which clinical finding should a nurse look for in a client with chronic renal failure?
This is a quiz that contains NCLEX review questions for chronic kidney disease (also chosen end phase renal failure). As a nurse providing intendance to a patient with CKD, it is of import to know the signs and symptoms, pathophysiology, nursing direction, patient instruction, and treatment for this condition.
In the previous NCLEX review series, I explained about other renal disorders y'all may be asked virtually on the NCLEX exam, so exist sure to check out those reviews and quizzes likewise.
Don't forget to lookout man the chronic kidney disease lecture before taking the quiz.
Chronic Kidney Affliction NCLEX Questions
This quiz will examination your knowledge on chronic kidney disease (end stage renal disease) in training for the NCLEX exam.
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Chronic Kidney Disease (Terminate Phase Renal Failure) NCLEX Questions
1. A 55 year old male person patient is diagnosed with chronic kidney disease. The patient'southward contempo GFR was 25 mL/min. What stage of chronic kidney disease is this known as?
A. Phase 1
B. Stage 3
C. Stage 4
D. Phase five
The answer is C. This is known as Stage iv of CKD because the GFR (glomerular filtration charge per unit) for this stage is 15-29 mL/min (patient's GFR is 25 mL/min). The other stage'south criteria are as follows:
Phase 1: Kidney damage with normal renal role GFR >90 ml/min merely with proteinuria (3 months or more);
Stage 2: Kidney damage with mild loss of renal function GFR 60-89 ml/min with proteinuria (3 months or more);
Stage 3: Mild-to-severe loss of renal office GFR 30-59 mL/min;
Stage iv: Astringent loss renal part GFR 15-29 mL/min;
Stage five: End stage renal illness GRF less 15 mL/min
2. A patient with CKD has a low erythropoietin (EPO) level. The patient is at take chances for?
A. Hypercalcemia
B. Anemia
C. Blood clots
D. Hyperkalemia
The reply is B. EPO (erythropoietin) helps create reddish blood cells in the bone marrow. The kidneys produce EPO and when the kidneys are damaged in CKD they tin decrease in the production of EPO. Therefore, the patient is at risk for anemia.
three. A 65 year sometime male patient has a glomerular filtration rate of 55 mL/min. The patient has a history of uncontrolled hypertension and coronary artery disease. You're assessing the new medication orders received for this patient. Which medication ordered past the physician will assistance treat the patient's hypertension along with providing a protective mechanism to the kidneys?
A. Lisinopril
B. Metoprolol
C. Amlodipine
D. Verapamil
The answer is A. At that place are two types of drugs that tin exist used to treat hypertension and protect the kidneys in patients with CKD. These drugs include angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs). The only drug listed here that is correct is Lisinopril. This drug is known equally an ACE inhibitor. Metoprolol is a BETA BLOCKER. Amlodipine and Verapamil are calcium channel blockers.
4. Which patient below is Not at risk for developing chronic kidney disease?
A. A 58 yr one-time female with uncontrolled hypertension.
B. A 69 year old male with diabetes mellitus.
C. A 45 year quondam female with polycystic ovarian illness.
D. A 78 year erstwhile female with an intrarenal injury.
The answer is C. Options A, B, and D are all at risk for developing CKD. However, pick C is not at adventure for CKD.
5. A patient with Stage 5 CKD is experiencing extreme pruritus and has several areas of crystallized white deposits on the skin. Equally the nurse, you know this is due to excessive amounts of what substance found in the blood?
A. Calcium
B. Urea
C. Phosphate
D. Erythropoietin
The answer is B. This patient is experiencing uremic frost that occurs in severe chronic kidney disease. This is due to high amounts of urea in the blood being secreted via the sweat glands onto the peel, which will announced every bit white deposits on the skin. The patient will experience itching with this.
six. Your patient with chronic kidney disease is scheduled for dialysis in the morning. While examining the patient's telemetry strip, you note alpine peaked T-waves. You lot notify the doc who orders a STAT basic metabolic panel (BMP). What event from the BMP confirms the EKG abnormality?
A. Phosphate 3.2 mg/dL
B. Calcium 9.3 mg/dL
C. Magnesium 2.ii mg/dL
D. Potassium 7.one mEq/50
The answer is D. The patient'due south potassium level is extremely elevated. A normal potassium level is 3.v-5.1 mEq/L. This patient is experiencing hyperkalemia, which can cause tall peak T-waves. Remember in CKD (especially prior to dialysis), the patient will experience electrolyte imbalances, especially hyperkalemia.
7. You are providing education to a patient with CKD about calcium acetate. Which statement by the patient demonstrates they understood your instruction about this medication? Select-all-that-apply:
A. "This medication volition help go on my calcium level normal."
B. "I will take this medication with meals or immediately afterward."
C. "It is important I eat high amounts of oatmeal, poultry, fish, and dairy products while taking this medication."
D. "This medication will help prevent my phosphate level from increasing."
The answers are B and D. Calcium acetate (likewise known as PhosLo) is a phosphate binder, which will aid keep the patient's phosphate level from condign besides high. It helps excrete the phosphate taken in the nutrient past excreting it out of the stool. Therefore, it should be taken with meals or immediately after. Choice C is wrong because the patient should Avoid these types of foods high in phosphate.
viii. While assessing forenoon labs on your patient with CKD. You notation the patient'due south phosphate level is 6.2 mg/dL. As the nurse, you await to find the calcium level to exist?
A. Elevated
B. Low
C. Normal
D. Same as the phosphate level
The answer is B. A normal phosphate level is 2.7-4.5 mg/dL. This patient is experiencing HYPERphosphatemia. When hyperphosphatemia presents the calcium level DECREASES because phosphate and calcium bind to each. When in that location is too much phosphate in the blood it takes as well much calcium with information technology and information technology decreases the calcium in the blood. Therefore, the nurse would expect to find the calcium level decreased.
nine. A patient with phase 4 chronic kidney disease asks what type of diet they should follow. You explain the patient should follow a:
A. Low protein, depression sodium, low potassium, depression phosphate diet
B. Loftier protein, depression sodium, low potassium, high phosphate diet
C. Low protein, high sodium, high potassium, high phosphate nutrition
D. Low poly peptide, low sodium, depression potassium, high phosphate diet
The answer is A. The patient should follow this type of diet because protein breaks down into urea (remember patient will have increased urea levels), depression sodium to prevent fluid excess, low potassium to prevent hyperkalemia (remember glomerulus isn't filtering out potassium/phosphate as it should), and depression phosphate to prevent hyperphosphatemia.
10. The kidneys are responsible for performing all the post-obit functions EXCEPT?
A. Activating Vitamin D
B. Secreting Renin
C. Secreting Erythropoietin
D. Maintaining cortisol production
The reply is D. The adrenal glands are responsible for maintaining cortisol production non the kidneys.
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