AMSN Renal and Urological Disorders

Question 1

A patient with acute kidney injury (AKI) has a serum potassium of 6.8 mEq/L and peaked T waves on ECG. The nurse's priority action is:

Accepted Answer

Prepare to administer calcium gluconate and notify the provider immediately

Answer

Hyperkalemia with ECG changes is a cardiac emergency; calcium gluconate is administered first to stabilize the myocardium while definitive treatment is arranged.

Question 2

A patient with chronic kidney disease (CKD) stage 4 asks why they need to restrict dietary phosphorus. The best response is:

Accepted Answer

'Your kidneys cannot excrete phosphorus well, which causes it to build up and leach calcium from bones.'

Answer

In CKD, impaired phosphorus excretion leads to hyperphosphatemia, which stimulates PTH release and causes calcium to be pulled from bone (renal osteodystrophy).

Question 3

A patient with nephrotic syndrome has 4+ pitting edema and serum albumin of 1.8 g/dL. The edema is primarily caused by:

Accepted Answer

Loss of albumin in urine reducing plasma oncotic pressure

Answer

Massive protein (albumin) loss in urine lowers plasma oncotic pressure, allowing fluid to shift into the interstitium, causing profound edema.

Question 4

A patient with a urinary tract infection (UTI) is prescribed trimethoprim-sulfamethoxazole (TMP-SMX). The nurse should instruct the patient to:

Accepted Answer

Take the full course of antibiotics even if symptoms resolve

Answer

Completing the full antibiotic course eradicates the infection completely and prevents recurrence and antibiotic resistance.

Question 5

A patient on hemodialysis reports shortness of breath and a 4 kg weight gain since the last dialysis session. The nurse's priority assessment is:

Accepted Answer

Lung sounds and oxygen saturation

Answer

Rapid weight gain between dialysis sessions indicates fluid overload; dyspnea and crackles on auscultation suggest pulmonary edema requiring urgent assessment.

AMSN - Academy of Medical-Surgical Nurses Practice Test

AMSN - Academy of Medical-Surgical Nurses Practice Test

AMSN Renal and Urological Disorders