N321: Final Exam - Med Surg Review Exam
With Complete Solutions
A client with renal failure is receiving epoetin alfa (Epogen) to support
erythropoiesis. The nurse questions the client about compliance with taking
which of the following medications that supports red blood cell (RBC)
production?
a) iron supplement
b) zinc supplement
c) calcium supplement
d) magnesium supplement - ANSWER a) iron supplement
The client with acute renal failure has a serum potassium of 6.0 mEq/L. The
nurse would plan which of the following as a priority action?
a) check the sodium level
b) place the client on a cardiac monitor
c) encourage increased vegetables in the diet
d) allow an extra 500 ml of fluid intake to dilute the electrolyte concentration -
ANSWER b) place the client on a cardiac monitor
Which of the following should be considered in the diet of the client with end-
stage-renal-disease (ESRD)?
a) limit fluid intake during anuric phase
b) limit phosphorus and vitamin D-rich food
c) limit calcium-rich food
d) limit carbohydrates - ANSWER a) limit fluid intake during anuric phase
R: Fluid intake of the client should be limited during anuric phase to prevent fluid
overload. Fluid overload increases renal workload, pulmonary edema, and
congestive heart failure.
The nurse instructs a client with renal failure who is receiving hemodialysis
about dietary modifications. The nurse determines that the client understands
these dietary modifications if the client selects which items from the dietary
menu?
a) cream of wheat, blueberries, coffee
b) sausage and eggs, banana, orange juice
, c) bacon, cantaloupe melon, tomato juice
d) cured pork, strawberries, orange juice - ANSWER a) cream of wheat,
blueberries, coffee
R: The diet for a client with renal failure who is receiving hemodialysis should
include controlled amounts of sodium, phosphorus, calcium, potassium, and
fluids. Option B, C, and D are high in sodium, phosphorus, and potassium.
Which of the following may be included in the diet of the client with chronic renal
failure?
a) orange slices
b) watermelon slices
c) cantaloupe slices
d) apple slices - ANSWER d) apple slices
R: The client with renal failure should be given low potassium diet because of
hyperkalemia. Apple contains very little potassium. So, it can be given to the
client.
Which of the following is an expected finding in the client with chronic renal
failure?
a) anemia
b) polyuria
c) increased creatinine clearance
d) increased serum calcium levels - ANSWER a) anemia
In the oliguric phase of renal failure, what is the most appropriate nursing
diagnosis?
a) fluid volume deficit
b) activity intolerance
c) ineffective breathing pattern
d) fluid volume excess - ANSWER d) fluid volume excess
A patient with acute renal failure (ARF) has an arterial blood pH of 7.30. The
nurse will assess the patient for
a. tachycardia.
b. rapid respirations.
c. poor skin turgor.
d. vasodilation. - ANSWER b. rapid respirations.
R: Patients with metabolic acidosis caused by ARF may have Kussmaul
respirations as the lungs try to regulate carbon dioxide. Tachycardia and
With Complete Solutions
A client with renal failure is receiving epoetin alfa (Epogen) to support
erythropoiesis. The nurse questions the client about compliance with taking
which of the following medications that supports red blood cell (RBC)
production?
a) iron supplement
b) zinc supplement
c) calcium supplement
d) magnesium supplement - ANSWER a) iron supplement
The client with acute renal failure has a serum potassium of 6.0 mEq/L. The
nurse would plan which of the following as a priority action?
a) check the sodium level
b) place the client on a cardiac monitor
c) encourage increased vegetables in the diet
d) allow an extra 500 ml of fluid intake to dilute the electrolyte concentration -
ANSWER b) place the client on a cardiac monitor
Which of the following should be considered in the diet of the client with end-
stage-renal-disease (ESRD)?
a) limit fluid intake during anuric phase
b) limit phosphorus and vitamin D-rich food
c) limit calcium-rich food
d) limit carbohydrates - ANSWER a) limit fluid intake during anuric phase
R: Fluid intake of the client should be limited during anuric phase to prevent fluid
overload. Fluid overload increases renal workload, pulmonary edema, and
congestive heart failure.
The nurse instructs a client with renal failure who is receiving hemodialysis
about dietary modifications. The nurse determines that the client understands
these dietary modifications if the client selects which items from the dietary
menu?
a) cream of wheat, blueberries, coffee
b) sausage and eggs, banana, orange juice
, c) bacon, cantaloupe melon, tomato juice
d) cured pork, strawberries, orange juice - ANSWER a) cream of wheat,
blueberries, coffee
R: The diet for a client with renal failure who is receiving hemodialysis should
include controlled amounts of sodium, phosphorus, calcium, potassium, and
fluids. Option B, C, and D are high in sodium, phosphorus, and potassium.
Which of the following may be included in the diet of the client with chronic renal
failure?
a) orange slices
b) watermelon slices
c) cantaloupe slices
d) apple slices - ANSWER d) apple slices
R: The client with renal failure should be given low potassium diet because of
hyperkalemia. Apple contains very little potassium. So, it can be given to the
client.
Which of the following is an expected finding in the client with chronic renal
failure?
a) anemia
b) polyuria
c) increased creatinine clearance
d) increased serum calcium levels - ANSWER a) anemia
In the oliguric phase of renal failure, what is the most appropriate nursing
diagnosis?
a) fluid volume deficit
b) activity intolerance
c) ineffective breathing pattern
d) fluid volume excess - ANSWER d) fluid volume excess
A patient with acute renal failure (ARF) has an arterial blood pH of 7.30. The
nurse will assess the patient for
a. tachycardia.
b. rapid respirations.
c. poor skin turgor.
d. vasodilation. - ANSWER b. rapid respirations.
R: Patients with metabolic acidosis caused by ARF may have Kussmaul
respirations as the lungs try to regulate carbon dioxide. Tachycardia and
