NSG 530 ACTUAL EXAM 3 2026/2027 |
Advanced Pathophysiology – Wilkes University
| Exams 1-4 Comprehensive Bank | Verified
Q&A with Detailed Rationales | Pass
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A client has developed acute kidney injury (AKI) as a complication of glomerulonephritis. Which should the nurse
expect to observe in the client?
1.Bradycardia
2.Hypertension
3.Decreased cardiac output
4.Decreased central venous pressure –
P 1
, • NSG 530 EXAM 09/15/2026
Correct Answer :2
Rationale:
AKI caused by glomerulonephritis is classified as intrinsic or intrarenal failure. This form of AKI commonly
manifests with hypertension, tachycardia, oliguria, lethargy, edema, and other signs of fluid overload. AKI from
prerenal causes is characterized by decreased blood pressure or a recent history of the same, tachycardia, and
decreased cardiac output and central venous pressure. Bradycardia is not part of the clinical picture for any form
of renal failure.
The nurse is planning discharge teaching for a client newly diagnosed with chronic kidney disease (CKD). Which
factor will enhance the educational process?
1.Anxiety
2.Memory deficits
3.Presence of family
4.Short attention span –
Correct Answer :3
Rationale
:The client with CKD may have several barriers to learning. The presence of family members is helpful because
they need to understand the disease and treatment and may help reinforce information with the client after the
formal teaching session is over. Anxiety about the disease and its ramifications frequently interferes with
learning. Physiological effects of the disease process also impair the client's mental functioning. Specifically, the
client may exhibit a short attention span and have memory deficits. Mental functioning usually improves once
hemodialysis has begun.
The nurse is analyzing the posthemodialysis laboratory test results for a client with chronic kidney disease. The
nurse interprets that the dialysis is having an expected but nontherapeutic effect if which value is decreased?
1.Potassium
2.Creatinine
3.Phosphorus
4.Red blood cell (RBC) count –
P 2
, • NSG 530 EXAM 09/15/2026
Correct Answer :4
Rationale:
Hemodialysis typically lowers the amounts of fluid, sodium, potassium, urea nitrogen, creatinine, uric acid,
magnesium, and phosphate levels in the blood. Hemodialysis also worsens anemia because RBCs are lost during
dialysis from blood sampling and anticoagulation and from residual blood left in the dialyzer. Although all of
these results are expected, only the lowered RBC count is nontherapeutic and worsens the anemia already
caused by the disease process.
A client with chronic kidney disease returns to the nursing unit following a hemodialysis treatment. On
assessment, the nurse notes that the client's temperature is 38.5°C (101.2°F). Which nursing action is most
appropriate?
1.Encourage fluid intake.
2.Notify the health care provider.
3.Continue to monitor vital signs.
4.Monitor the site of the shunt for infection.
- Correct Answer :2
Rationale:
A temperature of 101.2°F (38.5°C) is significantly elevated and may indicate infection. The nurse should notify the
health care provider (HCP). Dialysis clients cannot have fluid intake encouraged. Vital signs and the shunt site
should be monitored, but the HCP should be notified first.
The nurse is performing an assessment on a client who has returned from the dialysis unit following
hemodialysis. The client is complaining of headache and nausea and is extremely restless. Which is the priority
nursing action?
1.Monitor the client.
2.Elevate the head of the bed.
3.Assess the fistula site and dressing.
4.Notify the health care provider (HCP). –
P 3
, • NSG 530 EXAM 09/15/2026
Correct Answer :4
Rationale
:Disequilibrium syndrome may be caused by rapid removal of solutes from the body during hemodialysis. These
changes can cause cerebral edema that leads to increased intracranial pressure. The client is exhibiting early
signs and symptoms of disequilibrium syndrome and appropriate treatments with anticonvulsive medications
and barbiturates may be necessary to prevent a life-threatening situation. The HCP must be notified. Monitoring
the client, elevating the head of the bed, and assessing the fistula site are correct actions, but the priority action
is to notify the HCP.
A client diagnosed with chronic kidney disease (CKD) is scheduled to begin hemodialysis. The nurse determines
that which neurological and psychosocial manifestations, if exhibited by this client, are related to the CKD? Select
all that apply.
1.Agitation
2.Euphoria
3.Depression
4.Withdrawal
5.Labile emotions - Correct Answer :1, 3, 4, 5
Rationale:
The client with CKD often experiences a variety of psychosocial changes. These changes are related to uremia
and to the stress associated with living with a chronic disease that is life threatening. Euphoria is not part of the
clinical picture for the client in renal failure. Clients with CKD may have labile emotions or personality changes
and may exhibit withdrawal, depression, or agitation. Delusions and psychosis also can occur.
A client with chronic kidney disease (CKD) has been taking aluminum hydroxide gel. On the basis of this
information, the nurse determines that the client is most at risk for which problem?
1.Constipation
2.Dehydration
3.Inability to tolerate activity
4.Impaired physical mobility - Correct Answer :1
Rationale:
P 4