Renal Critical Care
Exam
Page 1 of 57
,A client with AKI has a serum potassium level of 7.0 mEq/L. The nurse should plan which
actions as a priority. Select all that apply.
1. Place the client on a cardiac monitor
2. Notify the HCP
3. Put the client on NPO status except for ice chips
4. Review the client's medications to determine if any contain or retain potassium
5. Allow an extra 500 mL of intravenous fluid intake to dilute the electrolyte
concentration
1, 2, 4
The potassium level is elevarted. The client is at risk for developing cardiac dysrhythmias and
cardiac arrest. Because of this the client should be placed on a cardiac monitor. The nurse
should notify the HCP and also review medications to determine if any contain potassium or
are potassium retaining. The client does not need to be put on NPO status. Fluid intake is not
increased because it contributes to fluid overload and would not affect the serum potassium
level significantly.
The client being hemodialyzed suddenly becomes short of breath and complains of
chest pain. The client is tachycardic, pale, and anxious. The nurse suspects air embolism.
The priority action for the nurse is to: (Select all that apply.)
1. Administer oxygen to the client.
2. Continue dialysis at a slower rate after checking the lines for air.
Page 2 of 57
, 3. Notify the HCP and Rapid Response team.
4. Stop dialysis and turn the client on the left side with head lower than feet.
5. Bolus the client with 500 mL of normal saline to break up the air embolus.
1, 3, 4
If the client experiences air embolus during hemodialysis, the nurse should terminate dialysis
immediately, position the client so the air embolus is in the right side of the heart, notify the
HCP and Rapid Response Team, and administer oxygen as needed. Slowing the dialysis
treatment or giving an IV bolus will not correct the air embolus or prevent complications.
The client arrives at the ED with complaints of low abdominal pain and hematuria. The
client is afebrile. The nurse next assess the client to determine a history of which
condition?
1. Pyelonephritis
2. Glomerulonephritis
3. Trauma to the bladder or abdomen
4. Renal cancer in the clients family
3
Bladder trauma or injury should be considered or suspected in the client with low abdominal
pain and hematuria. Glomerulonephritis and pyelonephritis would be accompanied by fever
and are thus not applicable to the client described in the question. Renal cancer would not
cause pain that is felt in the low abdomen; rather, the pain would be in the flank area.
Page 3 of 57
, The nurse discusses plans for future treatment options with a client with symptomatic
polycystic kidney disease. Which treatment should be included in this discussion? Select
all that apply.
1. Hemodialysis
2. Peritoneal dialysis
3. Kidney transplant
4. Bilateral nephrectomy
5. Intense immunosuppression therapy
1, 3, 4
Polycystic kidney disease is a genetic familial disease in which the kidneys enlarge with cysts
that rupture and scar the kidney, eventually resulting in end-stage renal disease. Treatment
options include hemodialysis or kidney trasnplant. Clients usually undergo bilateral
nephrectomy to remove the large, painful, cyst-filled kidneys. Peritoneal dialysis is not an
option due to the infected cysts. The condition does not respond to immunosuppression.
A client is admitted to the ED following a fall from a horse and the HCP prescribes
insertion of a urinary catheter. While preparing for the procedure, the nurse notes
blood at the urinary meatus. The nurse should take which action?
1. Notify the HCP before performing the catheterization.
2. Use a small-sized catheter and an anesthetic gel as a lubricant.
3. Administer parenteral pain medication before inserting the catheter.
4. Clean the meatus with soap and water before opening the catheterization kit.
Page 4 of 57
Exam
Page 1 of 57
,A client with AKI has a serum potassium level of 7.0 mEq/L. The nurse should plan which
actions as a priority. Select all that apply.
1. Place the client on a cardiac monitor
2. Notify the HCP
3. Put the client on NPO status except for ice chips
4. Review the client's medications to determine if any contain or retain potassium
5. Allow an extra 500 mL of intravenous fluid intake to dilute the electrolyte
concentration
1, 2, 4
The potassium level is elevarted. The client is at risk for developing cardiac dysrhythmias and
cardiac arrest. Because of this the client should be placed on a cardiac monitor. The nurse
should notify the HCP and also review medications to determine if any contain potassium or
are potassium retaining. The client does not need to be put on NPO status. Fluid intake is not
increased because it contributes to fluid overload and would not affect the serum potassium
level significantly.
The client being hemodialyzed suddenly becomes short of breath and complains of
chest pain. The client is tachycardic, pale, and anxious. The nurse suspects air embolism.
The priority action for the nurse is to: (Select all that apply.)
1. Administer oxygen to the client.
2. Continue dialysis at a slower rate after checking the lines for air.
Page 2 of 57
, 3. Notify the HCP and Rapid Response team.
4. Stop dialysis and turn the client on the left side with head lower than feet.
5. Bolus the client with 500 mL of normal saline to break up the air embolus.
1, 3, 4
If the client experiences air embolus during hemodialysis, the nurse should terminate dialysis
immediately, position the client so the air embolus is in the right side of the heart, notify the
HCP and Rapid Response Team, and administer oxygen as needed. Slowing the dialysis
treatment or giving an IV bolus will not correct the air embolus or prevent complications.
The client arrives at the ED with complaints of low abdominal pain and hematuria. The
client is afebrile. The nurse next assess the client to determine a history of which
condition?
1. Pyelonephritis
2. Glomerulonephritis
3. Trauma to the bladder or abdomen
4. Renal cancer in the clients family
3
Bladder trauma or injury should be considered or suspected in the client with low abdominal
pain and hematuria. Glomerulonephritis and pyelonephritis would be accompanied by fever
and are thus not applicable to the client described in the question. Renal cancer would not
cause pain that is felt in the low abdomen; rather, the pain would be in the flank area.
Page 3 of 57
, The nurse discusses plans for future treatment options with a client with symptomatic
polycystic kidney disease. Which treatment should be included in this discussion? Select
all that apply.
1. Hemodialysis
2. Peritoneal dialysis
3. Kidney transplant
4. Bilateral nephrectomy
5. Intense immunosuppression therapy
1, 3, 4
Polycystic kidney disease is a genetic familial disease in which the kidneys enlarge with cysts
that rupture and scar the kidney, eventually resulting in end-stage renal disease. Treatment
options include hemodialysis or kidney trasnplant. Clients usually undergo bilateral
nephrectomy to remove the large, painful, cyst-filled kidneys. Peritoneal dialysis is not an
option due to the infected cysts. The condition does not respond to immunosuppression.
A client is admitted to the ED following a fall from a horse and the HCP prescribes
insertion of a urinary catheter. While preparing for the procedure, the nurse notes
blood at the urinary meatus. The nurse should take which action?
1. Notify the HCP before performing the catheterization.
2. Use a small-sized catheter and an anesthetic gel as a lubricant.
3. Administer parenteral pain medication before inserting the catheter.
4. Clean the meatus with soap and water before opening the catheterization kit.
Page 4 of 57
