Med Surg Exam Renal Failure

Renal Failure 1. The kidneys are responsible for performing all the following functions EXCEPT? a. Activating Vitamin D b. Secreting Renin c. Secreting Erythropoietin d. Maintaining cortisol production 2. A 55-year-old male patient is admitted with a massive GI bleed. The patient is at risk for what type of acute kidney injury? a. Post-renal b. Intra-renal c. Pre-renal d. Intrinsic renal 3. The nurse is taking a history of a patient at risk for kidney failure. What does the nurse ask the patient about during the interview? Select all that apply a. Exposure to nephrotoxic chemicals b. Unexpected weight loss c. History of diabetes mellitus and hypertension d. Recent surgery, trauma, or transfusions e. Leakage of urine when coughing or laughing f. Recent or prolonged use of nonsteroidal anti-inflammatory drugs 4. Which of the following provides the most objective measurement of renal dysfunction? a. b. c. d. White blood cell count Glomerular filtration rate Altered urinary electrolytes Presence of nitrites in urine 5. The nurse is caring for a patient with acute kidney injury and notes a trend of increasingly elevated blood urea nitrogen levels. How does the nurse interpret this information? a. Breakdown of muscle of protein which leads to an increase in azotemia b. Sign of urinary retention and decreased urinary output c. Expected trend that can be reversed by discontinuing diuretics d. Sign of irreversible kidney failure 6. A client with chronic kidney disease asks the nurse about the relationship between the disease and high blood pressure. What is the nurse’s best response? a. “Because the kidneys cannot get rid of fluid, blood pressure goes up.” b. “The damaged kidneys no longer release a hormone that prevents high blood pressure.” c. “The waste products in the blood interfere with other mechanisms that control blood pressure.” d. “This is a compensatory mechanism that increases blood flow through the kidneys in an effort to get rid of some of the waste products.” 7. A patient with acute renal injury has a GFR (glomerular filtration rate) of 40 mL/min. Which signs and symptoms below may this patient present with? Select all that apply: a. Hypervolemia b. Hypokalemia c. Increased BUN level d. Decreased Creatinine level 8. Select all the patients below that are at risk for acute intrarenal injury? a. A 45 year old male with a renal calculus b. A 65 year old male with benign prostatic hyperplasia c. A 25 year old female receiving chemotherapy d. A 36 year old female with renal artery stenosis e. A 6 year old male with acute glomerulonephritis. f. A 87 year old male who is taking an aminoglycoside medication for an infection 9. The nurse is assessing a patient with kidney injury and notes that the patient is having Kussmaul respirations. What condition is the body attempting to compensate for? a. Hypoxia b. Alkalosis c. Acidosis d. Hypoxemia 10.A patient with AKI has a urinary output of 350 mL/day. In addition, morning labs showed an increased BUN and creatinine level along with potassium level of 6 mEq/L. What type of diet ordered by the physician is most appropriate for this patient? A. Low-sodium, high-protein, and low-potassium B. High-protein, low-potassium, and low-sodium C. Low-protein, low-potassium, and low-sodium D. High-protein and high-potassium 11.Which of the following measures may help a nurse determine a change in renal status? a. Observing the client's fluid intake. b. Checking for a thrill or a bruit daily. c. Observing the client's urinary output. d. Observing the skin color and nail beds. 12.A 55 year old male patient is diagnosed with chronic kidney disease. The patient's recent GFR was 25 mL/min. What stage of chronic kidney disease is this known as? a. Stage 1 b. Stage 3 c. Stage 4 d. Stage 5 13. What should the nurse do in order to monitor kidney function in the patient with chronic kidney disease? Select all that apply a. Monitor intake and output b. Check urine specific gravity c. Review blood nitrogen and serum creatinine levels d. Review x-ray reports e. Monitor serum potassium and sodium levels 14.A client with a history of chronic renal failure receives hemodialysis treatments three times per week through an arteriovenous (AV) fistula in the left arm. Which intervention should the nurse include in the care plan? a. Keep the AV fistula site dry. b. Keep the AV fistula wrapped in gauze. c. d. Take the client's blood pressure in the left arm. Assess the AV fistula for a bruit and thrill. 15. A client has a decreased secretion of erythropoietin from the kidneys due to end-stage kidney disease. What outcome will the decrease in erythropoietin have? a. Anemia from the decrease in maturation of red blood cells b. Decrease in blood sugar levels due to alteration in insulin levels c. Increase in blood sugar levels due to alteration in insulin levels d. Development of male sex characteristics