Renal Review-Prep U

Sevelamer hydrochloride (Renagel) has been prescribed for a client with chronic renal failure. The physician has prescribed Renagel 800 mg orally three times per day with meals to treat the client's hyperphosphatemia. The medication is available in 400 mg tablets. How many tablets per day will the nurse administer to the client?

6 tablets

A client who suffered hypovolemic shock during a cardiac incident has developed acute renal failure. Which is the best nursing rationale for this complication? A. Decrease in the blood flow through the kidneys B. Blood clot formed in the kidneys interfered with the flow C. Structural damage occurred in the nephrons of the kidneys D. Obstruction of urine flow from the kidneys

A. Decrease in the blood flow through the kidneys

Which of the following would the nurse expect to find when reviewing the laboratory test results of a client with renal failure? A. Increased serum creatinine level B. Increased serum calcium level C. Decreased serum potassium level D. Increased red blood cell count

A. Increased serum creatinine level

A client, aged 75, is diagnosed with a renal disease and administered nephrotoxic drugs in normal doses. The nurse is aware that it is important to observe the client closely for any changes in renal status. Which of the following measures may help a nurse determine a change in renal status? A. Observing the client's urinary output. B. Observing the client's fluid intake. C. Checking for a thrill or a bruit daily. D. Observing the skin color and nail beds.

A. Observing the client's urinary output.

What is used to decrease potassium level seen in acute renal failure? A. Sodium polystyrene sulfonate B. Calcium supplements C. IV dextrose 50% D. Sorbitol

A. Sodium polystyrene sulfonate

A client diagnosed with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L. The nurse anticipates administering: A. sodium polystyrene sulfonate (Kayexalate) B. Sorbitol C. IV dextrose 50% D. Calcium supplements

A. sodium polystyrene sulfonate (Kayexalate)

The most accurate indicator of fluid loss or gain in an acutely ill client is: A. weight. B. blood pressure. C. pulse rate. D. edema.

A. weight.

A client with a history of chronic renal failure receives hemodialysis treatments three times per week through an arteriovenous (AV) fistula in the left arm. Which intervention should the nurse include in the care plan? A. Keep the AV fistula wrapped in gauze. B. Assess the AV fistula for a bruit and thrill. C. Take the client's blood pressure in the left arm. D. Keep the AV fistula site dry.

B. Assess the AV fistula for a bruit and thrill.

The nurse is educating a client who is required to restrict potassium intake. What foods would the nurse suggest the client eliminate that are rich in potassium? A. Butter B. Citrus fruits C. Salad oils D. Cooked white rice

B. Citrus fruits

Hyperkalemia is a serious side effect of acute renal failure. Identify the electrocardiogram (ECG) tracing that is diagnostic for hyperkalemia. A. Prolonged ST segment B. Multiple spiked P waves C. Shortened QRS complex D. Tall, peaked T waves

D. Tall, peaked T waves

A patient with chronic kidney failure experiences decreased levels of erythropoietin. What serious complication related to those levels should the nurse assess for when caring for this client? A. Acidosis B. Pericarditis C. Anemia D. Hyperkalemia

C. Anemia

The client with chronic renal failure is exhibiting signs of anemia. Which is the best nursing rationale for this symptom? A. Impaired immunologic response B. Azotemia C. Diminished erythropoietin production D. Electrolyte imbalances

C. Diminished erythropoietin production

The nurse recognizes which condition as an integumentary manifestation of chronic renal failure? A. Tremors B. Seizures C. Asterixis D. Gray-bronze skin color

D. Gray-bronze skin color

A client has end-stage renal failure. Which of the following should the nurse include when teaching the client about nutrition to limit the effects of azotemia? A. Increase protein, carbohydrates, and fat intake. B. Eliminate fat intake and increase protein intake. C. Increase fat intake and limit carbohydrates. D. Increase carbohydrates and limit protein intake.

D. Increase carbohydrates and limit protein intake.

A client with decreased renal function is to receive a low-protein diet. The client asks the nurse why he needs this type of diet. The nurse would incorporate which reason into the response? A. Improve blood circulation B. Increase speed of treatment C. Improve digestion D. Lessen workload on the kidneys

D. Lessen workload on the kidneys

A client is admitted with nausea, vomiting, and diarrhea. His blood pressure on admission is 74/30 mm Hg. The client is oliguric and his blood urea nitrogen (BUN) and creatinine levels are elevated. The physician will most likely write an order for which treatment? A. Administer furosemide (Lasix) 20 mg IV B. Encourage oral fluids. C. Start hemodialysis after a temporary access is obtained. D. Start IV fluids with a normal saline solution bolus followed by a maintenance dose.

D. Start IV fluids with a normal saline solution bolus followed by a maintenance dose.

A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF? A. Increased serum levels of potassium, magnesium, and calcium B. Blood urea nitrogen (BUN) 100 mg/dL and serum creatinine 6.5 mg/dL C. Increased pH with decreased hydrogen ions D. Uric acid analysis 3.5 mg/dL and phenolsulfonphthalein (PSP) excretion 75%

B. Blood urea nitrogen (BUN) 100 mg/dL and serum creatinine 6.5 mg/dL

A nurse identifies a nursing diagnosis of risk for ineffective breathing pattern related to incisional pain and restricted positioning for a client who has had a nephrectomy. Which of the following would be most appropriate for the nurse to include in the client's plan of care? A. Keep the drainage catheter below the level of insertion. B. Encourage use of incentive spirometer every 2 hours. C. Administer isotonic fluid therapy as ordered. D. Monitor temperature every 4 hours.

B. Encourage use of incentive spirometer every 2 hours.

The nurse cares for a client with a right-arm arteriovenous fistula (AVF) for hemodialysis treatments. Which nursing action is contraindicated? A. Palpating the fistula for a "thrill" B. Obtaining a blood pressure reading from the right arm C. Placing the client's watch on the left wrist D. Obtaining blood samples from the left arm

B. Obtaining a blood pressure reading from the right arm

When assessing the impact of medications on the etiology of acute renal failure, the nurse recognizes which of the following as the drug that is not nephrotoxic? A. Neomycin B. Penicillin

B. Penicillin

A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client? A. Activity intolerance B. Risk for infection C. Toileting self-care deficit D. Impaired urinary elimination

B. Risk for infection

The nurse is providing supportive care to a client receiving hemodialysis in the management of acute renal failure. Which statement from the nurse best reflects the ability of the kidneys to recover from acute renal failure? A. Acute renal failure tends to turn to end-stage failure. B. The kidneys can improve over a period of months. C. Kidney function will improve with transplant. D. Once on dialysis, the need will be permanent.

B. The kidneys can improve over a period of months.

A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately? A. Serum potassium level of 4.9 mEq/L B. Urine output of 20 ml/hour

B. Urine output of 20 ml/hour

A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client's risk of: A. an increased serum calcium level secondary to kidney failure. B. water and sodium retention secondary to a severe decrease in the glomerular filtration rate. C. metabolic alkalosis secondary to retention of hydrogen ions. D. a decreased serum phosphate level secondary to kidney failure.

B. water and sodium retention secondary to a severe decrease in the glomerular filtration rate.