Management Of Clients With Renal Failure

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Question 1
Free
Multiple Choice

The nurse caring for a client in the diuretic phase of acute renal failure (ARF) should assess for manifestations of

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A

dehydration.

B

hypertension.

C

hypokalemia.

D

metabolic acidosis.

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Question 2
Free
Multiple Choice

A client with ARF is allowed a specific amount of fluid by mouth during 24 hours in order to

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A

compensate for insensible and measured fluid losses during the previous 24 hours.

B

equal the expected urine output for the next 24 hours.

C

prevent hyperkalemia, which could lead to serious cardiac dysrhythmia.

D

prevent the development of complicating hypostatic pneumonia.

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Question 3
Free
Multiple Choice

The nurse explains that a cation exchange resin such as Kayexalate will

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A

decrease diastolic blood pressure.

B

stimulate diuresis by osmosis.

C

increase appetite by decreasing insulin degradation.

D

increase gastrointestinal potassium excretion.

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Question 4
Free
Multiple Choice

A client with oliguric ARF would exhibit

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A

a BUN/creatinine ratio of 30:1.

B

hematuria.

C

proteinuria.

D

a urine specific gravity of 1.001.

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Question 5
Free
Multiple Choice

The nurse explains to a client's family that the most common overall manifestation of ARF is that

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A

expected urine output is altered.

B

the client's breath develops a fruity odor.

C

urine specific gravity is greater than 1.040.

D

urine develops a "root beer" color.

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Question 6
Multiple Choice

A client has been on dialysis for 6 weeks. The family is complaining that instead of feeling grateful at this second chance at life, the client has become irritable with them and seems depressed. The most helpful response by the nurse would be

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A
"Depression is very common at this time; it is hard to adapt to the losses s/he feels."
B
"I am surprised that your loved one doesn't feel happier about being alive."
C
"This must be very hard on you for your loved one to be so unappreciative."
D
"We can arrange a psychiatric consultation if you think it will help."
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Question 7
Multiple Choice

While caring for a client in the oliguric phase of ARF, the nurse's plan of care should include

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A
encouraging fluid intake to prevent dehydration.
B
increasing the client's protein intake to prevent muscle wasting.
C
maintaining reverse isolation to prevent infection.
D
meticulous skin care to prevent skin breakdown.
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Question 8
Multiple Choice

The nurse assesses the client for the electrolyte imbalance that tends to occur in the earlier stages of chronic renal failure, which is

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A
hypercalcemia.
B
hypocalcemia.
C
hypokalemia.
D
hyponatremia.
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Question 9
Multiple Choice

The client with chronic renal failure who would not be a candidate for peritoneal dialysis is a client

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A
who has diabetes mellitus.
B
who is a 10-year-old child.
C
with severe cardiovascular disease.
D
with severe respiratory disease.
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Question 10
Multiple Choice

During peritoneal dialysis the client's dialysate white blood cell count is 150/mm³ and neutrophils are 60%. This would indicate that the client has developed

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A
anemia.
B
bowel perforation.
C
peritonitis.
D
pyelonephritis.
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Question 11
Multiple Choice

The nurse notes in the first few exchanges during peritoneal dialysis of a client that the effluent is tinged pink. The nurse's most appropriate action is to

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A
continue the dialysis.
B
notify the physician.
C
send a specimen for culture.
D
stop the dialysis immediately.
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Question 12
Multiple Choice

The nurse explains to a client with chronic renal failure that the rationale for receiving calcium carbonate is that it

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A
binds with phosphorus to eliminate it from the body.
B
binds with potassium to eliminate it from the body.
C
helps prevent constipation.
D
helps prevent ulcer formation.
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Question 13
Multiple Choice

In caring for a chronic dialysis patient with an arteriovenous fistula, the nurse would

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A
avoid getting the fistula site wet during the client's bath.
B
irrigate the fistula with heparin to prevent clotting.
C
not use the arm with the fistula when taking the client's BP.
D
perform dressing changes to prevent infection.
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Question 14
Multiple Choice

During a client's first dialysis treatment, the client complains of a severe headache and appears somewhat confused. The priority action by the nurse's is to

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A
administer oxygen by nasal cannula.
B
encourage the client to drink fluids.
C
notify the physician immediately.
D
slow the rate of the dialysis.
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Question 15
Multiple Choice

A client has been found to be an acceptable candidate for a kidney transplant. The nurse counsels the client and family that the client now faces the greatest impediment to renal transplantation, which is

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A
high potential for rejection.
B
high risk for infection.
C
insufficient financial resources.
D
lack of sufficient donor organs.
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Question 16
Multiple Choice

Three months after a kidney transplant, a client develops fever, graft tenderness, malaise, and elevated white blood cell count. The nurse conducts further assessments based on understanding that the likely cause of these manifestations is

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A
graft rejection.
B
influenza.
C
pyelonephritis.
D
urinary tract infection.
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Question 17
Multiple Choice

A client with renal failure has an order to infuse dopamine (Intropin) to activate the dopamine receptors in the kidney. The nurse would set the infusion rate for

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A
21 to 25 mg/kg/minute.
B
11 to 20 mg/kg/minute.
C
6 to 10 mg/kg/minute.
D
1 to 5 mg/kg/minute.
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Question 18
Multiple Choice

For the nurse trying to assist a client with renal failure to stay within the prescribed fluid restriction, the least helpful strategy would be to

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A
give medication at mealtime.
B
provide frequent oral hygiene.
C
put allotted water into a spray bottle.
D
use ice chips liberally instead of fluids.
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Question 19
Multiple Choice

The nurse teaching a client about continuous ambulatory peritoneal dialysis (CAPD) would include the information that

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A
a small, lightweight pump must be carried in a pocket or on a belt.
B
CAPD eliminates the need for strict aseptic technique when handling the catheter.
C
the procedure involves instilling 250 to 500 ml of fluid at a time.
D
there are four daily cycles with an 8-hour dwell for one cycle during the night.
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Question 20
Multiple Choice

The nurse performing intermittent peritoneal dialysis notes that the medical record shows the client has not had a bowel movement for 3 days. The nurse would be careful to assess the client for

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A
cloudy dialysate output.
B
fluid leakage.
C
increased thirst.
D
reduced catheter outflow.
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