Lewis's Medical Surgical Nursing 11th Edition Harding Test Bank 2024/2025 (grade A+)

Lewis's Medical Surgical Nursing 11th Edition Harding Test Bank 2024/2025 (grade A+) 1. After the insertion of an arteriovenous graft in the right forearm, a patient reports pain and coldness of the right fingers. Which action should the nurse take? A. Remind the patient to take a daily low dose aspirin tablet. B. Report the patient’s symptoms to the healthcare provider. C. Elevate the patient’s arm on a pillow above the heart level. D. Teach the patient about normal arteriovenous graft function. ANS -B The patient’s problem suggests the development of distal ischemia (steal syndrome) and may require revision of the AVG Elevating 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. Which assessment finding should the nurse expect when a patient with acute kidney injury (AKI) has an arterial blood PH of 7.30? A. Persistent skin tenting. B. Rapid, deep respirations. C. Hot, flushed face and neck. D. Bounding peripheral pulses. ANS: B Patients with metabolic acidosis caused by AKI may have kussmaul respirations to eliminate 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: MSC: NCLEX: Physiological Integrity. 3. The nurse is planning care for the patient with severe heart failure who has developed increased blood urea nitrogen (BUN) and creatinine levels. What will be the primary treatment goal in the plan? A. Augmenting fluid volume. B. Maintaining cardiac output. C. Diluting nephrotoxic substances. D. Preventing systemic hypertension. ANS: B The primary goal of treatment for acute kidney injury (AKI) is to eliminate the cause and provide supportive care while the kidneys recover. Because this patient’s heart failure is causing AKI, the care will be directed toward treatment of the heart failure. For renal failure caused by hypertension, hypovolemia, or nephrotoxins, the other responses could be correct. DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Planning 4. A patient who has acute glomerulonephritis is hospitalized with hyperkalemia. Which information will the nurse monitor to evaluate the effectiveness of the prescribed calcium gluconate IV? A. Urine volume. B. Calcium level. C. Cardiac rhythm. D. Neurologic status. ANS: B