NURS 201 Quiz 8 V2 | NURS 201 Medical
Surgical Nursing | Actual Q&A with
Rationale (NURS201 Quiz 8) | West Coast
University
1. A nurse is caring for a client with acute kidney injury (AKI). Which phase of AKI is
characterized by a sudden decrease in urine output to less than 400 mL/day?
A. Diuretic phase
B. Recovery phase
C. Initiation phase
D. Oliguric phase
Answer: D
Rationale: The oliguric phase is the most common initial manifestation of AKI and is
defined by a urine output of less than 400 mL per 24 hours. During this phase, patients are
at high risk for fluid volume excess and electrolyte imbalances such as hyperkalemia. The
nurse must monitor for signs of metabolic acidosis and elevated BUN and creatinine levels
during this critical period.
2. A client with chronic kidney disease (CKD) is prescribed Sevelamer (Renagel). The nurse
understands that this medication is most effective when administered at which time?
A. At bedtime
,B. One hour before breakfast
C. With meals
D. Two hours after lunch
Answer: C
Rationale: Sevelamer is a phosphate binder used to manage hyperphosphatemia in clients
with CKD by preventing the absorption of phosphate from food. To be effective, the
medication must be in the stomach at the same time as the food being digested. Failure to
take the medication with meals will result in poor control of serum phosphorus levels and
potentially lead to renal osteodystrophy.
3. The nurse is assessing a client’s newly created arteriovenous (AV) fistula in the left arm.
Which finding requires immediate notification of the healthcare provider?
A. Presence of a thrill upon palpation
B. Slight redness at the incision site
C. Functional capillary refill in the fingers
D. Absence of a bruit on auscultation
Answer: D
Rationale: A functional AV fistula should have a palpable thrill and an audible bruit, which
indicate adequate blood flow through the access. The absence of these findings suggests a
, potential thrombosis or occlusion of the fistula. This is a medical emergency for a dialysis
patient because it compromises their vascular access for life-sustaining treatment.
4. A client is undergoing peritoneal dialysis (PD). During the drain cycle, the nurse notices the
effluent is cloudy. What is the priority nursing action?
A. Warm the next bag of dialysate
B. Document the finding as normal
C. Stop the dialysis immediately
D. Notify the provider and obtain a sample for culture
Answer: D
Rationale: Cloudy effluent is the primary clinical sign of peritonitis, a serious complication
of peritoneal dialysis. The nurse should immediately alert the physician and prepare to
send the fluid for a white blood cell count and culture. Prompt administration of antibiotics,
often added to the dialysate, is necessary to treat the infection and prevent systemic sepsis.
5. Which laboratory value is the most sensitive indicator of renal function in a client with
suspected renal failure?
A. Blood Urea Nitrogen (BUN)
B. Serum Creatinine
C. Serum Potassium
D. Urine Specific Gravity
Surgical Nursing | Actual Q&A with
Rationale (NURS201 Quiz 8) | West Coast
University
1. A nurse is caring for a client with acute kidney injury (AKI). Which phase of AKI is
characterized by a sudden decrease in urine output to less than 400 mL/day?
A. Diuretic phase
B. Recovery phase
C. Initiation phase
D. Oliguric phase
Answer: D
Rationale: The oliguric phase is the most common initial manifestation of AKI and is
defined by a urine output of less than 400 mL per 24 hours. During this phase, patients are
at high risk for fluid volume excess and electrolyte imbalances such as hyperkalemia. The
nurse must monitor for signs of metabolic acidosis and elevated BUN and creatinine levels
during this critical period.
2. A client with chronic kidney disease (CKD) is prescribed Sevelamer (Renagel). The nurse
understands that this medication is most effective when administered at which time?
A. At bedtime
,B. One hour before breakfast
C. With meals
D. Two hours after lunch
Answer: C
Rationale: Sevelamer is a phosphate binder used to manage hyperphosphatemia in clients
with CKD by preventing the absorption of phosphate from food. To be effective, the
medication must be in the stomach at the same time as the food being digested. Failure to
take the medication with meals will result in poor control of serum phosphorus levels and
potentially lead to renal osteodystrophy.
3. The nurse is assessing a client’s newly created arteriovenous (AV) fistula in the left arm.
Which finding requires immediate notification of the healthcare provider?
A. Presence of a thrill upon palpation
B. Slight redness at the incision site
C. Functional capillary refill in the fingers
D. Absence of a bruit on auscultation
Answer: D
Rationale: A functional AV fistula should have a palpable thrill and an audible bruit, which
indicate adequate blood flow through the access. The absence of these findings suggests a
, potential thrombosis or occlusion of the fistula. This is a medical emergency for a dialysis
patient because it compromises their vascular access for life-sustaining treatment.
4. A client is undergoing peritoneal dialysis (PD). During the drain cycle, the nurse notices the
effluent is cloudy. What is the priority nursing action?
A. Warm the next bag of dialysate
B. Document the finding as normal
C. Stop the dialysis immediately
D. Notify the provider and obtain a sample for culture
Answer: D
Rationale: Cloudy effluent is the primary clinical sign of peritonitis, a serious complication
of peritoneal dialysis. The nurse should immediately alert the physician and prepare to
send the fluid for a white blood cell count and culture. Prompt administration of antibiotics,
often added to the dialysate, is necessary to treat the infection and prevent systemic sepsis.
5. Which laboratory value is the most sensitive indicator of renal function in a client with
suspected renal failure?
A. Blood Urea Nitrogen (BUN)
B. Serum Creatinine
C. Serum Potassium
D. Urine Specific Gravity
