Exam 4: Acute Kidney Injury NCLEX Questions

A c Which descriptions characterize aki? Select all that apply A. Primary cause of death is infection B. It almost always affects older people C. Disease course is potentially reversible D. Most common cause is diabetic nephropathy E. Cardiovascular disease is most common cause of death B d During the oliguric phase of aki, the nurse monitors the patient for select all that apply A. Hypotension B. Ecg changes C. Hypernatremia D. Pulmonary edema E. Urine with high specific gravity C If a patient is in the diuretic phase of aki, the nurse must monitor for which serum electrolyte imbalances? A. Hyperkalemia and hyponatremia b. Hyperkalemia and hypernatremia c. Hypokalemia and hyponatremia d. Hypokalemia and hypernatremia B The nurse is caring for a 68-yr-old man who had coronary artery bypass surgery 3 weeks ago. During the oliguric phase of acute kidney disease, which action would be appropriate to include in the plan of care? A. Provide foods high in potassium. B. Restrict fluids based on urine output. C. Monitor output from peritoneal dialysis. D. Offer high-protein snacks between meals. D When caring for a patient during the oliguric phase of acute kidney injury (aki), which nursing action is appropriate? A. Weigh patient three times weekly. B. Increase dietary sodium and potassium. C. Provide a low-protein, high-carbohydrate diet. D. Restrict fluids according to previous daily loss D Which patient diagnosis or treatment is most consistent with prerenal acute kidney injury (aki)? A. Iv tobramycin B. Incompatible blood transfusion C. Poststreptococcal glomerulonephritis D. Dissecting abdominal aortic aneurysm A The patient has rapidly progressing glomerular inflammation. Weight has increased and urine output is steadily declining. What is the priority nursing intervention? A. Monitor the patient's cardiac status. B. Teach the patient about hand washing. C. Obtain a serum specimen for electrolytes. D. Increase direct observation of the patient. A b e Which assessment findings would alert the nurse that the patient has entered the diuretic phase of acute kidney injury (aki)? Select all that apply A. Dehydration B. Hypokalemia C. Hypernatremia D. Bun increases E. Urine output increases A An unlicensed assistive personnel (uap) reports to the rn that a patient with acute kidney failure had a urine output of 350 ml over the past 24 hours after receiving furosemide 40 mg iv push. The uap asks the nurse how this can happen. What is the nurse's best response? A. "during the oliguric phase of acute kidney failure, patients often do not respond well to either fluid challenges or diuretics." B. "there must be some sort of error. Someone must have failed to record the urine output." C. "a patient with acute kidney failure retains sodium and water, which counteracts the action of the furosemide." D. "the gradual accumulation of nitrogenous waste products results in the retention of water and sodium." A b d e The rn supervising a senior nursing student is discussing methods for preventing acute kidney injury (aki). Which points would the rn be sure to include in this discussion? Select all that apply A. Encourage patients to avoid dehydration by drinking adequate fluids. B. Instruct patients to drink extra fluids during periods of strenuous exercise. C. Immediately report a urine output of less than 2 ml/kg/hr. D. Record intake and output and weigh patients daily. E. Monitor laboratory values that reflect kidney function. C For which patient is the nurse most concerned about the risk for developing kidney disease? A. A 25-year-old patient who developed a urinary tract infection (uti) during pregnancy B. A 55-year-old patient with a history of kidney stones C. A 63-year-old patient with type 2 diabetes D. A 79-year-old patient with stress urinary incontinence D A patient with acute kidney injury (aki) has an arterial blood ph of 7.30. The nurse will assess the patient for a. Vasodilation. B. Poor skin turgor. C. Bounding pulses. D. Rapid respirations. C A patient with severe heart failure develops elevated blood urea nitrogen (bun) and creatinine levels. The nurse will plan care to meet the goal of a. Replacing fluid volume. B. Preventing hypertension. C. Maintaining cardiac output. D. Diluting nephrotoxic substances. C