MSNCB Renal Nursing 3

Question 1

A patient with nephrotic syndrome presents with pitting edema, proteinuria >3.5 g/day, and hypoalbuminemia. Which mechanism best explains the edema?

Accepted Answer

Decreased oncotic pressure due to protein loss in urine

Answer

Massive proteinuria depletes serum albumin, reducing oncotic pressure and allowing fluid to shift into the interstitial space.

Question 2

Which sign or symptom indicates uremic encephalopathy in a patient with ESRD?

Accepted Answer

Asterixis and confusion

Answer

Asterixis (flapping tremor) and altered mental status are classic neurological manifestations of uremia affecting the central nervous system.

Question 3

A nurse is preparing a patient for a renal biopsy. Which post-procedure instruction is most critical?

Accepted Answer

Monitor urine for hematuria and report persistent bleeding

Answer

Renal biopsy carries a risk of hemorrhage; monitoring urine for hematuria and reporting persistent or worsening bleeding is the priority post-procedure intervention.

Question 4

Which dietary modification is appropriate for a patient with CKD to manage metabolic acidosis?

Accepted Answer

Use sodium bicarbonate supplementation as directed

Answer

Oral sodium bicarbonate supplementation is a recommended treatment for CKD-associated metabolic acidosis to maintain serum bicarbonate ≥22 mEq/L.

Question 5

A patient receiving continuous renal replacement therapy (CRRT) develops hypotension. What is the nurse's priority action?

Accepted Answer

Decrease or pause ultrafiltration and notify the physician

Answer

Hypotension during CRRT is often caused by excessive fluid removal; decreasing or pausing ultrafiltration and notifying the physician prevents hemodynamic compromise.

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

MSNCB Renal Nursing 3