HESI Chronic Kidney Disease Case Study Practice Test

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• In acute hyperkalemia, after stabilizing the myocardium with calcium, which intervention is used to shift potassium intracellularly?
• Which statement best describes the goals of palliative care?
• Which statement best explains how immunosuppressive therapy is balanced to prevent rejection while minimizing infection risk?
• The nurse explains that providing analgesia in a postoperative transplant patient addresses which level of Maslow's hierarchy?
• Which factor is crucial when selecting a kidney donor for transplantation?
• What is a key infection prevention consideration for patients on dialysis?
• Which laboratory parameters are most used to monitor CKD-MBD and treatment impact?
• Which laboratory finding would most strongly indicate possible graft dysfunction in a renal transplant recipient?
• The client's hemoglobin 7.8: what action should the nurse take?
• In CKD, what is the recommended approach to nephrotoxic medications?
• Which condition is a primary risk factor commonly associated with chronic kidney disease?
• What rate should the nurse program for anti-thymocyte globulin (ATG) infusion given the dose 4.5 mg/kg for a 60 kg patient, volume 25 mg per 10 mL, infused over 6 hours?
• Which nursing intervention best supports a family member who expresses anger after a kidney transplant?
• Why is iron status essential when using ESAs in CKD?
• Why is dietary sodium restriction important in CKD, and what is a typical daily limit?
• CKD stage 1 is defined by evidence of kidney damage with an eGFR at least what value?
• What is a healthy emotional coping sign after transplant?
• In the scenario of possible organ rejection, which instruction should the nurse give the client?
• Which option lists the common signs or symptoms of anemia in CKD?
• Which assessment finding is most important to report to the healthcare provider for a patient with end-stage renal disease who presents with a blood pressure of 178/92 mmHg?
• Which statement best describes the impact of verbalizing anger during grief?
• What pharmacologic option might be considered when a CKD patient on phosphate control still has high PTH?
• What is the relationship between phosphate levels and calcium in CKD, and why is this clinically important?
• Which statement best educates a client about palliative care?
• Prior to administering potassium chloride, when the serum potassium is 6.5 mEq/L, what is the most important intervention for the nurse to implement?
• What does a urine albumin-to-creatinine ratio indicate?
• What is Dialysis Disequilibrium Syndrome, and which patients are at risk?
• Which assessment should be performed to determine the desired outcome of losartan therapy?
• Which symptom should the nurse ask about that is commonly associated with uremia?
• Capillary refill >10 seconds in the hand with the graft may indicate which condition?
• What is the role of kidney transplantation in CKD management, and what is a typical prerequisite?
• Beyond anemia, how can CKD affect hematologic status?
• Which complication would the client be most concerned about if choosing peritoneal dialysis?
• How do phosphate binders help CKD patients and when should they be taken?
• Which lab value would the nurse be most concerned about?
• During a follow-up visit, which data would best support a diagnosis of acute kidney transplant rejection?
• Which action best protects the transplanted kidney in the long term?
• Which action demonstrates adherence to the post-transplant plan?
• Which assessment should be reported to the healthcare provider immediately in a patient with a hemodialysis graft?
• APD stands for Automated Peritoneal Dialysis.
• How does CKD affect platelet function?
• An eGFR of 28 mL/min/1.73 m2 corresponds to which CKD stage?
• In end-stage renal disease, what is a typical consideration regarding the use of furosemide for fluid management?
• Which support system is most helpful after discharge to ensure adherence?
• Which statement reflects effective therapeutic communication with a grieving family member after transplant concerns arise?
• What respiratory response accompanies metabolic acidosis as compensation?
• What are the three main immediate treatments for hyperkalemia with potential ECG changes?
• What is a key sign of peritoneal dialysis-related infection?
• Name two major risk factors for CKD progression.
• CKD stage 3 is defined by an estimated glomerular filtration rate (eGFR) in which range?
• Post-transplant urinary output from a living donor kidney can be large and dilute; what action is appropriate?
• In CKD, anemia is most often due to decreased erythropoietin production. What is the most appropriate initial step in management?
• Which urine finding is a sensitive marker of kidney damage?
• What causes CKD-related secondary hyperparathyroidism?
• Which dietary outcome should be included in discharge teaching for diet management in ESRD on hemodialysis three times weekly?
• Which follow-up is essential after a kidney transplant?
• Which parameter best reflects CKD progression over time and why?
• Upon transfer from the SICU to the Surgical Unit, the patient reports incisional pain 6/10 and last analgesic was 4 hours ago. Which action should the nurse implement first?
• What is the typical daily protein goal for CKD not yet on dialysis?
• Which laboratory value is used to measure iron availability for ESA therapy?
• What is the recommended blood pressure target for CKD patients, and how does this relate to RAAS blockade?
• Which nursing intervention should be included in the client's plan of care?
• Albuminuria in CKD is associated with which of the following risks?
• Which statement about immunosuppressants is true?
• In CKD patients with edema before reaching stage 5, which class of diuretics is commonly used and what is a typical limitation?
• How is fluid restriction typically determined for a CKD patient?
• In CKD anemia management, what is the initial step to evaluate and guide therapy?
• What is the best nurse response to a family member who says, 'The doctors must have messed up; I will sue'?
• A patient has a urine albumin-to-creatinine ratio (UACR) of 350 mg/g. Into which albuminuria category does this fall, and what is the associated risk?
• In a patient with eGFR 28 mL/min/1.73 m2, potassium 5.9 mEq/L, bicarbonate 18 mEq/L, BUN 60 mg/dL, and creatinine 2.4 mg/dL, what is the most immediate nursing intervention?
• Which statement about bicarbonate use in hyperkalemia management is correct?
• CKD-related secondary hyperparathyroidism is driven by which combination?
• After kidney transplantation, what is typically required to protect graft function?
• Which medication class is commonly used to manage hypertension in CKD and has renal protective effects?
• Which acid-base disorder commonly accompanies CKD and what causes it?
• During the first 24 hours after kidney transplantation, what is the priority nursing assessment?
• Why is adequate energy intake important in CKD patients?
• A CKD patient has UACR 350 mg/g. Which albuminuria category does this correspond to?
• When starting erythropoiesis-stimulating agents for CKD anemia, what is a key consideration?
• Which therapy option is a calcimimetic used to control secondary hyperparathyroidism in CKD-MBD?
• Which action best reduces infection risk for a dual-lumen catheter site?
• What sign of malnutrition/inflammation might appear in CKD labs?
• After the HCP phone call, what action should the nurse take?
• Which factor is essential to protect the transplanted kidney?
• Which sign indicates steal syndrome in a patient with vascular access?
• Itching due to uremia is a symptom of advanced CKD. Which option lists this symptom correctly?
• Which factors influence eGFR calculation equations like CKD-EPI or MDRD?
• Which is the target Kt/V per HD session?
• Which of the following is a non-hemic symptom that affects quality of life in advanced CKD?
• Which medication is a phosphate binder commonly used in CKD?
• Which follow-up is required after a kidney transplant?
• In CKD, which foods are commonly restricted due to high potassium content, and name two lower-potassium alternatives?
• What is a typical sodium restriction goal for CKD patients?
• Which intervention is important to include in the care plan while a patient receives multiple immunosuppressants?
• What parameter is commonly used to assess dialysis adequacy in hemodialysis?
• Which statement about who discusses renal replacement therapy options with the client is accurate?
• In addition to palpating a thrill, what other assessment is recommended for an AV graft?
• What action should the nurse take when an unsafe medication order is received by phone?
• What vaccines are recommended for CKD patients, especially those with advanced CKD or on dialysis?
• Which statement about immunosuppressant therapy is true?
• Which vitamin deficiency is most closely linked to CKD-related bone mineral disorders?
• What is the preferred vascular access for long-term hemodialysis?
• In the immediate postoperative plan of care after kidney transplantation, which intervention is essential?
• In CKD edema management, which diuretic class is typically used if permitted?
• Which single lifestyle modification is essential to slow CKD progression?
• Who should discuss the risks and benefits of renal replacement therapies with the client?
• In CKD, what parameter helps monitor fluid status reliably in edema management?
• Major risk of peritoneal dialysis and the key sign of its complication?
• In CKD-MBD management, which laboratory parameter is commonly targeted to lower risk of vascular calcification?
• Which factor is NOT typically included in CKD-EPI or MDRD eGFR equations?
• A CKD patient presents with potassium 5.9 mEq/L. What immediate management steps should be taken to stabilize the myocardium?
• In CKD with edema and pulmonary congestion, outline a priority nursing action plan.
• Which symptom is NOT listed as a non-hemic symptom affecting quality of life in advanced CKD?
• A CKD patient has metabolic acidosis with HCO3- 16 mEq/L. What is the first-line management?
• How does reduced GFR affect pharmacokinetics of renally cleared drugs?
• Which laboratory finding indicates the desired outcome of calcium acetate therapy?
• What is a key consideration when starting ACE inhibitors or ARBs in CKD?
• Which neuropathy can occur in late CKD and its typical features?
• Which monitoring is recommended after starting ACE inhibitors or ARBs in CKD?
• What is a major consideration regarding kidney transplantation for CKD patients?
• Which symptom most strongly suggests acute rejection in a renal transplant recipient?
• What is the recommended follow-up plan after discharge?
• Which statement best describes CKD stage 1?
• Which analgesic is generally preferred in CKD for mild pain, with NSAIDs avoided and dosing adjustments may be needed for some opioids?
• What sleep-related issue is common in CKD?
• Which statement about albuminuria is true?
• What preventive care is particularly important for CKD patients?
• In a CKD patient receiving ESA therapy, which factor should be optimized to maximize response?
• Which is an appropriate nursing intervention when a family member expresses anger after loss?
• Why is overcorrection of hemoglobin discouraged when treating CKD-related anemia?
• Anemia management in CKD; what is the Hgb target to balance cardiovascular risk?
• In CKD, what is a key consideration for medication dosing?
• In CKD, which electrolyte abnormality is most commonly observed and why?
• Which assessment data indicates the desired outcome of epoetin alfa therapy?
• In CKD patient on phosphate control, there is still high PTH; which pharmacologic option might be considered?
• Which statement best describes the relationship between urine albumin-to-creatinine ratio and CKD risk?
• To manage metabolic acidosis in CKD, which intervention is commonly used?
• What is the recommended daily protein intake for an adult with CKD stage 4 not on dialysis?
• What nursing assessment finding indicates volume overload in CKD with edema?
• Which action demonstrates escalation of unsafe orders?
• What is the primary objective of hemodialysis in CKD management?
• What general education is essential when starting dialysis?
• What demonstrates adherence to post-transplant regimen?
• Which assessment data indicates the desired outcome of epoetin alfa therapy?
• What is the best education point regarding immunosuppressive therapy after transplant?
• Which laboratory value is more specific for evaluating renal function: creatinine or BUN?
• Based on the patient plan of care, which nursing intervention should be included to address anxiety?
• Which daily fluid limit is described for anuric CKD patients?
• Why are CKD patients at risk for pericarditis?
• What does a low GFR indicate?
• Which statement best describes the primary cause of CKD-related secondary hyperparathyroidism?
• How should dietary potassium be managed in advanced CKD?
• Which analgesic should be avoided or used with caution in CKD due to risk of renal impairment?
• What is a common early complication of peritoneal dialysis?
• In CKD-MBD, how does CKD affect vitamin D and bone turnover?
• A patient has phosphate 7.2 mg/dL, calcium 8.0 mg/dL, and PTH 250 pg/mL. What CKD-MBD pattern is suggested, and what therapy would you consider?
• What is uremic pruritus and how is it treated?
• Uncontrolled CKD commonly leads to what acid-base disturbance?
• Why is regular monitoring of immunosuppressive drug levels essential in transplant patients?
• Which statement about RAAS blockade in CKD management is correct?
• Which statement best describes phosphate binder use in CKD?
• What is the preferred long-term access for hemodialysis and why?
• Which statement about phosphate control in dialysis patients is true?
• Which sign indicates patency of an arteriovenous fistula used for hemodialysis?
• In CKD-related mineral and bone disorder, which mineral abnormalities stimulate PTH release?
• In CKD, metabolic acidosis is common; what is a standard management approach?
• From the listed nursing problems, which nursing diagnosis is most appropriate to address fluid overload in ESRD?
• Hemodialysis education: which statement indicates a need for further education?
• What infection prevention practices are critical for a patient with a PD catheter?
• How does CKD affect bone health and what is a typical management approach?
• GFR 9 mL/min/1.73m2 corresponds to which CKD stage?
• What precaution should be taken for CKD patients undergoing contrast imaging?
• What is the correct interpretation of these ABGs? pH 7.35, HCO3 18, PCO2 30?
• In peritoneal dialysis, adequacy is assessed by which measure?
• What is a common blood pressure target for adults with CKD and proteinuria?
• Which statement best describes the relationship between immunosuppressant levels and rejection risk?
• Which respiratory symptom would you expect in CKD with fluid overload?
• Which lab may remain elevated after dialysis?
• Which mechanism links CKD with bone health issues?
• What is the most common cause of chronic kidney disease in adults in the United States?
• What is the primary cause of anemia in chronic kidney disease?
• What is a feature of home dialysis compared with in-center dialysis?
• CAPD stands for Continuous Ambulatory Peritoneal Dialysis.
• Which of the following best describes a high-potassium food and two lower-potassium alternatives?
• Which statement about immunosuppressive therapy is true for balancing risk?
• CKD progression typically leads to what outcome?
• Which neuromuscular symptom can occur with hypocalcemia in CKD, and what electrolyte abnormality is typically responsible?
• In CKD, which hormone's reduced production contributes to anemia?
• How does dialysis affect phosphorus control, and what dietary modification accompanies dialysis?
• When monitoring RAAS blockade, which population requires careful potassium monitoring?
• How do you differentiate CKD from AKI in terms of onset and reversibility?
• How does metabolic acidosis influence bone health in CKD?
• What triggers a CKD patient to seek urgent care related to dialysis?
• What best describes maintenance of dialysis access?
• Which labs typically improve after a successful dialysis session?
• Which vitamin D analog is commonly used to treat CKD-related secondary hyperparathyroidism, and what must be monitored?
• Which laboratory finding would most strongly indicate vascular calcification risk in CKD-MBD?
• When are dialysis indications present? List at least four.
• Which statement best describes how dialysis adequacy is assessed for hemodialysis and peritoneal dialysis?
• CKD stage 5 is defined as which of the following?
• After discharge, which statement most accurately describes medication adherence?
• Which instruction is most accurate for fluid management between dialysis treatments?
• What is the prognostic value of albuminuria in CKD?
• In response to a serum potassium of 6.5 mEq/L and a provider's instruction to adjust the potassium chloride, what is the nurse's most important action?
• Postoperative care after a living-donor kidney transplant includes monitoring urinary output; which of the following is true?
• In CKD, what daily fluid intake guideline is often used for patients with edema or oliguria?
• Which intervention should the nurse ensure is included in the client’s plan of care for vascular access?
• Which statement about phosphate binders is true in CKD-MBD management?
• Which electrolyte abnormality is most concerning in CKD and can cause arrhythmias?
• Which lab finding indicates CKD-MBD (mineral and bone disorder) activity?
• Why is dietary phosphorus restricted in CKD?
• A 58-year-old patient has an estimated glomerular filtration rate (eGFR) of 28 mL/min/1.73 m2. According to KDIGO CKD staging, which stage does this correspond to?
• Which electrolyte abnormality requires urgent treatment if potassium is high?
• Why must RAAS blockade be monitored carefully in CKD for electrolyte disturbances, and what lab value is critical to track?
• Which phosphate binder is preferred to avoid calcium loading in CKD patients at risk for vascular calcification?
• Calcium acetate is prescribed as a phosphate binder for CKD. Which statement describes its role?
• Which finding most strongly suggests fluid volume overload in this ESRD patient?
• Why should NSAIDs be avoided in CKD patients?
• Which statement indicates understanding about CKD progression?
• Why is spot urine albumin-to-creatinine ratio useful in CKD screening?
• For a CKD patient with resistant hypertension despite ACE inhibitor therapy, what is a key consideration in selecting additional antihypertensives?
• Name two major dialysis modalities.
• Which is a classic indication to initiate dialysis in CKD?
• CKD stage 5 is defined by which of the following?
• How should a patient approach planning for dialysis modality choice and transplantation?
• Based on the assessment, which data best supports giving pain medication as the first intervention?
• Infection-control measures for immunosuppressed transplant patients, which practice is appropriate?
• Which assessment indicates the desired outcome of losartan therapy?
• If kidney function is functioning adequately after transplant, which statement best describes GFR value?
• What factor most influences a patient’s dialysis modality choice?
• Which documentation best describes a properly functioning arteriovenous graft (AV graft)?
• Which action can be assigned to the unlicensed assistive personnel (UAP)?
• Which nursing action is essential to reduce infection risk in a patient receiving immunosuppressants?
• A patient reports incisional pain during transfer. Which statement best reflects the nurse's best initial response?
• Which parameter is NOT typically monitored for CKD-MBD?
• Which statement about URR is correct in dialysis adequacy assessment?
• Which laboratory value is most appropriate to monitor when assessing kidney function after transplantation?
• Which electrolyte abnormality is most likely to occur in CKD due to reduced renal excretion of potassium?