York College, CUNYNURS 420 1)  A patient in ARF has a gradual increase in urinary output to 3400 ml a day with a BUN of 92 mg/dl (33 mmol/L) and a serum creatinine of 4

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York College, CUNYNURS 420

1)  A patient in ARF has a gradual increase in urinary output to 3400 ml a day with a BUN of 92 mg/dl (33 mmol/L) and a serum creatinine of 4.2 mg (371 μmol/L). The nurse should plan to

1. use a urine dipstick to monitor for proteinuri
2. auscultate the lungs to assess for pulmonary edema.
3. take the blood pressure to check for hypotension.
4. draw blood to monitor for hyperkalemia.

2. After noting increasing QRS intervals in a patient with ARF, which action should the nurse take first?

1. Notify the patient's health care provider.
2. Check the chart for the most recent blood potassium level.
3. Look at the patient's current BUN and creatinine levels.
4. Document the QRS interval.

3. A patient with renal insufficiency is scheduled for an intravenous pyelogram (IVP). Which of the following orders for the patient will the nurse question?

1. Ibuprofen (Advil) 400 mg PO PRN for pain
2. Dulcolax suppository 4 hours before IVP procedure
3. Normal saline 500 ml IV before procedure
4. NPO for 6 hours before IVP procedure

 4. Before administering sodium polystyrene sulfonate (Kayexalate) to a patient with hyperkalemia, the nurse should assess

1. the BUN and creatinine.
2. the blood glucose level.
3. the patient's bowel sounds.

 

4. the level of consciousness (LOC).

 

5. In the immediate postoperative period, the nurse caring for a patient who is a recipient of a kidney transplant would expect that fluid therapy would involve administration of IV fluids

1. to be determined hourly, based on every milliliter of urine output.
2. at a minimum rate of 100 ml/hr to perfuse the kidney.
3. titrated to keep blood pressure within a normal range.
4. at a rate to keep urine clear and without blood clots.

6. To monitor for corticosteroid-related complications after a kidney transplant, the nurse teaches the patient to report

1. pain at the donor kidney site.
2. dizziness with position change.
3. pain in the hips, knees, and other joints.
4. changes in the character of the urine.

7. Two hours after a kidney transplant, the nurse obtains the following pieces of data when assessing the patient. Which information is most important to communicate to the health care provider?

1. The BUN and creatinine levels are elevated.
2. The urine output is 900 to 1100 ml/hr.

 

3. The patient's central venous pressure (CVP) is decreased.
4. The patient has level 8 (on a 10-point scale) incision pain when coughing.

8. Which data obtained when assessing a patient who had a kidney transplant 8 years ago and who is receiving the immunosuppressants tacrolimus (Prograf), cyclosporine (Sandimmune), and prednisone (Deltasone) will be of most concern to the nurse?

1. The blood glucose is 144 mg/dl.
2. The patient has a round, moonlike face.
3. There is a nontender lump in the axilla.
4. The patient's blood pressure is 150/92.