Question 1

A client is admitted to the emergency department for vomiting and diarrhea that has lasted 4 days. The client's current weight is 154 pounds. The healthcare provider has diagnosed the client with a viral infection. The nurse has been monitoring intravenous fluids and urine output. Which urinary output would indicate that efforts to rehydrate this client have been successful?

Accepted Answer

A) 40 mL per hour 
B) 20 mL per hour 
C) 25 mL per hour 
D) 30 mL per hour

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 caring for a client admitted with a diagnosis of acute kidney injury (AKI). The client asks the nurse, "Are my kidneys failing? Will I need a kidney transplant?" Which response by the nurse is the most appropriate?

Accepted Answer

A) "No, don't think that. You're going to be fine." 
B) "In most cases, your condition can be reversed with prompt treatment and usually will not destroy the kidneys." 
C) "Kidney transplantation is highly likely, so it would be a good idea to start talking to your family members about organ donation." 
D) "When the doctor comes to see you, we can talk about whether you will need a transplant."

Question 4

A client with a diagnosis of chronic kidney disease (CKD)is experiencing manifestations of anemia. Based on this data, which treatment should the nurse anticipate for this client?

Accepted Answer

A) Begin fluid restriction. 
B) Administer intravenous glucose and insulin. 
C) Begin a low-sodium diet. 
D) Administer epoetin injections.

Question 5

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 6

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 7

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 8

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 9

The nurse is caring for a client diagnosed with heart failure who is admitted to the medical-surgical unit with acute hypokalemia. Which drug on the client's medication administration record may have contributed to the client's current hypokalemic state?

Accepted Answer

A) Demerol 
B) Cortisol 
C) Hydrochlorothiazide 
D) Skelaxin

Question 10

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 11

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 12

The nurse is providing care to a client who is exhibiting clinical manifestations of a severe fluid and electrolyte imbalance. Based on this data, which of the following orders should the nurse anticipate from the healthcare provider? Select all that apply.

Accepted Answer

A) Initiate intravenous therapy. 
B) Initiate hypodermoclysis. 
C) Administer antibiotics. 
D) Administer diuretics. 
E) Administer red blood cells.

Question 13

Which of the following lab values is indicative of hypokalemia?

Accepted Answer

A) Serum potassium of 3.25 mEq/L 
B) Serum potassium of 5.45 mEq/L 
C) Serum sodium of 125 mEq/L 
D) Serum sodium of 155 mEq/L

Question 14

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 15

Which stage of chronic kidney disease is characterized by hypertension, anemia, malnutrition, altered bone metabolism, metabolic acidosis, and a severely decreased glomerular filtration rate?

Accepted Answer

A) Stage 1 
B) Stage 2 
C) Stage 3 
D) Stage 4

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

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 18

While caring for a client diagnosed with end-stage renal disease (ESRD), the nurse tracks the client's serum albumin level. For which nursing diagnosis is this action most indicated?

Accepted Answer

A) Excess Fluid Volume 
B) Imbalanced Nutrition: Less than Body Requirements 
C) Risk for Ineffective Perfusion 
D) Risk for Infection

Question 19

The nurse is caring for an older adult client who is receiving intravenous fluids at 150 mL/hr. Upon assessment, the nurse notes crackles, shortness of breath, and jugular vein distention. Based on this data, which complication of IV fluid therapy does the nurse anticipate?

Accepted Answer

A) Speed shock 
B) Fluid volume excess 
C) Pulmonary embolism 
D) An allergic reaction

Question 20

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

Exam 6: Fluids and Electrolytes

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 caring for a client admitted with a diagnosis of acute kidney injury (AKI) . The client asks the nurse, "Are my kidneys failing? Will I need a kidney transplant?" Which response by the nurse is the most appropriate?

A client with a diagnosis of chronic kidney disease (CKD) is experiencing manifestations of anemia. Based on this data, which treatment should the nurse anticipate for this client?

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?

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.