ATI LPN
Test Bank for Medical Surgical Nursing: Concepts for Interprofessional Collaborative Care 10th Edition
Chapter 68 : Care of Patients with Acute Kidney Injury and Chronic Kidney Disease Questions
Question 1 of 5
A client has just had a central line catheter placed that is specific for hemodialysis. What is the most appropriate action by the nurse?
Correct Answer: D
Rationale: The central line should have a heparin or heparin/saline dwell after hemodialysis treatment to prevent clotting. The central line catheter used for dialysis should not be used for blood sampling, monitoring central venous pressures, or giving drugs or fluids.
Question 2 of 5
A client in the intensive care unit is started on continuous venous hemofiltration (CVVH). Which finding is the cause of immediate action by the nurse?
Correct Answer: A
Rationale: A blood leak detector alarm indicates a potential rupture in the dialysis membrane, which is a critical issue requiring immediate action to stop the procedure and ensure patient safety. Low ultrafiltrate volume, high venous pressure, or low arterial pressure may require adjustments but are not as immediately life-threatening.
Question 3 of 5
A client is exhibiting symptoms of pericarditis, which can occur with chronic kidney disease. Which nurse should be assigned to this client for continuity of care?
Correct Answer: C
Rationale: Continuity of care is important to assess subtle differences in clients.
Therefore, the registered nurse (RN) who was assigned to this client previously should again give care to this client. The first nurses would not be as knowledgeable about the unit and its clients. The licensed practical nurse may not have the education level of the RN to assess for pericarditis.
Question 4 of 5
A male client with chronic kidney disease (CKD) is refusing to take his medication and has missed two hemodialysis appointments. What is the best initial action for the nurse?
Correct Answer: A
Rationale: The initial action for the nurse is to assess anxiety, coping styles, and the client's acceptance of the required treatment for CKD. The client may be in denial of the diagnosis. While rescheduling hemodialysis appointments may help, and referral to a mental health practitioner and the possibility of peritoneal dialysis are all options to assess the client, the client's acceptance of the treatment should come first.
Question 5 of 5
A client is taking furosemide (Lasix) for management of chronic kidney disease (CKD). To detect the positive effect of the medication, what action of the nurse is best?
Correct Answer: A
Rationale: Furosemide (Lasix) is a loop diuretic that helps reduce fluid overload and hypertension in clients with early stages of CKD. One kilogram of weight equals about 1 liter of fluid retained in the client, so daily weights are necessary to monitor the response of the client to the medication. Heart and breath sounds should be assessed if there is fluid retention. The best initial action is to assess vital signs, including weight, to evaluate fluid status.