Exam 2
Renal and Neurological Knowledge Assessment
Test your understanding of renal and neurological health with this comprehensive quiz designed for healthcare professionals and students. With 50 carefully crafted questions, this quiz covers essential topics that are vital in clinical settings.
Key Features:
- In-depth questions on renal fun
ction and disorders - Assessment of neurological conditions and treatments
- Designed for various healthcare educational levels
A 77-year-old client has been admitted after being involved in a motor vehicle accident. The nurse notes that the client’s labs indicate minimally elevated serum creatinine levels. What can cause this increase in creatinine in older adults? Select all that apply.
Fluid volume deficit (FVD)
Acute kidney injury
Decreased cardiac output
Alterations in ratio of body fluids to muscle mass
Age-related decline in renal function
A client being treated for a chronic illness has a serum potassium level of 2.9 mEq/L (2.9 mmol/L). Which assessment finding(s) will the nurse expect to assess in the client? Select all that apply.
Anorexia
Hyperactive reflexes
Paresthesias
Muscle weakness
Leg cramps
The nurse is assessing a client for local complications of intravenous therapy. Which are local complications? Select all that apply.
Anorexia
Hyperactive reflexes
Numb fingers
Muscle weakness
Abdominal distention
The nurse is assessing a client for local complications of intravenous therapy. Which are local complications? Select all that apply.
Extravasation
Infection
Hematoma
Phlebitis
Air embolism
A 54-year-old male patient is admitted to the hospital with a case of severe dehydration. The nurse reviews the patient's laboratory results. Which of the following results are consistent with the diagnosis? Select all that apply.
Blood urea nitrogen (BUN) of 23 mg/dL
Serum osmolality of 310 mOsm/kg
Serum sodium of 148 mEq/L
Serum glucose of 90 mg/dL
Urine specific gravity of 1.03
Hematocrit level of 48%
The nurse is caring for an older adult client. Which age-related changes related to kidney function will guide the plan of care? Select all that apply.
Decrease in kidney weight
Renal arteries atrophy
Tubular basement membrane thickens
Decrease in bladder capacity
Urethral atrophy
A client with chronic kidney disease informs the nurse that they are having gastrointestinal issues. Which is the best response by the nurse to address the relationship between kidney problems and gastrointestinal issues? Select all that apply.
The right kidney's proximity to the pancreas, liver, and gallbladder
The indirect impact of digestive enzymes on renal function
The fact that the parietal peritoneum encapsulates the GI system and the kidneys
The left kidney's connection to the common bile duct
The role of the spleen in affecting intestinal symptoms
A client with a diagnosis of respiratory acidosis is experiencing renal compensation. What function does the kidney perform to assist in restoring acid–base balance? Select all that apply.
Sequestering free hydrogen ions in the nephrons
Returning bicarbonate to the body's circulation
Returning acid to the body's circulation
Excreting bicarbonate in the urine
Excreting acid in the urine
A client with gross hematuria has been admitted to a surgical floor in preparation for an upper cystoscopy in the morning. What post-procedure interventions would the nurse anticipate for this client? Select all that apply.
Nothing by mouth (NPO)
Intermittent straight catheterization
Sedative agent administration
Moist heat to abdomen
Monitor for urinary retention
A client that is receiving peritoneal dialysis is identified as being at risk for the development of peritonitis. Which nursing action(s) is/are the best preventative measure(s) to address this complication? Select all that apply.
Maintain aseptic technique when administering dialysate.
Wash the skin surrounding the catheter site with soap and water prior to each exchange.
Add antibiotics to the dialysate as ordered.
Administer prophylactic antibiotics as ordered.
Wear a mask during dressing changes.
The nurse is working on the renal transplant unit. To reduce the risk of infection in a client with a transplanted kidney, which action(s) will the nurse take? Select all that apply.
Wash hands carefully and frequently
Assess vital signs frequently
Instruct staff to always wear a mask
Perform skin hygiene
Perform oral care
The nurse is reviewing a patient’s laboratory results. What findings does the nurse assess that are consistent with acute glomerulonephritis? Select all that apply.
Red blood cells in the urine
Polyuria
Proteinuria
White blood cell casts in the urine
Hemoglobin of 12.8 g/dL
The nurse is creating a plan of care for a client with nephrotic syndrome. Which assessment findings will dictate necessary nursing actions? Select all that apply.
Anorexia
Weight gain
Shortness of breath
Hypotension
Periorbital edema
An inpatient client with acute kidney injury (AKI) has moderate edema to both legs. What resulting skin conditions would increase the client’s likelihood of skin breakdown? Select all that apply.
Atopic dermatitis
Pruritus
Psoriasis
Urticaria
Excoriation
A client is being prepared for the creation of an arteriovenous fistula. Which education will the nurse provide in the preoperative phase? Select all that apply.
The dominant forearm is the preferred site for creation of the fistula.
The purpose of the fistula is accommodating the dialysis needles.
Taking a BP reading on the affected arm can occlude the fistula.
Hemodialysis begins approximately 6 months after the fistula is created.
The fistula is created to enlarge the involved artery.
The nurse is caring for a client recovering from extracorporeal shock wave lithotripsy (ESWL). Which client statement(s) indicates that teaching about self-care has been effective? Select all that apply.
I will take my temperature every day.”
I may expect to experience some pain and discomfort."
The bruise on my back is from the treatment.”
I need to increase my intake of fluids every day.”
Blood in my urine should go away by day 4 or 5.”
A nurse is caring for a client whose urinary retention has not responded to conservative treatment. After educating about intermittent self- catheterization (ISC) at home, which statement indicates the education is effective? Select all that apply.
Assuming a sitting position for self-catheterization is most effective.”
I will use aseptic technique at home to catheterize.”
I will advance the catheter into the urethra only until urine flow is established.”
Self-catheterizing is done on average three to four times daily.”
I will lubricate the catheter prior to insertion to reduce tissue trauma.”
A client diagnosed with kidney stones is scheduled for extracorporeal shock wave lithotripsy (ESWL). Which will the nurse include in the client's postprocedure care? Select all that apply.
Strain the client's urine following the procedure.
Administer a bolus of 500 mL normal saline following the procedure.
Monitor the client for fluid overload following the procedure.
Insert a urinary catheter for 24 to 48 hours after the procedure.
Monitor pain levels closely.
Which of the following is a potential cause of transient incontinence? Select all that apply.
Delirium
Restricted activity
Infection of urinary tract
Atrophic vaginitis
Stool impaction
A client diagnosed with bladder cancer wants to avoid surgery. For which intravesical treatment will the nurse prepare teaching for this client?
Bacillus Calmette Guerin (BCG) Live
Radiation therapy
Periodic cystoscopy
Infusion of a cytotoxic agent
The nurse is caring for a client after lumbar puncture. The client reports a severe headache. Which actions should the nurse complete? Select all that apply.
Maintain the client on bed rest.
Administer fluids to the client.
Position the client in the supine position.
Prepare for an epidural blood patch.
Administer analgesic medication.
A health care provider has prescribed a standard electroencephalogram (EEG) test for the client. What general instructions should the nurse provide to the client? Select all that apply.
The procedure generally takes 45 to 60 minutes.
Please remove all jewelry and any metal objects prior to the procedure.
This procedure uses a water-soluble lubricant for electrode contact which can be easily wiped off and removed using shampoo.
If you feel nervous about the test I can provide you a light sedative medication to ease your anxiety.
Please refrain from drinking coffee and any caffeinated beverages the morning prior to the procedure.
It is required that you withhold taking your anticonvulsant medication 72 hours before the procedure.
Upper motor neuron lesions cause:
Little to no muscle atrophy.
Decreased muscle tone.
Flaccid paralysis.
Absent or decreased reflexes.
In which specific instances should the nurse assess the client's cranial nerves? Select all that apply.
When a neurogenic bladder develops
When level of consciousness is decreased
With brain stem pathology
In the presence of peripheral nervous system disease
When a spinal reflex is interrupted
When assessing a 36-year-old male, the nurse gently strokes the client’s right palm using a cotton applicator. As the nurse strokes the client’s palm the nurse then checks to see if the client will begin to grasp the applicator. This assessment is associated with which of the following reflexes?
Pathologic
Superficial
Deep tendon
Brachioradialis
A nurse is performing a complex neurological assessment on a client recently diagnosed with Alzheimer disease. What question should the nurse anticipate to ask when assessing the client’s language ability?
How are a pencil and pen alike?”
Can you write your name on this blank sheet of paper?”
Can you tell me what year it is?”
What is the name of the president of the United States?”
A client is given a medication that stimulates the parasympathetic system. Following administration of this medication, which outcome(s) will the nurse assess? Select all that apply.
Constricted pupils
Dilated bronchioles
Increased peristaltic movement
Relaxed muscular walls of the urinary bladder
Increased stomach secretions
A client is scheduled for a Computed Tomography (CT) scan of the head because of a recent onset of neurologic deficits. Which information will the nurse provide regarding the test? Select all that apply.
No metal objects can enter the procedure room.”
You will need to lie still throughout the procedure.”
There will be a lot of noise during the test.”
An IV containing a contrast agent will be administered.”
An 83-year-old woman suffers a stroke at home and is hospitalized for treatment and management. Which of the following diagnostic procedures would be best to visualize the extent of damage?
Magnetic resonance imaging (MRI)
Diffusion-weighted imaging (DWI)
Magnetic resonance angiography (MRA)
Computed tomography (CT)
A client is returning to the medical unit after surgery and has a history of migraines. Which intervention would the nurse prioritize for the overall treatment of this client?
Elevate the head of the bed 90 degrees and provide task lighting in a quiet enviroment.
Administer hydromorphone and/or sumatriptan medications for relief.
Maintain a clear liquid diet and administer intravenous fluids for hydration.
Obtain a scheduled order for ondansetron or trimethobenzamide.
After striking his head on a tree while falling from a ladder, a client is admitted to the emergency department. He's unconscious and his pupils are nonreactive. Which intervention should the nurse question?
Giving him a barbiturate
Placing him on mechanical ventilation
Performing a lumbar puncture
Elevating the head of his bed
Which interventions are appropriate for a client with increased intracranial pressure (ICP)? Select all that apply.
Administering prescribed antipyretics
Elevating the head of the bed to 90 degrees
Maintaining aseptic technique with an intraventricular catheter
Encouraging deep breathing and coughing every 2 hours
Frequent oral care
Which of the following is an early sign of increasing intracranial pressure (ICP)?
Loss of consciousness
Vomiting
Headache
Decerebrate posturing
A patient has a severe neurologic impairment from a head trauma. What does the nurse recognize is the type of posturing that occurs with the most severe neurologic impairment?
Decerebrate
Decorticate
Flaccid
Rigid
Which activity should be avoided in clients with increased intracranial pressure (ICP)?
Suctioning
Enemas
Position changes
Minimal environmental stimuli
The nurse is caring for a client with a brain tumor. What drug would the nurse expect to be prescribed to reduce the edema surrounding the tumor?
Solumedrol
Dextromethorphan
Dexamethasone
Furosemide
For a client with suspected increased intracranial pressure (ICP), an appropriate respiratory goal is to:
Prevent respiratory alkalosis.
Lower arterial pH.
Promote carbon dioxide elimination.
Maintain partial pressure of arterial oxygen (PaO2) above 80 mm Hg.
An adult client has sought care for the treatment of headaches that have become increasingly severe and frequent over the past several months. Which of the following questions addresses potential etiologic factors? Select all that apply.
Are you exposed to any toxins or chemicals at work?”
How would you describe your ability to cope with stress?”
What medications are you currently taking?”
When was the last time you were hospitalized?”
Does anyone else in your family struggle with headaches?”
A client suffered a closed head injury in a motor vehicle collision, and an ICP monitor was inserted. In the occurrence of increased ICP, what physiologic function contributes to the increase in intracranial pressure?
Vasodilation
Vasoconstriction
Hypertension
Increased PaO
A nurse is taking care of a client with swallowing difficulties after a stroke. What are some interventions the nurse can accomplish to prevent the client from aspirating while eating? Select all that apply.
Encourage the client to increase his/her intake of water and juice.
Assist the client out of bed and into the chair for meals.
Instruct the client to tuck his/her chin towards their chest when swallowing.
Request a swallowing assessment by a speech therapist before the client’s discharge.
Recommend the insertion of a percutaneous endoscopic gastrostomy (PEG) tube.
A client with an ischemic stroke has been brought to the emergency room. The health care provider institutes measures to restore cerebral blood flow. What area of the brain would most likely benefit from this immediate intervention?
Cerebral cortex
Temporal lobe
Central sulcus
Penumbra region
The nurse is caring for a client recovering from a stroke. Which action will the nurse take to prevent adduction of the client’s affected shoulder? Select all that apply.
Place a pillow in the axilla area.
Position the arm parallel to the torso.
Situate the arm in a slightly flexed position.
Put a rolled towel in the affected hand.
Position the wrist higher than the elbow.
A client is diagnosed with an ischemic stroke. For which reason(s) would the nurse question the use of tissue plasminogen activator (tPA) for this client? Select all that apply.
Platelet count 95,000/mm3
Prothrombin time 10 seconds
Systolic blood pressure 198 mm Hg
Diastolic blood pressure 120 mm Hg
Received low-molecular weight heparin injections twice a day
A nurse is communicating with a client who has aphasia after having a stroke. Which action should the nurse take?
Use one long sentence to say everything that needs to be said.
Keep the television on while she speaks.
Talk in a louder than normal voice.
Face the client and establish eye contact.
A client with a neurological disorder has difficulty swallowing. The nurse should take special care with the client's diet because of a potential risk of imbalanced nutrition. Which measure may be taken by the nurse to ensure that the client's diet allows for easy swallowing?
Instruct the client to lie on the bed when eating
Offer liquids frequently, in large quantities
Help the client sit upright when eating and feed slowly
Allow optimum physical activity before meals to expedite digestion
A client with a recent stroke history is admitted to a rehabilitation unit and placed on high fall risk precautions. The client is impulsive, easily distracted, frequently forgets his/her cane when walking, and the location of his/her room. What stroke conditions do these signs best indicate?
Ischemic stroke
Right hemispheric stroke
Hemorrhagic stroke
Left hemispheric stroke
Which of the following statements reflects nursing management of the patient with expressive aphasia?
Encourage the patient to repeat sounds of the alphabet.
Speak clearly and in simple sentences; use gestures or pictures when able.
Speak slowly and clearly to assist the patient in forming the sounds.
Frequently reorient the patient to time, place, and situation.
A client reports light-headedness, speech disturbance, and left-sided weakness lasting for several hours. The neurologist diagnosed a transient ischemic attack, which caused the client great concern. What would the nurse include during client education?
When symptoms cease, the client will return to presymptomatic state.
A TIA is an insidious, often chronic episode of neurologic impairment.
Symptoms of a TIA may linger for up to a week.
Two thirds of people that experience a TIA will go on to develop a stroke.
A client is prescribed sumatriptan for the treatment of migraine headache. Which client statement would indicate a need for additional teaching from the nurse?
I use this to prevent migraines.”
I take this when I get a headache.”
It constricts the blood vessels in my head.”
It alleviates my sensitivity to light and sound.”
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