Exam 4: Chronic Kidney Disease NCLEX Questions

Exam 4: Chronic Kidney Disease NCLEX Questions
A patient is admitted to the hospital with CKD. The nurse understands that this condition
is characterized by
a. progressive irreversible destruction of the kidneys
b. a rapid decrease in urine output with an elevated BUN
c. an increasing creatinine clearance with a decrease in urine output
d. prostration, somnolence, and confusion with coma and imminent death
Patients with CKD experience an increase incidence of cardiovascular disease related
to Select all that apply
a. hypertension
b. vascular calcifications
c. a genetic predisposition
d. hyperinsulinemia causing dyslipidemia
e. increased high-density lipoprotein levels
An ESRD patient receiving HD is considering asking a relative to donate a kidney for
transplantation. In assisting the patient to make a decision about treatment, the nurse
informs the patient that
a. successful transplantation usually provides a better quality of life than that offered by
dialysis
b. if rejection of the transplanted kidney occurs, no further treatment for the renal failure
is available
c. HD replaces the normal function of the kidneys, and patients do not have to live with
the continual fear of rejection
d. the immunosuppressive therapy following transplantation makes the person ineligible
to receive other forms of treatment if the kidney fails
To assess the patency of a newly placed arteriovenous graft for dialysis, the nurse
should Select all that apply
a. monitor the BP in the affected arm
b. irrigate the graft daily with low-dose heparin
c. palpate the area of the graft to feel a normal thrill
d. listen with a stethoscope over the graft to detect a bruit
e. frequently monitor the pulses and neurovascular status distal to the graft
A major advantage of peritoneal dialysis is
a. the diet is less restricted and dialysis can be performed at home
b. the dialysate is biocompatible and causes no long-term consequences
c. high glucose concentrations of the dialysate causes a reduction in appetite,
promoting weight loss
d. no medications are required because of the enhances efficiency of the peritoneal
membrane in removing toxins
A kidney transplant recipient complains of having fever, chills, and dysuria over the past
2 weeks. What is the first action the nurse should take?
a. assess temperature and initiate workup to rule out infection
b. reassure the patient that this is common after transplantation
c. provide warm cover for the patient and give 1 g acetaminophen orally
d. notify the nephrologist that the patient has developed symptoms of acute rejection
In replying to a patient's questions about the seriousness of her CKD, the nurse knows
that the stage of CKD is based on what?
a. total daily urine output
b. GFR
c. degree of altered mental status
d. serum creatinine and urea levels
The patient with CKD is receiving dialysis, and the nurse observes excoriations on the
patient's skin. What pathophysiologic changes in CKD most likely occur that can
contribute to this finding? Select all that apply
a. dry skin
b. sensory neuropathy
c. vascular calcifications
d. calcium-phosphate skin deposits
e. uremic crystallization from high BUN
What causes the GI manifestation of stomatitis in the patient with CKD?
a. high serum sodium levels
b. irritation of the GI tract from creatinine
c. increased ammonia from bacterial breakdown of urea
d. iron salts, calcium-containing phosphate binders, and limited fluid intake
The patient with CKD is brought to the ED with Kussmaul respirations. What does the
nurse know about CKD that could cause this patient's Kussmaul respirations?
a. uremic pleuritis is occurring
b. there is decreased pulmonary macrophage activity
c. they are caused by respiratory compensation for metabolic acidosis
d. pulmonary edema from HF and fluid overload is occurring
Which serum laboratory value indicates to the nurse that the patient's CKD is getting
worse?
a. decreased BUN
b. decreased sodium
c. decreased creatinine
d. decreased calculated GFR
What is the most serious electrolyte disorder associated with kidney disease?
a. hypocalcemia
b. hyperkalemia
c. hyponatremia
d. hypermagnesemia
What is the most appropriate snack for the nurse to offer a patient with stage 4 CKD?
a. raisins
b. ice cream
c. dill pickles
d. hard candy
Which complication of CKD is treated with erythropoietin?
a. anemia
b. hypertension
c. hyperkalemia
d. mineral and bone disorder
The patient with CKD is considering whether to use PD or HD. What are advantages of
PD when compared to HD? Select all that apply
a. less protein loss
b. rapid fluid removal
c. less cardiovascular stress
d. decreased hyperlipidemia
e. requires fewer dietary restrictions
To prevent the most common serious complication of PD, what is most important for the
nurse to do?
a. infuse the dialysate slowly
b. use strict aseptic technique in the dialysis procedures
c. have the patient empty the bowel before the inflow phase
d. reposition the patient frequently and promote deep breathing 

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