Ch. 46: Acute Renal Failure & 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 patient to take a daily low-dose aspirin tablet
c. Report the patient symptoms to the health care provider
d. Elevate the patients arm on pillows to above the heart level
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
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. augmented fluid volume
b. maintaining cardiac output
c. diluting nephrotoxic substances
d. preventing systemic hypertension
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. Neurological status
5. A 48-year-old patient with stage 2 chronic kidney disease (CKD) is scheduled for an intravenous pyelogram
(IVP). Which order for the patient will the nurse question?
a. NPO for 6 hours before procedure
b. Ibuprofen (Advil) 400 mg PO PRN for pain
c. Dulcolax suppository 4 hours before procedure
d. Normal saline 500 mL IV infused before procedure
6. Which statement by a 62-year-old patient with stage 5 chronic kidney disease (CKD) indicates that the
nurse is teaching about management of CKD has been effective?
a. “I need to get most of my protein from low-fat dairy products.”
b. “I will increase my intake of fruits and vegetables to 5 per day.”
c. “I will measure my urinary output each day to help calculate the amount I can drink.”
d. “I need to take erythropoietin to boost my immune system and help prevent infection.”
7. Which information will the nurse monitor in order to determine the effectiveness of prescribed calcium
carbonate (Caltrate) for a patient with chronic kidney disease (CKD)?
a. Blood pressure
b. Phosphate level
c. Neurologic status
, d. Creatinine clearance
8. Sodium polystyrene sulfonate (Kayexalate) is ordered for a patient with hyperkalemia. Before
administering the medication, the nurse should assess the
a. bowel sounds
b. blood glucose
c. blood urea nitrogen (BUN)
d. level of consciousness (LOC)
9. Which menu choice by the patient who is receiving hemodialysis indicates that the nurse is teaching has
been successful?
a. Split-pea soup, English muffin, and nonfat milk
b. Oatmeal with cream, half a banana, and herbal tea
c. Poached eggs, whole-wheat toast, and apple juice
d. Cheese sandwich, tomato soup, and cranberry juice
10. Before administration of calcium carbonate (Caltrate) 2A patient with chronic kidney disease (CKD), the
nurse should check laboratory results for
a. potassium levels
b. total cholesterol
c. serum phosphate
d. serum creatinine
11. A 37-year-old female patient is hospitalized with acute kidney injury (AKI). which information will be
most useful to the nurse in evaluating improvement in kidney function?
a. Urine volume
b. Creatinine level
c. Glomerular filtration rate (GFR)
d. Blood urea nitrogen (BUN) level
12. A patient will need vascular access for hemodialysis. Which statement by the nurse accurately describes
an advantage of a fistula over a graft?
a. A fistula is much less likely to clot
b. A fistula increases patient mobility
c. A fistula can accommodate larger needles
d. A fistula can be used sooner after surgery
13. When caring for a patient with a left arm arteriovenous fistula, which action will the nurse include in the
plan of care to maintain the patency of the fistula?
a. Auscultate for a bruit at the fistula site
b. Assess the quality of the left radial pulse
c. Compare blood pressures in the left and right arms
d. Irrigate the fistula site with saline every 8 to 12 hours
14. A 64-year-old male patient who has had progressive chronic kidney disease (CKD) for several years has
just begun regular hemodialysis. Which information about diet will the nurse include in patient teaching?
a. Increased calories are needed because glucose is lost during hemodialysis
b. Unlimited fluids are allowed because retained fluid is removed during dialysis
c. More protein is allowed because urea and creatinine are removed by dialysis
d. Dietary potassium is not restricted because the level is normalized by dialysis
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 patient to take a daily low-dose aspirin tablet
c. Report the patient symptoms to the health care provider
d. Elevate the patients arm on pillows to above the heart level
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
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. augmented fluid volume
b. maintaining cardiac output
c. diluting nephrotoxic substances
d. preventing systemic hypertension
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. Neurological status
5. A 48-year-old patient with stage 2 chronic kidney disease (CKD) is scheduled for an intravenous pyelogram
(IVP). Which order for the patient will the nurse question?
a. NPO for 6 hours before procedure
b. Ibuprofen (Advil) 400 mg PO PRN for pain
c. Dulcolax suppository 4 hours before procedure
d. Normal saline 500 mL IV infused before procedure
6. Which statement by a 62-year-old patient with stage 5 chronic kidney disease (CKD) indicates that the
nurse is teaching about management of CKD has been effective?
a. “I need to get most of my protein from low-fat dairy products.”
b. “I will increase my intake of fruits and vegetables to 5 per day.”
c. “I will measure my urinary output each day to help calculate the amount I can drink.”
d. “I need to take erythropoietin to boost my immune system and help prevent infection.”
7. Which information will the nurse monitor in order to determine the effectiveness of prescribed calcium
carbonate (Caltrate) for a patient with chronic kidney disease (CKD)?
a. Blood pressure
b. Phosphate level
c. Neurologic status
, d. Creatinine clearance
8. Sodium polystyrene sulfonate (Kayexalate) is ordered for a patient with hyperkalemia. Before
administering the medication, the nurse should assess the
a. bowel sounds
b. blood glucose
c. blood urea nitrogen (BUN)
d. level of consciousness (LOC)
9. Which menu choice by the patient who is receiving hemodialysis indicates that the nurse is teaching has
been successful?
a. Split-pea soup, English muffin, and nonfat milk
b. Oatmeal with cream, half a banana, and herbal tea
c. Poached eggs, whole-wheat toast, and apple juice
d. Cheese sandwich, tomato soup, and cranberry juice
10. Before administration of calcium carbonate (Caltrate) 2A patient with chronic kidney disease (CKD), the
nurse should check laboratory results for
a. potassium levels
b. total cholesterol
c. serum phosphate
d. serum creatinine
11. A 37-year-old female patient is hospitalized with acute kidney injury (AKI). which information will be
most useful to the nurse in evaluating improvement in kidney function?
a. Urine volume
b. Creatinine level
c. Glomerular filtration rate (GFR)
d. Blood urea nitrogen (BUN) level
12. A patient will need vascular access for hemodialysis. Which statement by the nurse accurately describes
an advantage of a fistula over a graft?
a. A fistula is much less likely to clot
b. A fistula increases patient mobility
c. A fistula can accommodate larger needles
d. A fistula can be used sooner after surgery
13. When caring for a patient with a left arm arteriovenous fistula, which action will the nurse include in the
plan of care to maintain the patency of the fistula?
a. Auscultate for a bruit at the fistula site
b. Assess the quality of the left radial pulse
c. Compare blood pressures in the left and right arms
d. Irrigate the fistula site with saline every 8 to 12 hours
14. A 64-year-old male patient who has had progressive chronic kidney disease (CKD) for several years has
just begun regular hemodialysis. Which information about diet will the nurse include in patient teaching?
a. Increased calories are needed because glucose is lost during hemodialysis
b. Unlimited fluids are allowed because retained fluid is removed during dialysis
c. More protein is allowed because urea and creatinine are removed by dialysis
d. Dietary potassium is not restricted because the level is normalized by dialysis
