Renal Highlights

Kelly Cloonan MSN, RN, CPN

Diana Kovacic MSN, BSN, RN

Answer: A

What statement by your 40 year old

hospitalized patient with a UTI indicates a

concern for pyelonephritis?

◦ A. Fever and chills

◦ B. Painful urination

◦ C. Dark urine

◦ D. Cloudy urine

Answer- B

The nurse is caring for a client with ESKD

and dialysis has been initiated. Which drug

order does the nurse question?

◦ A. Erythropoietin

◦ B. Diuretic

◦ C. ACE inhibitor

◦ D. Calcium channel blocker

Answer: C

What instruction will decrease your patient’s risk for renal calculi?

◦ A. Avoid taking in too much calcium

◦ B. Begin your antibiotics as soon as you suspect a stone

◦ C. Drink 3 liters of fluid or more per day

◦ D. Avoid too much exercise

Answer: FALSE

True or False

When taking an antibiotic for a UTI, the

patient should stop immediately once

symptoms subside.

Answer: B Intrarenal

Vancomycin and polycystic kidney disease

cause what type of acute renal failure?

◦ A. Prerenal

◦ B. Intrarenal

◦ C. Postrenal

Answer: B

Which assessment parameter(s) will the

nurse monitor to determine fluid and

sodium retention status?

◦ A. Weight

◦ B. Weight and Blood Pressure

◦ C. Capillary refill

◦ D. Output

Answer: D

Your assessment reveals tachycardia and

crackles bilaterally at the bases of the

lungs in your patient with chronic renal

failure. The patient is also very agitated.

Which is your first intervention?

◦ A. Assess your next patient

◦ B. Call a code

◦ C. Give ordered anti-anxiety medication

◦ D. Place patient in high Fowler’s position

Answer: B

Which of the following assessment

findings is not expected in a client in the

early stage of acute renal failure?

◦ A. Acidosis

◦ B. Diuresis

◦ C. Hyperkalemia

◦ D. Hypertension

Answer: C

Your client has acute renal failure and is

on dialysis. How much fluid will be

permitted each day?

◦ A. It will be based on amount of kidney

damaged

◦ B. 4 Liters per day

◦ C. Amount equal to excreted urine plus

500ml

◦ D. As much as the client wants

Answer: C

What does the breath often smell like in a

patient with CKD?

◦ A. Fruit

◦ B. Feces

◦ C. Urine

◦ D. Blood

Answer: Hypovolemia

A client taking furosemide (Lasix), may be

at risk for what type of volemia?

Answer: D

The nurse teaches a man who has passed a

calcium phosphate kidney stone to:

◦ A. Alternate an acid diet with an alkaline diet

◦ B. Eliminate all milk products from diet

◦ C. Have his urine checked each month for infection

◦ D. Maintain high fluid intake daily

Answer: A. Chronic

90-95% loss of kidney function is

_____renal failure.

◦ A. Chronic

◦ B. Acute

Answer: A, B, C

A nurse is caring for a client receiving Vancomycin. Because this drug has potential for nephrotoxicity, which laboratory results does the nurse monitor? (Select all that apply.)

◦ A. Blood urea nitrogen (BUN)

◦ B. Creatinine

◦ C. Drug peak and trough levels

◦ D. Prothrombin time (PT)

◦ E. Platelet count

◦ F. Hemoglobin and hematocrit

Answer: C

One of the nursing diagnoses for a client

with ESRD is: Inadequate tissue perfusion

related to anemia. Which of the following

is a nursing order for this nursing

diagnosis?

◦ A. Advise against the use of salt substitutes

◦ B. Administer antihypertensives as ordered

◦ C. Administer erythropoietin as ordered.

◦ D. Monitor fluid balance.

Answer: C Postrenal

Kidney stones and benign prostatic

hyperplasia cause what type of acute renal

failure?

◦ A. Prerenal

◦ B. Intrarenal

◦ C. Postrenal

Answer: C

The nurse is talking to a 68-year old male

patient who is a smoker and has a long

history of occupational exposure to toxic

chemicals. Because this patient has a high

risk for bladder cancer, the nurse is

concerned about which urinary complaint?

◦ A. Frequency

◦ B. Nocturia

◦ C. Painless hematuria

◦ D. Incontinence

Answer: B

When caring for a client in acute renal

failure, it is most important for the nurse

to call the physician to report changes in:

◦ A. BUN

◦ B. EKG

◦ C. Hematocrit

◦ D. Weight

Answer: D

The nurse is admitting a client with

chronic renal failure to the nursing unit.

The nurse assesses for which most

frequent cardiovascular sign that occurs in

the client with chronic renal failure?

◦ A. Bradycardia

◦ B. Tachycardia

◦ C. Hypotension

◦ D. Hypertension

Answer: A, B, C, E, F

The nurse is teaching self-care measures to a patient who had lithotripsy for kidney stones. What information does the nurse include? (select all that apply)

◦ A. Finish all antibiotics prescribed

◦ B. Balance regular exercise with sleep and rest

◦ C. Drink at least 3L of fluid a day

◦ D. Watch for and report bruising after lithotripsy

◦ E. Urine may be bloody for several days

◦ F. Report pain, fever, chills, or difficulty urinating to a health care provider

Answer: A Prerenal

Sepsis causes what type of acute renal

failure?

◦ A. Prerenal

◦ B. Intrarenal

◦ C. Postrenal

Answer: B

A patient is diagnosed with kidney cancer

and the health care provider recommends

the best therapy. Which treatment does

the nurse anticipate teaching the patient

about?

◦ A. Chemotherapy

◦ B. Surgical removal

◦ C. Hormonal therapy

◦ D. Radiation therapy

Answer: D

The client with chronic renal failure who

is scheduled for hemodialysis this morning

is due to receive a daily dose of lisinopril.

The nurse plans to administer this

medication:

◦ A. During dialysis

◦ B. Just before dialysis

◦ C. The day after dialysis

◦ D. Upon return from dialysis

Answer: Oliguric (output <400/d)

The __________ phase of acute renal

failure usually occurs within 1-3 weeks

and lasts up to 14 days. *

Answer: A Prerenal

Hypovolemia, shock, burns, and

cardiovascular disorders cause what type

of acute renal failure?

◦ A. Prerenal

◦ B. Intrarenal

◦ C. Postrenal

Answer: B

A client with a history of uric acid kidney

stones needs further teaching if he states:

◦ A. “I need to drink about 3 liters of fluid every

day”

◦ B. “I like to take 500mg of Vitamin C every day.”

◦ C. “I’m going to try and walk a little every two

hours.”

◦ D. “I will continue taking my allopurinol as

prescribed.”

Answer: B

Chronic renal failure, will cause

◦ A. Hypercalcemia

◦ B. Hypocalcemia

Answer: A

A client with renal failure is receiving epoetin alfa (Epogen) to support erythropoiesis. The nurse questions the client about compliance with taking which of the following medications that supports red blood cell production?

◦ A. Iron supplement

◦ B. Zinc supplement

◦ C. Calcium supplement

◦ D. Magnesium supplement

Answer- C

A 55-year old client is admitted with a diagnosis of renal calculi. He presented with severe right flank pain, nausea, and vomiting. The most important nursing action for him at this time is:

◦ A. Intake and output measurement

◦ B. Daily weights

◦ C. Straining of all urine

◦ D. Administration of O2 therapy

Answer: A

A nurse writes the following nursing

diagnosis for a client in acute renal failure-

Impaired gas exchange related to:

◦ A. Decreased red blood cell production

◦ B. Increased levels of vitamin D

◦ C. Increased red blood cell production

◦ D. Decreased production of renin

Answer: A

So, what will you tell your client to

increase in his/her diet with CRF?

◦ A. Calcium

◦ B. Potassium

◦ C. Sodium

◦ D. Phosphate