Question 1

The nurse is caring for a child who weighs 33 lb and has been diagnosed with dehydration.The healthcare provider's orders state that the child is to receive 50 mL/kg of oral fluids for the next 4 hours.How many total mL of fluid should the nurse provide to the client? Calculate to the nearest whole number.
________ mL

Accepted Answer

The answer of The nurse is caring for a child...

Question 2

Which statement is true?

Accepted Answer

A) A dehydrated client would be considered to be in a hypotonic state because the client would have a lower concentration of solutes in the body in relation to water. 
B) A dehydrated client would be considered to be in a hypertonic state because the client would have a lower concentration of solutes in the body in relation to water. 
C) A dehydrated client would be considered to be in a hypotonic state because the client would have a higher concentration of solutes in the body in relation to water. 
D) A dehydrated client would be considered to be in a hypertonic state because the client would have a higher concentration of solutes in the body in relation to water.

Question 3

A client diagnosed with acute kidney injury (AKI)is receiving peritoneal dialysis.The nurse is explaining the dialysis process to the client and family.Which statement should the nurse include in this discussion?

Accepted Answer

A) "The peritoneum is more permeable because of the presence of excess metabolites." 
B) "The metabolites will diffuse from the interstitial space to the bloodstream mainly through diffusion and ultrafiltration." 
C) "The peritoneum acts as a semipermeable membrane through which wastes move by diffusion and osmosis." 
D) "The solutes in the dialysate will enter the bloodstream through the peritoneum."

Question 4

The nurse is caring for a client with a potassium level of 5.9 mEq/L.The healthcare provider prescribes both glucose and insulin for the client.The client's spouse asks,"Why is insulin needed?" Which response by the nurse is the most appropriate?

Accepted Answer

A) "The insulin will cause extra potassium to move into his cells,which will lower the potassium level in the blood." 
B) "Insulin is safer than other medications that can lower potassium levels." 
C) "The insulin lowers his blood sugar levels and causes the extra potassium to be excreted." 
D) "The insulin will help his kidneys excrete the extra potassium."

Question 5

A client with acute kidney failure is complaining of a metallic taste in the mouth and has no appetite.Based on this data,which intervention by the nurse is the most appropriate?

Accepted Answer

A) Provide mouth care before meals. 
B) Administer an antiemetic as prescribed. 
C) Restrict fluids. 
D) Encourage the intake of protein,salt,and potassium.

Question 6

The nurse is preparing to discharge a client diagnosed with chronic kidney disease (CKD).The nurse is teaching the client and family about administering calcium acetate tablets by mouth with each meal at home.Which explanation about this medication is most appropriate for the nurse to include?

Accepted Answer

A) "The calcium acetate will lower your serum phosphate levels." 
B) "The calcium acetate helps neutralize your gastric acids." 
C) "The calcium acetate will help stimulate your appetite." 
D) "The calcium acetate will decrease your serum creatinine levels."

Question 7

The nurse is preparing to administer a hemodialysis treatment for a client diagnosed with chronic kidney disease (CKD).Which laboratory values should the nurse anticipate prior to the client's treatment? Select all that apply.

Accepted Answer

A) Increased blood urea nitrogen (BUN) 
B) Decreased potassium 
C) Decreased phosphorus 
D) Increased urine osmolality 
E) Increased creatinine

Question 8

A client diagnosed with acute kidney injury (AKI)has jugular vein distention,lower extremity edema,and elevated blood pressure.Based on this data,which nursing diagnosis is most appropriate?

Accepted Answer

A) Ineffective Renal Tissue Perfusion 
B) Excess Fluid Volume 
C) Risk for Decreased Cardiac Tissue Perfusion 
D) Risk for Infection

Question 9

Which of the following terms refers to severe,generalized edema,which may occur as a result of fluid volume excess?

Accepted Answer

A) Ascites 
B) Anasarca 
C) Hypervolemia 
D) Orthopnea

Question 10

The nurse is caring for a client diagnosed with chronic kidney disease (CKD)who is pale and experiencing fatigue.The nurse attributes these symptoms to anemia secondary to CKD.The client's spouse asks why the client is anemic.Which response by the nurse is the most appropriate?

Accepted Answer

A) "Your spouse has a genetic tendency for the development of anemia." 
B) "The increased metabolic waste products in your spouse's body depress the bone marrow and cause anemia." 
C) "Your spouse's kidneys are producing reduced amounts of the hormone erythropoietin,and this is the cause of the anemia." 
D) "Your spouse is not eating enough iron-rich foods,and this has led to anemia."

Question 11

A young school-age client is in the hospital with an acute kidney injury diagnosis following a streptococcus infection.The client's parents primarily speak Spanish but have a limited ability to understand English.Through an interpreter,the parents ask the nurse what mistake they made that caused their child to be so sick.Which response by the nurse is the most appropriate?

Accepted Answer

A) "Your child does not eat enough dietary protein." 
B) "Your child has a congenital defect that led to renal failure." 
C) "Your child's renal failure has been caused by a low calcium level." 
D) "Your child's recent infection may have caused the renal failure."

Question 12

A client diagnosed with heart failure is prescribed an oral fluid restriction of 1200 mL per day.How many ounces of fluid would the client be permitted during the day shift?

Accepted Answer

A) 200 mL 
B) 300 mL 
C) 400 mL 
D) 600 mL

Question 13

A client diagnosed with acute kidney injury (AKI)will be discharged to home in the next few days.When conducting dietary instruction,the nurse should teach the client to choose proteins that are high in biological value.Which client statement indicates that this teaching has been effective?

Accepted Answer

A) "I will be sure to include eggs in my diet." 
B) "I should include vegetables at every meal." 
C) "Legumes should be included in my diet,because they are complete proteins." 
D) "I will eat nuts daily because they are high in protein."

Question 14

The nurse is teaching a group of children and their parents about the prevention of heat-related illness during exercise.Which statement by a parent indicates an appropriate understanding of the preventive techniques taught during the session?

Accepted Answer

A) "It is important for my child to wear dark clothing while exercising in the heat." 
B) "Water is the drink of choice to replenish fluids that are lost during exercise." 
C) "My child only needs to hydrate at the end of an exercise session." 
D) "I will have my child stop every 15 to 20 minutes during physical activity to drink fluids."

Question 15

Why is development of Kussmaul respirations problematic in a client with chronic kidney disease (CKD)?

Accepted Answer

A) It suggests the client is experiencing metabolic acidosis. 
B) It suggests the client is dehydrated. 
C) It suggests the client is hypotensive. 
D) It suggests the client is experiencing proteinuria.

Question 16

Which symptom suggests that a client is entering the maintenance phase of acute kidney injury (AKI)?

Accepted Answer

A) Onset of metabolic acidosis 
B) Onset of diuresis 
C) Increase in glomerular filtration rate 
D) Decrease in serum potassium levels

Question 17

A pediatric nurse is assigned phone triage for the shift.The nurse takes a call from the mother of a 3-month-old infant.The mother tells the nurse that the child has been vomiting and experiencing diarrhea for several days.Based on this information,which response by the nurse is most appropriate?

Accepted Answer

A) "You should bring the infant in to be seen by the doctor." 
B) "Give your baby at least 2 ounces of juice every 2 hours." 
C) "Give your baby 50 mL of glucose water every hour." 
D) "Measure your baby's urine output for 24 hours and call back tomorrow."

Question 18

The nurse is caring for a client from another country who was admitted to the hospital with a diagnosis of hypertension and chronic kidney disease.The client is receiving hemodialysis three times a week.When the nurse inquires about diet,the client reports the use of salt substitutes.Why should the nurse teach the client to avoid these products?

Accepted Answer

A) They will increase the risk of AV fistula infection. 
B) They will cause the client to retain fluid. 
C) They will interact with the client's antihypertensive medications. 
D) They can contribute to hyperkalemia.

Question 19

The nurse identifies the diagnosis Risk for Impaired Skin Integrity as applicable for a client diagnosed with heart failure.Which assessment finding supports the use of this diagnosis for the client?

Accepted Answer

A) Shortness of breath with ambulation 
B) Productive cough 
C) +3 pitting edema both feet 
D) Heart rate 104 and regular

Question 20

The nurse instructs a client diagnosed with chronic kidney disease (CKD)regarding the prescribed medication furosemide (Lasix).Which client statement indicates that the teaching has been effective?

Accepted Answer

A) "I will take this medication to keep my calcium balance normal." 
B) "This medication will make sure I have enough red blood cells in my body." 
C) "I will take this pill to keep my protein level in my body stable." 
D) "This pill will reduce the swelling in my body and get rid of the extra potassium."

Exam 6: Fluids and Electrolytes

Which statement is true?

A client diagnosed with acute kidney injury (AKI) is receiving peritoneal dialysis.The nurse is explaining the dialysis process to the client and family.Which statement should the nurse include in this discussion?

The nurse is caring for a client with a potassium level of 5.9 mEq/L.The healthcare provider prescribes both glucose and insulin for the client.The client's spouse asks,"Why is insulin needed?" Which response by the nurse is the most appropriate?

A client with acute kidney failure is complaining of a metallic taste in the mouth and has no appetite.Based on this data,which intervention by the nurse is the most appropriate?

The nurse is preparing to discharge a client diagnosed with chronic kidney disease (CKD) .The nurse is teaching the client and family about administering calcium acetate tablets by mouth with each meal at home.Which explanation about this medication is most appropriate for the nurse to include?

The nurse is preparing to administer a hemodialysis treatment for a client diagnosed with chronic kidney disease (CKD) .Which laboratory values should the nurse anticipate prior to the client's treatment? Select all that apply.

A client diagnosed with acute kidney injury (AKI) has jugular vein distention,lower extremity edema,and elevated blood pressure.Based on this data,which nursing diagnosis is most appropriate?

Which of the following terms refers to severe,generalized edema,which may occur as a result of fluid volume excess?

The nurse is caring for a client diagnosed with chronic kidney disease (CKD) who is pale and experiencing fatigue.The nurse attributes these symptoms to anemia secondary to CKD.The client's spouse asks why the client is anemic.Which response by the nurse is the most appropriate?

A client diagnosed with heart failure is prescribed an oral fluid restriction of 1200 mL per day.How many ounces of fluid would the client be permitted during the day shift?

A client diagnosed with acute kidney injury (AKI) will be discharged to home in the next few days.When conducting dietary instruction,the nurse should teach the client to choose proteins that are high in biological value.Which client statement indicates that this teaching has been effective?

The nurse is teaching a group of children and their parents about the prevention of heat-related illness during exercise.Which statement by a parent indicates an appropriate understanding of the preventive techniques taught during the session?

Why is development of Kussmaul respirations problematic in a client with chronic kidney disease (CKD) ?

Which symptom suggests that a client is entering the maintenance phase of acute kidney injury (AKI) ?

A pediatric nurse is assigned phone triage for the shift.The nurse takes a call from the mother of a 3-month-old infant.The mother tells the nurse that the child has been vomiting and experiencing diarrhea for several days.Based on this information,which response by the nurse is most appropriate?

The nurse identifies the diagnosis Risk for Impaired Skin Integrity as applicable for a client diagnosed with heart failure.Which assessment finding supports the use of this diagnosis for the client?

The nurse instructs a client diagnosed with chronic kidney disease (CKD) regarding the prescribed medication furosemide (Lasix) .Which client statement indicates that the teaching has been effective?