NR324/NR 324 Exam 3 V3 | Adult Health I
Q&A with Rationale | Chamberlain
University
1. A patient with Chronic Kidney Disease (CKD) is prescribed a low-protein diet. What is the
primary rationale for this dietary restriction?
A. To prevent the buildup of nitrogenous waste products
B. To reduce the risk of developing hyperkalemia
C. To decrease the amount of sodium retention
D. To promote the excretion of phosphate in the urine
Correct Answer: A
Rationale: The metabolism of protein produces urea and other nitrogenous wastes that
the kidneys must filter. In CKD, the kidneys are unable to effectively clear these toxins,
leading to uremia. Limiting protein intake helps reduce the workload on the kidneys and
minimizes the accumulation of these harmful substances.
2. A nurse is assessing a patient’s arteriovenous (AV) fistula for hemodialysis. Which finding
should the nurse report to the provider immediately?
A. Absence of a thrill or bruit
B. An audible bruit upon auscultation
C. A palpable thrill over the site
,D. Slight redness at the needle insertion site
Correct Answer: A
Rationale: A thrill and a bruit are normal findings that indicate the AV fistula is patent and
functioning correctly. The absence of these signs suggests that the fistula has clotted or is
obstructed. This is a medical emergency for a dialysis patient and must be reported
immediately to prevent loss of the access site.
3. A patient is receiving peritoneal dialysis and the nurse notes that the returned dialysate is
cloudy. What should the nurse suspect?
A. The patient has consumed too much protein
B. The patient is developing peritonitis
C. The dialysate was infused too rapidly
D. This is a normal finding for the first week
Correct Answer: B
Rationale: Cloudy or opaque effluent is one of the earliest signs of peritonitis in a patient
performing peritoneal dialysis. This condition is a serious complication caused by infection
within the peritoneal cavity. The nurse should also assess for abdominal pain, rebound
tenderness, and fever.
4. Which laboratory result is the most sensitive indicator of acute kidney injury (AKI)?
A. Serum Creatinine
, B. Blood Urea Nitrogen (BUN)
C. Urine Specific Gravity
D. Serum Potassium
Correct Answer: A
Rationale: Serum creatinine is a byproduct of muscle metabolism and is excreted almost
entirely by the kidneys. An increase in serum creatinine levels is a reliable and specific
indicator of declining renal function. BUN can be affected by dehydration or diet, making it
less specific than creatinine.
5. A patient with a history of calcium oxalate kidney stones is being discharged. Which dietary
instruction is most appropriate?
A. Increase intake of spinach and rhubarb
B. Increase fluid intake to at least 2 to 3 liters per day
C. Maintain a high-sodium diet to promote dilute urine
D. Restrict all calcium-rich foods from the diet
Correct Answer: B
Rationale: High fluid intake is the most important intervention to prevent the recurrence
of any type of kidney stone by keeping urine dilute. Restricting calcium is often
counterproductive as it can lead to increased oxalate absorption in the gut. Patients should
specifically avoid high-oxalate foods like spinach and rhubarb.
Q&A with Rationale | Chamberlain
University
1. A patient with Chronic Kidney Disease (CKD) is prescribed a low-protein diet. What is the
primary rationale for this dietary restriction?
A. To prevent the buildup of nitrogenous waste products
B. To reduce the risk of developing hyperkalemia
C. To decrease the amount of sodium retention
D. To promote the excretion of phosphate in the urine
Correct Answer: A
Rationale: The metabolism of protein produces urea and other nitrogenous wastes that
the kidneys must filter. In CKD, the kidneys are unable to effectively clear these toxins,
leading to uremia. Limiting protein intake helps reduce the workload on the kidneys and
minimizes the accumulation of these harmful substances.
2. A nurse is assessing a patient’s arteriovenous (AV) fistula for hemodialysis. Which finding
should the nurse report to the provider immediately?
A. Absence of a thrill or bruit
B. An audible bruit upon auscultation
C. A palpable thrill over the site
,D. Slight redness at the needle insertion site
Correct Answer: A
Rationale: A thrill and a bruit are normal findings that indicate the AV fistula is patent and
functioning correctly. The absence of these signs suggests that the fistula has clotted or is
obstructed. This is a medical emergency for a dialysis patient and must be reported
immediately to prevent loss of the access site.
3. A patient is receiving peritoneal dialysis and the nurse notes that the returned dialysate is
cloudy. What should the nurse suspect?
A. The patient has consumed too much protein
B. The patient is developing peritonitis
C. The dialysate was infused too rapidly
D. This is a normal finding for the first week
Correct Answer: B
Rationale: Cloudy or opaque effluent is one of the earliest signs of peritonitis in a patient
performing peritoneal dialysis. This condition is a serious complication caused by infection
within the peritoneal cavity. The nurse should also assess for abdominal pain, rebound
tenderness, and fever.
4. Which laboratory result is the most sensitive indicator of acute kidney injury (AKI)?
A. Serum Creatinine
, B. Blood Urea Nitrogen (BUN)
C. Urine Specific Gravity
D. Serum Potassium
Correct Answer: A
Rationale: Serum creatinine is a byproduct of muscle metabolism and is excreted almost
entirely by the kidneys. An increase in serum creatinine levels is a reliable and specific
indicator of declining renal function. BUN can be affected by dehydration or diet, making it
less specific than creatinine.
5. A patient with a history of calcium oxalate kidney stones is being discharged. Which dietary
instruction is most appropriate?
A. Increase intake of spinach and rhubarb
B. Increase fluid intake to at least 2 to 3 liters per day
C. Maintain a high-sodium diet to promote dilute urine
D. Restrict all calcium-rich foods from the diet
Correct Answer: B
Rationale: High fluid intake is the most important intervention to prevent the recurrence
of any type of kidney stone by keeping urine dilute. Restricting calcium is often
counterproductive as it can lead to increased oxalate absorption in the gut. Patients should
specifically avoid high-oxalate foods like spinach and rhubarb.
