RENAL FAILURE (NCLEX) QUESTIONS WITH CORRECT ANSWERS GRADED TO PASS

What are the three types of renal failure? - CORRECT ANSWER Pre-renal failure, intra-renal failure, post-renal failure Which type of renal failure: Blood can't get to the kidneys. - CORRECT ANSWER Pre-renal failure (thus kidneys won't get perfused adequately) Which type of renal failure: Damage has occurred inside the kidneys. - CORRECT ANSWER Intra-renal failure Which type of renal failure: Urine can't get out of the kidneys. - CORRECT ANSWER Post-renal failure (thus the urine gets backed up into the kidneys) Which type of renal failure: Can be caused by hypotension. - CORRECT ANSWER Pre-renal failure Which type of renal failure: Can be caused by bradycardia (along with then a low cardiac output). - CORRECT ANSWER Pre-renal failure Which type of renal failure: Can be caused by hypovolemic. - CORRECT ANSWER Pre-renal failure Which type of renal failure: Can be caused by any form of shock. - CORRECT ANSWER Pre-renal failure Which type of renal failure: Can be caused by glomerulonephritis. - CORRECT ANSWER Intra-renal failure Which type of renal failure: Can be caused by nephrotic syndrome. - CORRECT ANSWER Intra-renal failure Which type of renal failure: Can be caused by dyes used in tests such as heart cath and CT scans. - CORRECT ANSWER Intra-renal failure Which type of renal failure: Can be caused by medications that are nephrotoxic. - CORRECT ANSWER Intra-renal failure Which type of renal failure: Can be caused by malignant hypertension. - CORRECT ANSWER Intra-renal failure (malignant hypertension causes severe vascular damage) Which type of renal failure: Can be caused by diabetes mellitus. - CORRECT ANSWER Intra-renal failure (DM can cause severe vascular damage) Which type of renal failure: Can be caused by an enlarged prostate. - CORRECT ANSWER Post-renal failure Which type of renal failure: Can be caused by kidney stones. - CORRECT ANSWER Post-renal failure Which type of renal failure: Can be caused by tumours. - CORRECT ANSWER Post-renal failure Which type of renal failure: Can be caused by ureteral obstruction. - CORRECT ANSWER Post-renal failure Which type of renal failure: Can be caused by an ileal condiut (edematous stoma). - CORRECT ANSWER Post-renal failure Hypertension (especially malignant hypertension) can cause ______, thus also causing increased amounts of _____ in the urine. - CORRECT ANSWER glomerular damage; protein (and can thus ultimately cause renal failure) Always be worried about kidney perfusion when patient is hypotensive as it can take as little as ______ of poor perfusion to cause acute tubular necrosis (kidney cell death). - CORRECT ANSWER 20 minutes What types of drugs increase the likelyhood of nephrotoxicity? - CORRECT ANSWER Antibiotics ("mycin" drugs; ex: aminoglycosides) Which two labs are affected by renal failure? - CORRECT ANSWER BUN & creatinine Does BUN increase or decrease with renal failure? - CORRECT ANSWER Increase (because the patients' kidneys cannot excrete BUN sufficiently) Does creatinine increase or decrease with renal failure? - CORRECT ANSWER Increase (because the patients' kidneys cannot excrete creatinine sufficiently) With renal failure, initially when there is only a little bit of urine coming out, it will be very concentrated. Thus, the specific gravity will be ______. - CORRECT ANSWER increased Initially with renal failure, the specific gravity is ______, but then eventually the specific gravity _______. - CORRECT ANSWER increased (concentrated) ; becomes fixed Why does the specific gravity become fixed with renal failure? - CORRECT ANSWER Because the kidneys lose the ability to concentrate and dilute the urine One of the most important functions of the kidneys is to ________. - CORRECT ANSWER concentration and dilute the urine according to what's going on in the body (but this function becomes impaired with renal failure) Normal saline is hypertonic, isotonic, or hypotonic? - CORRECT ANSWER Isotonic ______ refers to a test that involves giving the patient a bolus of 250mL (or greater) of normal saline to test kidney function. - CORRECT ANSWER Fluid challenge What does it mean if a patient has more dilute urine after undergoing a fluid challenge? - CORRECT ANSWER It means that the patients' kidney function is adequate What does it mean if a patients' urine specific gravity is low after undergoing a fluid challenge? - CORRECT ANSWER It means that the patients' kidney function is adequate (urine is dilute) What does it mean if a patient has concentrated urine after undergoing a fluid challenge? - CORRECT ANSWER It means that the patients' kidneys are not functioning adequately (pt may have kidney failure; urine is concentrated) What does it mean if a patients' urine specific gravity is high after undergoing a fluid challenge? - CORRECT ANSWER It means that the patients' kidneys are not functioning adequately (pt may have kidney failure) Anemia occurs during renal failure because there's not enough ______. - CORRECT ANSWER erythropoietin ______ refers the the hormone secreted by the kidneys that stimulates RBC production. - CORRECT ANSWER Erythropoietin Anytime a patient has kidney problems, they may develop what blood abnormality? - CORRECT ANSWER Anemia Patients with renal failure are at an increased risk for ______ and ______ because they're retaining more fluids. - CORRECT ANSWER hypertension; heart failure Why do patients with renal failure generally experience upper GI upset? - CORRECT ANSWER Because they're retaining toxins A patient with renal failure often has which three s/s due to the body retaining toxins? - CORRECT ANSWER Anorexia, nausea, & vomiting Patients with kidney failure generally have increased amounts of urea in their blood, which eventually goes out onto the skin and causes _______. - CORRECT ANSWER itching frost What's another term for itching frost? - CORRECT ANSWER Uremic frost What's another term for uremic frost? - CORRECT ANSWER Itching frost What can prevent renal failure patients from getting itching frost? - CORRECT ANSWER Dialysis What causes itching frost for patients with renal failure? - CORRECT ANSWER The increased amount of urea in the blood causes some of the urea to get pushed out onto the skin (thus causing the itch) Why is good skin care very important for patients with renal failure? - CORRECT ANSWER Because the urea on their skin (due to increased amount in their blood) means that there are little crystals on their skin, thus increasing the itchiness and potential for scratches and damages to the patients' skin (could cause wounds and lead to infection) Which two electrolytes are being retained with renal failure? - CORRECT ANSWER Potassium & phosphorous Which electrolyte should the nurse be most concerned about regarding a patient with renal failure? - CORRECT ANSWER Potassium (hyperkalemia) Why does hyperkalemia concern the nurse? - CORRECT ANSWER Hyperkalemia could cause lethal arrythmias Does a patient with renal failure get hyperkalemia or hypokalemia? - CORRECT ANSWER Hyperkalemia Does a patient with renal failure get hyperphosphatemia or hypophosphatemia? - CORRECT ANSWER Hyperphosphatemia Does a patient with renal failure get hypercalcemia or hypocalcemia? - CORRECT ANSWER Hypocalcemia Patients with renal failure have _______, which means that more is pulled from the bones to increase the serum level of such, thus putting the patient at risk for osteoporosis. - CORRECT ANSWER hypocalcemia