• Med Surg Exam 09/19/2026
Med Surg EXAM Capstone Assessment
Questions with Answers and Explanations
Complete Solutions, 100% Correct | New
Update | | Complete A+ Guide
The nurse is caring for a client with an acute kidney injury. Which of the following dietary recommendations is
inappropriate?
A. Limit intake of whole grains
B. Limit processed or canned foods
C. Increase foods high in potassium
P 1
, • Med Surg Exam 09/19/2026
D. Increase fresh vegetables and fruit - Correct Answer :C.
Rationale: This is an inappropriate dietary recommendation for a client with acute kidney injury, because the
kidneys are not able to excrete potassium as well as normal. If the client increases these foods, he or she could
get hyperkalemia.
The nurse is caring for a client who has suffered an acute kidney injury. Which of the following nursing
interventions are appropriate? Select all that apply.
A. Daily weights
B. Monitor I&O
C. Head CT with contrast
D. Fluid restriction
E. 1 gm NaCl tabs q6hrs - Correct Answer :A. , B. , D.
Rationale: Injury to the kidneys can result in fluid retention, and tracking the client's daily weights is a way to
monitor how well the kidneys are working. A client with an acute kidney injury should be monitored for I&O to
see how much fluid is being retained, and how much urine is being made by the kidneys.With a fluid restriction,
the client will retain less fluid and fluid overload will be less of a risk. With fluid overload, the client will begin to
demonstrate adventitious heart sounds and crackles in the lungs, which indicates the need for diuresis and/or
dialysis.
A 56-year-old client is suffering from interstitial nephritis and is seen in the hospital for care. The client's
creatinine levels are elevated and the client has poor skin turgor and dry mucous membranes upon exam. The
nurse ensures that the client does not receive any nephrotoxic medications that would worsen the condition.
Which medication should be avoided?
A. Amantadine
B. Combivir
C. Gentamicin
D. Abilify - Correct Answer :C.
Rationale: "Gentamicin" is correct. Nephrotoxic medications are those that can cause damage to the kidneys.
When a client is at risk, nephrotoxic drugs could cause such damage that a client goes into a state of acute renal
failure. Categories of nephrotoxic medications include aminoglycoside antibiotics (gentamicin is in this category),
antineoplastics, and nonsteroidal antiinflammatory drugs.
P 2
, • Med Surg Exam 09/19/2026
The nurse is admitting a client with a history of chronic kidney disease. Which of the following lab values would
you NOT expect to see?
A. BUN 42 mg/dL
B. BUN 7 mg/dL
C. Creatinine 2.1 mg/dL
D. K 6.1 mEq/L - Correct Answer :B.
Rationale: A client with kidney problems will have an increased BUN rather than a low-to-normal BUN.
A nurse is caring for a patient who is in end-stage renal disease and requires dialysis. Choose which alternative
best describes the type of diet the nurse should recommend for this patient.
A. A diet low in protein
B. A diet high in protein
C. A diet low in carbohydrates
D. A diet high in salt - Correct Answer :B.
Rationale: Many patients with kidney disease require low-protein diets because of the effects of protein on the
kidneys. HOWEVER, when a patient is in end-stage renal disease and requires dialysis, a low-protein diet may not
be necessary. In fact, the patient may more likely require a high-protein diet at this stage because of the loss of
nutrients from dialysis.
A patient with end-stage renal disease is to begin peritoneal dialysis (PD), and the nurse is creating a plan of care
to lower the risk of complications that could arise. Which of the following interventions would assist in
minimizing complications associated with PD? Select all that apply.
A. Assess potassium levels daily
B. Monitor for signs of cloudy dialysis outflow
C. Maintain aseptic technique when changing the implanted port dressing
D. Maintain sterile technique when caring for the catheter insertion site
E. Obtain a sample for culture if peritonitis is suspected - Correct Answer :B. , D. , E.
Rationale: -"Maintain sterile technique when caring for the catheter insertion site", "Monitor for signs of cloudy
dialysis outflow" and "Obtain a sample for culture if peritonitis is suspected" are correct. A patient with
P 3
, • Med Surg Exam 09/19/2026
peritoneal dialysis is at higher risk of infection because of the decreased immunity that comes with renal failure,
and because dialysis techniques - taking body fluid out of the body and returning it to the body - increase the risk
of contamination. Sterile technique is important for the nurse to maintain during care of the insertion site,
dressing changes and connecting and disconnecting the tubing. If the outflow of fluid becomes cloudy, this
indicates infection. A sample of the fluid for culture and sensitivity is going to help determine the infective
organism so that treatment can begin quickly.
The nurse is caring for a client who has been diagnosed with chronic kidney failure. Which of the following
aspects of this client's history could have contributed to this?
A. Diabetes mellitus
B. Hypertension
C. Transient ischemic attack (TIA)
D. Generalized anxiety disorder
E. Rheumatoid arthritis - Correct Answer :A., B., E.
Rationale: Diabetes can cause chronic kidney failure, because the high glucose level causes damage to the
nephrons, which decreases their ability to filter the blood.Hypertension causes too much pressure on the
structures of the kidneys over time, causing them to fail. Autoimmune disorders can cause chronic kidney failure
when the body's immune system begins to attack these organs.
A client with severe, uncontrolled hypertension is being evaluated for chronic kidney disease. The provider
checks the glomerular filtration rate and determines that it is 22 mL/min. Which stage of chronic kidney disease
does this GFR place the client?
A. Stage II
B. Stage III
C. Stage IV
D. Stage I - Correct Answer :C.
Rationale: "Stage IV" is correct. The glomerular filtration rate (GFR) is a measure of kidney function that
determines how well the kidney is able to filter waste products. A normal GFR is approximately 125 mL/minute. A
client who has a GFR of 22 mL/min would be categorized as having severe kidney disease and would be classified
at stage IV. Stage I GFR is >90 mL/minute. Stage II GFR is 60-89 mL/min. Stage III 30-59 mL/min. Stage IV 15-29
mL/min. Stage V <15 mL/min.
The nurse is caring for a client who has chronic kidney disease. Which of the following medications would the
nurse question?
A. Calcium gluconate
P 4
Med Surg EXAM Capstone Assessment
Questions with Answers and Explanations
Complete Solutions, 100% Correct | New
Update | | Complete A+ Guide
The nurse is caring for a client with an acute kidney injury. Which of the following dietary recommendations is
inappropriate?
A. Limit intake of whole grains
B. Limit processed or canned foods
C. Increase foods high in potassium
P 1
, • Med Surg Exam 09/19/2026
D. Increase fresh vegetables and fruit - Correct Answer :C.
Rationale: This is an inappropriate dietary recommendation for a client with acute kidney injury, because the
kidneys are not able to excrete potassium as well as normal. If the client increases these foods, he or she could
get hyperkalemia.
The nurse is caring for a client who has suffered an acute kidney injury. Which of the following nursing
interventions are appropriate? Select all that apply.
A. Daily weights
B. Monitor I&O
C. Head CT with contrast
D. Fluid restriction
E. 1 gm NaCl tabs q6hrs - Correct Answer :A. , B. , D.
Rationale: Injury to the kidneys can result in fluid retention, and tracking the client's daily weights is a way to
monitor how well the kidneys are working. A client with an acute kidney injury should be monitored for I&O to
see how much fluid is being retained, and how much urine is being made by the kidneys.With a fluid restriction,
the client will retain less fluid and fluid overload will be less of a risk. With fluid overload, the client will begin to
demonstrate adventitious heart sounds and crackles in the lungs, which indicates the need for diuresis and/or
dialysis.
A 56-year-old client is suffering from interstitial nephritis and is seen in the hospital for care. The client's
creatinine levels are elevated and the client has poor skin turgor and dry mucous membranes upon exam. The
nurse ensures that the client does not receive any nephrotoxic medications that would worsen the condition.
Which medication should be avoided?
A. Amantadine
B. Combivir
C. Gentamicin
D. Abilify - Correct Answer :C.
Rationale: "Gentamicin" is correct. Nephrotoxic medications are those that can cause damage to the kidneys.
When a client is at risk, nephrotoxic drugs could cause such damage that a client goes into a state of acute renal
failure. Categories of nephrotoxic medications include aminoglycoside antibiotics (gentamicin is in this category),
antineoplastics, and nonsteroidal antiinflammatory drugs.
P 2
, • Med Surg Exam 09/19/2026
The nurse is admitting a client with a history of chronic kidney disease. Which of the following lab values would
you NOT expect to see?
A. BUN 42 mg/dL
B. BUN 7 mg/dL
C. Creatinine 2.1 mg/dL
D. K 6.1 mEq/L - Correct Answer :B.
Rationale: A client with kidney problems will have an increased BUN rather than a low-to-normal BUN.
A nurse is caring for a patient who is in end-stage renal disease and requires dialysis. Choose which alternative
best describes the type of diet the nurse should recommend for this patient.
A. A diet low in protein
B. A diet high in protein
C. A diet low in carbohydrates
D. A diet high in salt - Correct Answer :B.
Rationale: Many patients with kidney disease require low-protein diets because of the effects of protein on the
kidneys. HOWEVER, when a patient is in end-stage renal disease and requires dialysis, a low-protein diet may not
be necessary. In fact, the patient may more likely require a high-protein diet at this stage because of the loss of
nutrients from dialysis.
A patient with end-stage renal disease is to begin peritoneal dialysis (PD), and the nurse is creating a plan of care
to lower the risk of complications that could arise. Which of the following interventions would assist in
minimizing complications associated with PD? Select all that apply.
A. Assess potassium levels daily
B. Monitor for signs of cloudy dialysis outflow
C. Maintain aseptic technique when changing the implanted port dressing
D. Maintain sterile technique when caring for the catheter insertion site
E. Obtain a sample for culture if peritonitis is suspected - Correct Answer :B. , D. , E.
Rationale: -"Maintain sterile technique when caring for the catheter insertion site", "Monitor for signs of cloudy
dialysis outflow" and "Obtain a sample for culture if peritonitis is suspected" are correct. A patient with
P 3
, • Med Surg Exam 09/19/2026
peritoneal dialysis is at higher risk of infection because of the decreased immunity that comes with renal failure,
and because dialysis techniques - taking body fluid out of the body and returning it to the body - increase the risk
of contamination. Sterile technique is important for the nurse to maintain during care of the insertion site,
dressing changes and connecting and disconnecting the tubing. If the outflow of fluid becomes cloudy, this
indicates infection. A sample of the fluid for culture and sensitivity is going to help determine the infective
organism so that treatment can begin quickly.
The nurse is caring for a client who has been diagnosed with chronic kidney failure. Which of the following
aspects of this client's history could have contributed to this?
A. Diabetes mellitus
B. Hypertension
C. Transient ischemic attack (TIA)
D. Generalized anxiety disorder
E. Rheumatoid arthritis - Correct Answer :A., B., E.
Rationale: Diabetes can cause chronic kidney failure, because the high glucose level causes damage to the
nephrons, which decreases their ability to filter the blood.Hypertension causes too much pressure on the
structures of the kidneys over time, causing them to fail. Autoimmune disorders can cause chronic kidney failure
when the body's immune system begins to attack these organs.
A client with severe, uncontrolled hypertension is being evaluated for chronic kidney disease. The provider
checks the glomerular filtration rate and determines that it is 22 mL/min. Which stage of chronic kidney disease
does this GFR place the client?
A. Stage II
B. Stage III
C. Stage IV
D. Stage I - Correct Answer :C.
Rationale: "Stage IV" is correct. The glomerular filtration rate (GFR) is a measure of kidney function that
determines how well the kidney is able to filter waste products. A normal GFR is approximately 125 mL/minute. A
client who has a GFR of 22 mL/min would be categorized as having severe kidney disease and would be classified
at stage IV. Stage I GFR is >90 mL/minute. Stage II GFR is 60-89 mL/min. Stage III 30-59 mL/min. Stage IV 15-29
mL/min. Stage V <15 mL/min.
The nurse is caring for a client who has chronic kidney disease. Which of the following medications would the
nurse question?
A. Calcium gluconate
P 4
