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Chapter 26 Question 1 A patient who has acute kidney injury and who weighs 90 kg had a urine output of 25 mL over the last 12 hours. The nurse would place this patient in which RIFLE category? 1. Injury 2. Risk 3. Failure 4. Loss Question 2 An elderly patient is scheduled for a CT scan with contrast. The nurse would anticipate preprocedure administration of which medication to help prevent renal damage? 1. N-acetylcysteine 2. Vitamin B12 3. Intravenous infusion of 5% dextrose 4. Vitamin D Question 3 A patient’s acute kidney injury is suspected of being of postrenal etiology. Which medical history would support this diagnosis? 1. The patient has been taking NSAIDs for arthritis pain. 2. The patient was diagnosed with heart failure last week. 3. The patient reports having the “flu” with vomiting and diarrhea for the last 6 days. 4. The patient has large renal calculi in the kidney and ureter. 5. The patient was just diagnosed with prostate cancer. Question 4 A patient’s serum creatinine level is increasing, but the urine creatinine clearance is decreasing. How would the nurse evaluate these two findings? 1. The patient may be experiencing the onset of heart failure. 2. The patient will probably have associated hypokalemia. 3. The patient is malnourished. 4. There is a decrease in glomerular function. Question 5 A patient with reduced glomerular filtration has a blood pressure of 168/100 mm Hg. The nurse suspects which pathophysiological effect is occurring? 1. Rebound hypertension due to fluid volume deficit 2. Sluggish response by the renin-angiotensin system 3. Kidneys hyper-excreting hydrogen ions 4. Increased renin production causing the retention of water and electrolytes Question 6 A patient with acute kidney injury is demonstrating signs of gastrointestinal bleeding. The nurse would explain this bleeding to be secondary to which event? 1. Low creatinine level 2. Elevated potassium level 3. Increased ammonia level 4. Low calcium level Question 7 A patient with acute kidney injury has a hemoglobin level of 9.0 mg/dL. How would the nurse explain this change to the patient? 1. “Your kidneys may not be making enough of a hormone that is required to build red blood cells.” 2. “Since you are retaining so much fluid, your blood is more dilute.” 3. “I am afraid you may have some bleeding we have not found as of yet.” 4. “Your lungs are not exchanging oxygen as well as they should, so your body is not producing hemoglobin.” Question 8 The nurse is transferring to a high-acuity unit where many patients receive intermittent hemodialysis. Which patient characteristic would the nurse expect? 1. Patients whose hemodynamic status requires slow removal of waste products 2. Patients whose kidney injury will resolve since intermittent dialysis is only done temporarily 3. Patients whose blood pressure and heart rate can be stabilized 4. Patients who have few imbalances in electrolyte levels Question 9 A patient is scheduled for arteriovenous access continuous renal replacement therapy (CRRT). Which nursing intervention should the nurse add to the patient’s plan of care? 1. Monitor the access site for leaking or hemorrhage. 2. Check settings on the external pump every 2 hours. 3. Monitor pulses in distal extremities. 4. Monitor for hemodynamic instability from rapid removal of water and wastes from the blood. 5. Monitor the tube for clotting. Question 10 A patient is receiving slow continuous ultrafiltration to treat an acute kidney injury. Which nursing assessment will this treatment specifically require? 1. Electrolyte levels 2. White blood cell count 3. Appetite 4. Urine output