Renal Failure (Acute & Chronic) By Rnpedia.Com

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Renal Failure (Acute & Chronic) By Rnpedia.Com

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Questions and Answers
  • 1. 
    For a male client in the oliguric phase of acute renal failure (ARF), which nursing intervention is most important?  
    • A. 

      Encouraging coughing and deep breathing

    • B. 

      Promoting carbohydrate intake

    • C. 

      Limiting fluid intake

    • D. 

      Providing pain-relief measures

  • 2. 
    A female client with acute renal failure is undergoing dialysis for the first time. The nurse in charge monitors the client closely for dialysis equilibrium syndrome, a complication that is most common during the first few dialysis sessions. Typically, dialysis equilibrium syndrome causes:  
    • A. 

      Confusion, headache, and seizures.

    • B. 

      Acute bone pain and confusion.

    • C. 

      Weakness, tingling, and cardiac arrhythmias.

    • D. 

      Hypotension, tachycardia, and tachypnea.

  • 3. 
    A female client is admitted with a diagnosis of acute renal failure. She is awake, alert, oriented, and complaining of severe back pain, nausea and vomiting and abdominal cramps. Her vital signs are blood pressure 100/70 mm Hg, pulse 110, respirations 30, and oral temperature 100.4°F (38°C). Her electrolytes are sodium 120 mEq/L, potassium 5.2 mEq/L; her urinary output for the first 8 hours is 50 ml. The client is displaying signs of which electrolyte imbalance?   
    • A. 

      Hyponatremia

    • B. 

      Hyperkalemia

    • C. 

      Hyperphosphatemia

    • D. 

      Hypercalcemia

  • 4. 
    A client suffering from acute renal failure has an unexpected increase in urinary output to 150ml/hr. The nurse assesses that the client has entered the second phase of acute renal failure. Nursing actions throughout this phase include observation for signs and symptoms of   
    • A. 

      Hypervolemia, hypokalemia, and hypernatremia.

    • B. 

      Hypervolemia, hyperkalemia, and hypernatremia.

    • C. 

      Hypovolemia, wide fluctuations in serum sodium and potassium levels.

    • D. 

      Hypovolemia, no fluctuation in serum sodium and potassium levels.

  • 5. 
    Nurse Tristan is caring for a male client in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat:    
    • A. 

      Hypernatremia.

    • B. 

      Hypokalemia.

    • C. 

      Hyperkalemia.

    • D. 

      Hypercalcemia.

  • 6. 
    The charge nurse assigned in the care for a client with acute renal failure and hypernatremia to you, a newly graduated RN. Which actions can you delegate to the nursing assistant?    
    • A. 

      Provide oral care every 3-4 hours

    • B. 

      Monitor for indications of dehydration

    • C. 

      Administer 0.45% saline by IV line

    • D. 

      Assess daily weights for trends

  • 7. 
     The nurse is reviewing laboratory results on a client with acute renal failure. Which one of the following should be reported immediately?  
    • A. 

      Blood urea nitrogen 50 mg/dl

    • B. 

      Hemoglobin of 10.3 mg/dl

    • C. 

      Venous blood pH 7.30

    • D. 

      Serum potassium 6 mEq/L

  • 8. 
    The nurse is reviewing laboratory results on a client with acute renal failure. Which one of the following should be reported IMMEDIATELY?  
    • A. 

      Blood urea nitrogen 50 mg/dl

    • B. 

      Hemoglobin of 10.3 mg/dl

    • C. 

      Venous blood pH 7.30

    • D. 

      Serum potassium 6 mEq/L

  • 9. 
    Marina with acute renal failure moves into the diuretic phase after one week of therapy. During this phase the client must be assessed for signs of developing:  
    • A. 

      Hypovolemia

    • B. 

      Renal failure

    • C. 

      Metabolic acidosis

    • D. 

      Hyperkalemia

  • 10. 
    A history of infection specifically caused by group A beta-hemolytic streptococci is associated with which of the following disorders?
    • A. 

      Acute glomerulonephritis

    • B. 

      Acute renal failure

    • C. 

      Chronic renal failure

    • D. 

      Nephrotic syndrome

  • 11. 
    A client with acute renal failure is aware that the most serious complication of this condition is:
    • A. 

      Constipation

    • B. 

      Anemia

    • C. 

      Infection

    • D. 

      Platelet dysfunction

  • 12. 
    After 1 week a client with acute renal failure moves, into the diuretic phase. During this phase the client must be carefully assessed for signs of:
    • A. 

      Hypovolemia

    • B. 

      Hyperkalemia

    • C. 

      Metabolic acidosis

    • D. 

      Chronic renal failure

  • 13. 
    Nurse Liza is assigned to care for a client who has returned to the nursing unit after left nephrectomy. Nurse Liza’s highest priority would be…
    • A. 

      Hourly urine output

    • B. 

      Temperature

    • C. 

      Able to turn side to side

    • D. 

      Able to sips clear liquid

  • 14. 
    Which of these drugs is nephrotoxic?
    • A. 

      Diuretics

    • B. 

      ACE inhibitors

    • C. 

      NSAIDs

    • D. 

      Sodium bicarbonate/ Potassium bicarbonate

  • 15. 
    The client with renal failure should be on which type of diet?
    • A. 

      High protein, high carbohydrate, low calorie

    • B. 

      Adequate calorie intake, high carbohydrate, limited protein

    • C. 

      Limited protein, low carbohydrate, adequate calorie intake

    • D. 

      Low calorie, limited protein, low carbohydrate

  • 16. 
    ____________ is a treatment for renal failure in which blood id continuously circulated (artery to vein or vein to vein) and filtered, allowing excess water and solutes to empty into a collecting device. Fluid may be replaced with a balanced electrolyte solution as needed during treatment.
    • A. 

      Hemodialysis

    • B. 

      Continuous ambulatory peritoneal dialysis

    • C. 

      Continuous cyclic peritoneal dialysis

    • D. 

      Continuous Renal Replacement Therapy

  • 17. 
    A client on peritoneal dialysis notices that the collecting bag of dialysate is cloudy, what is this an indication of?
    • A. 

      The client needs to change their dialysate

    • B. 

      The patient needs a kidney transplant

    • C. 

      Medication was added to the dialysate

    • D. 

      The patient is infected and experiencing peritonitis

  • 18. 
    _________ is the most frequent complication during hemodialysis.
    • A. 

      Hypertension

    • B. 

      Bleeding

    • C. 

      Infection

    • D. 

      Dialysis dementia

  • 19. 
    Clients on continuous ambulatory peritoneal dialysis (CAPD) must empty their peritoneal cavity and replace the dialysate every __________ hours.
    • A. 

      24

    • B. 

      6-8

    • C. 

      4-6

    • D. 

      48

  • 20. 
    Agents that damage the kidney tissue are called:
    • A. 

      Nephrons

    • B. 

      Nephrotoxins

    • C. 

      Antibodies

    • D. 

      Enterotoxins

  • 21. 
    Acute renal failure is generally identified by oliguria (urine output <_____ mL/day).
  • 22. 
    The risk for __________________ is particularly high when ischemia and exposure to a nephrotoxin occur at the same time.
  • 23. 
    _________ renal Failure is a rapid decline in renal function with an abrupt onset
  • 24. 
    The cause of ___________ failure is impaired blood supply to the kidney (Fluid Volume Deficit, hemorrhage, heart failure, shock)
    • A. 

      Prerenal

    • B. 

      Intrarenal

    • C. 

      Postrenal

    • D. 

      Perirenal

  • 25. 
    Whici is a normal value of Blood Urea Nitrogen (BUN)?
    • A. 

      0.5-1.1 mg/dL

    • B. 

      5-20 mg/dL

    • C. 

      40-70 mg/dL

    • D. 

      250-500 mg/dL

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