Exam 4

What type of lipid is used to build cell membranes?
A. Triglycerides
B. Steroids
C. Phospholipids

C

What type of lipid is used to provide the body with energy?
A. Triglycerides
B. Steroids
C. Phospholipids

A

What type of lipid is used to produce some hormones?
A. Triglycerides
B. Steroids
C. Phospholipids

B

Interpreting a lipid profile, what value represents cholesterol?
A. HDL
B. Total cholesterol
C. LDL
D. Triglycerides

C

Which of the following medications is an HMG-CoA reductase inhibitor?
A. ezetimibe
B. simvastatin
C. gemfibrozil
D. cholestyramine

B

Which of the following medications is a bile acid sequestrant?
A. ezetimibe
B. simvastatin
C. gemfibrozil
D. cholestyramine

D

Which of the following medications is a fibric acid derivative?
A. ezetimibe
B. simvastatin
C. gemfibrozil
D. cholestyramine

C

Based on the characteristics of normal renal function, a patient with significant renal disease would likely have which of the following conditions? Select all that apply.

A. Osteoporosis

B. Anemia

C. Hypertension

D. Hypernatremia

a, b, c

explanation: kidneys balance electrolyte, produce erythropoietin, and control BP

Which of the following drugs is most likely nephrotoxic?
A. atorvastatin
B. sertraline
C. ibuprofen
D. valproic acid

C

Which of the following is a thiazide diuretic?
A. spironolactone
B. furosemide
C. glycerin
D. hydrochlorothiazide

D

Which of the following is a loop diuretic?
A. spironolactone
B. furosemide
C. glycerin
D. hydrochlorothiazide

B

Which of the following is a potassium sparing diuretic?
A. spironolactone
B. furosemide
C. glycerin
D. hydrochlorothiazide

A

Why is it so important to measure a patient’s Weight?
A. Hypervolemia
B. Increased serum creatinine
C. Hypokalemia
D. Hyponatremia

A

Why is it so important to measure a patient’s I&O? ATA

A. Hypervolemia

B. Increased serum creatinine

C. Hypokalemia

D. Hyponatremia

c and d

Why is it so important to measure a patient’s serum electrolytes?
A. Hypervolemia
B. Increased serum creatinine
C. Hypokalemia
D. Hyponatremia

B, C, D

The client states to the nurse, "My healthcare provider says I have heart disease and I need to decrease the cholesterol in my diet. I don't understand how this happened." Which response should the nurse provide the client?


1. "The arteries around your heart are narrowed by low density lipoprotein (LDL) cholesterol buildup in them."

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2. "Low density lipoprotein (LDL) cholesterol is converted to saturated fat, which is stored in your coronary arteries."

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3. "It is a good idea to decrease low density lipoprotein (LDL) cholesterol in your diet, although current research has not proven a correlation yet."

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4. "Too much low density lipoprotein (LDL) cholesterol narrows all the arteries in your body so your heart does not receive enough blood to be healthy."

1) "The arteries around your heart are narrowed by low density lipoprotein (LDL) cholesterol buildup in them."

The nurse is providing education about lipids for a client with hyperlipidemia. Which information should the nurse include in the education?

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1. High density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver.
2. High density lipoprotein (HDL) is called good cholesterol because it increases the oxygen content in the arteries and reduces the amount of plaque buildup.
3. High density lipoprotein (HDL) decreases the bad cholesterol (low density lipoprotein \[LDL\]), and promotes excretion of it through the kidneys.
4. High density lipoprotein (HDL) decreases low density lipoprotein (LDL) and prevents it from converting to very low density lipoprotein (VDRL), which is the worst kind of cholesterol in the body.

1) High density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver.

Which information about the dietary intake of lipids should the nurse provide a client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

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1. "Phospholipids will help prevent Alzheimer's disease."
2. "Phospholipids are essential to building plasma membranes."
3. "Cholesterol is a building block for estrogen and testosterone."
4. "Triglycerides are the major form of fat in the body."
5. "Cholesterol in the diet is unnecessary as the liver synthesizes it."

2) "Phospholipids are essential to building plasma membranes."
3) "Cholesterol is a building block for estrogen and testosterone."
4) "Triglycerides are the major form of fat in the body."
5) "Cholesterol in the diet is unnecessary as the liver synthesizes it."

The nurse reviewing a client's serum cholesterol levels notes the following: Low density lipoprotein (LDL) = 105 mg/dl High density lipoprotein (HDL) = 37 mg/dl Low density lipoprotein (LDL)/high density lipoprotein (HDL) ratio = 4.1 Which should the nurse identify as the priority outcome in the client's plan of care?

1) Maintenance of normal lipid levels without the use of pharmacotherapy
2) Education about diet and exercise
3) Validate that the client understands the importance of lifestyle changes
4) The client's achievement of normal lipid levels through compliance with medications

1) Maintenance of normal lipid levels without the use of pharmacotherapy

The nurse has completed nutritional teaching for a client with a high low density lipoprotein (LDL) level. Which menu choice made by the client indicates an understanding of the teaching?

1) Beef tenderloin with gravy and noodles, fruit salad with apples and grapefruit, slice of rye bread, and apple pie
2) Grilled chicken salad with strawberries and pecans, baked macaroni and cheese, and low-fat brownie
3) Grilled chicken with rice and broccoli, tossed salad with walnuts and sliced apples, slice of whole-wheat bread, and low-fat chocolate pudding
4) Low-fat hamburger with whole-wheat bun, tossed salad with walnuts and olive oil, and raisin-oatmeal cookie

3) Grilled chicken with rice and broccoli, tossed salad with walnuts and sliced apples, slice of whole-wheat bread, and low-fat chocolate pudding

The patient is receiving cholestyramine (Questran) and complains of constipation. The physician orders bisacodyl (Dulcolax) tablets. When is the best time for the nurse to administer the bisacodyl (Dulcolax) tablets?

1) The drugs can be administered together.
2) Four hours after administration of cholestyramine (Questran).
3) Bisacodyl (Dulcolax) can be given any time but must be taken with food.
4) One hour after administration of cholestyramine (Questran).

2) Four hours after administration of cholestyramine (Questran).

The nurse has completed the education for a client prescribed gemfibrozil (Lopid). Which statement made by the client indicates an understanding of the information?

1) "I should take this medication on an empty stomach to help it absorb better."
2) "I must take this medication with food or I can have heartburn."
3) "My physician said it really doesn't matter how I take this medication."
4) "Taking this medication with yogurt will help it to absorb better."

2) "I must take this medication with food or I can have heartburn."

A client tells the nurse they will need a prescription for high cholesterol but does not know which would be best. Which information should the nurse provide the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1) "The best drugs to raise the high density lipoprotein (HDL) levels are the fibric acid drugs."
2) "The statin drugs are good but will cause a lot of flushing if you swallow them with warm fluids."
3) "The bile resins keep cholesterol from being absorbed but have some side effects."
4) "The statin drugs inhibit the making of cholesterol and are considered the best choice."
5) "Fibric acid drugs will decrease triglycerides, but your low density lipoprotein (LDL) will still be high."

3) "The bile resins keep cholesterol from being absorbed but have some side effects."
4) "The statin drugs inhibit the making of cholesterol and are considered the best choice."
5) "Fibric acid drugs will decrease triglycerides, but your low density lipoprotein (LDL) will still be high."

A client asks the nurse how fat is carried in the blood. Which response should the nurse provide?

1) "Fats in your blood are carried inside small molecules called phospholipids."
2) "Fats travel in the blood on little proteins called lipoproteins."
3) "Fats are free floating in your circulatory system."
4) "Fats are encapsulated inside little bags known as lecithin."

2) "Fats travel in the blood on little proteins called lipoproteins."

Which assessment data obtained from a client receiving a statin is a priority for the nurse to report to the healthcare provider?

1) "My calves hurt, and I had a hard time walking to the bathroom."
2) "I know I just started this medicine yesterday, but my stomach really is upset."
3) "Will you call my healthcare provider? I have a really bad headache."
4) "My heart rate really went up this morning."

1) "My calves hurt, and I had a hard time walking to the bathroom."

Which assessment finding for a client receiving a statin is a priority for the nurse to report to the healthcare provider?

1) Bowel sounds markedly increased in all four quadrants of the abdomen
2) Urine output of 200 mL/hour
3) Urine output of 20 mL/hour
4) Moderate elevation in liver function tests (LFTs)

3) Urine output of 20 mL/hour

Which assessment is a nursing priority for a client receiving cholestyramine (Questran)?

1) Auscultation of heart sounds
2) Auscultation of bowel sounds in all four abdominal quadrants
3) Assessment of 24-hour urine output
4) Palpation for peripheral edema in the lower extremities

2) Auscultation of bowel sounds in all four abdominal quadrants
explanation: Assessment of bowel sounds is a priority because cholestyramine​ (Questran) could cause obstruction of the intestines

Which information should the nurse include in the education for a client prescribed niacin to lower lipid levels?

1) "Be sure to take your niacin on an empty stomach as soon as you arise."
2) "Take one aspirin 30 minutes before you take your niacin."
3) "Take your niacin tablet with food and at least one full glass of water."
4) "It may be time to ask your healthcare provider about switching to another drug."

2) "Take one aspirin 30 minutes before you take your niacin."

Which is the priority action of the nurse when caring for a client receiving a statin with elevated creatine kinase (CK) levels?

1) Hold the prescription and obtain another creatine kinase (CK) level in 6 hours.
2) Administer the prescription and continue to assess for muscle pain.
3) Administer the prescription and obtain another creatine kinase (CK) level in 6 hours.
4) Hold the prescription and notify the healthcare provider.

4. Hold the prescription and notify the healthcare provider.

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explanation: do not administer prescription if myopathy is suspected

Which lipid type is associated with the highest risk for the development of atherosclerosis?

1) Phospholipids
2) Lecithins
3) Steroids
4) Triglycerides

3) Steroids

Which type of lipid serves as fuel for the body when energy is needed?

1) Phospholipids
2) Triglycerides
3) Steroids
4) Lecithins

2) Triglycerides

Which type of lipoprotein is often referred to as "the good type?"

1) Triglycerides
2) HDL
3) LDL
4) VLDL

2) HDL

Which statement provides the best rationale for monitoring HDL and LDL as opposed to total cholesterol?

1) HDL and LDL monitoring is less expensive than measuring total cholesterol.
2) Total cholesterol does not differentiate the amounts of "good" cholesterol and "bad" cholesterol.
3) HDL and LDL measurements are more general and frequently used to assess clients that are not at risk for heart disease.
4) Total cholesterol measurements are often inaccurate and not as reliable as HDL and LDL.

2) Total cholesterol does not differentiate the amounts of "good" cholesterol and "bad" cholesterol.

The nurse reviewing records should determine that which client's lab values are associated with the highest risk of developing heart disease?

1) Total 200, LDL 104, HDL 30
2) Total 210, LDL 135, HDL 58
3) Total 220, LDL 162, HDL 20
4) Total 186, LDL 125, HDL 54

3) Total 220, LDL 162, HDL 20

Which statement correctly identifies why restricting dietary intake of cholesterol generally will not result in a significant reduction of blood cholesterol?

1) Most clients are not compliant with the dietary restriction.
2) Cholesterol is found in nearly all foods, and it is not possible to eliminate it from the diet.
3) Cholesterol is made within the body and cannot be absorbed via external sources.
4) The liver reacts to a low-cholesterol diet by making more cholesterol.

4) The liver reacts to a low-cholesterol diet by making more cholesterol.

Which describes the mechanism of atorvastatin's (Lipitor) ability to lower blood cholesterol levels?

1) Binds exogenous cholesterol and excreting it in the feces
2) Increases excretion by activating enzymes within the hepatic system
3) Prevents dietary absorption within the GI tract
4) Inhibits an enzyme that is essential for cholesterol synthesis

4) Inhibits an enzyme that is essential for cholesterol synthesis

Which statement is accurate regarding the use of nicotinic acid (Niacin) for lowering blood cholesterol levels?

1) Works primarily by lowering LDL and HDL levels.
2) Due to adverse effects, niacin should not be used with statins.
3) Niacin may also reduce triglyceride levels. 4) High doses of 25-30 mg per day are often necessary.

3) Niacin may also reduce triglyceride levels.

The educator is preparing education about the different types of lipids for a nurse. Which should the educator include in the presentation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1) Triglycerides
2) Phospholipids
3) Steroids
4) Lecithins
5) Bile acids

1) Triglycerides
2) Phospholipids
3) Steroids

The nurse has provided client education regarding therapeutic lifestyle changes to help control cholesterol levels. Which statement made by the client indicates an understanding of the information?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1) "I will maintain an optimal weight."
2) "I will implement a medically supervised exercise plan."
3) "I will increase saturated fat in my diet."
4) "I will increase insoluble fiber in my diet."
5) "I will eliminate tobacco use."

1) "I will maintain an optimal weight."
2) "I will implement a medically supervised exercise plan."
5) "I will eliminate tobacco use."

The nurse is preparing to provide education for a client prescribed a statin. Which serious adverse effects should the nurse include in the teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1) Headache
2) Abdominal pain
3) Myopathy
4) Muscle or joint pain
5) Rhabdomyolysis

3) Myopathy
5) Rhabdomyolysis

Which anatomical location is Ezetimibe (Zetia) effective in blocking the absorption of cholesterol?

1) Stomach
2) Gallbladder
3) Liver
4) Jejunum

4) Jejunum

The educator is reviewing the classifications of prescriptions used to decrease blood cholesterol levels with a nurse. Which prescriptions should the educator include in the discussion of fibric acid agents? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1) Tricor
2) Zetia
3) Lopid
4) Colestid
5) Zocor

1) Tricor
3) Lopid

The nurse is discussing with a client, the dietary intake of omega-3 and CoQ10-rich foods to control lipid levels. Which foods should the nurse include in the discussion? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1) Sardines
2) Shrimp
3) Almonds
4) Olive oil
5) Carrots

1) Sardines
3) Almonds
4) Olive oil

A patient has been prescribed gemfibrozil (Lopid). Which laboratory tests should the nurse schedule for the client on the next clinic appointment? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1) Blood glucose
2) Liver enzymes
3) Potassium
4) Hemoglobin and hematocrit
5) Urinalysis

1) Blood glucose
2) Liver enzymes
4) Hemoglobin and hematocrit
explanation: ​Rationale: Gemfibrozil may increase serum glucose and liver enzyme levels. Gemfibrozil may decrease​ H&H. The potassium level should not be affected by gemfibrozil. A urinalysis is unnecessary.

1) The nurse has provided client education about the function of the renal system. Which statements made by the client indicate an understanding of the teaching? ATA
1. "Kidneys help the heart by balancing potassium."
2. "Kidneys balance the fluid and electrolytes in my body."
3. "Kidneys keep blood pressure from getting too low."
4. "Kidneys help decrease infections by excreting bacteria."
"Kidneys help regulate the oxygen levels in my blood

1. "Kidneys help the heart by balancing potassium."
2. "Kidneys balance the fluid and electrolytes in my body."
3. "Kidneys keep blood pressure from getting too low."
pg 322-323

Which should the nurse recognize are important safety precautions when administering a prescription to a client with renal failure? - ALA
1. The client will require lower dosages.
2. Some prescriptions increase fluid retention.
3. Measure hourly intake and output.
4. Some prescriptions are nephrotoxic.
5. Some prescriptions are bound to plasma proteins

1. The client will require lower dosages.
3. Measure hourly intake and output.
4. Some prescriptions are nephrotoxic.
pg 323

1) Which should the nurse suspect after noting the presence of protein on a routine urinalysis?
1. Acute kidney injury
2. Structural damage
3. Kidney infection
4. Chronic kidney injury

1. Structural damage
pg 323

1) Which conditions should the nurse anticipate the healthcare provider to possibly prescribe a diuretic? ATA
1. Heart failure
2. Cerebrovascular accident
3. Hypertension
4. Acute kidney injury
5. Ketoacidosis

1. Heart failure
3. Hypertension
5. Ketoacidosis
Pg 324

1) The nurse suspects a client receiving chlorothiazide (Diuril) is experiencing side effects from the prescription. Which assessment finding supports the nurse's suspicion?
1. Ataxia and frequent diarrhea
2. Serum potassium level of 3.0 mEq/L and low blood pressure
3. Serum sodium level of 160 mEq/L and headaches
4. Mental confusion and dependent edema

Serum potassium level of 3.0 mEq/L and low blood pressure
pg 327

1) A client prescribed bumetanide (Bumex) asks the nurse how the drug works. Which response should the nurse provide the client?
1. "This prescription causes your kidneys to reabsorb potassium."
2. "This prescription causes your kidneys to block the reabsorption of sodium."
3. "This prescription causes your kidneys to reabsorb calcium."
4 "This prescription causes your kidneys to reabsorb chloride."

3. "This prescription causes your kidneys to reabsorb calcium."
pg 326
​Rationale: Loop diuretics act on the Loop of Henle to block the reabsorption of sodium and potassium. Bumetanide is a​ potassium-excreting drug. Bumetanide does not reabsorb calcium. Bumetanide does not affect chloride levels.

1) The healthcare provider has prescribed hydrochlorothiazide (HCTZ) for a client with chronic renal failure. Which assessment finding indicates the treatment is ineffective?
1. Weak pulses
2. Hypotension
3. Poor skin turgor
4. Wheezing

4. Wheezing
pg 326-328

1) The nurse has completed the dietary teaching for a client prescribed spironolactone (Aldactone). Which statement made by the client indicates further teaching is required?
1. "I am really happy that I can have my cranberry juice."
2. "I can still have my orange juice and bananas for breakfast."
3. "I usually eat an apple a day to stay regular."
"I love to eat eggs and toast in the morning."

2. "I can still have my orange juice and bananas for breakfast."
pg-329-330

1) Which information should the nurse include when providing education for an older client prescribed chlorothiazide (Diuril)?
1. "Take the medication early in the morning."
2. "Avoid foods that are high in potassium."
3. "It is alright to have a glass of wine with this medication."
4. "Take the medication on an empty stomach."

1. "Take the medication early in the morning."
Pg 327-328

1) A client prescribed spironolactone (Aldactone) asks the nurse which fluids they should drink to prevent dehydration. Which response should the nurse provide?
1. "Citrus juices are very good for rehydration."
2. "Any kind of fluid is okay, but avoid alcohol."
3. "Plain water is really the best."
4. "Electrolyte-replacement drinks like sports drinks."

3. "Plain water is really the best."
Pg 330

1) A patient receiving chlorothiazide (Diuril) has developed hypokalemia. Which assessment findings support the diagnosis?
1. Hyperglycemia
2. Heart palpitations
3. Increased urine output
4. Diarrhea

2. Heart palpitations
pg 328

1) Which prescription is nephrotoxic if an overdose occurs?
1. Lorazepam (Ativan)
2. Amitriptyline (Elavil)
3. Ibuprofen (Advil)
4. Quetiapine (Seroquel)

3. Ibuprofen (Advil)
Pg 323

1. The nurse is preparing the education for a client prescribed chlorothiazide (Diuril). Which information should the nurse include in the teaching?

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a. Consumption of foods high in potassium

b. Assessment of blood glucose daily

c. Daily weights with a report of a gain of more than 1 pound in 24 hours

d. Report change in hearing

1. Consumption of foods high in potassium
Pg 327, 332

1) An older adult receiving ethacrynic acid (Edecrin) tells the nurse he or she doesn't hear as well as he or she used to. Which statement should the nurse include in the response?
1. "You may be dehydrated; are you drinking enough fluid?"
2. "I will let your healthcare provider know about this; it could be a side effect of your medication."
3. "How long have you been having difficulty hearing?"
4. "I will schedule a hearing exam; this could be a side effect of your medication."

2. "I will let your healthcare provider know about this; it could be a side effect of your medication."
pg 326

1) Which is the client at risk for that is receiving spironolactone (Aldactone)?
1. Pancytopenia
2. Aplastic anemia
3. Hyperkalemia
4. Hyponatremia

3. Hyperkalemia
Pg 328

1) Which is the primary functional unit of the kidney?
1. Loop of Henle
2. Bowman's capsule
3. Nephron
4. Distal tubule

3. Nephron
Pg 322-323

1) Which is the most appropriate food for the nurse to recommend to a client to eat that is prescribed a loop diuretic?
1. Meat
2. Bananas
3. Cheese
4. Yogurt

2. Bananas
Pg 326

1) Which general adverse effect is associated with the use of diuretics?
1. Constipation
2. Orthostatic hypotension
3. Weight gain
4. Hypertension

2. Orthostatic hypotension
Pg 332

1) The nurse is reviewing the medical history of a client prescribed hydrochlorothiazide (Microzide). Which condition should the nurse be concerned about?
1. Hypertension
2. Asthma
3. Gout
4. Hypothyroidism

3. gout

Pg 328

1) Which initial treatment prescribed should the nurse anticipate for the client that has overdosed on hydrochlorothiazide?

1\. Electrolyte replacement

2\. Intravenous normal saline

3\. Vasopressor

4\. Furosemide (Lasix)

2. Intravenous normal saline
Pg 32, 329

1) Which diuretic is most effective in reducing the mortality of a client with heart failure?
1. Chlorothiazide (Diuril)
2. Acetazolamide (Diamox)
3. Furosemide (Lasix)
4. Spironolactone (Aldactone)

4. Spironolactone (Aldactone)
Pg 329

1) The nurse has provided education for a client with diabetes type I prescribed hydrochlorothiazide (Microzide). Which statement made by the client indicates an understanding of the information?
1. "I expect my blood glucose to be elevated."
2. "I anticipate to monitor my blood glucose more frequently."
3. "I can expect my hemoglobin A1C to be elevated."
4. "I expect I will need more insulin to help control my glucose."

2. "I anticipate to monitor my blood glucose more frequently."

1) Which should the nurse recognize a client with acute renal failure cannot effectively regulate? ALA
1. Fluid balance
2. Electrolyte balance
3. The pH of body fluids
4. Heart rate
5. Blood pressure

1. Fluid balance
2. Electrolyte balance
3. The pH of body fluids
5. Blood pressure
322-323

1) Which should the nurse recognize is associated with chronic kidney disease (CKD)?Select all that apply.

1. Hypertension
2. Inflammation
3. Diabetes
4. Hypoperfusion
5. Sepsis

1. Hypertension
3. Diabetes
Pg 323

1) The educator is preparing to review the diuretics that do not require potassium supplements with a nurse. Which diuretics should the educator include? ALA

1\. Furosemide (Lasix)

2\. Chlorothiazide (Diuril)

3\. Amiloride (Midamor)

4\. Mannitol (Osmitrol)

5\. Spironolactone (Aldactone)

Answer: 3, 5
3. Amiloride (Midamor)
5. Spironolactone (Aldactone)
Pg 326

1) The nurse has provided dietary education for a client prescribed furosemide (Lasix). Which statement made by the client indicates an understanding of the information?
1. "I will increase my consumption of green, leafy vegetables."
2. "I will increase my consumption of poultry."
3. "I will try and eat an orange daily."
4. "I will try and incorporate more grains in my diet."

3. "I will try and eat an orange daily."
Pg 326
explanation: Loop diuretics place the client at risk for hypokalemia. Citrus fruits are a good source of potassium

1) Which vital signs should the nurse assess prior to the administration of a diuretic?
ALA
1. Temperature
2. Pulse
3. Respirations
4. Blood pressure
5. Pain

2. Pulse
4. Blood pressure
Pg 324-325, 331

1) The nurse is preparing to provide education on daily self-monitoring for a client with congestive heart failure prescribed a diuretic. Which information should the nurse plan to include in the teaching? ALA
1. Weight
2. Pulse
3. Temperature
4. Blood pressure
5. Respiratory rate

1. Weight
2. Pulse
4. Blood pressure
Pg 331-332

1) The educator is reviewing the physiology of the renal system with a nurse. Which statement made by the nurse indicates further teaching is required?
1. "The kidneys stimulate white blood cell production."
2. "The kidneys help regulate blood pressure."
3. "The kidneys regulate the acid-base balance of body fluids."
4. "The kidneys produce the active form of vitamin D."

1. "The kidneys stimulate white blood cell production."
Pg 322

1) The nurse is reviewing the laboratory reports for a client with chronic kidney failure. Which lab should the nurse understand reflects the progression of the kidney disease?
1. Glomerular filtration rate (GFR)
2. Serum creatinine
3. Blood urea nitrogen (BUN)
4. Urinalysis

1. Glomerular filtration rate (GFR)
Pg 323

A nurse is teaching about diet restrictions to a client who has acute kidney injury and is on hemodialysis. Which of the following recommendations should the nurse include in teaching?
A: Limit calcium intake to 2,500 mg/day.
B: Decrease total fat intake to 45% of daily calories.
C: Limit sodium intake to 4.5 g/day.
D: Decrease potassium intake to 60 to 70 mEq/kg.

D: Decrease potassium intake to 60 to 70 mEq/kg.

A nurse is teaching a client who has stage 2 chronic kidney disease about dietary management. Which of the following information should the nurse include in the instructions?

A: Limit dairy products to 1 cup/day.
B: Restrict protein intake.
C: Increase intake of foods high in potassium.
D: Maintain a high phosphorus diet.

B: Restrict protein intake.

explanation: damaged kidneys may not be able to remove excess protein

A nurse is planning care for a client who has ESKD. Which of the following should the nurse include in the plan of care? Select all that apply.

A: Monitor for constipation.

B: Instruct the client on restricting calories from carbohydrates.

C: Monitor the client's weight daily.

D: Evaluate intake and output.

E: Encourage the client to comply with fluid restrictions.

A: Monitor for constipation.

C: Monitor the client's weight daily.

D: Evaluate intake and output.

E: Encourage the client to comply with fluid restrictions.

explanation: constipation can occur partly because of their sedentary lifestyle, low fiber and fluid intake, concomitant medications (e.g., phosphate binders), and multiple comorbidities (e.g., diabetes).

A nurse is teaching a client about protein needs when on dialysis. Which of the following instructions should the nurse include in the teaching? Select all that apply.

A: Consume daily protein intake in the morning.
B: Take phosphate binders when eating protein rich foods.
C: Increase biologic sources of protein (eggs, milk, and soy).
D: Consume 35 kcal/kg of body weight to maintain body protein stores.
E: Increase protein intake by 50% of the recommended dietary allowance (RDA).

B: Take phosphate binders when eating protein rich foods.
C: Increase biologic sources of protein (eggs, milk, and soy).
D: Consume 35 kcal/kg of body weight to maintain body protein stores.
E: Increase protein intake by 50% of the recommended dietary allowance (RDA).

A nurse is completing discharge teaching about diet and fluid restrictions to a client who has a calcium oxalate based kidney stone. Which of the following instructions should the nurse include in the teaching?

A: Decrease broccoli intake.
B: Increase intake of vitamin C supplements.
C: Limit consumption of purine substances.
D: Reduce intake of spinach.

D: Reduce intake of spinach.

Where do you find intracellular fluid?
A. In blood vessels
B. within the GI tract
C. Inside cells
D. within the reproductive system

C

Where do you find extracellular fluid?
A. In blood vessels
B. within the GI tract
C. Inside cells
D. within the reproductive system

A

Indicate if each of the following is intake or output, emesis
• Intake
• Output

O

Indicate if each of the following is intake or output g-tube
• Intake
• Output

I

Indicate if each of the following is intake or output diarrhea
• Intake
• Output

O

Indicate if each of the following is intake or output IV fluids
• Intake
• Output

I

Which of the following sodium concentrations are normal saline?
a. 0.45%
b. 0.5%
c. 0.8%
d. 0.9%

d

Which of the following values represents hypokalemia?
a. 150 mEq/dl
b. 6.0 mEq/dl
c. 129 mEq/dl
d. 3.0 mEq/dl

d

Which of the following values represents hyponatremia?
a. 150 mEq/dl
b. 6.0 mEq/dl
c. 129 mEq/dl
d. 3.0 mEq/dl

c

Which of the following values represents hyperkalemia?
a. 150 mEq/dl
b. 6.0 mEq/dl
c. 129 mEq/dl
d. 3.0 mEq/dl

b

Which of the following values represents hypernatremia?
a. 150 mEq/dl
b. 6.0 mEq/dl
c. 129 mEq/dl
d. 3.0 mEq/dl

a

Identify if the pH is acidotic or alkalotic, 7.25
a. Acidosis
b. Alkalosis

a

Identify if the pH is acidotic or alkalotic, 7.47
a. Acidosis
b. Alkalosis

b

Identify if the pH is acidotic or alkalotic, 7.62
a. Acidosis
b. Alkalosis

b

Identify if the pH is acidotic or alkalotic, 7.32
a. Acidosis
b. Alkalosis

a

Identify which of the following corresponds to these disease states, prolonged nausea and vomiting due to gastroenteritis
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis

b

Identify which of the following corresponds to these disease states, gasping for air due to severe emotional upset
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis

d

Identify which of the following corresponds to these disease states, opioid overdose
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis

c

Identify which of the following corresponds to these disease states, alcohol overdose
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis

a

A client receiving sodium bicarbonate intravenously​ (IV) for correction of metabolic acidosis is experiencing​ cyanosis, decreased​ respirations, and an irregular pulse. Which is the​ nurse's priority​ action?

a. Stop the infusion and notify the healthcare provider
b. Continue the infusion
c. Increase the rate of the infusion
d. Decrease the rate of the infusion

a. Stop the infusion and notify the healthcare provider

Rationale: client receiving sodium bicarbonate is at risk for alkalosis & should be monitored for​cyanosis, slow​ respirations, & irregular pulse. Patient's symptoms are associated w/ alkalosis so infusion must be stopped & HC provider notified.

The nurse understands which is the primary purpose for intravenous fluid replacement for a client that has a burn​ injury?

a. Antibiotic administration
b. Maintain blood pressure
c. Electrolyte replacement
d. Administration of pain prescriptions

b. Maintain blood pressure

Rationale: Net loss of fluids from body can result in dehydration & shock. (IV) fluid therapy is used to maintain blood volume & support blood pressure. Antibiotic​ therapy, electrolyte​ replacement, or pain prescriptions are not primary purpose for​ (IV) fluid replacement.