Exami 5:i Kidneyi Disordersi (NCLEX)
Ai patienti isi admittedi toi thei hospitali withi CKD.i Thei nursei understandsi thati thisi
conditioni isi characterizedi by
a.i progressivei irreversiblei destructioni ofi thei kidneys
b.i ai rapidi decreasei ini urinei outputi withi ani elevatedi BUN
c.i ani increasingi creatininei clearancei withi ai decreasei ini urinei output
d.i prostration,i somnolence,i andi confusioni withi comai andi imminenti deathi -i
i i i i i i i i i i i i A
Patientsi withi CKDi experiencei ani increasei incidencei ofi cardiovasculari diseasei
relatedi toi Selecti alli thati apply
a.i hypertension
b.i vasculari calcifications
c.i ai genetici predisposition
d.i hyperinsulinemiai causingi dyslipidemia
e.i increasedi high-densityi lipoproteini levelsi -i
i i i i i i i i i i i i ABD
Ani ESRDi patienti receivingi HDi isi consideringi askingi ai relativei toi donatei ai
kidneyi fori transplantation.i Ini assistingi thei patienti toi makei ai decisioni abouti
treatment,i thei nursei informsi thei patienti that
a.i successfuli transplantationi usuallyi providesi ai betteri qualityi ofi lifei thani thati
offeredi byi dialysis
b.i ifi rejectioni ofi thei transplantedi kidneyi occurs,i noi furtheri treatmenti fori thei
renali failurei isi available
c.i HDi replacesi thei normali functioni ofi thei kidneys,i andi patientsi doi noti havei toi
livei withi thei continuali feari ofi rejection
d.i thei immunosuppressivei therapyi followingi transplantationi makesi thei personi
ineligiblei toi receivei otheri formsi ofi treatmenti ifi thei kidneyi failsi -i
i i i i i i i i i i i i A
Toi assessi thei patencyi ofi ai newlyi placedi arteriovenousi grafti fori dialysis,i thei
nursei shouldi Selecti alli thati apply
a.i monitori thei BPi ini thei affectedi arm
b.i irrigatei thei grafti dailyi withi low-dosei heparin
c.i palpatei thei areai ofi thei grafti toi feeli ai normali thrill
d.i listeni withi ai stethoscopei overi thei grafti toi detecti ai bruit
e.i frequentlyi monitori thei pulsesi andi neurovasculari statusi distali toi thei grafti -i
i i i i i i i i i i i i CDE
Ai majori advantagei ofi peritoneali dialysisi is
a.i thei dieti isi lessi restrictedi andi dialysisi cani bei performedi ati home
1i |i P a g e
,b.i thei dialysatei isi biocompatiblei andi causesi noi long-termi consequences
c.i highi glucosei concentrationsi ofi thei dialysatei causesi ai reductioni ini appetite,i
promotingi weighti loss
d.i noi medicationsi arei requiredi becausei ofi thei enhancesi efficiencyi ofi thei
peritoneali membranei ini removingi toxinsi -i
i i i i i i i i i i i i A
Ai kidneyi transplanti recipienti complainsi ofi havingi fever,i chills,i andi dysuriai overi
thei pasti 2i weeks.i Whati isi thei firsti actioni thei nursei shouldi take?
a.i assessi temperaturei andi initiatei workupi toi rulei outi infection
b.i reassurei thei patienti thati thisi isi commoni afteri transplantation
c.i providei warmi coveri fori thei patienti andi givei 1i gi acetaminopheni orally
d.i notifyi thei nephrologisti thati thei patienti hasi developedi symptomsi ofi acutei
rejectioni -i
i i i i i i i i i i i i A
Ini replyingi toi ai patient'si questionsi abouti thei seriousnessi ofi heri CKD,i thei nursei
knowsi thati thei stagei ofi CKDi isi basedi oni what?
a.i totali dailyi urinei output
b.i GFR
c.i degreei ofi alteredi mentali status
d.i serumi creatininei andi ureai levelsi -i
i i i i i i i i i i i i B
Thei patienti withi CKDi isi receivingi dialysis,i andi thei nursei observesi excoriationsi
oni thei patient'si skin.i Whati pathophysiologici changesi ini CKDi mosti likelyi occuri
thati cani contributei toi thisi finding?i Selecti alli thati apply
a.i dryi skin
b.i sensoryi neuropathy
c.i vasculari calcifications
d.i calcium-phosphatei skini deposits
e.i uremici crystallizationi fromi highi BUNi -i
i i i i i i i i i i i i ABD
Whati causesi thei GIi manifestationi ofi stomatitisi ini thei patienti withi CKD?
a.i highi serumi sodiumi levels
b.i irritationi ofi thei GIi tracti fromi creatinine
c.i increasedi ammoniai fromi bacteriali breakdowni ofi urea
d.i ironi salts,i calcium-containingi phosphatei binders,i andi limitedi fluidi intakei -i
i i i i i i i i i i i i C
Thei patienti withi CKDi isi broughti toi thei EDi withi Kussmauli respirations.i Whati
doesi thei nursei knowi abouti CKDi thati couldi causei thisi patient'si Kussmauli
respirations?
a.i uremici pleuritisi isi occurring
2i |i P a g e
,b.i therei isi decreasedi pulmonaryi macrophagei activity
c.i theyi arei causedi byi respiratoryi compensationi fori metabolici acidosis
d.i pulmonaryi edemai fromi HFi andi fluidi overloadi isi occurringi -i
i i i i i i i i i i i i C
Whichi serumi laboratoryi valuei indicatesi toi thei nursei thati thei patient'si CKDi isi
gettingi worse?
a.i decreasedi BUN
b.i decreasedi sodium
c.i decreasedi creatinine
d.i decreasedi calculatedi GFRi -i
i i i i i i i i i i i i D
Whati isi thei mosti seriousi electrolytei disorderi associatedi withi kidneyi disease?
a.i hypocalcemia
b.i hyperkalemia
c.i hyponatremia
d.i hypermagnesemiai -i
i i i i i i i i i i i i B
Whati isi thei mosti appropriatei snacki fori thei nursei toi offeri ai patienti withi stagei 4i
CKD?
a.i raisins
b.i icei cream
c.i dilli pickles
d.i hardi candyi -i
i i i i i i i i i i i i D
Whichi complicationi ofi CKDi isi treatedi withi erythropoietin?
a.i anemia
b.i hypertension
c.i hyperkalemia
d.i minerali andi bonei disorderi -i
i i i i i i i i i i i i A
Thei patienti withi CKDi isi consideringi whetheri toi usei PDi ori HD.i Whati arei
advantagesi ofi PDi wheni comparedi toi HD?i Selecti alli thati apply
a.i lessi proteini loss
b.i rapidi fluidi removal
c.i lessi cardiovasculari stress
d.i decreasedi hyperlipidemia
e.i requiresi feweri dietaryi restrictionsi -i
i i i i i i i i i i i i CE
3i |i P a g e
, Toi preventi thei mosti commoni seriousi complicationi ofi PD,i whati isi mosti
importanti fori thei nursei toi do?
a.i infusei thei dialysatei slowly
b.i usei stricti aseptici techniquei ini thei dialysisi procedures
c.i havei thei patienti emptyi thei boweli beforei thei inflowi phase
d.i repositioni thei patienti frequentlyi andi promotei deepi breathingi -i
i i i i i i i i i i i i B
Ai mani withi ESRDi isi scheduledi fori HDi followingi healingi ofi ani arteriovenousi
fistula.i Whati shouldi thei nursei explaini toi himi thati willi occuri duringi dialysis?
a.i hei willi bei ablei toi visit,i read,i sleep,i ori watchi TVi whilei recliningi ini ai chair
b.i hei willi bei placedi oni ai cardiaci monitori toi detecti anyi adversei effectsi thati
mayi occur
c.i thei dialyzeri willi removei andi holdi parti ofi hisi bloodi fori 20-30i minutesi toi
removei thei wastei products
d.i ai largei catheteri withi twoi lumensi willi bei insertedi intoi thei fistulai toi sendi
bloodi toi andi returni iti fromi thei dialyzeri -i
i i i i i i i i i i i i A
Ai patienti rapidlyi progressingi towardi ESRDi asksi abouti thei possibilityi ofi ai
kidneyi transplant.i Ini respondingi toi thei patient,i thei nursei knowsi thati whati isi ai
contraindicationi toi kidneyi transplantation?
a.i hepatitisi Ci infection
b.i coronaryi arteryi disease
c.i refractoryi hypertension
d.i extensivei vasculari diseasei -i
i i i i i i i i i i i i D
Duringi thei immediatei postoperativei carei ofi ai recipienti ofi ai kidneyi transplant,i
whati isi ai priorityi fori thei nursei toi do?
a.i regulatei fluidi intakei hourlyi basedi oni urinei output
b.i monitori urine-tingedi drainagei oni abdominali dressing
c.i medicatei thei patienti frequentlyi fori incisionali flanki pain
d.i removei thei urinaryi catheteri toi evaluatei thei ureterali implanti -i
i i i i i i i i i i i i A
Ai patienti receivedi ai kidneyi transplanti lasti month.i Becausei ofi thei effectsi ofi
immunosuppressivei drugsi andi CKD,i whati complicationi ofi transplantationi shouldi
thei nursei bei assessingi thei patienti for?
a.i infection
b.i rejection
c.i malignancy
d.i cardiovasculari diseasei -i
i i i i i i i i i i i i A
4i |i P a g e
Ai patienti isi admittedi toi thei hospitali withi CKD.i Thei nursei understandsi thati thisi
conditioni isi characterizedi by
a.i progressivei irreversiblei destructioni ofi thei kidneys
b.i ai rapidi decreasei ini urinei outputi withi ani elevatedi BUN
c.i ani increasingi creatininei clearancei withi ai decreasei ini urinei output
d.i prostration,i somnolence,i andi confusioni withi comai andi imminenti deathi -i
i i i i i i i i i i i i A
Patientsi withi CKDi experiencei ani increasei incidencei ofi cardiovasculari diseasei
relatedi toi Selecti alli thati apply
a.i hypertension
b.i vasculari calcifications
c.i ai genetici predisposition
d.i hyperinsulinemiai causingi dyslipidemia
e.i increasedi high-densityi lipoproteini levelsi -i
i i i i i i i i i i i i ABD
Ani ESRDi patienti receivingi HDi isi consideringi askingi ai relativei toi donatei ai
kidneyi fori transplantation.i Ini assistingi thei patienti toi makei ai decisioni abouti
treatment,i thei nursei informsi thei patienti that
a.i successfuli transplantationi usuallyi providesi ai betteri qualityi ofi lifei thani thati
offeredi byi dialysis
b.i ifi rejectioni ofi thei transplantedi kidneyi occurs,i noi furtheri treatmenti fori thei
renali failurei isi available
c.i HDi replacesi thei normali functioni ofi thei kidneys,i andi patientsi doi noti havei toi
livei withi thei continuali feari ofi rejection
d.i thei immunosuppressivei therapyi followingi transplantationi makesi thei personi
ineligiblei toi receivei otheri formsi ofi treatmenti ifi thei kidneyi failsi -i
i i i i i i i i i i i i A
Toi assessi thei patencyi ofi ai newlyi placedi arteriovenousi grafti fori dialysis,i thei
nursei shouldi Selecti alli thati apply
a.i monitori thei BPi ini thei affectedi arm
b.i irrigatei thei grafti dailyi withi low-dosei heparin
c.i palpatei thei areai ofi thei grafti toi feeli ai normali thrill
d.i listeni withi ai stethoscopei overi thei grafti toi detecti ai bruit
e.i frequentlyi monitori thei pulsesi andi neurovasculari statusi distali toi thei grafti -i
i i i i i i i i i i i i CDE
Ai majori advantagei ofi peritoneali dialysisi is
a.i thei dieti isi lessi restrictedi andi dialysisi cani bei performedi ati home
1i |i P a g e
,b.i thei dialysatei isi biocompatiblei andi causesi noi long-termi consequences
c.i highi glucosei concentrationsi ofi thei dialysatei causesi ai reductioni ini appetite,i
promotingi weighti loss
d.i noi medicationsi arei requiredi becausei ofi thei enhancesi efficiencyi ofi thei
peritoneali membranei ini removingi toxinsi -i
i i i i i i i i i i i i A
Ai kidneyi transplanti recipienti complainsi ofi havingi fever,i chills,i andi dysuriai overi
thei pasti 2i weeks.i Whati isi thei firsti actioni thei nursei shouldi take?
a.i assessi temperaturei andi initiatei workupi toi rulei outi infection
b.i reassurei thei patienti thati thisi isi commoni afteri transplantation
c.i providei warmi coveri fori thei patienti andi givei 1i gi acetaminopheni orally
d.i notifyi thei nephrologisti thati thei patienti hasi developedi symptomsi ofi acutei
rejectioni -i
i i i i i i i i i i i i A
Ini replyingi toi ai patient'si questionsi abouti thei seriousnessi ofi heri CKD,i thei nursei
knowsi thati thei stagei ofi CKDi isi basedi oni what?
a.i totali dailyi urinei output
b.i GFR
c.i degreei ofi alteredi mentali status
d.i serumi creatininei andi ureai levelsi -i
i i i i i i i i i i i i B
Thei patienti withi CKDi isi receivingi dialysis,i andi thei nursei observesi excoriationsi
oni thei patient'si skin.i Whati pathophysiologici changesi ini CKDi mosti likelyi occuri
thati cani contributei toi thisi finding?i Selecti alli thati apply
a.i dryi skin
b.i sensoryi neuropathy
c.i vasculari calcifications
d.i calcium-phosphatei skini deposits
e.i uremici crystallizationi fromi highi BUNi -i
i i i i i i i i i i i i ABD
Whati causesi thei GIi manifestationi ofi stomatitisi ini thei patienti withi CKD?
a.i highi serumi sodiumi levels
b.i irritationi ofi thei GIi tracti fromi creatinine
c.i increasedi ammoniai fromi bacteriali breakdowni ofi urea
d.i ironi salts,i calcium-containingi phosphatei binders,i andi limitedi fluidi intakei -i
i i i i i i i i i i i i C
Thei patienti withi CKDi isi broughti toi thei EDi withi Kussmauli respirations.i Whati
doesi thei nursei knowi abouti CKDi thati couldi causei thisi patient'si Kussmauli
respirations?
a.i uremici pleuritisi isi occurring
2i |i P a g e
,b.i therei isi decreasedi pulmonaryi macrophagei activity
c.i theyi arei causedi byi respiratoryi compensationi fori metabolici acidosis
d.i pulmonaryi edemai fromi HFi andi fluidi overloadi isi occurringi -i
i i i i i i i i i i i i C
Whichi serumi laboratoryi valuei indicatesi toi thei nursei thati thei patient'si CKDi isi
gettingi worse?
a.i decreasedi BUN
b.i decreasedi sodium
c.i decreasedi creatinine
d.i decreasedi calculatedi GFRi -i
i i i i i i i i i i i i D
Whati isi thei mosti seriousi electrolytei disorderi associatedi withi kidneyi disease?
a.i hypocalcemia
b.i hyperkalemia
c.i hyponatremia
d.i hypermagnesemiai -i
i i i i i i i i i i i i B
Whati isi thei mosti appropriatei snacki fori thei nursei toi offeri ai patienti withi stagei 4i
CKD?
a.i raisins
b.i icei cream
c.i dilli pickles
d.i hardi candyi -i
i i i i i i i i i i i i D
Whichi complicationi ofi CKDi isi treatedi withi erythropoietin?
a.i anemia
b.i hypertension
c.i hyperkalemia
d.i minerali andi bonei disorderi -i
i i i i i i i i i i i i A
Thei patienti withi CKDi isi consideringi whetheri toi usei PDi ori HD.i Whati arei
advantagesi ofi PDi wheni comparedi toi HD?i Selecti alli thati apply
a.i lessi proteini loss
b.i rapidi fluidi removal
c.i lessi cardiovasculari stress
d.i decreasedi hyperlipidemia
e.i requiresi feweri dietaryi restrictionsi -i
i i i i i i i i i i i i CE
3i |i P a g e
, Toi preventi thei mosti commoni seriousi complicationi ofi PD,i whati isi mosti
importanti fori thei nursei toi do?
a.i infusei thei dialysatei slowly
b.i usei stricti aseptici techniquei ini thei dialysisi procedures
c.i havei thei patienti emptyi thei boweli beforei thei inflowi phase
d.i repositioni thei patienti frequentlyi andi promotei deepi breathingi -i
i i i i i i i i i i i i B
Ai mani withi ESRDi isi scheduledi fori HDi followingi healingi ofi ani arteriovenousi
fistula.i Whati shouldi thei nursei explaini toi himi thati willi occuri duringi dialysis?
a.i hei willi bei ablei toi visit,i read,i sleep,i ori watchi TVi whilei recliningi ini ai chair
b.i hei willi bei placedi oni ai cardiaci monitori toi detecti anyi adversei effectsi thati
mayi occur
c.i thei dialyzeri willi removei andi holdi parti ofi hisi bloodi fori 20-30i minutesi toi
removei thei wastei products
d.i ai largei catheteri withi twoi lumensi willi bei insertedi intoi thei fistulai toi sendi
bloodi toi andi returni iti fromi thei dialyzeri -i
i i i i i i i i i i i i A
Ai patienti rapidlyi progressingi towardi ESRDi asksi abouti thei possibilityi ofi ai
kidneyi transplant.i Ini respondingi toi thei patient,i thei nursei knowsi thati whati isi ai
contraindicationi toi kidneyi transplantation?
a.i hepatitisi Ci infection
b.i coronaryi arteryi disease
c.i refractoryi hypertension
d.i extensivei vasculari diseasei -i
i i i i i i i i i i i i D
Duringi thei immediatei postoperativei carei ofi ai recipienti ofi ai kidneyi transplant,i
whati isi ai priorityi fori thei nursei toi do?
a.i regulatei fluidi intakei hourlyi basedi oni urinei output
b.i monitori urine-tingedi drainagei oni abdominali dressing
c.i medicatei thei patienti frequentlyi fori incisionali flanki pain
d.i removei thei urinaryi catheteri toi evaluatei thei ureterali implanti -i
i i i i i i i i i i i i A
Ai patienti receivedi ai kidneyi transplanti lasti month.i Becausei ofi thei effectsi ofi
immunosuppressivei drugsi andi CKD,i whati complicationi ofi transplantationi shouldi
thei nursei bei assessingi thei patienti for?
a.i infection
b.i rejection
c.i malignancy
d.i cardiovasculari diseasei -i
i i i i i i i i i i i i A
4i |i P a g e
