NUR 213 Test 3 Exam #1 Question with verified
answers
3
The dialysate return should be colorless or straw colored but should never be cloudy, which
indicates an infection; therefore, this data warrants immediate intervention.- √√The client
diagnosed with end-stage renal disease (ESRD), also known as chronic kidney disease
(CKD), who is on peritoneal dialysis is admitted to the critical care unit. Which assessment
data warrants immediate intervention by the nurse?
1. The client's serum creatinine level is 2.4 mg/dL.
2. The client's abdomen is soft to touch and nontender.
3. The dialysate being removed from the abdomen is cloudy.
4. The dialysate instilled was 1500 mL and removed was 2100 mL.
1
This client with dyspnea and a respiration rate of 12 has signs/symptoms of a respiratory
complication and should be assessed first because ascending paralysis at the C-6 level could
cause the client to stop breathing.- √√The charge nurse, along with the registered nurse
(RN) staff, in the critical care unit is caring for clients with a spinal cord injury (SCI). Which
client should the charge nurse assess first after receiving the change-of-shift report?
1. The client with a C-6 SCI who is complaining of dyspnea and has a respiratory rate
of 12 breaths/minute.
2. The client with an L-4 SCI who is frightened about being transferred to the rehabilitation
unit.
3. The client with an L-2 SCI who is complaining of a headache and feeling very hot
all of a sudden.
4. The client with a C-4 SCI who is on a ventilator and has a pulse oximeter reading
of 98%.
4
Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and some herbal
remedies are nephrotoxic; therefore, asking about medications is appropriate.- √√The
nurse is admitting a client diagnosed with acute renal failure (ARF). Which question is most
important for the nurse to ask during the admission interview?
1. "Have you recently traveled outside the United States?"
2. "Did you recently begin a vigorous exercise program?"
3. "Is there a chance you have been exposed to a virus?"
,4. "What over-the-counter medications do you take regularly?"
1
Blood urea nitrogen (BUN) levels reflect the balance between the production and excretion
of urea from the kidneys. Creatinine is a by-product of the metabolism of the muscles and
is excreted by the kidneys. Creatinine is the ideal substance for determining renal clearance
because it is relatively constant in the body and is the laboratory value most significant in
diagnosing renal failure.- √√The nurse is caring for a client diagnosed with ARF. Which
laboratory values are most significant for diagnosing ARF?
1. BUN and creatinine.
2. WBC and hemoglobin.
3. Potassium and sodium.
4. Bilirubin and ammonia level.
2
Hypotension, which causes a decreased blood supply to the kidney, is one of the most
common causes of prerenal failure (before the kidney).- √√The nurse is caring for a client
diagnosed with rule-out ARF. Which condition predisposes the client to developing prerenal
failure?
1. Diabetes mellitus.
2. Hypotension.
3. Aminoglycosides.
4. Benign prostatic hypertrophy.
1, 2, 3
Renal failure affects almost every system in the body. Neurologically, the client may have
drowsiness, headache, muscle twitching, and seizures. In the recovery period, the client is
alert and has no seizure activity. In renal failure, levels of erythropoietin are decreased,
leading to anemia. An increase in hemoglobin and hematocrit indicates the client is in the
recovery period. Nausea, vomiting, and diarrhea are common in the client with ARF;
therefore, an absence of these indicates the client is in the recovery period.- √√The client is
diagnosed with ARF. Which signs/symptoms indicate to the nurse the client is in the
recovery period? Select all that apply.
1. Increased alertness and no seizure activity.
2. Increase in hemoglobin and hematocrit.
3. Denial of nausea and vomiting.
4. Decreased urine-specific gravity.
,5. Increased serum creatinine level.
4
Normal potassium level is 3.5 to5.5 mEq/L. A level of 6.8 mEq/L is life threatening and could
lead to cardiac dysrhythmias. Therefore, the client may be dialyzed to decrease the
potassium level quickly. This requires a health-care provider order, so it is a collaborative
intervention.- √√The client diagnosed with ARF has a serum potassium level of 6.8 mEq/L.
Which collaborative treatment should the nurse anticipate for the client?
1. Administer a phosphate binder.
2. Type and crossmatch for whole blood.
3. Assess the client for leg cramps.
4. Prepare the client for dialysis.
3
Renal failure causes an imbalance of electrolytes (potassium, sodium, calcium,
phosphorus). Therefore, the desired client outcome is electrolytes within normal limits.-
√√The nurse is developing a plan of care for a client diagnosed with ARF. Which statement
is an appropriate outcome for the client?
1. Monitor intake and output every shift.
2. Decrease of pain by 3 levels on a 1-10 scale.
3. Electrolytes are within normal limits.
4. Administer enemas to decrease hyperkalemia.
3
Carbohydrates are increased to provide for the client's caloric intake and protein is
restricted to minimize protein breakdown and to prevent accumulation of toxic waste
products.- √√The client diagnosed with ARF is admitted to the intensive care unit and
placed on a therapeutic diet. Which diet is most appropriate for the client?
1. A high-potassium and low-calcium diet.
2. A low-fat and low-cholesterol diet.
3. A high-carbohydrate and restricted-protein diet.
4. A regular diet with six (6) small feedings a day.
2
Bedrest reduces exertion and the metabolic rate, thereby reducing catabolism and
subsequent release of potassium and accumulation of endogenous waste products (urea
and creatinine).- √√The client diagnosed with ARF is placed on bedrest. The client asks the
, nurse, "Why do I have to stay in bed? I don't feel bad." Which scientific rationale supports
the nurse's response?
1. Bedrest helps increase the blood return to the renal circulation.
2. Bedrest reduces the metabolic rate during the acute stage.
3. Bedrest decreases the workload of the left side of the heart.
4. Bedrest aids in reduction of peripheral and sacral edema.
1
The UAP can collect specimens. Collecting a midstream urine specimen requires the client
to clean the perineal area, to urinate a little, and then collect the rest of the urine output in
a sterile container.- √√The nurse and an unlicensed assistive personnel (UAP) are caring for
clients on a medical floor. Which nursing task is most appropriate for the nurse to delegate?
1. Collect a clean voided midstream urine specimen.
2. Evaluate the client's 8-hour intake and output.
3. Assist in checking a unit of blood prior to hanging. 4. Administer a cation-exchange resin
enema.
1
Preventing and treating shock with blood and fluid replacement will prevent acute renal
failure from hypoperfusion of the kidneys. Significant blood loss is expected in the client
with a gunshot wound.- √√The client is admitted to the emergency department after a
gunshot wound to the abdomen. Which nursing intervention should the nurse implement
first to prevent ARF?
1. Administer normal saline IV.
2. Take vital signs.
3. Place client on telemetry. 4. Assess abdominal dressing.
2
These crystals are uremic frost resulting from irritating toxins deposited in the client's
tissues. Bathing in cool water will remove the crystals, promote client comfort, and
decrease the itching resulting from uremic frost.- √√The UAP tells the nurse the client with
ARF has a white crystal-like layer on top of the skin. Which intervention should the nurse
implement?
1. Have the assistant apply a moisture barrier cream to the skin.
2. Instruct the UAP to bathe the client in cool water.
3. Tell the UAP not to turn the client in this condition.
4. Explain this is normal and do not do anything for the client.
answers
3
The dialysate return should be colorless or straw colored but should never be cloudy, which
indicates an infection; therefore, this data warrants immediate intervention.- √√The client
diagnosed with end-stage renal disease (ESRD), also known as chronic kidney disease
(CKD), who is on peritoneal dialysis is admitted to the critical care unit. Which assessment
data warrants immediate intervention by the nurse?
1. The client's serum creatinine level is 2.4 mg/dL.
2. The client's abdomen is soft to touch and nontender.
3. The dialysate being removed from the abdomen is cloudy.
4. The dialysate instilled was 1500 mL and removed was 2100 mL.
1
This client with dyspnea and a respiration rate of 12 has signs/symptoms of a respiratory
complication and should be assessed first because ascending paralysis at the C-6 level could
cause the client to stop breathing.- √√The charge nurse, along with the registered nurse
(RN) staff, in the critical care unit is caring for clients with a spinal cord injury (SCI). Which
client should the charge nurse assess first after receiving the change-of-shift report?
1. The client with a C-6 SCI who is complaining of dyspnea and has a respiratory rate
of 12 breaths/minute.
2. The client with an L-4 SCI who is frightened about being transferred to the rehabilitation
unit.
3. The client with an L-2 SCI who is complaining of a headache and feeling very hot
all of a sudden.
4. The client with a C-4 SCI who is on a ventilator and has a pulse oximeter reading
of 98%.
4
Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and some herbal
remedies are nephrotoxic; therefore, asking about medications is appropriate.- √√The
nurse is admitting a client diagnosed with acute renal failure (ARF). Which question is most
important for the nurse to ask during the admission interview?
1. "Have you recently traveled outside the United States?"
2. "Did you recently begin a vigorous exercise program?"
3. "Is there a chance you have been exposed to a virus?"
,4. "What over-the-counter medications do you take regularly?"
1
Blood urea nitrogen (BUN) levels reflect the balance between the production and excretion
of urea from the kidneys. Creatinine is a by-product of the metabolism of the muscles and
is excreted by the kidneys. Creatinine is the ideal substance for determining renal clearance
because it is relatively constant in the body and is the laboratory value most significant in
diagnosing renal failure.- √√The nurse is caring for a client diagnosed with ARF. Which
laboratory values are most significant for diagnosing ARF?
1. BUN and creatinine.
2. WBC and hemoglobin.
3. Potassium and sodium.
4. Bilirubin and ammonia level.
2
Hypotension, which causes a decreased blood supply to the kidney, is one of the most
common causes of prerenal failure (before the kidney).- √√The nurse is caring for a client
diagnosed with rule-out ARF. Which condition predisposes the client to developing prerenal
failure?
1. Diabetes mellitus.
2. Hypotension.
3. Aminoglycosides.
4. Benign prostatic hypertrophy.
1, 2, 3
Renal failure affects almost every system in the body. Neurologically, the client may have
drowsiness, headache, muscle twitching, and seizures. In the recovery period, the client is
alert and has no seizure activity. In renal failure, levels of erythropoietin are decreased,
leading to anemia. An increase in hemoglobin and hematocrit indicates the client is in the
recovery period. Nausea, vomiting, and diarrhea are common in the client with ARF;
therefore, an absence of these indicates the client is in the recovery period.- √√The client is
diagnosed with ARF. Which signs/symptoms indicate to the nurse the client is in the
recovery period? Select all that apply.
1. Increased alertness and no seizure activity.
2. Increase in hemoglobin and hematocrit.
3. Denial of nausea and vomiting.
4. Decreased urine-specific gravity.
,5. Increased serum creatinine level.
4
Normal potassium level is 3.5 to5.5 mEq/L. A level of 6.8 mEq/L is life threatening and could
lead to cardiac dysrhythmias. Therefore, the client may be dialyzed to decrease the
potassium level quickly. This requires a health-care provider order, so it is a collaborative
intervention.- √√The client diagnosed with ARF has a serum potassium level of 6.8 mEq/L.
Which collaborative treatment should the nurse anticipate for the client?
1. Administer a phosphate binder.
2. Type and crossmatch for whole blood.
3. Assess the client for leg cramps.
4. Prepare the client for dialysis.
3
Renal failure causes an imbalance of electrolytes (potassium, sodium, calcium,
phosphorus). Therefore, the desired client outcome is electrolytes within normal limits.-
√√The nurse is developing a plan of care for a client diagnosed with ARF. Which statement
is an appropriate outcome for the client?
1. Monitor intake and output every shift.
2. Decrease of pain by 3 levels on a 1-10 scale.
3. Electrolytes are within normal limits.
4. Administer enemas to decrease hyperkalemia.
3
Carbohydrates are increased to provide for the client's caloric intake and protein is
restricted to minimize protein breakdown and to prevent accumulation of toxic waste
products.- √√The client diagnosed with ARF is admitted to the intensive care unit and
placed on a therapeutic diet. Which diet is most appropriate for the client?
1. A high-potassium and low-calcium diet.
2. A low-fat and low-cholesterol diet.
3. A high-carbohydrate and restricted-protein diet.
4. A regular diet with six (6) small feedings a day.
2
Bedrest reduces exertion and the metabolic rate, thereby reducing catabolism and
subsequent release of potassium and accumulation of endogenous waste products (urea
and creatinine).- √√The client diagnosed with ARF is placed on bedrest. The client asks the
, nurse, "Why do I have to stay in bed? I don't feel bad." Which scientific rationale supports
the nurse's response?
1. Bedrest helps increase the blood return to the renal circulation.
2. Bedrest reduces the metabolic rate during the acute stage.
3. Bedrest decreases the workload of the left side of the heart.
4. Bedrest aids in reduction of peripheral and sacral edema.
1
The UAP can collect specimens. Collecting a midstream urine specimen requires the client
to clean the perineal area, to urinate a little, and then collect the rest of the urine output in
a sterile container.- √√The nurse and an unlicensed assistive personnel (UAP) are caring for
clients on a medical floor. Which nursing task is most appropriate for the nurse to delegate?
1. Collect a clean voided midstream urine specimen.
2. Evaluate the client's 8-hour intake and output.
3. Assist in checking a unit of blood prior to hanging. 4. Administer a cation-exchange resin
enema.
1
Preventing and treating shock with blood and fluid replacement will prevent acute renal
failure from hypoperfusion of the kidneys. Significant blood loss is expected in the client
with a gunshot wound.- √√The client is admitted to the emergency department after a
gunshot wound to the abdomen. Which nursing intervention should the nurse implement
first to prevent ARF?
1. Administer normal saline IV.
2. Take vital signs.
3. Place client on telemetry. 4. Assess abdominal dressing.
2
These crystals are uremic frost resulting from irritating toxins deposited in the client's
tissues. Bathing in cool water will remove the crystals, promote client comfort, and
decrease the itching resulting from uremic frost.- √√The UAP tells the nurse the client with
ARF has a white crystal-like layer on top of the skin. Which intervention should the nurse
implement?
1. Have the assistant apply a moisture barrier cream to the skin.
2. Instruct the UAP to bathe the client in cool water.
3. Tell the UAP not to turn the client in this condition.
4. Explain this is normal and do not do anything for the client.
