NCLEX The Client with Acute Renal Failure

4. exchange sodium for potassium ions in the colon.

43. The client's serum potassium level is elevated in acute renal failure, and the nurse administers sodium polystyrene sulfonate. The mechanism of action for this drug is to: 1. increase potassium excretion from the colon. 2. release hydrogen ions for sodium ions. 3. increase calcium absorption in the colon. 4. exchange sodium for potassium ions in the colon.

4. warm the dialysis solution in the warmer.

38. A client is to receive peritoneal dialysis. To prepare for the procedure, the nurse should: 1. assess the dialysis access for a bruit and thrill. 2. insert an indwelling urinary catheter and drain all urine from the bladder. 3. ask the client to turn toward the left side 4. warm the dialysis solution in the warmer.

1. Elevate the head of the bed 30 to 45 degrees. 2. Take vital signs. 3. Establish an IV access site. 4. Call the admitting healthcarr provider (HCP) for prescriptions.

39. A client has been admitted with acute renal failure. What should the nurse do? Select all that apply. 1. Elevate the head of the bed 30 to 45 degrees. 2. Take vital signs. 3. Establish an IV access site. 4. Call the admitting healthcare provider (HCP) for prescriptions. 5. Contact the hemodialysis unit.

4. oliguria

40. Which initial manifestation of acute renal failure is the most common? 1. dysuria 2. anuria 3. hematuria 4. oliguria

1. a decrease in the blood flow through the kidneys.

41. A client developed cardiogenic shock after a severe myocardial infarction and has now developed acute renal failure. The client's family asks the nurse why the client has developed acute renal failure. The nurse should base the response on the knowledge that there was: 1. a decrease in the blood flow through the kidneys. 2. an obstruction of urine flow from the kidneys. 3. a blood clot formed in the kidneys. 4. structural damage to the kidney resulting in acute tubular necrosis.

4. reduced renal blood flow

42. The client who is in acute renal failure has an elevated blood urea nitrogen (BUN). What is the likely cause of this finding? 1. fluid retention 2. hemolysis of red blood cells 3. below-normal metabolic rate 4. reduced renal blood flow

1. cardiac arrest.

44. A client with acute renal failure has an increase in the serum potassium level. The nurse should monitor the client for: 1. cardiac arrest. 2. pulmonary edema. 3. circulatory collapse. 4. hemorrhage.

4. prevent the development of ketosis.

45. A high-carbohydrate, low protein diet is prescribed for the client with acute renal failure. The intended outcome of this diet is to: 1. act as a diuretic. 2. reduce demands on the liver. 3. help maintain urine acidity. 4. prevent the development of ketosis.

1. a gelatin dessert

46. The client with acute renal failure asks the nurse for a snack. Because the client's potassium level is elevated, which snack is most appropriate? 1. a gelatin dessert 2. yogurt 3. an orange 4. peanuts

1. pulmonary edema

47. In the oliguric phase of acute renal failure, the nurse should assess the client for: 1. Pulmonary edema 2. Metabolic alkalosis 3. hypotension. 4. hypokalemia.

1. Use the unaffected arm for blood pressure measurements.

48. The client in acute renal failure has an external cannula inserted in the forearm for hemodialysis. Which nursing measure is appropriate for the care of this client? 1. Use the unaffected arm for blood pressure measurements. 2. Draw blood from the cannula for routine laboratory work. 3. Percuss the cannula for bruits each shift. 4. Inject heparin into the cannula each shift.

2. slow the rate of dialysis.

49. During dialysis, the client has disequilibrium syndrome. The nurse should first: 1. administer oxygen per nasal cannula. 2. slow the rate dialysis. 3. reassure the client that the symptoms are normal. 4. place the client in Trendelenburg's position

3. decreased hemoglobin concentration

50. Which abnormal blood value would not be improved by dialysis treatment? 1. Elevated serum creatinine level 2. hyperkalemia 3. decreased hemoglobin concentration 4. hypernatremia

4. swelling at the shunt site.

51. The nurse teaches the client how to recognize infection in the the shunt by telling the client to assess the shunt each day for: 1. absence of a bruit. 2. sluggish capillary refill time 3. coolness of the involved extremity 4. Swelling at the shunt site.

1. continue to improve over a period of weeks.

52. The client with acute renal failure is recovering and asks the nurse. "Will my kidneys ever function normally again?" The nurse's response is based on knowledge that the client's renal status will most likely: 1. Continue to improve over a period of weeks 2. Result in the need for permanent hemodialysis 3. Improve only if the client recieves a renal transplant 4. Result in end stage renal failure