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
In discharge teaching for a client post-kidney transplantation, which instructions should the nurse include? (Select all that apply)
Correct Answer: B,C,D
Rationale: In discharge teaching, the nurse must emphasize that the client needs to have an antibiotic prophylactically before cleared procedures to prevent infection. There may be a need for dose reduction in medications if the kidney is not excreting them properly (antacids with magnesium, antibiotics, antidiabetic drugs, insulin, opioids, and anticoagulants).
Question 2 of 5
A client is undergoing hemodialysis. The client's blood pressure at the beginning of the procedure was 136/88 mm Hg, and now it is 100/54 mm Hg. What actions should the nurse perform to maintain blood pressure? (Select all that apply)
Correct Answer: A,B,D
Rationale: Hypotension occurs often during hemodialysis treatments as a result of vasodilation from the warmed dialysate. Adjusting the extracorporeal blood flow, placing the client in the Trendelenburg position, and administering a normal saline bolus can help stabilize blood pressure.
Question 3 of 5
The nurse is assessing a client with a diagnosis of pre-renal acute kidney injury. Which condition would the nurse expect to find in the client's recent history?
Correct Answer: B
Rationale: Myocardial infarction can lead to decreased cardiac output, reducing renal perfusion and causing pre-renal acute kidney injury. Myelonephritis and kidney stones are more associated with intrinsic or post-renal causes, respectively, while septic shock could also contribute but is less specific in this context.
Question 4 of 5
A client is admitted with acute kidney injury (AKI) and a urine output of 2000 mL/day. What is the major concern of the nurse regarding this client's care?
Correct Answer: B
Rationale: The client may have an inflammatory cause of AKI with proteins entering the glomerulus and holding the fluid in the filtrate, causing polyuria. Electrolyte loss and fluid balance is essential. Edema and pain are not usually a problem with fluid loss. There could be changes in the client's cardiac, respiratory, and mental health status if the electrolyte imbalance is not treated.
Question 5 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.