Test Your Knowledge About End Stage Renal Disease Quiz!

1.

The nurse is caring for the client who has had a renal biopsy. Which of the following interventions would the nurse avoid in the care of the client after this procedure?
- A.
  
  Encourage fluids to at least 3L in the first 24 hours
- B.
  
  Administering narcotics as needed
- C.
  
  Testing serial samples iwth dipsticks for occult blood
- D.
  
  Ambulating the client in the room and hall for short distances
Correct Answer
D. Ambulating the client in the room and hall for short distances

Explanation
After a renal biopsy, the nurse would avoid ambulating the client in the room and hall for short distances. This is because ambulating the client can increase the risk of bleeding and injury at the biopsy site. It is important to keep the client at rest and limit physical activity to prevent complications. Encouraging fluids, administering narcotics for pain relief, and testing for occult blood are all appropriate interventions after a renal biopsy.

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2.

A client is admitted to the hospital and has a diagnosis of early-stage chronic renal failure. Which of the following would the nurse expect to note on the assessment of the client?
- A.
  
  Polyuria
- B.
  
  Polydypsia
- C.
  
  Oliguria
- D.
  
  Anuria
Correct Answer
A. Polyuria

Explanation
In early-stage chronic renal failure, the kidneys are still able to produce urine, although their function is compromised. Polyuria, which is the increased production of urine, would be expected in this condition as the kidneys are unable to properly concentrate the urine. This leads to the client producing larger volumes of urine than normal.

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3.

A client is admitted to the hospital and has a diagnosis of early-stage chronic renal failure. Which of the following would the nurse expect to note on the assessment of the client? (Select all that apply.)
- A.
  
  Polyuria
- B.
  
  Polydipsia
- C.
  
  Oliguria
- D.
  
  Anuria
Correct Answer(s)
A. Polyuria
B. Polydipsia

Explanation
In the early stages of chronic renal failure, a client may exhibit symptoms of polyuria, characterized by increased urine output, and polydipsia, marked by heightened thirst as a response to dehydration. These symptoms reflect the kidneys' ability to still filter waste and maintain some urine production. Oliguria, a decrease in urine output, and anuria, the absence of urine production, are more commonly associated with advanced stages of chronic renal failure, where kidney function significantly deteriorates, resulting in reduced or no urine production.

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4.

ESRD occurs when the GFR is less than ___ per minute.
- A.
  
  5 ml
- B.
  
  10 ml
- C.
  
  15 ml
- D.
  
  25 ml
Correct Answer
C. 15 ml

Explanation
ESRD, or end-stage renal disease, occurs when the glomerular filtration rate (GFR) is less than 15 ml per minute. GFR is a measure of how well the kidneys are functioning and indicates the amount of blood that is filtered by the kidneys in a minute. A GFR of less than 15 ml per minute indicates severe kidney dysfunction, where the kidneys are no longer able to effectively filter waste products and excess fluid from the body. This is the point at which dialysis or kidney transplantation becomes necessary for survival.

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5.

The leading cause of ESRD is the client with a history of
- A.
  
  Hypotension
- B.
  
  Anemia
- C.
  
  Prostate cancer
- D.
  
  Diabetes Mellitus
Correct Answer
D. Diabetes Mellitus

Explanation
Diabetes Mellitus is the leading cause of End-Stage Renal Disease (ESRD). ESRD occurs when the kidneys are no longer able to function properly and filter waste products from the blood. Diabetes Mellitus can cause damage to the blood vessels in the kidneys, leading to kidney failure over time. This can result in ESRD, requiring the client to undergo dialysis or receive a kidney transplant. Hypotension, anemia, and prostate cancer may contribute to kidney damage, but they are not the leading cause of ESRD.

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6.

The client with ESRD tells the nurse that she hates the thought of being tied to the machine, but is also glad to start dialysis because she will be able to eat and drink what she wants. Based on this information, the nurse identifies the nursing diagnosis of
- A.
  
  Self-esteem disturbance related to dependence on dialysis
- B.
  
  Anxiety related to perceived threat to health status and role functioning
- C.
  
  Ineffective management of therapeutic regimen related to lack of knowledge of treatment plan
- D.
  
  Risk for imbalanced nutrition: more than body requirements, related to increased dietary intake
Correct Answer
C. Ineffective management of therapeutic regimen related to lack of knowledge of treatment plan

Explanation
The client's statement about hating being tied to the machine but also being glad to start dialysis because she will be able to eat and drink what she wants suggests that she may have a lack of knowledge about the treatment plan. This lack of knowledge can lead to ineffective management of the therapeutic regimen, as the client may not fully understand the importance of adhering to the treatment plan and may not be able to effectively manage her dialysis. Therefore, the nursing diagnosis of ineffective management of therapeutic regimen related to lack of knowledge of treatment plan is the most appropriate choice.

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7.

The nurse is performing an assessment on a client who has returned from the dialysis unit following hemodialysis. The client is complaining of a headache and nausea and is extremely restless. Which of the following is the most appropriate nursing action?
- A.
  
  Notify the physician
- B.
  
  Monitor the client
- C.
  
  Elevate the head of the bed
- D.
  
  Medicate the client for nausea
Correct Answer
A. Notify the pHysician

Explanation
The nurse should notify the physician because the client is experiencing symptoms that could indicate a potential complication from hemodialysis, such as dialysis disequilibrium syndrome. This syndrome occurs when there is a rapid shift in electrolytes and fluid levels during dialysis, leading to neurological symptoms such as headache, nausea, and restlessness. The physician should be notified so that appropriate interventions can be initiated to address the client's symptoms and prevent further complications. Monitoring the client, elevating the head of the bed, or medicating for nausea may be appropriate actions, but notifying the physician is the priority in this situation.

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8.

A Client in Acute Renal failure is a candidate for continuous renal placement therapy (CRRT). The most common indication for use of CRRT is
- A.
  
  Azotemia
- B.
  
  Pericarditis
- C.
  
  Hyperkalemia
- D.
  
  Fluid overload
Correct Answer
D. Fluid overload

Explanation
The most common indication for the use of continuous renal replacement therapy (CRRT) in a client with acute renal failure is fluid overload. CRRT is a form of dialysis that helps remove excess fluid from the body when the kidneys are unable to do so. In acute renal failure, the kidneys may not be functioning properly, leading to fluid retention and overload. CRRT helps to remove this excess fluid, restoring fluid balance in the body.

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9.

A patient rapidly progressing toward ESRD asks about the possibility of a kidney transplant. In responding to the patient, the nurse knows that contraindications to kidney transplantation include
- A.
  
  Hepatitis C infection
- B.
  
  Extensive vascular disease
- C.
  
  Coronary artery disease
- D.
  
  Refractory hypertension
Correct Answer
B. Extensive vascular disease

Explanation
Contraindications to kidney transplantation include extensive vascular disease. This means that if a patient has significant damage or blockage in their blood vessels, they may not be a suitable candidate for a kidney transplant. Extensive vascular disease can increase the risk of complications during and after the transplant surgery, as well as decrease the chances of a successful transplant outcome. Therefore, it is important for the nurse to inform the patient that their extensive vascular disease may be a contraindication to kidney transplantation.

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10.

Signs and symptoms of acute kidney rejection that the nurse should teach the patient to observe for include
- A.
  
  Tachycardia and headache
- B.
  
  Fever and painful transplant site
- C.
  
  Sever hypotension and weight loss
- D.
  
  Recurrent urinary tract infections and oral yeast infections
Correct Answer
B. Fever and painful transplant site

Explanation
The signs and symptoms of acute kidney rejection that the nurse should teach the patient to observe for include fever and painful transplant site. This is because fever is a common symptom of infection or inflammation, which can indicate kidney rejection. Additionally, a painful transplant site can be a sign of organ rejection as the body's immune system may be attacking the transplanted kidney. Monitoring these symptoms is crucial for early detection and prompt medical intervention to prevent further complications.

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11.

The most serious electrolyte disorder associated with kidney disease is
- A.
  
  Hypermagnesemia
- B.
  
  Hyponatremia
- C.
  
  Hyperkalemia
- D.
  
  Metabolic acidosis
Correct Answer
C. Hyperkalemia

Explanation
Hyperkalemia is the most serious electrolyte disorder associated with kidney disease. Kidneys play a crucial role in maintaining the balance of electrolytes in the body, including potassium. When the kidneys are not functioning properly, they may fail to excrete excess potassium, leading to hyperkalemia. This condition can be life-threatening as it can cause abnormal heart rhythms and cardiac arrest. Therefore, hyperkalemia is the most serious electrolyte disorder in kidney disease.

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Test Your Knowledge About End Stage Renal Disease Quiz!

The nurse is caring for the client who has had a renal biopsy. Which of the following interventions would the nurse avoid in the care of the client after this procedure?

A client is admitted to the hospital and has a diagnosis of early-stage chronic renal failure. Which of the following would the nurse expect to note on the assessment of the client?

A client is admitted to the hospital and has a diagnosis of early-stage chronic renal failure. Which of the following would the nurse expect to note on the assessment of the client? (Select all that apply.)

ESRD occurs when the GFR is less than ___ per minute.

The leading cause of ESRD is the client with a history of

The client with ESRD tells the nurse that she hates the thought of being tied to the machine, but is also glad to start dialysis because she will be able to eat and drink what she wants. Based on this information, the nurse identifies the nursing diagnosis of

The nurse is performing an assessment on a client who has returned from the dialysis unit following hemodialysis. The client is complaining of a headache and nausea and is extremely restless. Which of the following is the most appropriate nursing action?

A Client in Acute Renal failure is a candidate for continuous renal placement therapy (CRRT). The most common indication for use of CRRT is

A patient rapidly progressing toward ESRD asks about the possibility of a kidney transplant. In responding to the patient, the nurse knows that contraindications to kidney transplantation include

Signs and symptoms of acute kidney rejection that the nurse should teach the patient to observe for include

The most serious electrolyte disorder associated with kidney disease is