NURS 422 Exam 5 Guide With
Complete Solution
1. The nurse is assessing a client with a diagnosis of pre-renal acute kidney
injury (AKI). Which condition would the nurse expect to find in the clients
recent history?
a. Pyelonephritis
b. Myocardial infarction
c. Bladder cancer
d. Kidney stones - ANSWER b
2. A marathon runner comes into the clinic and states I have not urinated
very much in the last few days. The nurse notes a heart rate of 110 beats/min
and a blood pressure of 86/58 mm Hg. Which action by the nurse is the
priority?
a. Give the client a bottle of water immediately.
b. Start an intravenous line for fluids.
c. Teach the client to drink 2 to 3 liters of water daily.
d. Perform an electrocardiogram. - ANSWER a
3. A male client comes into the emergency department with a serum
creatinine of 2.2 mg/dL and a blood urea nitrogen (BUN) of 24 mL/dL. What
question should the nurse ask first when taking this clients history?
,a. Have you been taking any aspirin, ibuprofen, or naproxen recently?
b. Do you have anyone in your family with renal failure?
c. Have you had a diet that is low in protein recently?
d. Has a relative had a kidney transplant lately? - ANSWER a
4. A client is admitted with acute kidney injury (AKI) and a urine output of
2000 mL/day. What is the major concern of the nurse regarding this clients
care?
a. Edema and pain
b. Electrolyte and fluid imbalance
c. Cardiac and respiratory status
d. Mental health status - ANSWER b
5. A client with acute kidney injury has a blood pressure of 76/55 mm Hg.
The health care provider ordered 1000 mL of normal saline to be infused over
1 hour to maintain perfusion. The client is starting to develop shortness of
breath. What is the nurses priority action?
a. Calculate the mean arterial pressure (MAP).
b. Ask for insertion of a pulmonary artery catheter.
c. Take the clients pulse.
d. Slow down the normal saline infusion. - ANSWER d
6. A client has a serum potassium level of 6.5 mmol/L, a serum creatinine
level of 2 mg/dL, and a urine output of 350 mL/day. What is the best action
by the nurse?
,a. Place the client on a cardiac monitor immediately.
b. Teach the client to limit high-potassium foods.
c. Continue to monitor the clients intake and output.
d. Ask to have the laboratory redraw the blood specimen. - ANSWER a
7. A client has just had a central line catheter placed that is specific for
hemodialysis. What is the most appropriate action by the nurse?
a. Use the catheter for the next laboratory blood draw.
b. Monitor the central venous pressure through this line.
c. Access the line for the next intravenous medication.
d. Place a heparin or heparin/saline dwell after hemodialysis. - ANSWER a
8. A client in the intensive care unit is started on continuous venovenous
hemofiltration (CVVH). Which finding is the cause of immediate action by the
nurse?
a. Blood pressure of 76/58 mm Hg
b. Sodium level of 138 mEq/L
c. Potassium level of 5.5 mEq/L
d. Pulse rate of 90 beats/min - ANSWER a
9. The nurse is caring for four clients with chronic kidney disease. Which
client should the nurse assess first upon initial rounding?
a. Woman with a blood pressure of 158/90 mm Hg
b. Client with Kussmaul respirations
, c. Man with skin itching from head to toe
d. Client with halitosis and stomatitis - ANSWER b
10. The charge nurse of the medical-surgical unit is making staff
assignments. Which staff member should be assigned to a client with chronic
kidney disease who is exhibiting a low-grade fever and a pericardial friction
rub?
a. Registered nurse who just floated from the surgical unit
b. Registered nurse who just floated from the dialysis unit
c. Registered nurse who was assigned the same client yesterday
d. Licensed practical nurse with 5 years experience on this floor - ANSWER c
11. A male client with chronic kidney disease (CKD) is refusing to take his
medication and has missed two hemodialysis appointments. What is the best
initial action for the nurse?
a. Discuss what the treatment regimen means to him.
b. Refer the client to a mental health nurse practitioner.
c. Reschedule the appointments to another date and time.
d. Discuss the option of peritoneal dialysis. - ANSWER a
12. A client is taking furosemide (Lasix) 40 mg/day for management of
chronic kidney disease (CKD). To
NURSINGTB.COM
detect the positive effect of the medication, what action of the nurse is best?
Complete Solution
1. The nurse is assessing a client with a diagnosis of pre-renal acute kidney
injury (AKI). Which condition would the nurse expect to find in the clients
recent history?
a. Pyelonephritis
b. Myocardial infarction
c. Bladder cancer
d. Kidney stones - ANSWER b
2. A marathon runner comes into the clinic and states I have not urinated
very much in the last few days. The nurse notes a heart rate of 110 beats/min
and a blood pressure of 86/58 mm Hg. Which action by the nurse is the
priority?
a. Give the client a bottle of water immediately.
b. Start an intravenous line for fluids.
c. Teach the client to drink 2 to 3 liters of water daily.
d. Perform an electrocardiogram. - ANSWER a
3. A male client comes into the emergency department with a serum
creatinine of 2.2 mg/dL and a blood urea nitrogen (BUN) of 24 mL/dL. What
question should the nurse ask first when taking this clients history?
,a. Have you been taking any aspirin, ibuprofen, or naproxen recently?
b. Do you have anyone in your family with renal failure?
c. Have you had a diet that is low in protein recently?
d. Has a relative had a kidney transplant lately? - ANSWER a
4. A client is admitted with acute kidney injury (AKI) and a urine output of
2000 mL/day. What is the major concern of the nurse regarding this clients
care?
a. Edema and pain
b. Electrolyte and fluid imbalance
c. Cardiac and respiratory status
d. Mental health status - ANSWER b
5. A client with acute kidney injury has a blood pressure of 76/55 mm Hg.
The health care provider ordered 1000 mL of normal saline to be infused over
1 hour to maintain perfusion. The client is starting to develop shortness of
breath. What is the nurses priority action?
a. Calculate the mean arterial pressure (MAP).
b. Ask for insertion of a pulmonary artery catheter.
c. Take the clients pulse.
d. Slow down the normal saline infusion. - ANSWER d
6. A client has a serum potassium level of 6.5 mmol/L, a serum creatinine
level of 2 mg/dL, and a urine output of 350 mL/day. What is the best action
by the nurse?
,a. Place the client on a cardiac monitor immediately.
b. Teach the client to limit high-potassium foods.
c. Continue to monitor the clients intake and output.
d. Ask to have the laboratory redraw the blood specimen. - ANSWER a
7. A client has just had a central line catheter placed that is specific for
hemodialysis. What is the most appropriate action by the nurse?
a. Use the catheter for the next laboratory blood draw.
b. Monitor the central venous pressure through this line.
c. Access the line for the next intravenous medication.
d. Place a heparin or heparin/saline dwell after hemodialysis. - ANSWER a
8. A client in the intensive care unit is started on continuous venovenous
hemofiltration (CVVH). Which finding is the cause of immediate action by the
nurse?
a. Blood pressure of 76/58 mm Hg
b. Sodium level of 138 mEq/L
c. Potassium level of 5.5 mEq/L
d. Pulse rate of 90 beats/min - ANSWER a
9. The nurse is caring for four clients with chronic kidney disease. Which
client should the nurse assess first upon initial rounding?
a. Woman with a blood pressure of 158/90 mm Hg
b. Client with Kussmaul respirations
, c. Man with skin itching from head to toe
d. Client with halitosis and stomatitis - ANSWER b
10. The charge nurse of the medical-surgical unit is making staff
assignments. Which staff member should be assigned to a client with chronic
kidney disease who is exhibiting a low-grade fever and a pericardial friction
rub?
a. Registered nurse who just floated from the surgical unit
b. Registered nurse who just floated from the dialysis unit
c. Registered nurse who was assigned the same client yesterday
d. Licensed practical nurse with 5 years experience on this floor - ANSWER c
11. A male client with chronic kidney disease (CKD) is refusing to take his
medication and has missed two hemodialysis appointments. What is the best
initial action for the nurse?
a. Discuss what the treatment regimen means to him.
b. Refer the client to a mental health nurse practitioner.
c. Reschedule the appointments to another date and time.
d. Discuss the option of peritoneal dialysis. - ANSWER a
12. A client is taking furosemide (Lasix) 40 mg/day for management of
chronic kidney disease (CKD). To
NURSINGTB.COM
detect the positive effect of the medication, what action of the nurse is best?
