NUR265 Exam 1 Study Guide

Question 1

Which laboratory finding is most indicative of acute kidney injury (AKI)?

Answer 1

Increased serum creatinine

A rise in serum creatinine is a hallmark indicator of AKI due to impaired filtration.

Question 2

A nurse is caring for a patient with a small bowel obstruction. Which symptom should be expected?

Answer 2

Projectile vomiting with fecal odor

Small bowel obstructions often cause nausea and vomiting that may have a fecal odor due to stasis.

Question 3

Which clinical manifestation is most concerning in a patient with heart failure?

Answer 3

Pink frothy sputum

Pink frothy sputum indicates pulmonary edema, a life-threatening complication of heart failure.

Question 4

Which finding suggests a complication from hemodialysis?

Answer 4

Hypotension

Hypotension is a common and potentially serious complication during or after hemodialysis.

Question 5

A client with chronic kidney disease is prescribed calcium carbonate. What is the primary purpose of this medication?

Answer 5

Bind dietary phosphorus

Calcium carbonate binds dietary phosphorus in the gut to prevent hyperphosphatemia.

Question 6

What is the priority assessment for a patient with suspected upper GI bleed?

Answer 6

Blood pressure and heart rate

Vital signs are critical to assess hemodynamic stability in acute bleeding situations.

Question 7

Which diet modification is appropriate for a patient with diverticulitis?

Answer 7

Low-residue diet

A low-residue diet is recommended during acute diverticulitis to reduce bowel irritation.

Question 8

What lab result must be monitored for a patient with atrial fibrillation started on warfarin?

Answer 8

INR

INR is used to monitor therapeutic effectiveness of warfarin therapy.

Question 9

What ECG change is most indicative of a myocardial infarction?

Answer 9

ST segment elevation

ST segment elevation is a classic ECG finding in ST-elevation myocardial infarction (STEMI).

Question 10

Which electrolyte imbalance is commonly associated with end-stage renal disease (ESRD)?

Answer 10

Hyperkalemia

Hyperkalemia is a frequent and dangerous complication in ESRD due to impaired renal potassium excretion.

Question 11

What is the priority nursing action after a kidney biopsy?

Answer 11

Monitor for hematuria

Hematuria may indicate bleeding, which is a serious post-procedural risk after renal biopsy.

Question 12

Which symptom is most concerning in a patient with suspected perforated peptic ulcer?

Answer 12

Sudden severe abdominal pain

Sudden severe abdominal pain may indicate a perforation, a surgical emergency.

Question 13

What is the most appropriate position for a patient after a total gastrectomy?

Answer 13

Semi-Fowler’s

Semi-Fowler’s position helps reduce the risk of aspiration and promotes comfort.

Question 14

What is the mechanism of action of ACE inhibitors in heart failure?

Answer 14

Reduces afterload

ACE inhibitors reduce afterload and improve cardiac output by dilating blood vessels.

Question 15

What finding indicates a positive response to diuretic therapy in heart failure?

Answer 15

Increased urine output

Increased urine output shows effective fluid removal, reducing preload and symptoms.

Question 16

Which symptom is most characteristic of nephrotic syndrome?

Answer 16

Proteinuria

Massive proteinuria is a hallmark of nephrotic syndrome due to glomerular damage.

Question 17

Which dietary modification is recommended for a patient with chronic kidney disease?

Answer 17

Low potassium, low phosphorus

CKD patients should avoid foods high in potassium and phosphorus to prevent electrolyte imbalances.

Question 18

What finding is most expected in a patient with a large bowel obstruction?

Answer 18

High-pitched bowel sounds

High-pitched bowel sounds are often heard early in large bowel obstruction due to increased peristalsis.

Question 19

Which lab value is most concerning in a patient with severe liver cirrhosis?

Answer 19

Low albumin

Low serum albumin in cirrhosis leads to ascites and edema due to decreased oncotic pressure.

Question 20

Which condition is an absolute contraindication to thrombolytic therapy in myocardial infarction?

Answer 20

Active internal bleeding

Active bleeding is a contraindication to thrombolytics due to risk of hemorrhage.

Question 21

Which is a typical side effect of beta-blocker therapy in heart failure?

Answer 21

Orthostatic hypotension

Beta-blockers can cause orthostatic hypotension due to their antihypertensive effects.

Question 22

What is a common cause of prerenal acute kidney injury (AKI)?

Answer 22

Dehydration

Dehydration leads to reduced renal perfusion, a primary cause of prerenal AKI.

Question 23

Which finding should the nurse report immediately for a patient receiving peritoneal dialysis?

Answer 23

Cloudy effluent

Cloudy effluent is an early sign of peritonitis, a serious complication of peritoneal dialysis.

Question 24

What is the purpose of administering lactulose to a patient with cirrhosis?

Answer 24

Reduce ammonia levels

Lactulose reduces serum ammonia by promoting its excretion through the stool.

Question 25

Which dietary instruction is most appropriate for a patient with hepatic encephalopathy?

Answer 25

Low-protein diet ## Footnote A low-protein diet is often recommended to decrease ammonia production.

Question 26

What is the initial treatment goal for a patient experiencing cardiogenic shock?

Answer 26

Improve myocardial oxygen supply ## Footnote Improving myocardial oxygen delivery is the priority in cardiogenic shock to preserve cardiac function.

Question 27

Which medication is commonly used to manage chest pain in acute coronary syndrome?

Answer 27

Morphine ## Footnote Morphine is used to relieve chest pain and anxiety, and to reduce myocardial oxygen demand.

Question 28

What symptom indicates fluid overload in a patient with renal failure?

Answer 28

Crackles in lungs ## Footnote Crackles suggest pulmonary edema due to fluid overload, common in renal failure.

Question 29

Which lab value is expected in a patient with decreased erythropoietin due to kidney disease?

Answer 29

Low hemoglobin ## Footnote Low hemoglobin occurs due to reduced erythropoietin production in chronic kidney disease.

Question 30

What condition increases the risk of postrenal AKI?

Answer 30

Bladder obstruction ## Footnote Postrenal AKI is often caused by obstruction such as bladder or ureter blockage.

Question 31

A patient with Crohn’s disease is at risk for which complication?

Answer 31

Fistulas ## Footnote Fistulas are common complications of Crohn’s disease due to transmural inflammation.

Question 32

What intervention is most important for a patient with hepatic ascites?

Answer 32

Measuring abdominal girth ## Footnote Monitoring abdominal girth helps assess fluid accumulation and response to treatment.

Question 33

What symptom should the nurse expect in a patient with hepatic encephalopathy?

Answer 33

Asterixis ## Footnote Asterixis (flapping tremor) is a hallmark neurological sign of hepatic encephalopathy.

Question 34

What is the goal of nitroglycerin therapy in angina?

Answer 34

Decrease oxygen consumption of the heart ## Footnote Nitroglycerin decreases myocardial oxygen demand by dilating veins and reducing preload.

Question 35

What sign is most concerning in a patient with aortic stenosis?

Answer 35

Syncope ## Footnote Syncope indicates decreased cerebral perfusion, a serious symptom in aortic stenosis.

Question 36

A patient with heart failure gains 3 pounds in 24 hours. What is the best action?

Answer 36

Call provider ## Footnote Rapid weight gain may indicate fluid retention and worsening heart failure.

Question 37

What is the goal of nitroglycerin therapy in angina?

Answer 37

Decrease oxygen consumption of the heart ## Footnote Nitroglycerin decreases myocardial oxygen demand by dilating veins and reducing preload. "Ignatavicius et al., 2024, p. 726"

Question 38

What sign is most concerning in a patient with aortic stenosis?

Answer 38

Syncope ## Footnote Syncope indicates decreased cerebral perfusion, a serious symptom in aortic stenosis. "Ignatavicius et al., 2024, p. 744"

Question 39

A patient with heart failure gains 3 pounds in 24 hours. What is the best action?

Answer 39

Call provider ## Footnote Rapid weight gain may indicate fluid retention and worsening heart failure. "Ignatavicius et al., 2024, p. 739"

Question 40

What symptom indicates fluid overload in a patient with renal failure?

Answer 40

Crackles in lungs ## Footnote Crackles suggest pulmonary edema due to fluid overload, common in renal failure. "Ignatavicius et al., 2024, p. 1222"

Question 41

Which lab value is expected in a patient with decreased erythropoietin due to kidney disease?

Answer 41

Low hemoglobin ## Footnote Low hemoglobin occurs due to reduced erythropoietin production in chronic kidney disease. "Ignatavicius et al., 2024, p. 1226"

Question 42

What condition increases the risk of postrenal AKI?

Answer 42

Bladder obstruction ## Footnote Postrenal AKI is often caused by obstruction such as bladder or ureter blockage. "Ignatavicius et al., 2024, p. 1216"

Question 43

A patient with Crohn’s disease is at risk for which complication?

Answer 43

Fistulas ## Footnote Fistulas are common complications of Crohn’s disease due to transmural inflammation. "Ignatavicius et al., 2024, p. 1091"

Question 44

What intervention is most important for a patient with hepatic ascites?

Answer 44

Measuring abdominal girth ## Footnote Monitoring abdominal girth helps assess fluid accumulation and response to treatment. "Ignatavicius et al., 2024, p. 1126"