Question 1

The nurse is analyzing the intake and output record for a client being treated for dehydration.The client weighs 176 lb and had a 24-hour intake of 2000 mL and urine output of 1200 mL.Based on this data,which conclusion by the nurse is the most appropriate?

Accepted Answer

A) Treatment needs to include a diuretic. 
B) Treatment has not been effective. 
C) Treatment is effective and should continue. 
D) Treatment has been effective and should end.

Question 2

During a home visit,the nurse is concerned that an older adult client is developing chronic kidney disease (CKD).The client has no history of cardiovascular disease.Which data in the client's assessment caused the nurse to have this concern? Select all that apply.

Accepted Answer

A) Progressive edema 
B) Complaints of hip joint pain 
C) New onset of hypertension 
D) Recent increase in hunger and thirst 
E) Warm moist skin

Question 3

The nurse is planning care for a client admitted with a diagnosis of heart failure.Based on this diagnosis,which type of kidney failure is the client at an increased risk for experiencing?

Accepted Answer

A) Prerenal hypovolemia 
B) Intrarenal glomerular injury 
C) Intrarenal acute tubular necrosis 
D) Prerenal low cardiac output

Question 4

The nurse is administering peritoneal dialysis to a client with a diagnosis of chronic kidney disease (CKD).The nurse notes the presence of a cloudy dialysate return.After notifying the healthcare provider,which action by the nurse is the most appropriate and of highest priority?

Accepted Answer

A) Measure the client's abdominal girth. 
B) Document the cloudy dialysate. 
C) Culture the dialysate return. 
D) Increase dialysate instillation.

Question 5

Which laboratory finding is suggestive of chronic kidney disease?

Accepted Answer

A) Increase in creatinine clearance 
B) Decrease in serum sodium 
C) Increase in hematocrit 
D) Decrease in BUN

Question 6

The nurse is reviewing laboratory values for a female client suspected of having a fluid imbalance.Which laboratory value should indicate a diagnosis of dehydration to the nurse?

Accepted Answer

A) Serum osmolality 230 mOsm/kg 
B) Hematocrit 30% 
C) Hematocrit 53% 
D) Serum potassium 3.8 mEq/L

Question 7

The nurse on a medical-surgical unit completes the shift assessment for a client diagnosed with a multisystem fluid volume deficit.In the assessment,the nurse documents that the client is experiencing tachycardia,decreased urine output,and pale,cool skin.Based on this information,which should the nurse anticipate as the cause of the client's current symptoms?

Accepted Answer

A) Natural compensatory mechanisms 
B) Cardiac failure 
C) Pharmacological effects of a diuretic 
D) Rapidly infused intravenous fluids

Question 8

The nurse receives a shift report on a pediatric medical-surgical unit.The nurse has been assigned four clients for the shift.Which client should the nurse plan to assess first based on an increased risk for dehydration?

Accepted Answer

A) A 4-year-old child with a broken leg 
B) A 15-month-old child with tachypnea 
C) A 16-year-old child with migraine headaches 
D) A 10-year-old child with cellulitis of the left leg

Question 9

The nurse is caring for a client who is receiving intravenous fluids postoperatively following cardiac surgery.The nurse is aware that this client is at risk for fluid volume excess.The family asks why the client is at risk for this condition.Which response by the nurse is the most appropriate?

Accepted Answer

A) "Fluid volume excess commonly occurs due to new onset liver failure caused by the surgery." 
B) "Fluid volume excess is frequently caused by the administration of intravenous fluids." 
C) "Fluid volume excess is common due to increased levels of antidiuretic hormone in response to the stress of surgery." 
D) "Fluid volume excess is frequently caused by inactivity."

Question 10

A client agrees to receive long-term hemodialysis to treat acute kidney injury (AKI).Based on this information,the nurse should prepare the client for which surgical procedure?

Accepted Answer

A) Insertion of a double-lumen catheter into the subclavian artery 
B) Placement of a peritoneal catheter 
C) Insertion of a subarachnoid-peritoneal shunt 
D) Placement of an arteriovenous fistula

Question 11

The nurse is planning care for a client diagnosed with chronic kidney disease (CKD)and osteoporosis.Based on this information,which should be the nurse's priority diagnosis for this client?

Accepted Answer

A) Anxiety 
B) Disturbed Body Image 
C) Risk for Injury 
D) Risk for Bleeding

Question 12

The nurse is reviewing the lab values for a client being cared for on the unit.The client's phosphorus level is currently 2.0 mg/dL.Based on this data,which nursing intervention is most appropriate for the nurse to implement?

Accepted Answer

A) Enforce contact precautions. 
B) Encourage consumption of a high-calorie carbohydrate diet. 
C) Strain all urine. 
D) Encourage consumption of milk and yogurt.

Question 13

A nurse is evaluating whether the drug sodium polystyrene sulfonate (Kayexalate)is exerting the desired therapeutic effect for a client diagnosed with chronic kidney disease (CKD).Which therapeutic effect should the nurse anticipate from this medication?

Accepted Answer

A) Increased serum sodium 
B) Increased stool excretion 
C) Decreased urine specific gravity 
D) Decreased serum potassium

Question 14

What is the most frequent complication during hemodialysis?

Accepted Answer

A) Hemorrhage 
B) Hypotension 
C) Localized infection 
D) Hypertension

Exam 6: Fluids and Electrolytes

The nurse is analyzing the intake and output record for a client being treated for dehydration.The client weighs 176 lb and had a 24-hour intake of 2000 mL and urine output of 1200 mL.Based on this data,which conclusion by the nurse is the most appropriate?

During a home visit,the nurse is concerned that an older adult client is developing chronic kidney disease (CKD) .The client has no history of cardiovascular disease.Which data in the client's assessment caused the nurse to have this concern? Select all that apply.

The nurse is planning care for a client admitted with a diagnosis of heart failure.Based on this diagnosis,which type of kidney failure is the client at an increased risk for experiencing?

The nurse is administering peritoneal dialysis to a client with a diagnosis of chronic kidney disease (CKD) .The nurse notes the presence of a cloudy dialysate return.After notifying the healthcare provider,which action by the nurse is the most appropriate and of highest priority?

Which laboratory finding is suggestive of chronic kidney disease?

The nurse is reviewing laboratory values for a female client suspected of having a fluid imbalance.Which laboratory value should indicate a diagnosis of dehydration to the nurse?

The nurse receives a shift report on a pediatric medical-surgical unit.The nurse has been assigned four clients for the shift.Which client should the nurse plan to assess first based on an increased risk for dehydration?

The nurse is caring for a client who is receiving intravenous fluids postoperatively following cardiac surgery.The nurse is aware that this client is at risk for fluid volume excess.The family asks why the client is at risk for this condition.Which response by the nurse is the most appropriate?

A client agrees to receive long-term hemodialysis to treat acute kidney injury (AKI) .Based on this information,the nurse should prepare the client for which surgical procedure?

The nurse is planning care for a client diagnosed with chronic kidney disease (CKD) and osteoporosis.Based on this information,which should be the nurse's priority diagnosis for this client?

The nurse is reviewing the lab values for a client being cared for on the unit.The client's phosphorus level is currently 2.0 mg/dL.Based on this data,which nursing intervention is most appropriate for the nurse to implement?

A nurse is evaluating whether the drug sodium polystyrene sulfonate (Kayexalate) is exerting the desired therapeutic effect for a client diagnosed with chronic kidney disease (CKD) .Which therapeutic effect should the nurse anticipate from this medication?

What is the most frequent complication during hemodialysis?