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Renal Highlights
Kelly Cloonan MSN, RN, CPN
Diana Kovacic MSN, BSN, RN
Answer: A
What statement by your 40 year old
hospitalized patient with a UTI indicates a
concern for pyelonephritis?
◦ A. Fever and chills
◦ B. Painful urination
◦ C. Dark urine
◦ D. Cloudy urine
Answer- B
The nurse is caring for a client with ESKD
and dialysis has been initiated. Which drug
order does the nurse question?
◦ A. Erythropoietin
◦ B. Diuretic
◦ C. ACE inhibitor
◦ D. Calcium channel blocker
Answer: C
What instruction will decrease your patient’s risk for renal calculi?
◦ A. Avoid taking in too much calcium
◦ B. Begin your antibiotics as soon as you suspect a stone
◦ C. Drink 3 liters of fluid or more per day
◦ D. Avoid too much exercise
Answer: FALSE
True or False
When taking an antibiotic for a UTI, the
patient should stop immediately once
symptoms subside.
Answer: B Intrarenal
Vancomycin and polycystic kidney disease
cause what type of acute renal failure?
◦ A. Prerenal
◦ B. Intrarenal
◦ C. Postrenal
Answer: B
Which assessment parameter(s) will the
nurse monitor to determine fluid and
sodium retention status?
◦ A. Weight
◦ B. Weight and Blood Pressure
◦ C. Capillary refill
◦ D. Output
Answer: D
Your assessment reveals tachycardia and
crackles bilaterally at the bases of the
lungs in your patient with chronic renal
failure. The patient is also very agitated.
Which is your first intervention?
◦ A. Assess your next patient
◦ B. Call a code
◦ C. Give ordered anti-anxiety medication
◦ D. Place patient in high Fowler’s position
Answer: B
Which of the following assessment
findings is not expected in a client in the
early stage of acute renal failure?
◦ A. Acidosis
◦ B. Diuresis
◦ C. Hyperkalemia
◦ D. Hypertension
Answer: C
Your client has acute renal failure and is
on dialysis. How much fluid will be
permitted each day?
◦ A. It will be based on amount of kidney
damaged
◦ B. 4 Liters per day
◦ C. Amount equal to excreted urine plus
500ml
◦ D. As much as the client wants
Answer: C
What does the breath often smell like in a
patient with CKD?
◦ A. Fruit
◦ B. Feces
◦ C. Urine
◦ D. Blood
Answer: Hypovolemia
A client taking furosemide (Lasix), may be
at risk for what type of volemia?
Answer: D
The nurse teaches a man who has passed a
calcium phosphate kidney stone to:
◦ A. Alternate an acid diet with an alkaline diet
◦ B. Eliminate all milk products from diet
◦ C. Have his urine checked each month for infection
◦ D. Maintain high fluid intake daily
Answer: A. Chronic
90-95% loss of kidney function is
_____renal failure.
◦ A. Chronic
◦ B. Acute
Answer: A, B, C
A nurse is caring for a client receiving Vancomycin. Because this drug has potential for nephrotoxicity, which laboratory results does the nurse monitor? (Select all that apply.)
◦ A. Blood urea nitrogen (BUN)
◦ B. Creatinine
◦ C. Drug peak and trough levels
◦ D. Prothrombin time (PT)
◦ E. Platelet count
◦ F. Hemoglobin and hematocrit
Answer: C
One of the nursing diagnoses for a client
with ESRD is: Inadequate tissue perfusion
related to anemia. Which of the following
is a nursing order for this nursing
diagnosis?
◦ A. Advise against the use of salt substitutes
◦ B. Administer antihypertensives as ordered
◦ C. Administer erythropoietin as ordered.
◦ D. Monitor fluid balance.
Answer: C Postrenal
Kidney stones and benign prostatic
hyperplasia cause what type of acute renal
failure?
◦ A. Prerenal
◦ B. Intrarenal
◦ C. Postrenal
Answer: C
The nurse is talking to a 68-year old male
patient who is a smoker and has a long
history of occupational exposure to toxic
chemicals. Because this patient has a high
risk for bladder cancer, the nurse is
concerned about which urinary complaint?
◦ A. Frequency
◦ B. Nocturia
◦ C. Painless hematuria
◦ D. Incontinence
Answer: B
When caring for a client in acute renal
failure, it is most important for the nurse
to call the physician to report changes in:
◦ A. BUN
◦ B. EKG
◦ C. Hematocrit
◦ D. Weight
Answer: D
The nurse is admitting a client with
chronic renal failure to the nursing unit.
The nurse assesses for which most
frequent cardiovascular sign that occurs in
the client with chronic renal failure?
◦ A. Bradycardia
◦ B. Tachycardia
◦ C. Hypotension
◦ D. Hypertension
Answer: A, B, C, E, F
The nurse is teaching self-care measures to a patient who had lithotripsy for kidney stones. What information does the nurse include? (select all that apply)
◦ A. Finish all antibiotics prescribed
◦ B. Balance regular exercise with sleep and rest
◦ C. Drink at least 3L of fluid a day
◦ D. Watch for and report bruising after lithotripsy
◦ E. Urine may be bloody for several days
◦ F. Report pain, fever, chills, or difficulty urinating to a health care provider
Answer: A Prerenal
Sepsis causes what type of acute renal
failure?
◦ A. Prerenal
◦ B. Intrarenal
◦ C. Postrenal
Answer: B
A patient is diagnosed with kidney cancer
and the health care provider recommends
the best therapy. Which treatment does
the nurse anticipate teaching the patient
about?
◦ A. Chemotherapy
◦ B. Surgical removal
◦ C. Hormonal therapy
◦ D. Radiation therapy
Answer: D
The client with chronic renal failure who
is scheduled for hemodialysis this morning
is due to receive a daily dose of lisinopril.
The nurse plans to administer this
medication:
◦ A. During dialysis
◦ B. Just before dialysis
◦ C. The day after dialysis
◦ D. Upon return from dialysis
Answer: Oliguric (output <400/d)
The __________ phase of acute renal
failure usually occurs within 1-3 weeks
and lasts up to 14 days. *
Answer: A Prerenal
Hypovolemia, shock, burns, and
cardiovascular disorders cause what type
of acute renal failure?
◦ A. Prerenal
◦ B. Intrarenal
◦ C. Postrenal
Answer: B
A client with a history of uric acid kidney
stones needs further teaching if he states:
◦ A. “I need to drink about 3 liters of fluid every
day”
◦ B. “I like to take 500mg of Vitamin C every day.”
◦ C. “I’m going to try and walk a little every two
hours.”
◦ D. “I will continue taking my allopurinol as
prescribed.”
Answer: B
Chronic renal failure, will cause
◦ A. Hypercalcemia
◦ B. Hypocalcemia
Answer: A
A client with renal failure is receiving epoetin alfa (Epogen) to support erythropoiesis. The nurse questions the client about compliance with taking which of the following medications that supports red blood cell production?
◦ A. Iron supplement
◦ B. Zinc supplement
◦ C. Calcium supplement
◦ D. Magnesium supplement
Answer- C
A 55-year old client is admitted with a diagnosis of renal calculi. He presented with severe right flank pain, nausea, and vomiting. The most important nursing action for him at this time is:
◦ A. Intake and output measurement
◦ B. Daily weights
◦ C. Straining of all urine
◦ D. Administration of O2 therapy
Answer: A
A nurse writes the following nursing
diagnosis for a client in acute renal failure-
Impaired gas exchange related to:
◦ A. Decreased red blood cell production
◦ B. Increased levels of vitamin D
◦ C. Increased red blood cell production
◦ D. Decreased production of renin
Answer: A
So, what will you tell your client to
increase in his/her diet with CRF?
◦ A. Calcium
◦ B. Potassium
◦ C. Sodium
◦ D. Phosphate