Question 1

A diabetic client with a history of hypertension may receive a prescription for which medication
to provide a renal protective effect by reducing intraglomerular pressure? Select all that apply.

Accepted Answer

ACE inhibitors
C) Angiotensin receptor blockers

Question 2

86female client has been admitted to the hospital for the dehydration
and hypoNA after she curtailed her fluid intake to minimize urinary incontinence. labS suggestive of prerenal failure. nurse assessing this PT for  early signs of prerenal injury?

Accepted Answer

Sharp decrease in urine output

Question 3

A client had excessive blood loss and prolonged hypotension during surgery. His postoperative
urine output is sharply decreased, and his blood urea nitrogen (BUN) is elevated. The most likely
cause for the change is acute:

Accepted Answer

Tubular necrosis

Question 4

A client with significant burns on his lower body has developed sepsis on the 3rd day following
his accident. Which of the following manifestations would the nurse anticipate for an ischemic
acute tubular necrosis rather than prerenal failure?

Accepted Answer

GFR does not increase after restoration of renal blood flow

Question 5

A drug abuser was found unconscious after shooting up heroin 2 days prior. Because of the
pressure placed on the hip and arm, the client has developed rhabdomyolysis. The nurse knows
this can:

Accepted Answer

Obstruct the renal tubules with myoglobin and damage tubular cells

Question 6

A client is beginning to recover from acute tubular necrosis. The nurse would likely be assessing
which of the following manifestations of the recovery phase of ATN?

Accepted Answer

Diuresis

Question 7

When acute tubular necrosis (ATN) is suspected, the nurse will likely see which of the following
laboratory findings on the urinalysis report? Select all that apply.

Accepted Answer

Protein
C) Red blood cells
E) Cast cells

Question 8

Which of the following individuals likely faces the greatest risk for the development of chronic
kidney disease?

Accepted Answer

A client with a recent diagnosis of type 2 diabetes who does not monitor his blood
sugars or control his diet

Question 9

The primary care provider for a newly admitted hospital client has added the glomerular
filtration rate (GFR) to the blood work scheduled for this morning. The client's GFR  50 mL/minute/1.73 m2 The nurse explains to the client that

Accepted Answer

A loss of over half the client's normal kidney function

Question 10

As chronic kidney disease progresses, the second stage (renal insufficiency) is identified by:

Accepted Answer

Decrease in GFR of 60 to 89 mL/minute/1.73 m2

Question 11

As nitrogenous wastes increase in the blood, the CKD client may exhibit which of the following
clinical manifestations? Select all that apply.

Accepted Answer

Numbness in lower extremities
D) Restless leg syndrome
E) Pruritis

Question 12

A client with a diagnosis of chronic kidney disease (CKD) may require the administration of
which of the following drugs to treat coexisting conditions that carry a high mortality?

Accepted Answer

Antihypertensive medications

Question 13

The nurse is providing care for a client who has a diagnosis of kidney failure. Which of the
following laboratory findings is consistent with this client's diagnosis?

Accepted Answer

Hypocalcemia

Question 14

A chronic kidney disease client who has renal osteodystrophy should be assessed for which of
the following complications? Select all that apply.

Accepted Answer

Muscle weakness
C) Bone pain
D) Stress fractures

Question 15

A client who has developed stage 3 renal failure has been diagnosed with high phosphate levels.
To avoid the development of osteodystrophy, the physician may prescribe a phosphate-binding
agent that does not contain:

Accepted Answer

ALUMINUM

Question 16

PT chronic kidney disease has 
increasing fatigue, lethargy, and activity intolerance in recent weeks.t his GFR remains at a low, but stable, level. Which of the following assessments
is most likely to inform a differential diagnosis?

Accepted Answer

Blood work for hemoglobin, red blood cells, and hematocrit

Question 17

Impaired skin integrity and skin manifestations are common in persons with chronic kidney
disease. Pale skin and subcutaneous bruising are often present as a result of:

Accepted Answer

Impaired platelet function

Question 18

If a CKD client is developing uremic encephalopathy, the earliest manifestations may include:
Select all that apply.

Accepted Answer

Decreased alertness
DIMINSHED AWARNESS

Question 19

A chronic kidney disease (CKD) client asks the nurse, “Why do I itch all the time?” The nurse
bases her response on which of the following integumentary physiologic factors that causes
pruritis? Select all that apply.

Accepted Answer

Decrease in perspiration
ELEVATED SERUM PHOSPHATE

Question 20

A client with a recent diagnosis of renal failure who will require hemodialysis is being educated
in the dietary management of the disease. Which of the client's following statements shows an
accurate understanding of this component of treatment?

Accepted Answer

“I've made a list of high-phosphate foods, so that I can try to avoid them.”

Question 21

Client and family education regarding peritoneal dialysis should include assessing the client for:

Accepted Answer

Dehydration that may appear as dry mucous membranes or poor skin turgor

Question 22

While assessing a peritoneal dialysis client in his home, the nurse notes that the fluid
draining from the abdomen is cloudy, is white in color, and contains a strong odor. The nurse
suspects this client has developed a serious complication known as:

Accepted Answer

Peritonitis

Question 23

Regardless of the cause, chronic kidney disease results in progressive permanent loss of
nephrons and glomerular filtration, and renal:

Accepted Answer

Endocrine functions

Question 24

Manifestations of childhood renal disease are varied and may differ from adult-onset renal
failure. A school-aged child with chronic kidney disease may exhibit:

Accepted Answer

Developmental delays such as uncoordinated gait and minimal fine motor skills

Question 25

Reduced glomerular filtration rate (GFR), with a serum creatinine level that remains in the
normal range, is associated with aging because elderly persons tend to have reduced:

Accepted Answer

MUSCLE MASS

CHAPTER 26

MIDTERM UNIT 5

Question	Answer
A diabetic client with a history of hypertension may receive a prescription for which medication to provide a renal protective effect by reducing intraglomerular pressure? Select all that apply.	ACE inhibitors C) Angiotensin receptor blockers
86female client has been admitted to the hospital for the dehydration and hypoNA after she curtailed her fluid intake to minimize urinary incontinence. labS suggestive of prerenal failure. nurse assessing this PT for early signs of prerenal injury?	Sharp decrease in urine output
A client had excessive blood loss and prolonged hypotension during surgery. His postoperative urine output is sharply decreased, and his blood urea nitrogen (BUN) is elevated. The most likely cause for the change is acute:	Tubular necrosis
A client with significant burns on his lower body has developed sepsis on the 3rd day following his accident. Which of the following manifestations would the nurse anticipate for an ischemic acute tubular necrosis rather than prerenal failure?	GFR does not increase after restoration of renal blood flow
A drug abuser was found unconscious after shooting up heroin 2 days prior. Because of the pressure placed on the hip and arm, the client has developed rhabdomyolysis. The nurse knows this can:	Obstruct the renal tubules with myoglobin and damage tubular cells
A client is beginning to recover from acute tubular necrosis. The nurse would likely be assessing which of the following manifestations of the recovery phase of ATN?	Diuresis
When acute tubular necrosis (ATN) is suspected, the nurse will likely see which of the following laboratory findings on the urinalysis report? Select all that apply.	Protein C) Red blood cells E) Cast cells
Which of the following individuals likely faces the greatest risk for the development of chronic kidney disease?	A client with a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or control his diet
The primary care provider for a newly admitted hospital client has added the glomerular filtration rate (GFR) to the blood work scheduled for this morning. The client's GFR 50 mL/minute/1.73 m2 The nurse explains to the client that	A loss of over half the client's normal kidney function
As chronic kidney disease progresses, the second stage (renal insufficiency) is identified by:	Decrease in GFR of 60 to 89 mL/minute/1.73 m2
As nitrogenous wastes increase in the blood, the CKD client may exhibit which of the following clinical manifestations? Select all that apply.	Numbness in lower extremities D) Restless leg syndrome E) Pruritis
A client with a diagnosis of chronic kidney disease (CKD) may require the administration of which of the following drugs to treat coexisting conditions that carry a high mortality?	Antihypertensive medications
The nurse is providing care for a client who has a diagnosis of kidney failure. Which of the following laboratory findings is consistent with this client's diagnosis?	Hypocalcemia
A chronic kidney disease client who has renal osteodystrophy should be assessed for which of the following complications? Select all that apply.	Muscle weakness C) Bone pain D) Stress fractures
A client who has developed stage 3 renal failure has been diagnosed with high phosphate levels. To avoid the development of osteodystrophy, the physician may prescribe a phosphate-binding agent that does not contain:	ALUMINUM
PT chronic kidney disease has increasing fatigue, lethargy, and activity intolerance in recent weeks.t his GFR remains at a low, but stable, level. Which of the following assessments is most likely to inform a differential diagnosis?	Blood work for hemoglobin, red blood cells, and hematocrit
Impaired skin integrity and skin manifestations are common in persons with chronic kidney disease. Pale skin and subcutaneous bruising are often present as a result of:	Impaired platelet function
If a CKD client is developing uremic encephalopathy, the earliest manifestations may include: Select all that apply.	Decreased alertness DIMINSHED AWARNESS
A chronic kidney disease (CKD) client asks the nurse, “Why do I itch all the time?” The nurse bases her response on which of the following integumentary physiologic factors that causes pruritis? Select all that apply.	Decrease in perspiration ELEVATED SERUM PHOSPHATE
A client with a recent diagnosis of renal failure who will require hemodialysis is being educated in the dietary management of the disease. Which of the client's following statements shows an accurate understanding of this component of treatment?	“I've made a list of high-phosphate foods, so that I can try to avoid them.”
Client and family education regarding peritoneal dialysis should include assessing the client for:	Dehydration that may appear as dry mucous membranes or poor skin turgor
While assessing a peritoneal dialysis client in his home, the nurse notes that the fluid draining from the abdomen is cloudy, is white in color, and contains a strong odor. The nurse suspects this client has developed a serious complication known as:	Peritonitis
Regardless of the cause, chronic kidney disease results in progressive permanent loss of nephrons and glomerular filtration, and renal:	Endocrine functions
Manifestations of childhood renal disease are varied and may differ from adult-onset renal failure. A school-aged child with chronic kidney disease may exhibit:	Developmental delays such as uncoordinated gait and minimal fine motor skills
Reduced glomerular filtration rate (GFR), with a serum creatinine level that remains in the normal range, is associated with aging because elderly persons tend to have reduced:	MUSCLE MASS

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