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The patient that is being evaluated for potential kidney disease should be aware of all of the following trouble signs, except? Puffy eyes Increased thirst Normal urination Fatigue and weakness - answer Correct Answer: Normal urination Frothy or bloody urine could be a potential trouble sign. In addition to the other 3 options above, other signs could include difficult or painful urination and swollen feet, ankles, abdomen, hands, or face. Which of the following is not a nephrology association? ANNA NANT NLN AAKP - answer Correct Answer: NLN The ANNA is the American Neprhology Nurses' Association. The NANT is the National Association of Nephrology Technicians. The AAKP is the American Association of Kidney Patients.
The NLN is the National League of Nurses. The balance of phosphorous and magnesium in the body is regulated by which of the following? Gastrointestinal system Brain Kidneys Both A and C - answer Correct Answer: Both A and C These are two very important components of many of the organic molecules. They serve as intermediates of the metabolic pathways. The 3 systems that maintain the balance of phosphorous and magnesium are the gastrointestinal system, kidneys, and the bone. With glomerularnephritis (GN), the treatment regimen should be aimed at which of the following? Allowing the patient to experience better sleep. Arresting the inflammatory process. Decreasing edema. None of the above - answer Correct Answer: Arresting the inflammatory process.
referred to a nephrologist be appropriate? Unexplained anemia + eGFR <60 mL/min/1.73m eGFR <30 mL/min/1.73 m ACR >30 mg/mmol (300 mg/g) All of the above - answer Correct Answer: All of the above Referral to a nephrologist might be considered appropriate: Unexplained anemia + eGFR<60 mL/min/1.73m2. eGFR <30 mL/min/1.73 m ACR >30 mg/mmol (300 mg/g) Hypertension hard to get to target despite
3 anti-hypertensive agents eGFR decline >3 mL/min/1.73 m What is ACR? - answer Urine albumin to creatinine ratio (ACR), also known as urine microalbumin, helps identify kidney disease that can occur as a complication of diabetes. All of the following would be taken into consideration when offering a patient dialysis except? A life expectancy of more than 60 days. A patient that is not dying from a nonrenal cause. The patient that has a life expectancy of less than 30 days.
The patient that possesses the ability to interact with the environment. - answer Correct Answer: The patient that has a life expectancy of less than 30 days. When talking with the patient and/or surrogates, the principles of autonomy, beneficence, nonmaleficence, and justice should be utilized and tempered with the informed consent, obligations, professional duties, and shared decision making. The above 3 options should be taken into consideration prior to offering the patient dialysis. If the patient does not meet these options, they may still be offered short time dialysis. What is the preferred type of medication for the hypertensive CKD (chronic kidney disease) patient? CCB's ACEI's β blockers ARB's - answer Correct Answer: ACEI's CCB's are calcium channel blockers which work to reduce blood pressure. β blockers are beta blockers and are considered the first-line agent for the treatment of hypertension, myocardial infarctions, and CHF patients. ARBs are angiotensin II receptor blockers and have a similar action to
The Symptom Management Model The Middle-Range Theory of Unpleasant-Symptoms - answer Correct Answer: The Symptom Management Model The other 3 options above are not correct. The Symptom Management Model focuses on all three interrelated dimensions. The three are symptom experience, symptom management strategies, and symptom outcomes. The major premise with this model is that all 3 must be considered in order to manage the symptoms of the patient effectively. All of the following would be considered a common agent that can contribute to kidney disease except? Glucose Contrast media Drugs Heavy metals - answer Correct Answer: Glucose Glucose is not an agent that typically contributes to kidney disease. Contrast media, drugs, and heavy metals can contribute to kidney disease. The kidneys are a frequent target for toxic injury, because they are the major route of excretion for a number of drugs. What is the difference in taking a interdisciplinary approach to chronic
kidney disease versus a multidisciplinary approach? Working collaboratively versus working sequentially. Communicating by regular discussion versus medical record. Physician versus dietitian, social worker, nurse, and patient. All of the above - answer Correct Answer: All of the above Since the 1990's there has been a collaborative effort to improve the processes and complications in kidney disease. Taking an interdisciplinary approach with the renal patients is one of those efforts. Interdisciplinary means working collaboratively, communicating regularly, and a team of professionals working together to improve the outcome of the patients prognosis. The patient on hemodialysis has an increased susceptibility to infections. Which of the following diseases can be transmitted both by direct or indirect exposure? Hepatitis A Hepatitis C Hepatitis B Tuberculosis - answer Correct Answer: Hepatitis B
by certain areas of the dialyzer. Which of the following types of dialyzers are not commonly used in the United States? Parallel plate Hollow fiber Polymer plate None of the above - answer Correct Answer: Parallel plate At one time, these were used extensively, but now are not commonly used in the United States. This dialyzer is made up of sheets of thin plastic membranes one on top of another similar to a sandwich. This dialyzer was designed for the blood and dialysis solution to pass through alternate spaces that are between the membrane sheets. The chronic ingestion of analgesics is typically associated with which of the following diseases? Analgesic nephropathy (AN) GN Diabetes mellitus Hypertension - answer Correct Answer: Analgesic nephropathy (AN)
The combination analgesics such as phenacetin were actually removed from the market, because it was felt they were some of the worse offenders that caused chronic renal failure. The treatment for AN is to stop the offending agent. If this is not done the disease process will continue to progress. Which of the following precautions should be taken when performing hemodialysis on a patient that is HBsAg-positive? Staff should not care for the HBsAg-positive patient and a patient that is susceptible on the same shift. The HBsAg-positive patient should have dialysis in a separate room that is designated only for the HBsAg-positive patients. Both A and B None of the above - answer Correct Answer: Both A and B In addition to the two options above, the patient should also use separate equipment and supplies. The dialyzers should not be reused with the HBsAg-positive patients. Renal insufficiency can alter the distribution of medications. This can be due to all of the following except? Tissue binding
The professional definition of nursing is defined as " the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations." Which of the following is another term for Chronic Kidney Disease stage 5? Glomerular disease End-stage renal disease Uremia All of the above - answer Correct Answer: End-stage renal disease Chronic Kidney Disease stage 5 is when the patient is at the point that they require dialysis in order to survive. When a person's kidney function falls below 10 to 15% of normal, the end-stage has been reached and either transplantation or dialysis becomes necessary or the patient will not survive. Which of the following would be considered the most commonly used method of assessing medication adherence with the ESRD (end-stage renal disease) patient? Self-reporting Electronic monitoring Pill count
None of the above - answer Correct Answer: Pill count Assessing the ESRD patient for medication adherence is not always an easy task. In the clinical setting, such objective findings as laboratory values and body weight can help the clinician, but there are no standardized criteria for this. Some of the measures that have been used are self-reporting, electronic monitoring, and pill counting. Which of the following would be correct for the sensor device which alarms and detects any foam or air in the extracorporeal circuit before the blood is returned to the patient? Sensory alarm Air detector Both A and B None of the above - answer Correct Answer: Air detector Air can be potentially lethal if infused into the patient. The purpose of the air detector is to prevent air from being returned to the patient. If the air detector alarm system is properly engaged, it will give both audible and visual alarms, stop the flow of the blood pump, and occlude the venous line. This will help to decrease UF if air is detected.
Stop the bleeding at the site. Return the appropriate blood to the patient. If there is significant loss of blood, administer oxygen, volume expanders and/or transfuse. Notify the physician. Of the following, which would be considered the process during dialysis when the body's water is removed? Ultrafiltration Osmosis Diffusion All of the above - answer Correct Answer: Ultrafiltration The passage of a fluid through a semipermeable membrane would be considered osmosis. The movement of a substance from a area of high concentration to an area of low concentration would be diffusion. The process during dialysis when the body water is removed would be ultrafiltration. Which of the following would be considered a clinical presentation of hypertensive nephrosclerosis (HN)? Progressive renal insufficiency with a urinalysis that shows absent or mild proteinuria.
Long-term essential hypertension. Both A and B None of the above - answer Correct Answer: Both A and B Both the options above are considered as clinical presentations of HN. In addition, there can be extra-renal signs and symptoms such as left ventricular hypertrophy and retinal changes seen. All of the following would be considered inhibitors of drug metabolism except? Erythromycin Grapefruit juice Rifampin Cimetidine - answer Correct Answer: Rifampin Rifampin would be an inducer of drug metabolism. Erythromycin, grapefruit juice, and cimetidine would be inhibitors of drug metabolism. Which of the following would not be included as expected outcomes for the interventions for the peritoneal dialysis patient that is experiencing metabolic and endocrine disturbances?
All of the following nursing interventions should be implemented to help prevent infections during peritoneal dialysis treatments, except? Observe the clarity and the color of the effluent. Only change the exit-site dressing when it becomes soiled. Observe strict aseptic techniques during catheter dressing changes. Monitor the patient's renal blood urea nitrogen and creatinine clearance levels. - answer Correct Answer: Only change the exit-site dressing when it becomes soiled. The exit-site dressing is typically changed daily or more often if the circumstance warrants it. The policy and procedures of the facility need to be followed for the changing of the exit-site dressing. The other 3 options above would be interventions that could be implemented to help prevent infections. With the renal patient, which of the following is considered the primary cause of peritonitis? Microbial contamination Vaccination Sterile technique None of the above - answer Correct Answer: Microbial contamination
Vaccination and sterile technique would not be considered the primary cause of peritonitis. Microbial contamination is the primary consideration in the prevention of peritonitis. Which of the following would not be considered a gastrointestinal side effect of corticosteroids (prednisone)? Peptic ulcers Gastritis Diarrhea Pancreatitis - answer Correct Answer: Diarrhea Diarrhea is not the typical side effect of corticosteroids. The gastrointestinal side effects are: Peptic ulcers Gastritis Pancreatitis Abdominal distension The nursing management of hyperlipidemia in the post-transplant renal patient could include all of the following except? Decrease in the patient's activity level.
