Chapter 47 Nursing Management Acute Renal Failure And Chron
Chapter 47: Nursing Management: Acute Kidney Injury and Chronic Kidney Disease
Test Bank
MULTIPLE CHOICE
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 the patient to take a daily low-dose aspirin tablet.
c. Report the patient’s symptoms to the health care provider.
d. Elevate the patient’s arm on pillows to above the heart level.
ANS: C
The patient’s complaints suggest the development of distal ischemia (steal syndrome) and may require revision of the AVG. Elevation of the arm above the heart will further decrease perfusion. Pain and coolness are not normal after AVG insertion. Aspirin therapy is not used to maintain grafts.
DIF: Cognitive Level: Apply (application)
REF:
1120
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
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.
ANS: B
Patients with metabolic acidosis caused by AKI may have Kussmaul respirations as the lungs try to regulate carbon dioxide. Bounding pulses and vasodilation are not associated with metabolic acidosis. Because the patient is likely to have fluid retention, poor skin turgor would not be a finding in AKI.
DIF: Cognitive Level: Apply (application)
REF:
1104
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
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. augmenting fluid volume.
b. maintaining cardiac output.
c. diluting nephrotoxic substances.
d. preventing systemic hypertension.
ANS: B
The
Test Bank
MULTIPLE CHOICE
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 the patient to take a daily low-dose aspirin tablet.
c. Report the patient’s symptoms to the health care provider.
d. Elevate the patient’s arm on pillows to above the heart level.
ANS: C
The patient’s complaints suggest the development of distal ischemia (steal syndrome) and may require revision of the AVG. Elevation of the arm above the heart will further decrease perfusion. Pain and coolness are not normal after AVG insertion. Aspirin therapy is not used to maintain grafts.
DIF: Cognitive Level: Apply (application)
REF:
1120
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity
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.
ANS: B
Patients with metabolic acidosis caused by AKI may have Kussmaul respirations as the lungs try to regulate carbon dioxide. Bounding pulses and vasodilation are not associated with metabolic acidosis. Because the patient is likely to have fluid retention, poor skin turgor would not be a finding in AKI.
DIF: Cognitive Level: Apply (application)
REF:
1104
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity
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. augmenting fluid volume.
b. maintaining cardiac output.
c. diluting nephrotoxic substances.
d. preventing systemic hypertension.
ANS: B
The