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 with acute kidney injury has a blood pressure of 76/55 mm Hg. The health care provider ordered 1000 mL of normal saline to be infused over 1 hour to maintain perfusion. The client is starting to develop shortness of breath. What is the priority action?
Correct Answer: C
Rationale: The nurse should assess that the client could be developing fluid overload and respiratory distress and slow down the normal saline infusion to prevent worsening of symptoms. Calculating MAP is important but not the priority when shortness of breath is evident. A pulmonary artery catheter is invasive and not the first action. Monitoring respiratory rate is important but secondary to adjusting the infusion.
Question 2 of 5
A client has a serum potassium level of 6.5 mEq/L, a serum creatinine level of 2 mg/dL, and a urine output of 350 mL per 24 hours. What is the priority action by the nurse?
Correct Answer: A
Rationale: The priority action by the nurse should be to check the cardiac status with a monitor. High potassium levels can lead to dysrhythmias. The other choices are logical nursing interventions for acute kidney injury but not the best immediate action.
Question 3 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 4 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 5 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.