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NURS 275 Exam 1 (Retake) Questions with
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A nurse is caring for a client who has substance-induced psychotic disorder and is experiencing auditory hallucinations. The client states, "The voices won't leave me alone!" Which of the following statements should the nurse make? (Select all that apply) A. "When did you start hearing these things?" B. "The voices are not real, or else we would both hear them." C. "It must be scary to hear voices" D. "Are the voices you hear telling you to hurt yourself?" E. "Why are the voices talking to only you?" A, C, D A nurse is completing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse document as positive symptoms? (Select all that apply)
A. Auditory hallucination B. Lack of motivation C. Use of clang associations D. Delusion of persecution E. Constantly waving arms F. Flat affect A, C, D, E A nurse is caring for a client with schizoaffective disorder. Which of the following statements indicates the client is experiencing depersonalization? A. "I am a superhero and am immortal" B. "I am no one and everyone is me" C. "I feel monsters pinching me all over" D. "I know that you are stealing my thoughts" B A nurse is caring for a client on an acute mental health unit. The client reports hearing voices that are stating, "kill your doctor." Which of the following actions should the nurse take first? A. Encourage client to participate in group therapy on the unit
D. Severe agitation E. Anhedonia A, C, D A nurse is planning care for a client who has bipolar disorder and is experiencing a manic episode. Which of the following interventions should the nurse include in the plan of care? (Select all that apply) A. Provide flexible client behavior expectations B. Offer concise explanations C. Establish consistent limits D. Disregard client concerns E. Use a firm approach with communication B, C, E A nurse is teaching a newly licensed nurse about the use of ECT for the treatment of bipolar disorder. Which of the following statements by the newly licensed nurse indicates understanding? A. "ECT is the recommended initial treatment for bipolar disorder" B. "ECT is contraindicated for clients who have suicidal ideation" C. "ECT is effective for clients who are experiencing severe mania"
D. "ECT is prescribed to prevent relapse of bipolar disorder" C A nurse is caring for a client who has bipolar disorder. Which of the following is the priority nursing action? A. Set consistent limits for expected client behavior B. Administer prescribed meds as scheduled C. Provide client with step by step instructions during hygiene activities D. Monitor client for escalating behavior D A nurse is caring for a client who has bipolar disorder. The client states, "I am very rich, and I feel I must give my money to you." Which of the following responses should the nurse make? A. "Why do you think you feel the need to give me money?" B. "I am here to provide care and cannot accept this from you" C. "I can request that your case manager discuss appropriate charity options with you" D. "You should know that giving away your money is inappropriate" B
A. "That is a good choice. Ibuprofen does not interact with lithium" B. "Regular aspirin would be a better choice" C. "Lithium decreases the effectiveness of ibuprofen" D. "The ibuprofen will make your lithium level fall too low" B A nurse is discussing early indications of toxicity with a client who has a new prescription for lithium carbonate for bipolar disorder. The nurse should include which of the following manifestations in the teaching? (Select all that apply) A. Constipation B. Polyuria C. Rash D. Muscle weakness E. Tinnitus B, D A nurse is discussing routine follow up needs with a client who has a new prescription for valproate. The nurse should inform the client of the need for routine monitoring of which of the following? A. AST/ALT and LDH
B. Creatinine and BUN C. WBC and granulocyte counts D. Blood sodium and potassium A A patient with acute kidney injury has the following labs: GFR 92 mL/min, BUN 17 mg/dL, potassium 4.9 mEq/L, and creatinine 1 mg/dL. The patient's 24 hour urinary output is 1.75 Liters. Based on these findings, what stage of AKI is this patient in? A. Initiation B. Diuresis C. Oliguric D. Recovery D A 36 year old male patient is diagnosed with acute kidney injury. The patient is voiding 4 L/day of urine. What complication can arise based on the stage of AKI this patient is in? Select all that apply: A. Water intoxication B. Hypotension C. Low urine specific gravity
You're developing a nursing care plan for a patient in the diuresis stage of AKI. What nursing diagnosis would you include in the care plan? A. Excess fluid volume B. Risk for electrolyte imbalance C. Urinary retention D. Acute pain B While educating a group of nursing students about the stages of acute kidney injury, a student asks how long the oliguric stage lasts. You explain to the student this stage can last? A. 1-2 weeks B. 1-3 days C. Few hours to 2 weeks D. 12 months A A patient with AKI has a urinary output of 350 mL/day. In addition, morning labs showed an increased BUN and creatinine level along with potassium level of 6 mEq/L. What type of diet ordered by the physician is most appropriate for this patient?
A. Low-sodium, high-protein, and low-potassium B. High-protein, low-potassium, and low-sodium C. Low-protein, low-potassium, and low-sodium D. High-protein and high-potassium C Which patient will the nurse identify as at risk for acute kidney injury? Select all that apply: A. 68 yo male with DM B. 16 yo male football player in preseason practice C. 27 yo female recovering from shock following a car accident D. 52 yo male with newly diagnosed hypertension E. 30 yo female in intensive care receiving multiple IV antibiotics B, C, E The nurse is providing discharge teaching to a client recovering from kidney transplantation. Which client statement indicates understanding? A. "I can stop my medications when my kidney function returns to normal" B. "If my urine output decreases, I will increase my fluids"
Intrarenal AKI Group of antibiotics that cause intrarenal AKI Aminoglycosides Primary cause of edema in AKI Glomerulonephritis (fluid leakage causes lower GFR, oliguria, edema, hypertension, azotemia) Cause of acute tubular necrosis Ischemia These two chronic diseases increase risk of CKD Diabetes, hypertension Modifiable risk factors for CKD Obesity, cardiovascular disease, uncontrolled diabetes, smoking, exposure to nephrotoxic meds
Nephrotoxic medications (Examples) NSAIDS, aminoglycosides, cephalosporins Lab value that determines staging of chronic kidney disease GFR Tall peaked T waves with widened QRS complex and disappearing P waves on ECG indicate what? Hyperkalemia GFR <15-29 mL/min/1.73 m^2 indicates what stage of CKD? Stage 5 or end stage kidney disease Term for massive protein in urine Proteinuria The part of the kidney where "ide" meds are effective Ascending loop of henle
BUN to creatinine ratio Term for high concentration of urea and creatinine in the blood Azotemia Values obtained in a BMP? Potassium, sodium, BUN, creatinine, chloride, bicarbonate, glucose Medication used to treat anemia in CKD Erythropoietin One pound of weight gain in acutely ill patients indicates---- retained fluid 1000 mL Also known as the silent disease CKD Optimal diet for renal failure
High calories, low protein, no extra sodium and no extra potassium Best practice to monitor weight Same amount of clothing, same time of day, same scale Acute renal failure will demonstrate---- BUN level and ------serum creatinine level Increased/ Increased Physiologic renal changes associated with aging include what? Reduced kidney size/weight, lower GFR, decreased sodium reabsorption and decreased potassium excretion Medication used to treat metabolic acidosis Sodium bicarbonate Name one benefit of peritoneal dialysis Can be done at home
A patient with acute renal injury has a GFR (glomerular filtration rate) of 40 mL/min. Which signs and symptoms below may this patient present with? Select all that apply: A. Hypervolemia B. Hypokalemia C. Increased BUN level D. Decreased Creatinine level A, C You're assessing morning lab values on a female patient who is recovering from a myocardial infraction. Which lab value below requires you to notify the physician? A. Potassium level 4.2 mEq/L B. Creatinine clearance 35 mL/min C. BUN 20 mg/dL D. Blood pH 7. B A 55 year old male patient is admitted with a massive GI bleed. The patient is at risk for what type of acute kidney injury?
A. Post-renal B. Intra-renal C. Pre-renal D. Intrinsic renal C Select all the patients below that are at risk for acute intra-renal injury? A. A 45 year old male with a renal calculus. B. A 65 year old male with benign prostatic hyperplasia. C. A 25 year old female receiving chemotherapy. D. A 36 year old female with renal artery stenosis. E. A 6 year old male with acute glomerulonephritis. F. An 87 year old male who is taking an aminoglycoside medication for an infection. C, E, F
