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NUR 2016: CHRONIC KIDNEY DISEASE, DIALYSIS, & RENAL TRANSPLANT: TEST QUESTIONS & ANSWERS, Exams of Nursing

Aims Community CollegeNursing

NUR 2016: CHRONIC KIDNEY DISEASE, DIALYSIS, & RENAL TRANSPLANT: TEST QUESTIONS & ANSWERS

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2024/2025

Available from 06/08/2025

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NUR 2016: CHRONIC KIDNEY DISEASE, DIALYSIS, & RENAL
TRANSPLANT: TEST QUESTIONS WITH CORRECT ANSWERS
1) What is skeletal buffering? -- Answer โœ”โœ” The process in which bones release or
absorb minerals to help regulate blood pH in response to acidity or alkalinity
2) When the kidneys cannot perform their function of activation of vitamin D, what
electrolyte imbalance occurs? -- Answer โœ”โœ” Hypocalcemia
3) When the kidneys cannot perform their function of phosphate elimination, what
happens? -- Answer โœ”โœ” Hyperphosphatemia, hyperparathyroidism
4) What are osteodystrophies? -- Answer โœ”โœ” Abnormal growth or formation of bone,
can cause bone pain and fractures
5) Why are osteodystrophies common with chronic kidney disease? -- Answer โœ”โœ”
Due to hypocalcemia, hyperphosphatemia, skeletal buffering (bones lose minerals to
buffer acid-base imbalances because the kidneys can't help buffering)
6) Nursing considerations for chronic kidney failure in the high-acuity patient: --
Answer โœ”โœ” Dialysis required, hypertension likely, fluid restriction and dietary
restrictions of protein, sodium, potassium, and phosphate, hypoxia associated with
anemia, increased risk of infection, GI disturbances and anorexia common
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NUR 2016: CHRONIC KIDNEY DISEASE, DIALYSIS, & RENAL

TRANSPLANT: TEST QUESTIONS WITH CORRECT ANSWERS

  1. What is skeletal buffering? -- Answer โœ”โœ” The process in which bones release or absorb minerals to help regulate blood pH in response to acidity or alkalinity
  2. When the kidneys cannot perform their function of activation of vitamin D, what electrolyte imbalance occurs? -- Answer โœ”โœ” Hypocalcemia
  3. When the kidneys cannot perform their function of phosphate elimination, what happens? -- Answer โœ”โœ” Hyperphosphatemia, hyperparathyroidism
  4. What are osteodystrophies? -- Answer โœ”โœ” Abnormal growth or formation of bone, can cause bone pain and fractures
  5. Why are osteodystrophies common with chronic kidney disease? -- Answer โœ”โœ” Due to hypocalcemia, hyperphosphatemia, skeletal buffering (bones lose minerals to buffer acid-base imbalances because the kidneys can't help buffering)
  6. Nursing considerations for chronic kidney failure in the high-acuity patient: -- Answer โœ”โœ” Dialysis required, hypertension likely, fluid restriction and dietary restrictions of protein, sodium, potassium, and phosphate, hypoxia associated with anemia, increased risk of infection, GI disturbances and anorexia common
  1. What are the dietary considerations for chronic kidney disease? -- Answer โœ”โœ” Restrict proteins, phosphorus, sodium, potassium, and fluids. Supplement with amino acids
  2. What is dialysis? -- Answer โœ”โœ” Movement of fluid and molecules across a semipermeable membrane. Urea, Creatinine, uric acid, phos, and potassium move from blood to dialysate. WBC and RBC are too large to move through the membrane so they stay put.
  3. ____ is added to dialysate to create higher osmotic gradient to pull fluid out of blood. -- Answer โœ”โœ” Glucose
  4. In dialysis, solutes and water move across the membrane from dialysate to blood or from blood to dialysate by: -- Answer โœ”โœ” Osmosis, diffusion, ultrafiltration
  5. What is osmosis? -- Answer โœ”โœ” diffusion of water across a selectively permeable membrane
  6. What is diffusion? -- Answer โœ”โœ” Movement of molecules from high to low concentration
  7. What is ultrafiltration? -- Answer โœ”โœ” Separation of particles based on size under pressure
  8. What are the two types of dialysis? -- Answer โœ”โœ” peritoneal and hemodialysis
  1. What are the signs and symptoms of peritonitis? -- Answer โœ”โœ” Cloudy dialysate drainage, diffuse abdominal pain, rebound tenderness, hypotension, may possibly lead to shock
  2. What is the treatment for peritonitis secondary to peritoneal dialysis? -- Answer โœ”โœ” Initially rapid exchanges, antibiotics, may require hemodialysis and discontinuation of peritoneal
  3. Which is more common, peritoneal dialysis or hemodialysis? -- Answer โœ”โœ” Hemodialysis
  4. How does hemodialysis work? -- Answer โœ”โœ” Blood is diverted from the patient to a machine, a dialyzer, where the blood is cleansed and returned to the patient
  5. With hemodialysis, blood can be removed, cleaned, and returned to the body at the rates of - mL/min. -- Answer โœ”โœ” 200 - 800
  6. If a patient needs temporary hemodialysis, what vascular access may be used? -- Answer โœ”โœ” A central line via subclavian, internal jugular or femoral approach. (Called a Quinton catheter.)
  7. If a patient has a Quinton catheter for dialysis, what is each pigtail used for? -- Answer โœ”โœ” Red is to pull blood away, blue is to put it back, purple pigtail is the ONLY one that is okay for us to use if it is present. (The only other responsibility we have is keeping the dressing clean, dry and intact)
  8. When a Quinton catheter is not being used for dialysis, the catheter should be... -- Answer โœ”โœ” Packed with heparin
  1. True or false: It is okay for the nurse to flush the Quinton catheter. -- Answer โœ”โœ” False (should be heparin locked)
  2. What is an arteriovenous fistula? -- Answer โœ”โœ” A connection between an artery and a vein
  3. What is an arteriovenous graft? -- Answer โœ”โœ” artificial conduit that connects an artery to a vein (used as a substitute for a dialysis fistula in cases where an AV fistula cannot be made.)
  4. An arm with a fistula is a restricted extremity, meaning... -- Answer โœ”โœ” No blood sugars, no blood pressures, no lab draws, no injections
  5. What should we assess the fistula for? -- Answer โœ”โœ” Listen for bruit and feel for thrill
  6. What is a bruit? -- Answer โœ”โœ” blowing, swishing sound indicating blood flow turbulence
  7. What is a thrill? -- Answer โœ”โœ” palpable vibration
  8. How long does hemodialysis take? -- Answer โœ”โœ” 2 - 6 hours
  1. What is chronic kidney disease? -- Answer โœ”โœ” progressive, irreversible loss of kidney function.
  2. How does chronic kidney disease differ from acute kidney injury? -- Answer โœ”โœ” Longer, more insidious onset. Typically caused by a long-term disease or medical comorbidities. It may be the result of a poorly managed AKI
  3. How many stages are there in chronic kidney injury? -- Answer โœ”โœ” Five stages, delineated by GFR (stages are a one way street, once you are at a certain stage, you cannot go back! You can only progress thru the stages.)
  4. What delineates stage one of chronic kidney injury? -- Answer โœ”โœ” Diminished renal reserve, destruction of nephrons and compensatory hyperfiltration, GFR > 90
  5. What delineates stage two of chronic kidney injury? -- Answer โœ”โœ” Renal insufficiency, GFR 60-89, hypertension, anemia, isosthenuria
  6. What is isosthenuria? -- Answer โœ”โœ” Urine that has an osmolality equal to plasma
  7. What delineates stage three of chronic kidney injury? -- Answer โœ”โœ” GFR reduced to 30-59, onset of kidney failure
  8. What delineates stage four of chronic kidney injury? -- Answer โœ”โœ” GFR drops to 15 - 29, serum triglycerides increase, hyperkalemia, hyperphosphatemia, metabolic acidosis, fatigue, nausea, bone pain
  1. What delineates stage five of chronic kidney injury? -- Answer โœ”โœ” End-stage renal disease (ESRD), true renal failure, GFR less than 15, severe uremic symptoms if not treated with dialysis
  2. How is chronic kidney disease diagnosed? -- Answer โœ”โœ” Evidence of kidney damage last > 3 months with or without change in GFR, GFR of less than 60 for at least 3 months with or without kidney damage (highly dependent on lab values)
  3. What are the functions of the kidney? -- Answer โœ”โœ” Sodium and water balance, potassium balance, elimination of nitrogenous wastes, erythropoietin production, acid-base balance, activation of vitamin D, phosphate elimination
  4. Chronic kidney injury activates the RAAS system leading to... -- Answer โœ”โœ” Sodium and water retention, hypertension, heart failure, pulmonary edema, edema
  5. Chronic kidney injury causes hyperkalemia leading to... -- Answer โœ”โœ” Lethal arrhythmias
  6. When the kidneys cannot perform their function of elimination of nitrogenous wastes, what occurs? -- Answer โœ”โœ” Uremiaโ€”urine in blood that begins to poison body systems
  7. When the kidneys cannot perform their function of erythropoietin production, what happens? -- Answer โœ”โœ” Anemia
  8. When the kidneys cannot perform their function of acid-base balance, what does it lead to? -- Answer โœ”โœ” Acidosis, skeletal buffering