Acute Kidney Injury Nclex Questions

Acute Kidney Injury Nclex Questions ScienceMedicineNursing yi_yan7Top creator on Quizlet Save Acute Renal Injury & CKD - NCLEX 26 terms NurseLouPreview Chronic Kidney Disease NCLEX Que...28 terms Jenrea1Preview ICP Nclex Questions, ICP NCLEX sty...120 terms Mariko_Roberts Preview NCLEX 109 term abi The nurse is caring for a client admitted with a diagnosis of acute kidney injury (AKI). The client asks the nurse, "Are my kidneys failing? Will I need a kidney transplant?" Which response by the nurse is the most appropriate?

• "No, don't think that. You're going to be fine."
• "In most cases, your condition can be reversed with prompt treatment and usually will not destroy the kidneys."
• "Kidney transplantation is highly likely, so it would be a good idea to start talking to your family members about organ donation."
• "When the doctor comes to see you, we can talk about whether you will need a transplant."

Answer: B

Explanation: Acute kidney injury (AKI) is often resolved without the need for transplant if treatment is initiated quickly. There is no need to start lining up donors or wait for the provider to arrive to explore options. Telling the client that everything will be fine is condescending, provides no information, and is not within the nurse's ability to know.A client diagnosed with frequent urinary tract infections is seen in the urology clinic. The nurse reviews the client's medical history and determines that the client is at risk for acute kidney injury. Which items in the client's history support this conclusion? Select all that apply.

• Dehydration
• Renal calculi
• Ineffective wound healing
• Low serum albumin
• Hypertension

Answer: A, B, E

Explanation: Dehydration, renal calculi, and hypertension can all precipitate acute kidney injury (AKI). Ineffective wound healing has not been shown to cause renal failure unless the infection becomes systemic. A low serum albumin does not cause AKI.

A young school-age client is in the hospital with an acute kidney injury diagnosis following a streptococcus infection. The client's parents primarily speak Spanish but have a limited ability to understand English. Through an interpreter, the parents ask the nurse what mistake they made that caused their child to be so sick. Which response by the nurse is the most appropriate?

• "Your child does not eat enough dietary protein."
• "Your child has a congenital defect that led to renal failure."
• "Your child's renal failure has been caused by a low calcium level."
• "Your child's recent infection may have caused the renal failure."

Answer: D

Explanation: Clients with streptococcus are at risk for kidney and cardiac sequelae. In this case, the child has no evidence of a congenital defect leading to acute kidney injury (AKI). A low-protein or low-calcium diet will not lead to AKI.The nurse is planning care for a client diagnosed with acute kidney injury (AKI). The nurse plans the client's care based on the nursing diagnosis of Excess Fluid Volume. Which assessment data supports this nursing diagnosis?

• Pitting edema in the lower extremities
• Bowel sounds positive in four quadrants
• Wheezing in the lungs
• Generalized weakness

Answer: A

Explanation: The client in acute kidney injury (AKI) will likely be edematous, because the kidneys are not producing urine. Wheezing in the lungs is an assessment consistent with asthma, not AKI. Bowel sounds in four quadrants is a normal assessment finding. Generalized weakness may be due to whatever disease process precipitated the kidney failure.A client diagnosed with acute kidney injury (AKI) is receiving peritoneal dialysis. The nurse is explaining the dialysis process to the client and family. Which statement should the nurse include in this discussion?

• "The peritoneum is more permeable because of the presence of excess metabolites."
• "The metabolites will diffuse from the interstitial space to the bloodstream mainly through diffusion and ultrafiltration."
• "The peritoneum acts as a semipermeable membrane through which wastes move by diffusion and osmosis."
• "The solutes in the dialysate will enter the bloodstream through the peritoneum."

Answer: C

Explanation: The peritoneum acts as a semipermeable membrane, allowing substances to move from an area of high concentration (the blood) to an area of lower concentration (the dialysate). Metabolic waste products and excess water can be eliminated through osmosis and diffusion using the peritoneum as the semipermeable membrane.

The nurse is caring for a client diagnosed with acute kidney injury (AKI). When reviewing the client's laboratory data, which findings should indicate to the nurse that the client has met the expected outcomes? Select all that apply.

• Decreasing serum creatinine
• Decreasing blood urea nitrogen (BUN)
• Decreasing neutrophil count
• Decreasing lymphocyte count
• Decreasing erythrocyte count

Answer: A, B

Explanation: Creatinine is the metabolic end product of creatine phosphate and is excreted via the kidneys in relatively constant amounts. BUN, a measurement of the nitrogen portion of urea, is also excreted in urine and is a good indicator of renal function. Neutrophils, lymphocytes, and erythrocytes are not used to monitor the return of renal function.What is the most frequent complication during hemodialysis?

• Hemorrhage
• Hypotension
• Localized infection
• Hypertension

Answer: B

Explanation: Hypotension is the most frequent complication during hemodialysis. It may result from changes in serum osmolality, rapid removal of fluid from the vascular compartment, vasodilation, and other factors. Bleeding is another possible complication, although it does not occur as often as hypotension. Infection is also commonly associated with hemodialysis, although it occurs following treatment rather than during dialysis.A client diagnosed with acute kidney injury (AKI) will be discharged to home in the next few days. When conducting dietary instruction, the nurse should teach the client to choose proteins that are high in biological value. Which client statement indicates that this teaching has been effective?

• "I will be sure to include eggs in my diet."
• "I should include vegetables at every meal."
• "Legumes should be included in my diet, because they are complete proteins."
• "I will eat nuts daily because they are high in protein."

Answer: A

Explanation: Eggs are an excellent source of essential amino acids and are recommended as part of the diet for a client with acute kidney injury (AKI) who is on a protein-restricted diet. Legumes, nuts, and vegetables do contain protein, but they are incomplete proteins and thus not as good a protein source as eggs.

The nurse is planning care for a client admitted with a diagnosis of heart failure. Based on this diagnosis, which type of kidney failure is the client at an increased risk for experiencing?

• Prerenal hypovolemia
• Intrarenal glomerular injury
• Intrarenal acute tubular necrosis
• Prerenal low cardiac output

Answer: D

Explanation: Heart failure is one possible cause of prerenal kidney failure due to low cardiac output. In comparison, causes of prerenal kidney failure due to hypovolemia include hemorrhage, dehydration, burns, wounds, and excess fluid loss from the gastrointestinal tract. Causes of intrarenal kidney failure due to glomerular injury include glomerulonephritis, disseminated intravascular coagulation, vasculitis, hypertension, toxemia of pregnancy, and hemolytic uremic syndrome. Finally, causes of intrarenal kidney failure due to acute tubular necrosis include ischemia resulting from conditions associated with prerenal failure, toxins, hemolysis, and rhabdomyolysis.The nurse is concerned that an older adult client is at risk for developing acute kidney injury (AKI). Which data in the client's history supports the nurse's concern? Select all that apply.

• Diagnosed with hypotension
• Recent aortic valve replacement surgery
• Prescribed high doses of intravenous antibiotics
• Total hip replacement surgery 5 years ago
• Taking medication for type 2 diabetes mellitus

Answer: A, B, C

Explanation: Older adults develop acute kidney injury more frequently because of the higher incidence of serious illnesses, hypotension, major surgeries, diagnostic procedures, and treatment with nephrotoxic drugs. Decreased kidney function associated with aging also puts the older client at risk for acute kidney injury. Hypotension, aortic valve replacement surgery, and receipt of high doses of intravenous antibiotics increase this client's risk for developing acute kidney injury. A previous history of hip replacement surgery and current treatment for type 2 diabetes mellitus are not identified risk factors for the development of acute kidney injury.The community nurse visits the home of a young child who is home from school because of sudden onset of nausea, vomiting, and lethargy. The nurse suspects acute kidney injury (AKI). Which clinical manifestations support the nurse's suspicions? Select all that apply.

• Elevated blood pressure
• Postural hypotension
• Wheezing
• Edema
• Hematuria

Answer: A, D, E

Explanation: Pediatric manifestations of acute kidney injury characteristically begin with a healthy child who suddenly becomes ill with nonspecific symptoms that indicate a significant illness or injury. These symptoms may include any combination of the following: nausea, vomiting, lethargy, edema, gross hematuria, oliguria, and hypertension. Postural hypotension is a manifestation of acute kidney injury in an older person. Wheezing is not a manifestation of acute kidney injury.