PN 140 Final Exam NCLEX Practice
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A nurse is caring for a client with systemic lupus erythematosus (SLE). The client begins to cry
and tells the nurse that she is afraid that her skin will be disfigured with lesions. Which
intervention does the nurse plan to teach this client to minimize skin infections associated
with SLE?
Select all that apply.
A) Use sunscreen with an SPF of 15 or greater.
B) Remain indoors on sunny days.
C) Avoid swimming in a pool or the ocean.
D) Avoid sun exposure between 10:00 a.m. and 3:00 p.m.
E) Decrease sun exposure between 3:00 p.m. and 5:00 p.m.
Answer: A, D
The nurse teaches the client to live a normal life with a few extra precautions. There is a
relationship between sun exposure and infection, so the client is taught to use sunscreen with
an SPF of at least 15 and to avoid the sun between 10:00 a.m. and 3:00 p.m. The client may
swim but should reapply sunscreen after swimming. The client does not need to stay indoors on
sunny days or to decrease sun exposure between 3:00 p.m. and 5:00 p.m.
A patient on a medical unit has a potassium level of 6.8 mEq/L. What is the priority action
that the nurse should take?
a. Place the patient on a cardiac monitor.
b. Check the patient's BP.
,c. Instruct the patient to avoid high-potassium foods.
d. Call the lab and request a redraw of the lab to verify results.
a. Dysrhythmias may occur with an elevated potassium level and are potentially lethal. Monitor
the rhythm while contacting physician or calling the rapid response team.
A patient is admitted to the hospital with CKD. You understand that this condition is
characterized by
A. Progressive irreversible destruction of the kidneys
B. A rapid decrease in urinary output with an elevated BUN level
C. Increasing creatinine clearance with a decrease in urinary output
D. Prostration, somnolence, and confusion with coma and imminent death
A. Progressive irreversible destruction of the kidneys
CKD involves progressive, irreversible loss of kidney function.
Measures indicated in the conservative therapy of CKD include
A. decreased fluid intake, carbohydrate intake, and protein intake.
B. increased fluid intake; decreased carbohydrate intake and protein intake.
C. decreased fluid intake and protein intake; increased carbohydrate intake.
D. decreased fluid intake and carbohydrate intake; increased protein intake.
C. decreased fluid intake and protein intake; increased carbohydrate intake.
Water and any other fluids are not routinely restricted in the pre-end-stage renal disease (ESRD)
stages. Patients on hemodialysis have a more restricted diet than patients receiving peritoneal
dialysis. For those receiving hemodialysis, as their urinary output diminishes, fluid restrictions
are enhanced. Intake depends on the daily urine output. Generally, 600 mL (from insensible
loss) plus an amount equal to the previous day's urine output is allowed for a patient receiving
hemodialysis. Patients are advised to limit fluid intake so that weight gains are no more than 1
to 3 kg between dialyses (interdialytic weight gain). For the patient who is undergoing dialysis,
protein is not routinely restricted. The beneficial role of protein restriction in CKD stages 1
through 4 as a means to reduce the decline in kidney function is being studied. Historically,
dietary counseling often encouraged restriction of protein for CKD patients. Although there is
some evidence that protein restriction has benefits, many patients find these diets difficult to
adhere to. For CKD stages 1 through 4, many clinicians encourage a diet with normal protein
,intake. However, you should teach patients to avoid high-protein diets and supplements
because they may overstress the diseased kidneys.
Nurses need to educate patients at risk for CKD. Which individuals are considered to be at
increased risk (select all that apply)?
A. Older African Americans
B. Individuals older than 60 years
C. Those with a history of pancreatitis
D. Those with a history of hypertension
E. Those with a history of type 2 diabetes
A. Older African Americans
B. Individuals older than 60 years
D. Those with a history of hypertension
E. Those with a history of type 2 diabetes
Risk factors for CKD include diabetes mellitus, hypertension, age older than 60 years,
cardiovascular disease, family history of CKD, exposure to nephrotoxic drugs, and ethnic
minorities (e.g., African American, Native American).
Which statement regarding continuous ambulatory peritoneal dialysis (CAPD) is of highest
priority when teaching a patient new to this procedure?
A. "It is essential that you maintain aseptic technique to prevent peritonitis."
B. "You will be allowed a more liberal protein diet after you complete CAPD."
C. "It is important for you to maintain a daily written record of blood pressure and weight."
D. "You must continue regular medical and nursing follow-up visits while performing CAPD."
A. "It is essential that you maintain aseptic technique to prevent peritonitis."
Peritonitis is a potentially fatal complication of peritoneal dialysis, and it is imperative to teach
the patient methods to prevent it from occurring. Although the other teaching statements are
accurate, they do not address the potential for mortality by peritonitis, making that nursing
action the highest priority.
, How should you assess the patency of a newly placed arteriovenous graft for dialysis?
A. Irrigate the graft daily with low-dose heparin.
B. Monitor for any increase in blood pressure in the affected arm.
C. Listen with a stethoscope over the graft for presence of a bruit.
D. Frequently monitor the pulses and neurovascular status distal to the graft.
C. Listen with a stethoscope over the graft for presence of a bruit.
A thrill can be felt by palpating the area of anastomosis of the arteriovenous graft, and a bruit
can be heard with a stethoscope. The bruit and thrill are created by arterial blood rushing into
the vein.
What are the main advantages of peritoneal dialysis compared to hemodialysis?
A. No medications are required because of the enhanced efficiency of the peritoneal
membrane in removing toxins.
B. The diet is less restricted and dialysis can be performed at home.
C. The dialysate is biocompatible and causes no long-term consequences.
D. High glucose concentrations of the dialysate cause a reduction in appetite, promoting
weight loss.
B. The diet is less restricted and dialysis can be performed at home.
Advantages of peritoneal dialysis include fewer dietary restrictions and home dialysis is
possible.
The nurse teaches a client who is recovering from acute kidney disease to avoid which type of
medication?
A Nonsteroidal anti-inflammatory drugs (NSAIDs)
B Angiotensin-converting enzyme (ACE) inhibitors
C Opiates
D Calcium channel blockers filtration rate and blood flow within the kidney.
A Nonsteroidal anti-inflammatory drugs (NSAIDs)
Questions-EXAM STUDY GUIDE ACCURATE
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES || 100%
GUARANTEED PASS <BRAND NEW
VERSION>
A nurse is caring for a client with systemic lupus erythematosus (SLE). The client begins to cry
and tells the nurse that she is afraid that her skin will be disfigured with lesions. Which
intervention does the nurse plan to teach this client to minimize skin infections associated
with SLE?
Select all that apply.
A) Use sunscreen with an SPF of 15 or greater.
B) Remain indoors on sunny days.
C) Avoid swimming in a pool or the ocean.
D) Avoid sun exposure between 10:00 a.m. and 3:00 p.m.
E) Decrease sun exposure between 3:00 p.m. and 5:00 p.m.
Answer: A, D
The nurse teaches the client to live a normal life with a few extra precautions. There is a
relationship between sun exposure and infection, so the client is taught to use sunscreen with
an SPF of at least 15 and to avoid the sun between 10:00 a.m. and 3:00 p.m. The client may
swim but should reapply sunscreen after swimming. The client does not need to stay indoors on
sunny days or to decrease sun exposure between 3:00 p.m. and 5:00 p.m.
A patient on a medical unit has a potassium level of 6.8 mEq/L. What is the priority action
that the nurse should take?
a. Place the patient on a cardiac monitor.
b. Check the patient's BP.
,c. Instruct the patient to avoid high-potassium foods.
d. Call the lab and request a redraw of the lab to verify results.
a. Dysrhythmias may occur with an elevated potassium level and are potentially lethal. Monitor
the rhythm while contacting physician or calling the rapid response team.
A patient is admitted to the hospital with CKD. You understand that this condition is
characterized by
A. Progressive irreversible destruction of the kidneys
B. A rapid decrease in urinary output with an elevated BUN level
C. Increasing creatinine clearance with a decrease in urinary output
D. Prostration, somnolence, and confusion with coma and imminent death
A. Progressive irreversible destruction of the kidneys
CKD involves progressive, irreversible loss of kidney function.
Measures indicated in the conservative therapy of CKD include
A. decreased fluid intake, carbohydrate intake, and protein intake.
B. increased fluid intake; decreased carbohydrate intake and protein intake.
C. decreased fluid intake and protein intake; increased carbohydrate intake.
D. decreased fluid intake and carbohydrate intake; increased protein intake.
C. decreased fluid intake and protein intake; increased carbohydrate intake.
Water and any other fluids are not routinely restricted in the pre-end-stage renal disease (ESRD)
stages. Patients on hemodialysis have a more restricted diet than patients receiving peritoneal
dialysis. For those receiving hemodialysis, as their urinary output diminishes, fluid restrictions
are enhanced. Intake depends on the daily urine output. Generally, 600 mL (from insensible
loss) plus an amount equal to the previous day's urine output is allowed for a patient receiving
hemodialysis. Patients are advised to limit fluid intake so that weight gains are no more than 1
to 3 kg between dialyses (interdialytic weight gain). For the patient who is undergoing dialysis,
protein is not routinely restricted. The beneficial role of protein restriction in CKD stages 1
through 4 as a means to reduce the decline in kidney function is being studied. Historically,
dietary counseling often encouraged restriction of protein for CKD patients. Although there is
some evidence that protein restriction has benefits, many patients find these diets difficult to
adhere to. For CKD stages 1 through 4, many clinicians encourage a diet with normal protein
,intake. However, you should teach patients to avoid high-protein diets and supplements
because they may overstress the diseased kidneys.
Nurses need to educate patients at risk for CKD. Which individuals are considered to be at
increased risk (select all that apply)?
A. Older African Americans
B. Individuals older than 60 years
C. Those with a history of pancreatitis
D. Those with a history of hypertension
E. Those with a history of type 2 diabetes
A. Older African Americans
B. Individuals older than 60 years
D. Those with a history of hypertension
E. Those with a history of type 2 diabetes
Risk factors for CKD include diabetes mellitus, hypertension, age older than 60 years,
cardiovascular disease, family history of CKD, exposure to nephrotoxic drugs, and ethnic
minorities (e.g., African American, Native American).
Which statement regarding continuous ambulatory peritoneal dialysis (CAPD) is of highest
priority when teaching a patient new to this procedure?
A. "It is essential that you maintain aseptic technique to prevent peritonitis."
B. "You will be allowed a more liberal protein diet after you complete CAPD."
C. "It is important for you to maintain a daily written record of blood pressure and weight."
D. "You must continue regular medical and nursing follow-up visits while performing CAPD."
A. "It is essential that you maintain aseptic technique to prevent peritonitis."
Peritonitis is a potentially fatal complication of peritoneal dialysis, and it is imperative to teach
the patient methods to prevent it from occurring. Although the other teaching statements are
accurate, they do not address the potential for mortality by peritonitis, making that nursing
action the highest priority.
, How should you assess the patency of a newly placed arteriovenous graft for dialysis?
A. Irrigate the graft daily with low-dose heparin.
B. Monitor for any increase in blood pressure in the affected arm.
C. Listen with a stethoscope over the graft for presence of a bruit.
D. Frequently monitor the pulses and neurovascular status distal to the graft.
C. Listen with a stethoscope over the graft for presence of a bruit.
A thrill can be felt by palpating the area of anastomosis of the arteriovenous graft, and a bruit
can be heard with a stethoscope. The bruit and thrill are created by arterial blood rushing into
the vein.
What are the main advantages of peritoneal dialysis compared to hemodialysis?
A. No medications are required because of the enhanced efficiency of the peritoneal
membrane in removing toxins.
B. The diet is less restricted and dialysis can be performed at home.
C. The dialysate is biocompatible and causes no long-term consequences.
D. High glucose concentrations of the dialysate cause a reduction in appetite, promoting
weight loss.
B. The diet is less restricted and dialysis can be performed at home.
Advantages of peritoneal dialysis include fewer dietary restrictions and home dialysis is
possible.
The nurse teaches a client who is recovering from acute kidney disease to avoid which type of
medication?
A Nonsteroidal anti-inflammatory drugs (NSAIDs)
B Angiotensin-converting enzyme (ACE) inhibitors
C Opiates
D Calcium channel blockers filtration rate and blood flow within the kidney.
A Nonsteroidal anti-inflammatory drugs (NSAIDs)
