Chapter_26-_Acute_Renal_Failure_and_Chronic_Kidney_Disease My Nursing Test Banks

 

1.

The most common indicator of acute renal failure is:

A)

anemia.

B)

uremia.

C)

edema.

D)

azotemia.

2.

A patient 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:

A)

prerenal inflammation.

B)

bladder outlet obstruction.

C)

ischemic tubular necrosis.

D)

intrarenal nephrotoxicity.

3.

A patient is beginning to recover from acute tubular necrosis. The recovery phase of ATN is characterized by:

A)

edema.

B)

diuresis.

C)

proteinuria.

D)

hypokalemia.

4.

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

A)

tubule dysplasia.

B)

vascular pressure.

C)

endocrine functions.

D)

hypophosphatemia.

5.

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

A)

isotonic polyuria.

B)

metabolic acidosis.

C)

hyperparathyroidism.

D)

diminished renal reserve.

6.

Both high-turnover and low-turnover renal osteodystrophy, the skeletal complications of chronic kidney disease, are manifested by abnormal _________ and defective bone __________.

A)

shape; joint motion

B)

absorption; remodeling

C)

matrix density; marrow

D)

parathyroid hormone; surface

7.

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:

A)

thrombocytopenia.

B)

anticoagulant therapy.

C)

decreased vascular volume.

D)

impaired platelet function.

8.

When acute tubular necrosis (ATN) has occurred instead of prerenal azotemia, laboratory test findings will show the presence of excessive urine:

A)

protein.

B)

glucose.

C)

calcium.

D)

sodium.

9.

Manifestations of childhood renal disease are varied and may differ from adult onset renal failure. Features of childhood chronic kidney disease include:

A)

mental retardation.

B)

developmental delays.

C)

bladder incontinence.

D)

early sexual maturity.

10.

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

A)

calcium intake

B)

muscle mass

C)

drug tolerance

D)

renal perfusion

11.

An 86-year-old female patient has been admitted to the hospital for the treatment of dehydration and hyponatremia after she curtailed her fluid intake to prevent urinary incontinence. The patients most recent laboratory results are suggestive of acute renal failure. How would this patients renal failure be categorized?

A)

Prerenal

B)

Postrenal

C)

Intrinsic

D)

Intrarenal

12.

A patient with significant burns on his lower body has developed sepsis on the third day following his accident. Which of the following developments is most clearly suggestive of ischemic acute tubular necrosis rather than prerenal failure?

A)

The patient exhibits pulmonary and peripheral edema.

B)

The patients GFR does not increase after restoration of renal blood flow.

C)

Emergency hemodialysis does not result in decreased BUN and creatinine.

D)

The patient exhibits oliguria and frank hematuria.

13.

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

A)

A first-time mother who recently lost 1.5 L of blood during a postpartum hemorrhage

B)

A patient whose diagnosis of thyroid cancer necessitated a thyroidectomy

C)

A patient who experienced a hemorrhagic stroke and now has sensory and motor deficits

D)

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

14.

The primary care provider for a newly admitted hospital patient has added the glomerular filtration rate (GFR) to the blood work scheduled for this morning. The patients GFR will be extrapolated from serum levels of:

A)

urea.

B)

protein.

C)

creatinine.

D)

myoglobin.

15.

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

A)

Metabolic alkalosis

B)

Hypophosphatemia

C)

Hypocalcemia

D)

Hypokalemia

16.

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

A)

Ive made a list of high-phosphate foods so that I can try to avoid them.

B)

Im making a point of trying to eat lots of bananas and other food rich in potassium.

C)

Im going to try a high-protein, low-carbohydrate diet.

D)

I dont think Ive been drinking enough, so I want to include 8 to 10 glasses of water each day.

17.

A patient with a diagnosis of chronic kidney disease (CKD) may require the administration of which of the following drugs to treat the consequences of CKD?

A)

Antihypertensive medications

B)

Antiarrhythmic medications

C)

Opioid analgesics

D)

Nonsteroidal anti-inflammatory drugs (NSAIDs)

18.

A patient with a longstanding diagnosis of chronic kidney disease has been experiencing increasing fatigue, lethargy, and activity intolerance in recent weeks. His care team has established that his GFR remains at a low, but stable, level. Which of the following assessments is most likely to inform a differential diagnosis?

A)

Blood work for white cells and differential

B)

Cystoscopy and ureteroscopy

C)

Assessment of pancreatic exocrine and endocrine function

D)

Blood work for hemoglobin, red blood cells, and hematocrit

19.

Which of the following descriptions is true of peritoneal dialysis?

A)

Vascular access is achieved through an internal arteriovenous fistula or an external arteriovenous shunt.

B)

Treatments typically occur three times each week for three to four hours.

C)

The dialyzer is usually a hollow cylinder composed of bundles of capillary tubes.

D)

Treatment involves the introduction of a sterile dialyzing solution, which is drained after a specified time.

20.

Which of the following integumentary problems most often accompanies chronic kidney disease?

A)

Dry skin and pruritus

B)

Petechiae and purpura

C)

Hirsutism and psoriasis

D)

Alopecia

Answer Key

1.

D

2.

C

3.

B

4.

C

5.

A

6.

B

7.

D

8.

A

9.

B

10.

B

11.

A

12.

B

13.

D

14.

C

15.

C

16.

A

17.

A

18.

D

19.

D

20.

A

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