Acute Kidney Injury
A client with AKI has a urine specific gravity of 1.032. Which interpretation should the nurse make?
A. Overhydration
B. Normal renal function
C. Highly concentrated urine
D. Inability to concentrate urine
C. Highly concentrated urine
Which finding is expected in cirrhosis?
A. Bradycardia
B. Jaundice
C. Hypercalcemia
D. High albumin
B. Jaundice
A client with suspected appendicitis reports pain that started around the umbilicus and then migrated to the right lower quadrant. What term describes this finding?A. Guarding
B. Rebound tenderness
C. Referred pain
D. McBurney’s point pain
D. McBurney’s point pain
Which finding suggests acute rejection?
A. BP 110/70
B. Urine output 1.5 L/day
C. Fever + graft tenderness
D. Mild fatigue
C. Fever + graft tenderness
A client with AKI has the following labs:
BUN 78 mg/dL, Cr 5.6 mg/dL, K⁺ 6.1 mEq/L.
Which prescription should the nurse question?
A. Spironolactone
B. Regular insulin IV
C. IV dextrose
D. Sodium polystyrene
A. Spironolactone
A client with cirrhosis has ascites. Which nursing action is appropriate?
A. Restrict sodium intake
B. Administer high-protein diet
C. Encourage fluid intake
D. Avoid diuretics
A. Restrict sodium intake
A client with appendicitis suddenly reports decreased pain followed by abdominal distention and tachycardia. Which complication does the nurse suspect?
A. Bowel obstruction
B. Perforation
C. Cholecystitis
D. Pancreatitis
B. Perforation
Which lab requires immediate action for a transplant patient?
A. Creatinine 2.5 (baseline 1.0)
B. Hemoglobin 11
C. Sodium 138
D. Glucose 130
A. Creatinine 2.5 (baseline 1.0)
Which finding indicates the oliguric phase of AKI?
A. Polyuria with low specific gravity
B. Urine output <400 mL/24 hr
C. Stable electrolyte levels
D. Decreasing BUN and creatinine
B. Urine output <400 mL/24 hr
The nurse is caring for a client with hepatic encephalopathy. Which finding indicates worsening condition?
A. Asterixis
B. Clear speech
C. Normal LOC
D. Soft abdomen
A. Asterixis
The nurse is caring for a client with acute diverticulitis. Which order should the nurse question?
A. NPO status
B. IV antibiotics
C. High-fiber diet
D. IV fluids
C. High-fiber diet
Which teaching is essential for a new transplant recipient?
A. “Stop taking immunosuppressants if you feel sick.”
B. “Avoid crowds and sick contacts.”
C. “Limit oral fluids.”
D. “Expect swelling around the incision for weeks.”
B. “Avoid crowds and sick contacts.”
Four clients with AKI arrive on the unit. Which client should the nurse assess first?
A. K⁺ 5.5 mEq/L
B. Metabolic acidosis
C. Urine output 250 mL/day
D. Peak T-waves on ECG
D. Peak T-waves on ECG
A client with hepatic encephalopathy is prescribed lactulose. What is the desired outcome?
A. Decreased potassium
B. Increased bowel movements
C. Higher albumin levels
D. Reduced urine output
B. Increased bowel movements
A client with suspected bowel obstruction has persistent vomiting, no flatus, and a distended, rigid abdomen. Which action is priority?
A. Administer oral simethicone
B. Insert NG tube for decompression
C. Encourage ambulation
D. Give laxatives
B. Insert NG tube for decompression
Which symptom after transplant surgery should the nurse report first?
A. Nausea after pain medication
B. Blood glucose 200
C. Decreased urine output
D. Mild incisional pain
C. Decreased urine output
A client with AKI asks why the provider limited protein intake. Which explanation is correct?
A. “It prevents dehydration.”
B. “It limits urea buildup in your blood.”
C. “It reduces sodium levels.”
D. “It prevents low calcium.”
B. “It limits urea buildup in your blood.”
Which assessment finding indicates improvement in hepatic encephalopathy?
A. Decreased bowel movements
B. Improved mental status
C. Increased abdominal distention
D. Worsening tremors
B. Improved mental status
A client with peritonitis is receiving IV fluids. Which finding indicates the treatment is effective?
A. Decreased abdominal rigidity
B. Heart rate increased from 90→122
C. Urine output 15 mL/hr
D. WBC increased from 9,000→15,000
A. Decreased abdominal rigidity
Which medication must be taken lifelong after a kidney transplant?
A. Prednisone
B. Tamsulosin
C. Furosemide
D. Hydrochlorothiazide
A. Prednisone