ATI LPN
Timby's Introductory Medical-Surgical Nursing Thirteenth, North American Edition
Chapter 58 Questions
Question 1 of 5
An instructor is teaching a group of students about how to perform peritoneal dialysis. Which statement would indicate to the instructor that the students need additional teaching?
Correct Answer: B
Rationale: The dialysate should be warmed in a commercial warmer and never in a microwave oven. Strict aseptic technique is essential. The infusion clamp is opened during the infusion and clamped after the infusion. When the dwell time is done, the drain clamp is opened and the fluid is allowed to drain by gravity into the drainage bag.
Question 2 of 5
A client with newly diagnosed renal cancer is questioning why detection was delayed. Which is an appropriate response by the nurse?
Correct Answer: C
Rationale: Renal cancers rarely cause symptoms in the early stage. Tumors can become quite large before causing symptoms. Painless, gross hematuria is often the first symptom in renal cancer and does not present until later stages of the disease. Adenocarcinomas are the most common renal cancer (about 80%) whereas squamous cell renal cancers are rare. It is not therapeutic to place doubt or blame for delayed diagnosis.
Question 3 of 5
A client in chronic kidney disease becomes confused and complains of abdominal cramping, racing heart rate, and numbness of the extremities. The nurse relates these symptoms to which lab value?
Correct Answer: B
Rationale: Hyperkalemia is the life-threatening effect of renal failure. The client can become apathetic, confused, and have abdominal cramping, dysrhythmias, nausea, muscle weakness, and numbness of the extremities. Symptoms of hypocalcemia are muscle twitching, irritability, and tetany. Elevation in urea levels can result in azotemia, which can be exhibited in fluid and electrolyte and/or acid-base imbalance. Elevation of WBCs is not indicated.
Question 4 of 5
The nurse evaluates the client as experiencing symptoms of disequilibrium syndrome, following an initial hemodialysis treatment. Which is the appropriate action to be taken by the nurse?
Correct Answer: C
Rationale: Disequilibrium syndrome is a neurologic condition believed to be caused by cerebral edema associated with rapid movement of water. The symptoms are self-limiting and disappear within several hours after dialysis but can be prevented by slowing the dialysis process to allow time for gradual equilibrium of water. The nurse should document the symptoms and notify the physician with repeated incidence.
Question 5 of 5
The nurse is providing supportive care to a client receiving hemodialysis in the management of acute kidney injury. Which statement from the nurse best reflects the ability of the kidneys to recover from acute kidney injury?
Correct Answer: A
Rationale: The kidneys have a remarkable ability to recover from serious insult. Recovery may take 3 to 12 months. As long as recovery is continuing, there is no need to consider transplant or permanent hemodialysis. Acute kidney injury can progress to chronic renal failure.