Chapter 16: Acute Kidney Injury

Chapter 16: Acute Kidney Injury

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The critical care nurse knows that in critically ill patients, renal dysfunction

a.	is a very rare problem.
b.	affects nearly two thirds of patients.
c.	has a low mortality rate once renal replacement therapy has been initiated.
d.	has little effect on morbidity, mortality, or quality of life.

 

 

ANS:   B

The kidney is the primary regulator of the body’s internal environment. With sudden cessation of renal function, all body systems are affected by the inability to maintain fluid and electrolyte balance and eliminate metabolic waste. Renal dysfunction is a common problem in critically ill patients, with nearly two thirds of patients experiencing some degree of renal dysfunction. The most severe cases, requiring renal replacement therapy, have a reported mortality rate of 50% to 60%. Acute kidney injury that progresses to chronic renal failure is associated with increased morbidity, mortality, and reduced quality of life.

 

DIF:    Cognitive Level: Remember/Knowledge                              REF:    p. 417

OBJ:    Review the anatomy and physiology of the renal system.

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

2. The nurse is caring for a patient who has sustained blunt trauma to the left flank area, and is evaluating the patient’s urinalysis results. The nurse should become concerned when

a.	creatinine levels in the urine are similar to blood levels of creatinine.
b.	sodium and chloride are found in the urine.
c.	urine uric acid levels have the same values as serum levels.
d.	red blood cells and albumin are found in the urine.

 

 

ANS:   D

Normal glomerular filtrate is basically protein free and contains electrolytes, including sodium, chloride, and phosphate, and nitrogenous waste products, such as creatinine, urea, and uric acid, in amounts similar to those in plasma. Red blood cells, albumin, and globulin are too large to pass through the healthy glomerular membrane. Their presence in urine may indicate glomerular damage.

 

DIF:    Cognitive Level: Understand/Comprehension                      REF:    p. 418

OBJ:    Review the anatomy and physiology of the renal system.

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

3. A normal glomerular filtration rate is

a.	less than 80 mL/min.
b.	80 to 125 mL/min.
c.	125 to 180 mL/min.
d.	more than 189 mL/min.

 

 

ANS:   B

At a normal glomerular filtration rate (GFR) of 80 to 125 mL/min, the kidneys produce 180 L/day of filtrate. As the filtrate passes through the various components of the nephrons’ tubules, 99% is reabsorbed into the peritubular capillaries or vasa recta.

 

DIF:    Cognitive Level: Remember/Knowledge                              REF:    p. 448

OBJ:    Review the anatomy and physiology of the renal system.

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity

 

4. A normal urine output is considered to be

a.	80 to 125 mL/min.
b.	180 L/day.
c.	80 mL/min.
d.	1 to 2 L/day.

 

 

ANS:   D

At a normal glomerular filtration rate (GFR) of 80 to 125 mL/min, the kidneys produce 180 L/day of filtrate. As the filtrate passes through the various components of the nephrons’ tubules, 99% is reabsorbed into the peritubular capillaries or vasa recta. Eventually, the remaining filtrate (1% of the original 180 L/day) is excreted as urine, for an average urine output of 1 to 2 L/day.

 

DIF:    Cognitive Level: Remember/Knowledge                              REF:    p. 418

OBJ:    Review the anatomy and physiology of the renal system.

TOP:    Nursing Process Step: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity