ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 49 Questions
Question 1 of 5
The nurse is caring for a patient who has had an insertion of an arteriovenous graft (AVG) in the right forearm and has symptoms of pain and coldness of the right fingers. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The patient's complaints suggest the development of distal ischemia (steal syndrome) and may require revision of the AVG. Elevation of the arm above the heart will decrease perfusion. Pain and coolness are not normal after AVG insertion. Aspirin therapy is not used to maintain grafts.
Question 2 of 5
The nurse is caring for a patient with acute kidney injury (AKI) who has an arterial blood pH of 7.30 Which of the following assessment findings should the nurse anticipate?
Correct Answer: D
Rationale: Patients with metabolic acidosis caused by AKI may have Kussmaul's respirations as the lungs try to regulate carbon dioxide. Bounding pulses and vasodilation are not associated with metabolic acidosis. Because the patient is likely to have fluid retention, poor skin turgor would not be a finding in AKI.
Question 3 of 5
The nurse is caring for a patient with severe heart failure who develops elevated blood urea nitrogen (BUN) and creatinine levels. The nurse will plan care to meet which of the following goals of treatment?
Correct Answer: C
Rationale: The primary goal of treatment for acute kidney injury (AKI) is to eliminate the cause and provide supportive care while the kidneys recover. Because this patient's heart failure is causing AKI, the care will be directed toward treatment of the heart failure. For renal failure caused by hypertension, hypovolemia, or nephrotoxins, the other responses would be correct.
Question 4 of 5
The nurse is caring for a patient with acute glomerulonephritis, acute kidney injury (AKI), and hyperkalemia who is prescribed calcium gluconate IV. Which of the following parameters should the nurse assess to evaluate the effectiveness of the medication?
Correct Answer: C
Rationale: The calcium gluconate helps prevent dysrhythmias that might be caused by the hyperkalemia. The nurse will monitor the other data as well, but these will not be helpful in determining the effectiveness of the calcium gluconate.
Question 5 of 5
The nurse is caring for a patient with stage 2 chronic kidney disease (CKD) who is scheduled for an intravenous pyelogram (IVP). Which of the following prescriptions for the patient should the nurse question?
Correct Answer: C
Rationale: The contrast dye used in IVPs is potentially nephrotoxic, and concurrent use of other nephrotoxic medications such as the NSAIDs should be avoided. The suppository and NPO status are necessary to ensure adequate visualization during the IVP. IV fluids are used to ensure adequate hydration, which helps reduce the risk for contrast-induced renal failure.