Chapter 28

Which is a risk factor for acute renal failure? (Select all that apply.) A. Diabetes mellitus B. Atherosclerosis C. Advanced age D. Hypertension E. Young age

A. Diabetes mellitus B. Atherosclerosis C. Advanced age D. Hypertension Diabetes mellitus, atherosclerosis, advanced age, and hypertension are risk factors for acute renal failure resulting from their affect on the circulatory system. Youth alone is not a risk factor for acute renal failure.

Which are restricted when treating a client in renal failure? (Select all that apply.) A. Fluid B. Protein C. Sodium D. Potassium E. Carbohydrates

A. Fluid B. Protein C. Sodium D. Potassium Because of the patient's inability to concentrate and excrete fluids effectively, dietary fluids, protein consumption, dietary sodium, and dietary potassium are restricted. Carbohydrates are not restricted, since they do not affect fluid concentration or excretion.

Which is a characteristic finding in renal failure? A. Increased serum phosphorus B. Increased serum calcium C. Crystals in the urine D. Protein in the urine

A. Increased serum phosphorus Increased serum phosphorus is a characteristic finding in renal failure. Decreased (not increased) serum calcium is a characteristic finding. Crystals in the urine are not characteristic of renal failure. While it may occur, protein in the urine is not characteristic of renal failure.

A patient with chronic renal failure who exhibits the inability to excrete fluid is likely to present with which of the following? (Select all that apply.) A. Rales B. Nausea C. Bounding pulses D. Peripheral edema E. Jugular venous distention

A. Rales C. Bounding pulses D. Peripheral edema E. Jugular venous distention In chronic renal failure, patients are unable to excrete fluid resulting in excess fluid volume that is likely to result in auditory rales in the lungs, bounding pulses, peripheral edema, and jugular vein distention. In chronic renal failure, patients are unable to excrete fluid resulting in excess fluid volume, but that is not the cause of nausea.

Which is the leading cause of chronic renal failure? A. Congestive heart failure B. Diabetes mellitus C. Hypertension D. Infection

B. Diabetes mellitus Diabetes mellitus is the leading cause of chronic renal failure. While causes, CHF and hypertension are not the leading causes of chronic renal failure. Infection is more likely associated with acute renal failure than with chronic renal failure.

Which are types of dialysis? (Select all that apply.) A. Diffusion B. Hemodialysis C. Continuous renal replacement D. Continuous cycling peritoneal dialysis D. Continuous ambulatory peritoneal dialysis

B. Hemodialysis C. Continuous renal replacement D. Continuous cycling peritoneal dialysis D. Continuous ambulatory peritoneal dialysis Hemodialysis uses an artificial kidney to serves as the dialyzing semi-permeable membrane. Continuous renal replacement therapy is limited to in-hospital acute kidney injury patients requiring continuous hemofiltration, and hemodialysis procedures filter and dialyze the blood without interruption. Continuous cycling peritoneal dialysis and continuous ambulatory peritoneal dialysis are types of peritoneal dialysis that substitute the peritoneum as the dialyzing membrane. Diffusion is not a type of dialysis, but rather a process that describes the spread of particles through random motion from regions of higher concentration to regions of lower concentration.

What level of nephron loss constitutes the first stage of renal failure? A. Loss of 20% B. Loss of 50% C. Loss of 75% D. Loss of 90%

B. Loss of 50% Loss of 50% is consistent with the first stage of renal failure. First stage renal failure is not consistent with a 20% or 75% loss of nephrons function. End-stage renal failure occurs when 90% of the nephrons are lost.

Which hormone is responsible for renal failure induced anemia? A. Aldosterone B. Angiotensin I C. Erythropoietin D. Parathyroid hormone

C. Erythropoietin Erythropoietin is responsible for stimulating marrow to make red blood cells. In renal failure, there are insufficient quantities of this substance. Aldosterone is not involved in red blood cell production but rather it regulates the balance of salt and water in the body. Angiotensin I is not involved in red blood cell production, but rather in the regulating of blood volume and systemic vascular resistance. Parathyroid hormone is not involved in red blood cell production but rather the control of blood and bone calcium.

The retention of nitrogenous wastes is referred to as A. anuria. B. oliguria. C. azotemia. D. nonoliguric.

C. azotemia. Azotemia is the term for retention of nitrogenous wastes. Anuria refers to the absence of urine. Oliguria refers to urine output that is less than 1 mL/kg/hour in infants, less than 0.5 mL/kg/hour in children, and less than 400 mL/day in adults. Nonoliguric refers to normal urine production.

Postrenal failure is a result of A. nephron damage. B. dehydration. C. obstruction. D. blood loss.

C. obstruction. Postrenal obstruction is distal obstruction bilateral to the kidney. Nephron damage is characteristic of intrarenal failure. Prerenal failure is usually caused by decreased blood volume either from dehydration or blood loss.