NURS 2040 MEDICAL SURGICAL NURSING || EXAM 3 PRACTICE QUESTIONS
1. During cthe coliguric cphase cof cAKI, cthe cnurse cmonitors cthe cpatient cfor
c(select call cthat capply)
a) hypotension.
b) ECG cchanges.
c) hypernatremia.
d) pulmonary cedema.
e) urine cwith chigh cspecific cgravity.: cANSWER: cb cand cd
2. When ca cpatient cis cin cthe cdiuretic cphase cof cAKI, cthe cnurse cmust
cmonitor cfor cwhich cserum celectrolyte cimbalances? ca) cHyperkalemia
cand chyponatremia
b) Hyperkalemia cand chypernatremia
c) Hypokalemia cand chyponatremia
Hypokalemia cand chypernatremia: cANSWER: cc) cHypokalemia cand
chyponatremia
3. The cnurse cassesses cthe cpatient cwith cchronic ckidney cdisease cwith
cthe cunderstanding cthat cthis ccondition cis ccharacterized cby
a) progressive cirreversible cdestruction cof cthe ckidneys.
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,b) a crapid cdecrease cin curine coutput cwith can celevated cBUN.
c) an cincreasing ccreatinine cclearance cwith ca cdecrease cin curine coutput.
d) prostration, csomnolence, cand cconfusion cwith ccoma cand cimminent cdeath.:
ANSWER: ca) cprogressive cirreversible cdestruction cof cthe ckidneys.
4. Nurses ccan cscreen cpatients cat crisk cfor cdeveloping cchronic ckidney
cdisease. cThose cconsidered cto cbe cat cincreased crisk cinclude c(select call
cthat capply) ca) colder cBlack cpatients.
b) patients cmore cthan c60 cyears cold.
c) those cwith ca chistory cof cpancreatitis.
d) those cwith ca chistory cof chypertension.
those cwith ca chistory cof ctype c2 cdiabetes.: cANSWER: ca,b, cdand ce
5. Which cpoints cmust cthe cnurse cconsider cwhen cplanning cnutrition csupport
cfor cpatients cwith cchronic ckidney cdisease? c(select call cthat capply)
a) Sodium cmay cbe crestricted cin csomeone cwith cadvanced cCKD.
b) Fluid cis cnot cusually crestricted cfor cpatients con cperitoneal cdialysis.
c) Decreased cfluid cintake cand ca clow-potassium cdiet care cneeded cfor ca
cpatient con chemodialysis.
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,d) Decreased cfluid cintake cand ca clow-potassium cdiet care cneeded cfor ca
cpatient con cperitoneal cdialysis.
e) Decreased cfluid cintake cand ca cdiet cin cprotein-rich cfoods care cpart cof ca
cdiet cfor ca cpatient con chemodialysis: cANSWER: ca,b cand cc
6. To cassess cthe cpatency cof ca cnewly cplaced carteriovenous cgraft, cthe
cnurse cshould c(select call cthat capply)
a) monitor cthe cBP cin cthe caffected carm.
b) irrigate cthe cgraft cdaily cwith clow-dose cheparin.
c) palpate cthe carea cof cthe cgraft cto cfeel ca cnormal cthrill.
d) listen cwith ca cstethoscope cover cthe cgraft cto cdetect ca cbruit.
assess cthe cpulses cand cneurovascular cstatus cdistal cto cthe cgraft.: cANSWER:
cc cd cand ce
7. During chemodialysis, cthe cpatient cdevelops clight-headedness cand
cnausea. cWhat cwould cthe cnurse cdo cfirst?
a) Give chypertonic csaline.
b) Initiate ca cblood ctransfusion.
c) Decrease cthe crate cof cfluid cremoval.
Administer cantiemetic cmedications.: cANSWER: cc) cDecrease cthe crate cof
cfluid cremoval.
The cpatient cis chaving chypotension cfrom ca crapid cremoval cof cvascular
cvolume. cThe crate cand cvolume cof cfluid cremoval cwill cbe cdecreased, cand
c0.9% csaline csolution cmay cbe cinfused. cHypertonic csaline cis cnot cused
cbecause cof cthe chigh csodium cload. cA cblood ctransfusion cis cnot cindicated.
cAntiemetic cmedications cmay chelp cthe cnausea cbut cwould cnot chelp cthe
chypovolemia.
8. A cpatient cwith cstage c2 cchronic ckidney cdisease cis cscheduled cfor can
coutpatient cdiagnostic cprocedure cusing ccontrast cmedia. cWhich cpriority
caction cwould cthe cnurse cperform?
a) Assess cthe cpatient's chydration cstatus.
b) Insert ca curinary ccatheter cfor cthe cexpected cdiuresis.
c) Evaluate cthe cpatient's clower cextremities cfor cedema.
d) Check cthe cpatient's curine cfor cthe cpresence cof cketones.: cANSWER:
ca)Assess cthe cpatient's chydration cstatus.
Preexisting ckidney cdisease cis cthe cmost cimportant crisk cfactor cfor cthe
cdevelopment cof ccontrast-associated cnephropathy cand cnephrotoxic
cinjury. cIf ccontrast cmedia cmust cbe cadministered cto ca chigh-risk cpatient,
cthe cpatient cneeds cto chave coptimal chydration.
3 c/
c78
,The cnurse cshould cassess cthe chydration cstatus cof cthe cpatient cbefore cth
cprocedure
4 c/
c78
1. During cthe coliguric cphase cof cAKI, cthe cnurse cmonitors cthe cpatient cfor
c(select call cthat capply)
a) hypotension.
b) ECG cchanges.
c) hypernatremia.
d) pulmonary cedema.
e) urine cwith chigh cspecific cgravity.: cANSWER: cb cand cd
2. When ca cpatient cis cin cthe cdiuretic cphase cof cAKI, cthe cnurse cmust
cmonitor cfor cwhich cserum celectrolyte cimbalances? ca) cHyperkalemia
cand chyponatremia
b) Hyperkalemia cand chypernatremia
c) Hypokalemia cand chyponatremia
Hypokalemia cand chypernatremia: cANSWER: cc) cHypokalemia cand
chyponatremia
3. The cnurse cassesses cthe cpatient cwith cchronic ckidney cdisease cwith
cthe cunderstanding cthat cthis ccondition cis ccharacterized cby
a) progressive cirreversible cdestruction cof cthe ckidneys.
1 c/
c78
,b) a crapid cdecrease cin curine coutput cwith can celevated cBUN.
c) an cincreasing ccreatinine cclearance cwith ca cdecrease cin curine coutput.
d) prostration, csomnolence, cand cconfusion cwith ccoma cand cimminent cdeath.:
ANSWER: ca) cprogressive cirreversible cdestruction cof cthe ckidneys.
4. Nurses ccan cscreen cpatients cat crisk cfor cdeveloping cchronic ckidney
cdisease. cThose cconsidered cto cbe cat cincreased crisk cinclude c(select call
cthat capply) ca) colder cBlack cpatients.
b) patients cmore cthan c60 cyears cold.
c) those cwith ca chistory cof cpancreatitis.
d) those cwith ca chistory cof chypertension.
those cwith ca chistory cof ctype c2 cdiabetes.: cANSWER: ca,b, cdand ce
5. Which cpoints cmust cthe cnurse cconsider cwhen cplanning cnutrition csupport
cfor cpatients cwith cchronic ckidney cdisease? c(select call cthat capply)
a) Sodium cmay cbe crestricted cin csomeone cwith cadvanced cCKD.
b) Fluid cis cnot cusually crestricted cfor cpatients con cperitoneal cdialysis.
c) Decreased cfluid cintake cand ca clow-potassium cdiet care cneeded cfor ca
cpatient con chemodialysis.
2 c/
c78
,d) Decreased cfluid cintake cand ca clow-potassium cdiet care cneeded cfor ca
cpatient con cperitoneal cdialysis.
e) Decreased cfluid cintake cand ca cdiet cin cprotein-rich cfoods care cpart cof ca
cdiet cfor ca cpatient con chemodialysis: cANSWER: ca,b cand cc
6. To cassess cthe cpatency cof ca cnewly cplaced carteriovenous cgraft, cthe
cnurse cshould c(select call cthat capply)
a) monitor cthe cBP cin cthe caffected carm.
b) irrigate cthe cgraft cdaily cwith clow-dose cheparin.
c) palpate cthe carea cof cthe cgraft cto cfeel ca cnormal cthrill.
d) listen cwith ca cstethoscope cover cthe cgraft cto cdetect ca cbruit.
assess cthe cpulses cand cneurovascular cstatus cdistal cto cthe cgraft.: cANSWER:
cc cd cand ce
7. During chemodialysis, cthe cpatient cdevelops clight-headedness cand
cnausea. cWhat cwould cthe cnurse cdo cfirst?
a) Give chypertonic csaline.
b) Initiate ca cblood ctransfusion.
c) Decrease cthe crate cof cfluid cremoval.
Administer cantiemetic cmedications.: cANSWER: cc) cDecrease cthe crate cof
cfluid cremoval.
The cpatient cis chaving chypotension cfrom ca crapid cremoval cof cvascular
cvolume. cThe crate cand cvolume cof cfluid cremoval cwill cbe cdecreased, cand
c0.9% csaline csolution cmay cbe cinfused. cHypertonic csaline cis cnot cused
cbecause cof cthe chigh csodium cload. cA cblood ctransfusion cis cnot cindicated.
cAntiemetic cmedications cmay chelp cthe cnausea cbut cwould cnot chelp cthe
chypovolemia.
8. A cpatient cwith cstage c2 cchronic ckidney cdisease cis cscheduled cfor can
coutpatient cdiagnostic cprocedure cusing ccontrast cmedia. cWhich cpriority
caction cwould cthe cnurse cperform?
a) Assess cthe cpatient's chydration cstatus.
b) Insert ca curinary ccatheter cfor cthe cexpected cdiuresis.
c) Evaluate cthe cpatient's clower cextremities cfor cedema.
d) Check cthe cpatient's curine cfor cthe cpresence cof cketones.: cANSWER:
ca)Assess cthe cpatient's chydration cstatus.
Preexisting ckidney cdisease cis cthe cmost cimportant crisk cfactor cfor cthe
cdevelopment cof ccontrast-associated cnephropathy cand cnephrotoxic
cinjury. cIf ccontrast cmedia cmust cbe cadministered cto ca chigh-risk cpatient,
cthe cpatient cneeds cto chave coptimal chydration.
3 c/
c78
,The cnurse cshould cassess cthe chydration cstatus cof cthe cpatient cbefore cth
cprocedure
4 c/
c78
