NMNC 3210 EXAM 2 QUESTIONS
WITH 100% CORRECT
ANSWERS | ALREADY PASSED
The nurse preparing to give a dose of calcium acetate to a patient with chronic kidney
disease (CKD). Which laboratory result will the nurse monitor to determine if the desired
effect was achieved?
-Sodium
-Potassium
-Magnesium
-Phosphorus - Answer- -Phosphorus
Rationale:
Phosphorus and calcium have inverse or reciprocal relationships, meaning that when
phosphorus levels are high, calcium levels tend to be low. Therefore, administration of
calcium should help to reduce a patient's abnormally high phosphorus level, as seen
with CKD. Calcium acetate will not have an effect on sodium, potassium, or magnesium
levels.
Which patient has the most significant risk factors for CKD?
-A 50-yr-old white woman with hypertension
-A 61-yr-old Native American man with diabetes
-A 28-yr-old black woman with a urinary tract infection
-A 40-yr-old Hispanic woman with cardiovascular disease - Answer- -A 61-yr-old Native
American man with diabetes
Rationale:
The nurse identifies the 61-year-old Native American with diabetes as the most at risk.
Diabetes causes about 50% of CKD. This patient is the oldest, and Native Americans
with diabetes develop CKD 6 times more frequently than other ethnic groups.
Hypertension causes about 25% of CKD. Hispanics have CKD about 1.5 times more
than non-Hispanics. Blacks have the highest rate of CKD because hypertension is
significantly increased in blacks. A UTI will not cause CKD unless it is not treated or
UTIs occur recurrently.
A patient is recovering in the intensive care unit (ICU) 24 hours after receiving a kidney
transplant. What is an expected assessment finding during the earliest stage of
recovery?
-Hypokalemia
,-Hyponatremia
-Large urine output
-Leukocytosis with cloudy urine output - Answer- -Large urine output
Rationale:
Patients often have diuresis in the hours and days immediately after a kidney transplant.
Electrolyte imbalances and signs of infection are unexpected findings that warrant
prompt intervention.
A patient with type 2 diabetes and chronic kidney disease has a serum potassium level
of 6.8 mEq/L. Which finding will the nurse monitor for?
-Fatigue
-Dysrhythmias
-Hypoglycemia
-Elevated triglycerides - Answer- -Dysrhythmias
Rationale:
Hyperkalemia is the most serious electrolyte disorder associated with kidney disease.
Fatal dysrhythmias can occur when the serum potassium level reaches 7 to 8 mEq/L.
Fatigue and hypertriglyceridemia may be present but do not require urgent intervention.
Hypoglycemia is a complication related to diabetes control, not hyperkalemia. However,
administration of insulin and dextrose is an emergency treatment for hyperkalemia.
A patient with end-stage renal disease (ESRD) secondary to diabetes has arrived at the
outpatient dialysis unit for hemodialysis. Which assessments should the nurse perform
as a priority before, during, and after the treatment?
-Level of consciousness
-Blood pressure and fluid balance
-Temperature, heart rate, and blood pressure
-Assessment for signs and symptoms of infection - Answer- -Blood pressure and fluid
balance
Rationale:
Although all the assessments are relevant to the care of a patient receiving
hemodialysis, fluid removal during the procedure will require monitoring blood pressure
and fluid balance prior, during, and after.
The home care nurse visits a patient receiving peritoneal dialysis. Which statement
indicates a need for immediate follow-up by the nurse?
-"Drain time is faster if I rub my abdomen."
-"The fluid draining from the catheter is cloudy."
-"The drainage is bloody when I have my period."
-"I wash around the catheter with soap and water." - Answer- -"The fluid draining from
the catheter is cloudy."
Rationale:
The primary manifestation of peritonitis is a cloudy peritoneal effluent. Blood may be
present in the effluent of women who are menstruating, and no intervention is indicated.
Daily catheter care may include washing around the catheter with soap and water. Drain
time may be facilitated by gently massaging the abdomen.
,The nurse is providing care for a patient admitted to the hospital for treatment of
nephrotic syndrome. What are the priority nursing assessments?
-Assessment of pain and level of consciousness
-Assessment of serum calcium and phosphorus levels
-Blood pressure and assessment for orthostatic hypotension
-Daily weights and measurement of the patient's abdominal girth - Answer- -Daily
weights and measurement of the patient's abdominal girth
Rationale:
Peripheral edema is characteristic of nephrotic syndrome, and a key nursing
responsibility in the care of patients with the disease is close monitoring of abdominal
girth, weights, and extremity size. Pain, level of consciousness, and orthostatic blood
pressure are less important in the care of patients with nephrotic syndrome. Abnormal
calcium and phosphorus levels are not commonly associated with the diagnosis of
nephrotic syndrome.
The nurse counsels a patient on dietary restrictions to prevent recurrent uric acid renal
calculi. Which foods should the patient avoid?
-Venison, crab, and liver
-Spinach, cabbage, and tea
-Milk, yogurt, and dried fruit
-Asparagus, lentils, and chocolate - Answer- -Venison, crab, and liver
Rationale:
Foods high in purines (e.g., venison, crab, liver) should be avoided to prevent uric acid
calculi formation. Foods high in calcium (e.g., milk, yogurt, dried fruit, lentils, chocolate)
should be avoided to prevent calcium calculi formation. Foods high in oxalate (e.g.,
spinach, cabbage, tea, asparagus, chocolate) should be avoided to prevent oxalate
calculi formation (see Table 45.12).
Which clinical manifestations of inflammatory bowel disease are common to both
patients with ulcerative colitis (UC) and Crohn's disease? (Select all that apply)
-Restricted to rectum
-Strictures are common
-Bloody, diarrhea stools
-Cramping abdominal pain
-Lesions penetrate intestine - Answer- -Bloody, diarrhea stools
-Cramping abdominal pain
Rationale:
Manifestations of UC and Crohn's disease include bloody diarrhea, cramping abdominal
pain, and nutritional disorders. Intestinal lesions associated with UC are usually
restricted to the rectum before moving into the colon. Lesions that penetrate the
intestine or cause strictures are characteristic of Crohn's disease.
, A patient after a stroke who primarily uses a wheelchair for mobility has developed
diarrhea with fecal incontinence. What is a priority assessment by the nurse?
-Fecal impaction
-Perineal hygiene
-Dietary fiber intake
-Antidiarrheal agent use - Answer- -Fecal impaction
Rationale:
Patients with limited mobility are at risk for fecal impactions caused by constipation that
may lead to liquid stool leaking around the hardened impacted feces, so assessing for
fecal impaction is the priority. Perineal hygiene can be assessed at the same time.
Assessing the dietary fiber and fluid intake and antidiarrheal agent use will be assessed
and considered next.
A patient is given a bisacodyl suppository and asks the nurse how long it will take to
work. What is the best response by the nurse?
-2 to 5 minutes
-15 to 60 minutes
-2 to 4 hours
-6 to 8 hours - Answer- -15 to 60 minutes
Rationale:
Bisacodyl suppositories usually are effective within 15 to 60 minutes of administration,
so the nurse should plan accordingly to assist the patient to use the bedpan or
commode.
The nurse is developing a plan of care for a patient with an abdominal mass and
suspected bowel obstruction. Which factor in the patient's history does the nurse
recognize as increasing the patient's risk for colorectal cancer?
-Osteoarthritis
-History of colorectal polyps
-History of lactose intolerance
-Use of herbs as dietary supplements - Answer- -History of colorectal polyps
Rationale:
A history of colorectal polyps places this patient at risk for colorectal cancer. This tissue
can degenerate over time and become malignant. Osteoarthritis, lactose intolerance,
and the use of herbs do not pose additional risk to the patient.
The nurse identifies that which patient is at highest risk for developing colon cancer?
-A 28-yr-old man who has a body mass index of 27 kg/m2
-A 32-yr-old woman with a 12-year history of ulcerative colitis
-A 52-yr-old man who has followed a vegetarian diet for 24 years
-A 58-yr-old woman taking prescribed estrogen replacement therapy - Answer- -A 32-yr-
old woman with a 12-year history of ulcerative colitis
Rationale:
WITH 100% CORRECT
ANSWERS | ALREADY PASSED
The nurse preparing to give a dose of calcium acetate to a patient with chronic kidney
disease (CKD). Which laboratory result will the nurse monitor to determine if the desired
effect was achieved?
-Sodium
-Potassium
-Magnesium
-Phosphorus - Answer- -Phosphorus
Rationale:
Phosphorus and calcium have inverse or reciprocal relationships, meaning that when
phosphorus levels are high, calcium levels tend to be low. Therefore, administration of
calcium should help to reduce a patient's abnormally high phosphorus level, as seen
with CKD. Calcium acetate will not have an effect on sodium, potassium, or magnesium
levels.
Which patient has the most significant risk factors for CKD?
-A 50-yr-old white woman with hypertension
-A 61-yr-old Native American man with diabetes
-A 28-yr-old black woman with a urinary tract infection
-A 40-yr-old Hispanic woman with cardiovascular disease - Answer- -A 61-yr-old Native
American man with diabetes
Rationale:
The nurse identifies the 61-year-old Native American with diabetes as the most at risk.
Diabetes causes about 50% of CKD. This patient is the oldest, and Native Americans
with diabetes develop CKD 6 times more frequently than other ethnic groups.
Hypertension causes about 25% of CKD. Hispanics have CKD about 1.5 times more
than non-Hispanics. Blacks have the highest rate of CKD because hypertension is
significantly increased in blacks. A UTI will not cause CKD unless it is not treated or
UTIs occur recurrently.
A patient is recovering in the intensive care unit (ICU) 24 hours after receiving a kidney
transplant. What is an expected assessment finding during the earliest stage of
recovery?
-Hypokalemia
,-Hyponatremia
-Large urine output
-Leukocytosis with cloudy urine output - Answer- -Large urine output
Rationale:
Patients often have diuresis in the hours and days immediately after a kidney transplant.
Electrolyte imbalances and signs of infection are unexpected findings that warrant
prompt intervention.
A patient with type 2 diabetes and chronic kidney disease has a serum potassium level
of 6.8 mEq/L. Which finding will the nurse monitor for?
-Fatigue
-Dysrhythmias
-Hypoglycemia
-Elevated triglycerides - Answer- -Dysrhythmias
Rationale:
Hyperkalemia is the most serious electrolyte disorder associated with kidney disease.
Fatal dysrhythmias can occur when the serum potassium level reaches 7 to 8 mEq/L.
Fatigue and hypertriglyceridemia may be present but do not require urgent intervention.
Hypoglycemia is a complication related to diabetes control, not hyperkalemia. However,
administration of insulin and dextrose is an emergency treatment for hyperkalemia.
A patient with end-stage renal disease (ESRD) secondary to diabetes has arrived at the
outpatient dialysis unit for hemodialysis. Which assessments should the nurse perform
as a priority before, during, and after the treatment?
-Level of consciousness
-Blood pressure and fluid balance
-Temperature, heart rate, and blood pressure
-Assessment for signs and symptoms of infection - Answer- -Blood pressure and fluid
balance
Rationale:
Although all the assessments are relevant to the care of a patient receiving
hemodialysis, fluid removal during the procedure will require monitoring blood pressure
and fluid balance prior, during, and after.
The home care nurse visits a patient receiving peritoneal dialysis. Which statement
indicates a need for immediate follow-up by the nurse?
-"Drain time is faster if I rub my abdomen."
-"The fluid draining from the catheter is cloudy."
-"The drainage is bloody when I have my period."
-"I wash around the catheter with soap and water." - Answer- -"The fluid draining from
the catheter is cloudy."
Rationale:
The primary manifestation of peritonitis is a cloudy peritoneal effluent. Blood may be
present in the effluent of women who are menstruating, and no intervention is indicated.
Daily catheter care may include washing around the catheter with soap and water. Drain
time may be facilitated by gently massaging the abdomen.
,The nurse is providing care for a patient admitted to the hospital for treatment of
nephrotic syndrome. What are the priority nursing assessments?
-Assessment of pain and level of consciousness
-Assessment of serum calcium and phosphorus levels
-Blood pressure and assessment for orthostatic hypotension
-Daily weights and measurement of the patient's abdominal girth - Answer- -Daily
weights and measurement of the patient's abdominal girth
Rationale:
Peripheral edema is characteristic of nephrotic syndrome, and a key nursing
responsibility in the care of patients with the disease is close monitoring of abdominal
girth, weights, and extremity size. Pain, level of consciousness, and orthostatic blood
pressure are less important in the care of patients with nephrotic syndrome. Abnormal
calcium and phosphorus levels are not commonly associated with the diagnosis of
nephrotic syndrome.
The nurse counsels a patient on dietary restrictions to prevent recurrent uric acid renal
calculi. Which foods should the patient avoid?
-Venison, crab, and liver
-Spinach, cabbage, and tea
-Milk, yogurt, and dried fruit
-Asparagus, lentils, and chocolate - Answer- -Venison, crab, and liver
Rationale:
Foods high in purines (e.g., venison, crab, liver) should be avoided to prevent uric acid
calculi formation. Foods high in calcium (e.g., milk, yogurt, dried fruit, lentils, chocolate)
should be avoided to prevent calcium calculi formation. Foods high in oxalate (e.g.,
spinach, cabbage, tea, asparagus, chocolate) should be avoided to prevent oxalate
calculi formation (see Table 45.12).
Which clinical manifestations of inflammatory bowel disease are common to both
patients with ulcerative colitis (UC) and Crohn's disease? (Select all that apply)
-Restricted to rectum
-Strictures are common
-Bloody, diarrhea stools
-Cramping abdominal pain
-Lesions penetrate intestine - Answer- -Bloody, diarrhea stools
-Cramping abdominal pain
Rationale:
Manifestations of UC and Crohn's disease include bloody diarrhea, cramping abdominal
pain, and nutritional disorders. Intestinal lesions associated with UC are usually
restricted to the rectum before moving into the colon. Lesions that penetrate the
intestine or cause strictures are characteristic of Crohn's disease.
, A patient after a stroke who primarily uses a wheelchair for mobility has developed
diarrhea with fecal incontinence. What is a priority assessment by the nurse?
-Fecal impaction
-Perineal hygiene
-Dietary fiber intake
-Antidiarrheal agent use - Answer- -Fecal impaction
Rationale:
Patients with limited mobility are at risk for fecal impactions caused by constipation that
may lead to liquid stool leaking around the hardened impacted feces, so assessing for
fecal impaction is the priority. Perineal hygiene can be assessed at the same time.
Assessing the dietary fiber and fluid intake and antidiarrheal agent use will be assessed
and considered next.
A patient is given a bisacodyl suppository and asks the nurse how long it will take to
work. What is the best response by the nurse?
-2 to 5 minutes
-15 to 60 minutes
-2 to 4 hours
-6 to 8 hours - Answer- -15 to 60 minutes
Rationale:
Bisacodyl suppositories usually are effective within 15 to 60 minutes of administration,
so the nurse should plan accordingly to assist the patient to use the bedpan or
commode.
The nurse is developing a plan of care for a patient with an abdominal mass and
suspected bowel obstruction. Which factor in the patient's history does the nurse
recognize as increasing the patient's risk for colorectal cancer?
-Osteoarthritis
-History of colorectal polyps
-History of lactose intolerance
-Use of herbs as dietary supplements - Answer- -History of colorectal polyps
Rationale:
A history of colorectal polyps places this patient at risk for colorectal cancer. This tissue
can degenerate over time and become malignant. Osteoarthritis, lactose intolerance,
and the use of herbs do not pose additional risk to the patient.
The nurse identifies that which patient is at highest risk for developing colon cancer?
-A 28-yr-old man who has a body mass index of 27 kg/m2
-A 32-yr-old woman with a 12-year history of ulcerative colitis
-A 52-yr-old man who has followed a vegetarian diet for 24 years
-A 58-yr-old woman taking prescribed estrogen replacement therapy - Answer- -A 32-yr-
old woman with a 12-year history of ulcerative colitis
Rationale:
