
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