Renal Nursing Flashcards
7 cards from real MSNCB practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Renal Nursing flashcards as text
Which acid-base disturbance is most characteristic of ESRD?
Answer: Metabolic acidosis with elevated anion gap
ESRD impairs renal acid excretion and bicarbonate regeneration, resulting in high anion gap metabolic acidosis.
A post-renal transplant patient develops oliguria, fever, and graft tenderness on day 5. What does this most likely indicate?
Answer: Acute rejection requiring immediate evaluation
Fever, oliguria, and graft tenderness appearing days to weeks post-transplant are classic signs of acute cellular rejection requiring prompt biopsy and treatment.
Which serum laboratory value is the most reliable indicator of glomerular filtration rate (GFR)?
Answer: Cystatin C
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.
A patient with AKI is receiving kayexalate (sodium polystyrene sulfonate) for hyperkalemia. Which adverse effect requires monitoring?
Answer: Intestinal necrosis
Sodium polystyrene sulfonate (Kayexalate) carries a risk of intestinal necrosis, particularly in post-operative patients or those with reduced gut motility.
Which fluid assessment technique is most appropriate to monitor fluid status in a hemodialysis patient between sessions?
Answer: Daily weight measurement
Daily weight is the most reliable and practical method to assess fluid accumulation between hemodialysis sessions in anuric or oliguric patients.
A nurse notes that a patient's PD dwell time has been extended inadvertently. Which complication should the nurse anticipate?
Answer: Hyperglycemia from prolonged glucose absorption
Prolonged dwell time increases glucose absorption from the hypertonic dialysate, leading to hyperglycemia, especially in diabetic patients.
Which medication class must be used cautiously in patients with CKD stage 3 or higher due to risk of lactic acidosis?
Answer: Metformin
Metformin is contraindicated or requires dose adjustment in CKD stage 3b and above because impaired renal clearance allows accumulation, increasing lactic acidosis risk.