N4 - test - Chap 45 Acute Renal Failure and Chronic Kidney Disease

Med surg Book

1. A patient is admitted to the hospital with chronic kidney disease. The nurse understands that this condition is characterized by
A. progressive irreversible destruction of the kidneys.
B. a rapid decrease in urinary output with an elevated BUN.
C. an increasing creatinine clearance with a decrease in urinary output.
D. prostration, somnolence, and confusion with coma and imminent death.

2. Prerenal causes of ARF include
A. prostate cancer and calculi formation.
B. hypovolemia and myocardial infarction.
C. acute glomerulonephritis and neoplasms.
D. septic shock and nephrotoxic injury from drugs.

3. During the oliguric phase of ARF, the nurse monitors the patient for
A. hypernatremia and CNS depression.
B. pulmonary edema and ECG changes.
C. Kussmaul respirations and hypotension.
D. urine with high specific gravity and low sodium concentration.

4. If a patient is in the diuretic phase of ARF, the nurse must monitor for which serum electrolyte imbalances?
A. Hyperkalemia and hyponatremia
B. Hyperkalemia and hypernatremia
C. Hypokalemia and hyponatremia
D. Hypokalemia and hypernatremia

5. A systemic effect of chronic kidney disease that is usually reversed by the initiation of dialysis is
A. anemia.
B. hyperlipidemia.
C. psychologic changes.
D. nausea and vomiting.

6. Measures indicated in the conservative therapy of chronic kidney disease include
A. decreased fluid intake, carbohydrate intake, and protein intake.
B. increased fluid intake, decreased carbohydrate intake and protein intake.
C. decreased fluid intake and protein intake, increased carbohydrate intake.
D. decreased fluid intake and carbohydrate intake, increased protein intake.

7. One of the major disadvantages of peritoneal dialysis is that
A. hypotension is a constant problem because of continuous fluid removal.
B. blood loss can be extensive because of the use of heparin to keep the catheter patent.
C. solutes are removed more rapidly from the blood than from the CNS, causing disequilibrium synrome.
D. high glucose concentrations of the dialysate necessary for ultrafiltration cause carbohydrate and lipid abnormalities.

8. To assess the patency of a newly placed arteriovenous graft for dialysis, the nurse should
A. irrigate the graft daily with low-dose heparin.
B. monitor for any increase in BP in the affected arm.
C. listen with a stethoscope over the graft for the presence of a bruit.
D. frequently monitor the pulses and neurovascular status distal to the graft.

9. A patient in ESRD receiving hemodialysis is considering asking a relative to donate a kidney for transplant. In assisting the patient to make a decision about treatment, the nurse informs the patient that
A. successful transplantation usually provides better quality of life than that offered by dialysis.
B. if rejection of the transplanted kidney occurs, no further treatment for the renal failure is available.
C. the immunosuppressive therapy that is required following transplantation causes fatal malignancies in many patients.
D. hemodialysis replaces the normal functions of the kidneys and patients do not have to live with the continual fear of rejection.

10. Following a kidney transplant, the nurse teaches the patient that signs of rejection include
A. fever, weight loss, increased urinary output, increased BP.
B. fever, weight gain, increased urinary output, increased BP.
C. fever, weight loss, increased urinary output, decreased BP.
D. fever, weight gain, decreased urinary output, increased BP.

11. Most of the long-term problems that occur in the patient with a kidney transplant are a result of
A. chronic rejection.
B. immunosuppressive therapy.
C. recurrence of the original renal disease.
D. failure of the patient to follow the prescribed regimen.