MSNCB Renal Nursing 4

Question 1

Which acid-base disturbance is most characteristic of ESRD?

Accepted Answer

Metabolic acidosis with elevated anion gap

Answer

ESRD impairs renal acid excretion and bicarbonate regeneration, resulting in high anion gap metabolic acidosis.

Question 2

A post-renal transplant patient develops oliguria, fever, and graft tenderness on day 5. What does this most likely indicate?

Accepted Answer

Acute rejection requiring immediate evaluation

Answer

Fever, oliguria, and graft tenderness appearing days to weeks post-transplant are classic signs of acute cellular rejection requiring prompt biopsy and treatment.

Question 3

Which serum laboratory value is the most reliable indicator of glomerular filtration rate (GFR)?

Accepted Answer

Cystatin C

Answer

Cystatin C is produced at a constant rate by all nucleated cells and is freely filtered by the glomerulus, making it a more accurate GFR marker than creatinine.

Question 4

A patient with AKI is receiving kayexalate (sodium polystyrene sulfonate) for hyperkalemia. Which adverse effect requires monitoring?

Accepted Answer

Intestinal necrosis

Answer

Sodium polystyrene sulfonate (Kayexalate) carries a risk of intestinal necrosis, particularly in post-operative patients or those with reduced gut motility.

Question 5

Which fluid assessment technique is most appropriate to monitor fluid status in a hemodialysis patient between sessions?

Accepted Answer

Daily weight measurement

Answer

Daily weight is the most reliable and practical method to assess fluid accumulation between hemodialysis sessions in anuric or oliguric patients.

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

MSNCB Renal Nursing 4