NCM 118 – RLE EXAM

Which ethnic groups currently have a higher rate of CKD?

a) African Americans and Caucasians
b) Asians and Native Americans
c) Native Americans and African Americans
d) African Americans and Asians
When preparing to administer medications, the nurse should identify the patient by comparing
the following
a) Patient verbalizing their name, DOB and compare it to the chart
b) Patient verbalizing their room number and name- compared to the patient chart
c) Patient verbalizing their name and medical record number compared to their armband
d) Patient verbalizing their name, DOB and compare to armband and chart.
This type of dialysis can be a desirable method for people who are always on the go. Dialysis can
be performed at home and takes less time to accomplish.
a) Hemodialysis
b) Peritoneal Dialysis
c) Acute Renal Failure
d) Chronic Renal Failure
The physician ordered to give Paracetamol 150mg IV every 4 hours as needed for fever. The stock
dose is 300mg/2 (150mg/ml). Your patient’s vital signs is as follows:
BP=100/70, RR=18, HR=100, TEMP=37
a) Give 1ml of paracetamol;
b) Give 2ml of paracetamol
c) Give 0.5ml of paracetamol
d) Don’t give paracetamol
The physician ordered midazolam 1mg IV now. You checked the ampoule and saw midazolam
5mg/5ml (1mg/ml). compute for dosage
a) Give 5ml of midazolam
b) Give 2 ml of midazolam
c) Give 1ml of midazolam
d) Don’t give midazolam
The nurse is performing peritoneal dialysis exchange on the patient with CKF. This is the first
peritoneal dialysis treatment. The nurse inspects the drainage. Which should the nurse report to
the physician immediately?
a) Bloody drainage
b) More than 2 L of drainage
c) Cloudy drainage
d) Glucose in drainage
The patient had undergone spinal anesthesia for appendectomy. To prevent spinal headaches,
the nurse should place the patient in which of the following positions?
a) Semi-fowler’s
b) Flat on bed for 6 to 8 hours
c) Prone position
d) Modified Trendelenburg position
Which of the following assessment data is most important to determine when caring for a patient
who has received spinal anesthesia?
a) The time of the return of motion and sensation in the patient’s legs and toes
b) The character of the patient’s respiration
c) The patient’s level of consciousness
d) The amount of wound drainage
What is the route administration of Vitamin K?
a) IM
b) ID
c) SC
d) IV
In distinguishing acute from chronic renal failure, which of the following is the most reliable
evidence of CKD?
a) History of increased serum creatinine
b) History of increased BUN
c) Above-normal plasma sodium
d) Above-normal serum calcium
The primary function of veins is to carry blood
a) From the body to the heart
b) From the heart to the body
c) From the lungs to the body
d) From stomach to heart
Which of the following is the most dangerous complication during induction of spinal anesthesia?
a) Cardiac arrest
b) Hypotension
c) Hyperthermia
d) Respiratory paralysis
A patient with Stage 5 CKD is experiencing extreme pruritus and has several areas of crystallized
white deposits on the skin. As the nurse, you know this is due to excessive amounts of what
substance found in the blood?
a) Calcium
b) Urea
c) Phosphate
d) Erythropoietin
What is the final step after completion of a venipuncture?
a) Report to the doctor
b) Document your actions and how the procedure was tolerated
c) Clean up your mess
d) Regulate the IV
It is an irreversible condition characterized by kidney damage and impaired function that often
progresses over time.
a) Chronic Kidney Disease
b) Diabetic Nephropathy
c) Chronic Glomeruli Nephritis
d) HPN Nephropathy
Aseptic refers to?
a) A disinfectant
b) An underground receptacle for waste
c) Being free of pathogenic microorganisms
d) None of the above
Hand hygiene only needs to be performed after any manipulation of the catheter site or
apparatus?
a) True
b) False
The following are the roles and responsibilities of nursery nurse except
 Facilitates immediate and uninterrupted skin to skin contact and support the mother to initiate
breastfeeding
 Confirms the identification of the newborn by applying ID bands
 Administers early vitamin k, MMR, Polio, hepa b vaccine and gentamicin
 Conducts initial immediate head to toe physical assessment, including anthropometric measurement
 None of the above
 Other:
The nurse knows that all of the following are a right of medication administration except
a) Right patient
b) Right room
c) Right time
d) Right dose
Your kidneys are what part of which system in your body?
a) Reproductive system
b) Respiratory system
c) Gastrointestinal tract
d) Urinary system
The physician orders tranexamic acid 1gm IV every 8 hours. You checked the ampoule and saw
Tranexamic acid 500mg/5ml (100mg/ml). compute for dosage
a) 5ml
b) 10ml
c) 2ml
d) 2.5ml
It is the artificial replacement for lost kidney function (RENAL REPLACEMENT THERAPY)
a) Hemodialysis
b) Peritoneal Dialysis
c) Acute Renal Failure
d) Chronic Renal Failure
You are teaching the patient starting hemodialysis. Which statement, if made by the patient,
indicates the need for further teaching?
a) "To protect my fistula I shouldn't wear tight fitting clothing on that side"
b) "If I see any redness or swelling on the site, I should call my doctor"
c) "I shouldn't sleep on my side with the graft but it's ok to take a blood pressure on that arm"
d) "I need to wait to take my medications until after my dialysis treatment"
After 2 unsuccessful attempts at insertion of an IV, the best thing for a health care professional
to do would be?
a) Call the doctor to tell him you can’t get the IV
b) Keep trying until you get the IV
c) Consult another professional to initiate therapy
d) Hydrate the patient with oral fluids and try again in a few hours
Which of the following situation will apply the moments of Hand Hygiene. Select all that apply
 Before assessing the patient's dressing in the operative site
 After discarding the contents of urine bag
 Before donning gloves for skin preparation
 Hand hygiene after contacting all patients at the same time
 After insertion of Foley catheter
 Other:
You are seeing a patient on hemodialysis for a monthly lab review. During the review, you notice
that his albumin level is 2.6 g/dL. He says he eats one meal per day and would like advice on what
meats and meat alternatives to prepare. Which proteins are among those you would advise your
patient to eat?
a) Chicken, fish, beef, eggs, soybeans, quinoa
b) Potatoes, rice, breads, and pasta
c) Legumes
d) Sesame seeds, pumpkin seeds, almonds, walnuts
A 48-year-old female patient has been admitted to the emergency department with the following
arterial blood gas results:
pH 7.54
PaCO2 29 torr
HCO3- 24 mEq/L
Which of the following is the best interpretation of these results?
a) Metabolic acidosis
b) Metabolic alkalosis
c) Respiratory acidosis
d) Respiratory alkalosis
It is a patient safety communication tool that is used by a team of operating room professionals
(nurses, surgeons, anesthesiologists, and others) to discuss important details about each
surgical case. It consists of 3 main parts, which are: sign-in (prior to anesthesia), time-out (before
skin incision) and sign-out (after operation).
a) Pre-operative Checklist
b) Surgical Safety Checklist
c) Surgical Counting Form
d) Surgical Consent
What is the best choice of IV cannula size?
a) The largest one you feel you can successfully insert in the patient
b) The smallest one you can find
c) The smallest gauge to accommodate therapy
d) The largest gauge to accommodate therapy
A priority nursing diagnosis for a child being admitted from surgery following a tonsillectomy is:
a) Body image disturbance
b) Impaired verbal communication
c) Risk for aspiration
d) Pain
A client is scheduled for surgery in the morning. Preoperative orders have been written. What is
most important to do before surgery?
a) Remove all jewelry or tape wedding ring
b) Verify that all laboratory work is complete
c) Inform family or next of kin
d) Have all consent forms signed
If the nurse is unable to clearly read the doctors order they should. Ask another nurse who has
been working with that physician for a long time to decipher the hand writing
a) Call the physician and request clarification
b) Contact the pharmacy to discuss the order
c) Notify the charge nurse
Most often used for a temporary access. It is sometimes used for a short period of time in people
who get an AV fistula and need to start dialysis before the fistula is ready.
a) AV Graft
b) AV Fistula
c) IJ Catheter
d) Femoral Catheter
What function of the kidneys is responsible for water homeostasis?
a) Excretory
b) Metabolic
c) Endocrine
d) Digestive
The physician has ordered atropine sulfate 0.4mg IM before surgery. The medication is supplied
in 0.8mg per milliliter. The nurse should administer how many milliliters of medication?
a) 0.25 mL
b) 0.5 mL
c) 1 mL
d) 1.25 mL
Types of access that connection of vein and an artery that utilizes a hollow synthetic tube.
a) AV Graft
b) AV Fistula
c) IJ Catheter
d) Femoral Catheter
What is the most important step when discontinuing IV therapy?
a) Ensure the patient isn’t bruised
b) Inspect the extremity for any signs of edema and apply warm compress if swelling is noted
c) Inspect the condition of the catheter tip and notify the physician immediately if any damage is noted
d) Document the date, time and initials of the professional who removed the IV on the patient’s band-
aid
A 55yo Male patient is diagnosed with CKD. the its recent GFR was 25mL/min. what stage of CKD
is this known as?
a) 1
b) 3
c) 4
d) 5
Which patient below is NOT at risk for developing CKD?
a) a 58yo Female with uncontrolled HTN
b) a 69yo Female with DM
c) a 45yo male with polycystic ovarian disease
d) a 78yo female with an intrarenal injury
The nurse is preparing a client for surgery. What is the most effective method for obtaining an
accurate blood pressure reading from the client?
a) Obtain a cuff that covers the upper one-third of the client’s arm
b) Position the cuff approximately 4 inches above the antecubital arm
c) Use a cuff that is wide enough to cover the upper two-thirds of the client’s arm
d) Identify the Korotkoff sounds, and take a systolic reading at 10mmHg after the first sound
The patient for thyroidectomy will be under General Anesthesia, as a circulating nurse you need
to apply the safety straps before induction of anesthesia
a) True
b) False
It is a fistula connection made by vascular surgeon of an artery or vein, arteries carry blood from
the heart to the body, while veins carry blood from the body back to the heart.
a) AV Graft
b) AV Fistula
c) IJ Catheter
d) Femoral Catheter
A patient with chronic kidney disease (CKD) has a glomerular filtration rate (GFR) of 44 mg/dL
and is experiencing uremia. What stage of CKD is this patient in?
a) 1
b) 2
c) 3
d) 4
Which of the following can cause a person to develop CKD?
a) Chronic condition such as diabetes or hypertension
b) Taking medications as prescribed
c) Seeking medical treatment in a timely manner
d) Maintaining optimal blood sugar and blood pressure control
The nurse is admitting a patient to the operating room. Which of the following nursing actions
should be given the highest priority by the nurse?
a) Assessing the patient’s level of consciousness
b) Checking the patient’s vital signs
c) Checking the patient’s identification and correct operative permit/consent
d) Positioning and performing skin preparation to the patient
Nurse Faith is preparing to teach the patient with CKD about dietary modifications. Which of the
following aspects of the patient is most important for the nurse evaluate before teaching begins?
a) Family History
b) Attention span
c) Uric Acid level
d) Support system
It is not necessary to wear gloves when discontinuing an IV since there is no risk of exposure to
blood or body fluids.
a) True
b) False
If a patient is expected to need multiple IVs or an extended hospitalization, it is best to choose
which of the following sites for the first IV
a) Antecubital fossa
b) Non-dominant hand
c) Dominant hand
d) It doesn’t matter where the first IV is placed
The 84-year-old male has returned from the recovery room following a total hip repair. He
complains of pain and is medicated with morphine sulfate and promethazine. Which medication
should be kept available for the client being treated with opioid analgesics?
a) Naloxone (Narcan)
b) Ketorolac (Toradol)
c) Acetylsalicylic acid (aspirin)
d) Atropine sulfate (Atropine)
The physician orders 1 liter of PNSS to be infused for 12 hours. After 6 hours, you noticed that
500 cc of IVF remained. How many hours left?
a) 4 hours
b) 6 hours
c) 8 hours
d) None of the above
A patient with stage 4 CKD asks what type of diet they should follow. You explain the patient
should follow a
a) low protein, low sodium, low K, low phosphate diet
b) high protein, low Na, low K, high P diet
c) low protein, high Na, high K, high P diet
d) low protein, low Na, low K, high P diet

A doctor orders to start IVF D5 LR 1 liter to run for 16 hours with a drop factor of 15.
Write your answers to the following questions

Vitamin K is administered to the newborn shortly after birth for which of the following reasons?
a) To treat infection
b) To facilitate clotting
c) To replace electrolytes
d) To stop hemorrhage

mL/hr*
a) 62.5ml/hr
b) 67 ml/hr
c) 125ml/hr
d) None of the above

Drops per minute (gtts/min)

20-21gtts/min
a) 15-16gttsin
b) 10-11gtts/min
c) None of the above

mL of solution received by patient after 12 hours shift

a) 800ml
b) 1500ml
c) 750ml
d) None of the above