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 is placed on fluid restrictions because of chronic kidney disease (CKD). Which assessment finding would alert the nurse that the client's fluid balance is stable at this time?
Correct Answer: C
Rationale: The absence of adventitious sounds upon auscultation of the lungs indicates a lack of fluid overload and fluid balance in the client's body. Decreased calcium levels and increased phosphorus levels are common findings with CKD. Edema would indicate a fluid imbalance.
Question 2 of 5
A client with chronic kidney disease (CKD) is experiencing nausea, vomiting, visual changes, and anorexia. Which action by the nurse is best?
Correct Answer: A
Rationale: The signs and symptoms are indications of digoxin (Lanoxin) toxicity. The nurse should check the level of this medication. Administering antiemetics, asking if the client can eat, and obtaining a referral to a specialist all address the client's symptoms but do not lead to the cause of the symptoms.
Question 3 of 5
The nurse is taking the vital signs of a client after hemodialysis. Blood pressure is 110/98 mm Hg, pulse 66 beats/min, and temperature is 98°F (37.6°C). What is the most appropriate action by the nurse?
Correct Answer: B
Rationale: The blood pressure of 110/98 mm Hg is relatively low post-hemodialysis and could indicate hypotension, a common complication. The most appropriate action is to monitor the client closely for signs of hypotension, such as dizziness or weakness, to ensure stability.
Question 4 of 5
Dialysis works using the passive transfer of toxins by diffusion. Which statement by the client indicates a need for further teaching?
Correct Answer: A
Rationale: Dialysis works by diffusion, not osmosis. The client's statement about osmosis indicates a misunderstanding, as osmosis refers to water movement, whereas dialysis involves the movement of toxins and solutes across a semipermeable membrane from an area of higher to lower concentration.
Question 5 of 5
A client is having a peritoneal dialysis treatment. The nurse notes an opaque color to the effluent. What is the priority action by the nurse?
Correct Answer: B
Rationale: An opaque or cloudy effluent is the first sign of peritonitis. A sample of the effluent would need to be sent to the laboratory for culture and sensitivity in order to administer the correct antibiotic. Warming the dialysate in a microwave and flushing the tubing are not safe actions by the nurse.