Hesi Patient Reviews With Rn Case Studies and Practice Testchronic Kidney Disease
This is a quiz that contains NCLEX review questions for acute kidney injury (as well called acute renal failure). Every bit a nurse providing care to a patient with AKI, it is important to know the signs and symptoms, pathophysiology, nursing direction, patient educational activity, and handling for these conditions.
In the previous NCLEX review serial, I explained about other renal disorders y'all may be asked most on the NCLEX test, so exist certain to check out those reviews and quizzes besides.
Don't forget to scout the acute kidney injury lecture before taking the quiz.
Acute Kidney Injury NCLEX Practise Questions
This quiz will test your knowledge on Acute Kidney Injury (likewise chosen Acute Renal Failure) in preparation for NCLEX.
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Astute Kidney Injury (Acute Renal Failure) NCLEX Questions
one. ______________ is solely filtered from the bloodstream via the glomerulus and is NOT reabsorbed back into the bloodstream but is excreted through the urine.
A. Urea
B. Creatinine
C. Potassium
D. Magnesium
The answer is B. Creatinine is a waste production from muscle breakdown and is removed from the bloodstream via the glomerulus of the nephron. It is the only substance that is solely filtered out of the blood just NOT reabsorbed dorsum into the system. It is excreted out through the urine. This is why a creatinine clearance exam is used equally an indicator for determining renal office and for computing the glomerular filtration rate.
2. A patient with astute renal injury has a GFR (glomerular filtration charge per unit) of xl mL/min. Which signs and symptoms below may this patient present with? Select all that apply:
A. Hypervolemia
B. Hypokalemia
C. Increased BUN level
D. Decreased Creatinine level
The answers are A and C. The glomerular filtration rate indicates how well the glomerulus is filtering the blood. A normal GFR tends to be 90 mL/min or college. A GFR of forty mL/min indicates that the kidney'due south ability to filter the blood is decreased. Therefore, the kidneys will be unable to remove waste and excessive water from the blood…hence hypervolemia and an increased BUN level will present in this patient. The patient volition experience HYPERkalemia (not hypo) considering the kidneys are unable to remove potassium from the blood. In add-on, an INCREASED creatinine level (not decreased) will present because the kidneys cannot remove excessive waste products, such as creatinine.
three. You lot're assessing morning time lab values on a female patient who is recovering from a myocardial infraction. Which lab value below requires yous to notify the dr.?
A. Potassium level 4.two mEq/Fifty
B. Creatinine clearance 35 mL/min
C. BUN 20 mg/dL
D. Blood pH 7.40
The answer is B. A normal creatinine clearance level in a female should be 85-125 mL/min (95-140 mL/min males). A creatinine clearance level indicates the corporeality of blood the kidneys can make per minute that incorporate no amounts of creatinine in it. Think creatinine is a waste of muscle breakup. Therefore, the kidneys should be able to remove excessive amounts of information technology from the bloodstream. A patient who has experienced a myocardial infraction is at run a risk for pre-renal acute injury due to decreased cardiac output to the kidneys from a damaged centre muscle (the eye isn't able to pump as efficiently because of ischemia). All the other labs values are normal.
four. A 55 yr onetime male patient is admitted with a massive GI bleed. The patient is at risk for what type of astute kidney injury?
A. Mail-renal
B. Intra-renal
C. Pre-renal
D. Intrinsic renal
The answer is C. Pre-renal injury is due to decreased perfusion to the kidneys secondary to a crusade (massive GI bleeding…patient is losing blood volume). This leads to a major subtract in kidney part because the kidneys are deprived of nutrients to function and the amount of blood information technology can filter. Pre-renal injury can eventually pb to intrarenal damage where the nephrons go damaged.
5. Select all the patients beneath that are at take a chance for acute intra-renal injury?
A. A 45 year old male with a renal calculus.
B. A 65 year erstwhile male with benign prostatic hyperplasia.
C. A 25 year old female person receiving chemotherapy.
D. A 36 year old female with renal avenue stenosis.
E. A 6 year old male with astute glomerulonephritis.
F. An 87 twelvemonth former male who is taking an aminoglycoside medication for an infection.
The answers are: C, E, and F. These patients are at risk for an intra-renal injury, which is where there is damage to the nephrons of kidney. The patients in options A and B are at adventure for Postal service-RENAL injury because there is an obstruction that can cause back flow of urine into the kidney, which tin atomic number 82 to decreased function of the kidney. The patient in option D is at gamble for PRE-RENAL injury because there is an issue with perfusion to the kidney.
6. A patient with astute kidney injury has the following labs: GFR 92 mL/min, BUN 17 mg/dL, potassium iv.nine mEq/L, and creatinine one mg/dL. The patient's 24 hour urinary output is 1.75 Liters. Based on these findings, what phase of AKI is this patient in?
A. Initiation
B. Diuresis
C. Oliguric
D. Recovery
The answer is D. This patient is in the recovery stage of AKI. The patient'due south labs and urinary output betoken the renal function has returned to normal. Retrieve the recovery stages starts when the GFR (glomerular filtration rate) has returned to normal (normal GFR xc mL/min or higher), which volition allow waste levels and electrolyte levels to be maintained.
vii. A 36 year sometime male patient is diagnosed with astute kidney injury. The patient is voiding 4 L/day of urine. What complication can arise based on the stage of AKI this patient is in? Select all that employ:
A. Water intoxication
B. Hypotension
C. Depression urine specific gravity
D. Hypokalemia
Eastward. Normal GFR
The answers are: B, C, and D. This patient is in the DIURESIS stage of AKI. The nephrons are now starting to filter out waste product only cannot concentrate the urine. There is at present a high amount of urea in the filtrate (because the nephrons tin can filter the urea out of the blood) and this causes osmotic diuresis. Urinary output will be excessive (3 to half dozen Fifty/day). Therefore, the patient is at risk for hypotension, diluted urine (low urine specific gravity), and hypokalemia (waste potassium in the urine). The patient is not at risk for water intoxication and will not have a normal GFR until the recovery stage.
8. Truthful or Simulated: All patients with acute renal injury will progress through the oliguric stage of AKI but not all patients will progress through the diuresis stage.
The respond is Simulated. Some patients will skip the oliguric stage of AKI and progress to the diuresis phase.
nine. Which patient below with acute kidney injury is in the oliguric stage of AKI:
A. A 56 year old male person who has metabolic acidosis, decreased GFR, increased BUN/Creatinine, hyperkalemia, edema, and urinary output 350 mL/mean solar day.
B. A 45 year old female with metabolic alkalosis, hypokalemia, normal GFR, increased BUN/creatinine, edema, and urinary output 600 mL/day.
C. A 39 year erstwhile male with metabolic acidosis, hyperkalemia, improving GFR, resolving edema, and urinary output 4 L/mean solar day.
D. A 78 year old female with respiratory acidosis, increased GFR, decreased BUN/creatinine, hypokalemia, and urinary output 550 mL/day.
The answer is A. During the oliguric phase of AKI the patient will have a urinary output of 400 mL/solar day or LESS. This is due to a decreased GRF (glomerular filtration charge per unit), which will lead to increased amounts of waste in the blood (increased BUN/Creatinine), metabolic acidosis (decreased excretion of hydrogen ions), hyperkalemia, hypervolemia (edema/hypertension), and urinary output of <400 mL/day.
10. You're developing a nursing intendance programme for a patient in the diuresis stage of AKI. What nursing diagnosis would yous include in the care program?
A. Excess fluid volume
B. Take a chance for electrolyte imbalance
C. Urinary retention
D. Acute hurting
The reply is B. During the diuresis phase of AKI, the patient volition be losing an excessive amount of urine (three-6 Liters/solar day) and is at chance for fluid volume deficient and electrolyte imbalance. The nurse must monitor the patient'south electrolyte levels, particularly potassium (hypokalemia).
11. While educating a group of nursing students about the stages of acute kidney injury, a educatee asks how long the oliguric stage lasts. You explain to the educatee this stage can terminal?
A. 1-two weeks
B. 1-3 days
C. Few hours to ii weeks
D. 12 months
The answer is A. The oliguric stage tin last one-two weeks. Regarding the other stages of AKI: Initiation: few hours to several days, diuresis: one-three weeks, and recovery: 12 months or more.
12. A patient with AKI has a urinary output of 350 mL/day. In addition, morning time labs showed an increased BUN and creatinine level forth with potassium level of 6 mEq/L. What type of diet ordered past the physician is most appropriate for this patient?
A. Low-sodium, loftier-poly peptide, and low-potassium
B. Loftier-protein, low-potassium, and low-sodium
C. Depression-protein, low-potassium, and low-sodium
D. High-poly peptide and loftier-potassium
The answer is C. The patient with AKI, especially in the oliguric stage of AKI, should eat a low-protein, low-potassium, and low-sodium diet. This is because the kidneys are unable to filter out waste material products, excessive h2o, and maintain electrolyte balance. The patient will have a buildup of waste (BUN and creatinine). Remember these waste material products are the byproduct of protein (urea) and muscle breakdown (creatinine). And so the patient should avoid high-poly peptide foods. In addition, the patient is at risk for hyperkalemia and fluid overload (needs depression-potassium and sodium foods).
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