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Exam (elaborations)

LEWIS'S MEDICAL SURGICAL NURSING (11TH EDITION) TEST BANK -CHAPTER 46:

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LEWIS'S MEDICAL SURGICAL NURSING (11TH EDITION) TEST BANK -CHAPTER 46: ACUTE KIDNEY INJURY AND CHRONIC KIDNEY DISEASE 1. After the insertion of an arteriovenous graft (AVG) in the right forearm, a 54-year-old patient complains of pain and coldness of the right fingers. Which action should the nurse take? a) Teach the patient about normal AVG function. b) Remind the patient to take a daily low-dose aspirin tablet. c) Report the patients symptoms to the health care provider. d) Elevate the patients arm on pillows to above the heart level. - CORRECT ANSWER -*ANS: C The patients complaints suggest the development of distal ischemia (steal syndrome) and may require revision of the AVG. Elevation of the arm above the heart will further decrease perfusion. Pain and coolness are not normal after AVG insertion. Aspirin therapy is not used to maintain grafts. DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity 2. When a patient with acute kidney injury (AKI) has an arterial blood pH of 7.30, the nurse will expect an assessment finding of a) persistent skin tenting b) rapid, deep respirations. c) bounding peripheral pulses. d) hot, flushed face and neck. - CORRECT ANSWER -ANS: B Patients with metabolic acidosis caused by AKI may have Kussmaul respirations as the lungs try to regulate carbon dioxide. Bounding pulses 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 AKI. DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity 3. The nurse is planning care for a patient with severe heart failure who has developed elevated blood urea nitrogen (BUN) and creatinine levels. The primary collaborative treatment goal in the plan will be a) augmenting fluid volume.

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Uploaded on
June 9, 2025
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Written in
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  • lewiss medical surgical nursing 11th edition t
  • acute kidney injury and chronic kidney disease

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