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Lewis Med-Surg Ch. 46 Acute Kidney Injury and CKD EXAM QUESTIONS AND CORRECT ANSWERS
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Lewis Med-Surg Ch. 46 Acute Kidney Injury and CKD EXAM QUESTIONS AND CORRECT ANSWERS
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Lewis Med-Surg Ch. 46 Acute Kidney Injury and CKD EXAM2024-2025 QUESTIONS AND CORRECT ANSWERS
A patient with diabetes who has bacterial pneumonia is being treated with IV gentamicin 60
mg IV BID. The nurse will monitor for adverse effects of the medication by evaluating the
patient's
a. blood glucose.
b. urine osmolality.
c. serum creatinine.
d. serum potassium. - answer>>>ANS: C
When a patient at risk for chronic kidney disease (CKD) receives a potentially nephrotoxic
medication, it is important to monitor renal function with BUN and creatinine levels. The
other laboratory values would not be useful in assessing for the adverse effects of the
gentamicin.
DIF: Cognitive Level: Apply (application) REF: 1083
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity
A 55-yr-old patient with end-stage kidney disease (ESKD) is scheduled to receive a
prescribed dose of epoetin alfa (Procrit). Which information should the nurse report to the
health care provider before giving the medication?
a. Creatinine 1.6 mg/dL
b. Oxygen saturation 89%
c. Hemoglobin level 13 g/dL
d. Blood pressure 98/56 mm Hg - answer>>>ANS: C
High hemoglobin levels are associated with a higher rate of thromboembolic events and
increased risk of death from serious cardiovascular events (heart attack, heart failure, stroke)
when erythropoietin (EPO) is administered to a target hemoglobin of greater than 12 g/dL.
Hemoglobin levels higher than 12 g/dL indicate a need for a decrease in epoetin alfa dose.
,The other information also will be reported to the health care provider but will not affect
whether the medication is administered.
DIF: Cognitive Level: Apply (application) REF: 1081
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
Which intervention will be included in the plan of care for a patient with acute kidney injury
(AKI) who has a temporary vascular access catheter in the left femoral vein?
a. Start continuous pulse oximetry.
b. Restrict physical activity to bed rest.
c. Restrict the patient's oral protein intake.
d. Discontinue the urethral retention catheter. - answer>>>ANS: B
The patient with a femoral vein catheter must be on bed rest to prevent trauma to the vein.
Protein intake is likely to be increased when the patient is receiving dialysis. The retention
catheter is likely to remain in place because accurate measurement of output will be needed.
There is no indication that the patient needs continuous pulse oximetry.
DIF: Cognitive Level: Apply (application) REF: 1088
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
A 25-yr-old male patient has been admitted with a severe crushing injury after an industrial
accident. Which laboratory result will be most important to report to the health care provider?
a. Serum creatinine level of 2.1 mg/dL
b. Serum potassium level of 6.5 mEq/L
c. White blood cell count of 11,500/μL
d. Blood urea nitrogen (BUN) of 56 mg/dL - answer>>>ANS: B
The hyperkalemia associated with crushing injuries may cause cardiac arrest and should be
treated immediately. The nurse also will report the other laboratory values, but abnormalities
in these are not immediately life threatening.
, DIF: Cognitive Level: Analyze (analysis) REF: 1072
OBJ: Special Questions: Prioritization TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
A 72-yr-old patient with a history of benign prostatic hyperplasia (BPH) is admitted with
acute urinary retention and elevated blood urea nitrogen (BUN) and creatinine levels. Which
prescribed therapy should the nurse implement first?
a. Insert urethral catheter.
b. Obtain renal ultrasound.
c. Draw a complete blood count.
d. Infuse normal saline at 50 mL/hour. - answer>>>ANS: A
The patient's elevation in BUN is most likely associated with hydronephrosis caused by the
acute urinary retention, so the insertion of a retention catheter is the first action to prevent
ongoing postrenal failure for this patient. The other actions also are appropriate but should be
implemented after the retention catheter.
DIF: Cognitive Level: Analyze (analysis) REF: 1071
OBJ: Special Questions: Prioritization TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
A 62-yr-old female patient has been hospitalized for 4 days with acute kidney injury (AKI)
caused by dehydration. Which information will be most important for the nurse to report to
the health care provider?
a. The creatinine level is 3.0 mg/dL.
b. Urine output over an 8-hour period is 2500 mL.
c. The blood urea nitrogen (BUN) level is 67 mg/dL.
d. The glomerular filtration rate is less than 30 mL/min/1.73 m2 - answer>>>ANS: B
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