ARF FINAL TEST PREPARATION QUESTIONS AND ANSWERS!!!
1. A patient admitted with severe dehydration has a urine output of 380 ml over the next 24 hours and
elevated blood urea nitrogen (BUN) and creatinine levels. A finding that the nurse would expect when
reviewing the patient's urinalysis is
a. proteinuria.
b. bacteriuria.
c. high specific gravity.
d. tubular casts. - ANSWER Answer: C
Rationale: The patient's renal failure has been caused by the prerenal problem of hypovolemia. Prerenal
oliguria is characterized by the ability of the kidneys to concentrate urine, resulting in a high urine
specific gravity. The urinalysis in intrarenal failure would show proteins and tubular casts. Bacteriuria
would be typical of a urinary tract infection (UTI), not renal failure.
Cognitive Level: Application Text Reference: pp. 1198-1199
Nursing Process: Assessment NCLEX: Physiological Integrity
2. A patient with acute renal failure (ARF) has an arterial blood pH of 7.30. The nurse will assess the
patient for
a. tachycardia.
b. rapid respirations.
c. poor skin turgor.
d. vasodilation. - ANSWER Answer: B
Rationale: Patients with metabolic acidosis caused by ARF may have Kussmaul respirations as the lungs
try to regulate carbon dioxide. Tachycardia and vasodilation are not associated with metabolic acidosis.
Because the patient is likely to have fluid retention, poor skin turgor would not be a finding in ARF.
Cognitive Level: Application Text Reference: pp. 1200-1201
心脏不仅是一个生理器
Nursing Process: Assessment NCLEX: Physiological Integrity
3. A patient with severe heart failure develops elevated BUN and creatinine levels. The nurse plans care
for the patient based on the knowledge that collaborative care of the patient will be directed toward the
goal of
, a. preventing hypertension.
b. replacing fluid volume.
c. diluting nephrotoxic substances.
d. maintaining cardiac output. - ANSWER Answer: D
Rationale: The primary goal of treatment for ARF is to eliminate the cause and provide supportive care
while the kidneys recover. Because this patient's heart failure is causing ARF, the care will be directed
toward treatment of the heart failure. For renal failure caused by hypertension, hypovolemia, or
nephrotoxins, the other responses would be correct.
Cognitive Level: Application Text Reference: pp. 1201-1202
Nursing Process: Planning NCLEX: Physiological Integrity
4. When reviewing the laboratory values for a patient admitted with a severe crushing injury after an
industrial accident, the nurse will be most concerned about levels of
a. creatinine.
b. potassium.
c. white blood cells (WBCs).
d. BUN. - ANSWER Answer: B
Rationale: The hyperkalemia associated with crushing injuries may cause cardiac arrest and should be
treated immediately. The nurse will also review the other laboratory values, but abnormalities in these
are not immediately life threatening.
Cognitive Level: Application Text Reference: p. 1200
Nursing Process: Assessment NCLEX: Physiological Integrity
5. A patient admitted with sepsis has had several episodes of severe hypotension. Laboratory results
indicate a BUN 50 mg/dl (10.7 mmol/L), serum creatinine 2.0 mg/dl (177 µmol/L), urine sodium 70
心脏不仅是一个生理器
mEq/L (70 mmol/L), urine specific gravity 1.010, and cellular casts and debris in the urine. The nurse
knows these findings are consistent with
a. chronic renal insufficiency.
b. prerenal failure.
c. postrenal failure.
1. A patient admitted with severe dehydration has a urine output of 380 ml over the next 24 hours and
elevated blood urea nitrogen (BUN) and creatinine levels. A finding that the nurse would expect when
reviewing the patient's urinalysis is
a. proteinuria.
b. bacteriuria.
c. high specific gravity.
d. tubular casts. - ANSWER Answer: C
Rationale: The patient's renal failure has been caused by the prerenal problem of hypovolemia. Prerenal
oliguria is characterized by the ability of the kidneys to concentrate urine, resulting in a high urine
specific gravity. The urinalysis in intrarenal failure would show proteins and tubular casts. Bacteriuria
would be typical of a urinary tract infection (UTI), not renal failure.
Cognitive Level: Application Text Reference: pp. 1198-1199
Nursing Process: Assessment NCLEX: Physiological Integrity
2. A patient with acute renal failure (ARF) has an arterial blood pH of 7.30. The nurse will assess the
patient for
a. tachycardia.
b. rapid respirations.
c. poor skin turgor.
d. vasodilation. - ANSWER Answer: B
Rationale: Patients with metabolic acidosis caused by ARF may have Kussmaul respirations as the lungs
try to regulate carbon dioxide. Tachycardia and vasodilation are not associated with metabolic acidosis.
Because the patient is likely to have fluid retention, poor skin turgor would not be a finding in ARF.
Cognitive Level: Application Text Reference: pp. 1200-1201
心脏不仅是一个生理器
Nursing Process: Assessment NCLEX: Physiological Integrity
3. A patient with severe heart failure develops elevated BUN and creatinine levels. The nurse plans care
for the patient based on the knowledge that collaborative care of the patient will be directed toward the
goal of
, a. preventing hypertension.
b. replacing fluid volume.
c. diluting nephrotoxic substances.
d. maintaining cardiac output. - ANSWER Answer: D
Rationale: The primary goal of treatment for ARF is to eliminate the cause and provide supportive care
while the kidneys recover. Because this patient's heart failure is causing ARF, the care will be directed
toward treatment of the heart failure. For renal failure caused by hypertension, hypovolemia, or
nephrotoxins, the other responses would be correct.
Cognitive Level: Application Text Reference: pp. 1201-1202
Nursing Process: Planning NCLEX: Physiological Integrity
4. When reviewing the laboratory values for a patient admitted with a severe crushing injury after an
industrial accident, the nurse will be most concerned about levels of
a. creatinine.
b. potassium.
c. white blood cells (WBCs).
d. BUN. - ANSWER Answer: B
Rationale: The hyperkalemia associated with crushing injuries may cause cardiac arrest and should be
treated immediately. The nurse will also review the other laboratory values, but abnormalities in these
are not immediately life threatening.
Cognitive Level: Application Text Reference: p. 1200
Nursing Process: Assessment NCLEX: Physiological Integrity
5. A patient admitted with sepsis has had several episodes of severe hypotension. Laboratory results
indicate a BUN 50 mg/dl (10.7 mmol/L), serum creatinine 2.0 mg/dl (177 µmol/L), urine sodium 70
心脏不仅是一个生理器
mEq/L (70 mmol/L), urine specific gravity 1.010, and cellular casts and debris in the urine. The nurse
knows these findings are consistent with
a. chronic renal insufficiency.
b. prerenal failure.
c. postrenal failure.
