NSG 456 Exam 2 Practice Questions With Correct Answers.

NSG 456 Exam 2 Practice Questions With Correct Answers. A nurse is preparing a client to go to dialysis after they finish their morning. Which of the following medications should the nurse hold prior to dialysis? (Select all that apply) A. Insulin lispro B. Propranolol C. Nitroglycerin patch D. Demorol - answerB. Propranolol C. Nitroglycerin patch D. Demorol Hold propranolol (anti-hypertensive) and nitroglycerin (vasodilator) prior to dialysis because client will need a systolic BP of 90-100 to undergo dialysis Hold demorol because demorol cause seizures A nurse is caring for a client who is complaining of unrelieved pain in the right lower extremity. Upon assessment, the nurse notes that there is no pedal pulse and the extremity is cool to the touch. The nurse's priority action is to A. Immediately call the provider B. Place the client is reverse Trendelenburg C. Start the client on an NPO diet D. Start IV fluid resuscitation - answerD. Start IV fluid resuscitation This client is exhibiting signs of rhabdomyolysis. The main treatment goal for a patient with rhabdomyolysis is fluid resuscitation to increase or restore intravascular volume, increase glomerular filtration rate, and dilute myoglobin and other renal tubular toxins A nurse is caring for a client who is extremely irritable, and is complaining of nausea, vomiting, and diarrhea. After looking at the lab work, the nurse determines the client's serum potassium level to be 6.2mg/dL. Which medication should the nurse anticipate the provider to order? EXAM STUDY MATERIALS July 29, 2024 12:59 PM A. sodium polystyrene sulfonate B. magnesium citrate C. potassium chloride D. chlorpropamide - answerA. sodium polystyrene sulfonate The nurse is providing teaching to a client who has a diagnosis of stage IV chronic kidney disease. The nurse knows the teaching has been effective when the client makes the following food choices: A. Double cheese burger with a side of french fries B. Grilled chicken breast with lentil salad C. A two egg omelette with peanut butter toast D. Pasta with pesto and a side salad - answerD. Pasta with pesto and a side salad Protein is produced by the liver and turned into urea, which is excreted by the kidneys. A client in stage IV CKD will have a decreased GFR, meaning less of the urea will be excreted in the urine. Therefore, lower-protein is requires to keep uremic waste products low A nurse is caring for a client who is in the oliguric phase of an acute kidney injury. Which ABG results would the nurse expect? A. pH 7.22, pCO2 55, HCO3 25 B. pH 7.51, pCO2 29, HCO3 20 C. pH 7. 45, pCO2 39, HCO3 24 D. pH 7.29, pCO2 37, HCO3 19 - answerD. pH 7.29, pCO2 37, HCO3 19 This ABG shows metabolic acidosis. Clients in the oliguric phase of an AKI will have decreased secretion of hydrogen ions which will increase the acidity of the blood. Decreased hydrogen ion excretion is due to the decreased GFR. Clients may compensate with Kussmal's respirations (fast, rapid respirations), which attempts to get rid of acid through blowing off CO2 which is an acid. 1. ______________ is solely filtered from the bloodstream via the glomerulus and is NOT reabsorbed back into the bloodstream but is excreted through the urine. A. Urea B. Creatinine EXAM STUDY MATERIALS July 29, 2024 12:59 PM C. Potassium D. Magnesium - answerB. Creatinine Creatinine is a waste product from muscle breakdown and is removed from the bloodstream via the glomerulus of the nephron. It is the only substance that is solely filtered out of the blood but NOT reabsorbed back into the system. It is excreted out through the urine. This is why a creatinine clearance test is used as an indicator for determining renal function and for calculating the glomerular filtration rate. A patient with acute renal injury has a GFR (glomerular filtration rate) of 40 mL/min. Which signs and symptoms below may this patient present with? Select all that apply: A. Hypervolemia B. Hypokalemia C. Increased BUN level D. Decreased Creatinine level - answerA. Hypervolemia C. Increased BUN level The glomerular filtration rate indicates how well the glomerulus is filtering the blood. A normal GFR tends to be 90 mL/min or higher. A GFR of 40 mL/min indicates that the kidney's ability to filter the blood is decreased. Therefore, the kidneys will be unable to remove waste and excessive water from the blood...hence hypervolemia and an increased BUN level will present in this patient. The patient will experience HYPERkalemia (not hypo) because the kidneys are unable to remove potassium from the blood. In addition, an INCREASED creatinine level (not decreased) will present because the kidneys cannot remove excessive waste products, such as creatinine. You're assessing morning lab values on a female patient who is recovering from a myocardial infraction. Which lab value below requires you to notify the physician? A. Potassium level 4.2 mEq/L B. Creatinine clearance 35 mL/min C. BUN 20 mg/dL D. Blood pH 7.40 - answerB. Creatinine clearance 35 mL/min A normal creatinine clearance level in a female should be 85-125 mL/min (95-140 mL/min males). A creatinine clearance level indicates the amount of blood the kidneys can make per minute that contain no amounts of creatinine in it. Remember creatinine is a waste product of muscle breakdown. Therefore, the kidneys should be able to remove excessive amounts of it from the bloodstream. A patient who has experienc