Question 1

A client in the emergency department is being admitted for fluid volume deficit.When preparing to assess this client,on which body system should the nurse focus to determine the cause of the imbalance?

Accepted Answer

A) The most common cause of fluid volume deficit is excessive loss of gastrointestinal fluids, which can result from vomiting, diarrhea, suctioning, intestinal fistulas, or intestinal drainage. Other causes of fluid losses include chronic abuse of laxatives and/or enemas. The client may demonstrate cardiovascular system changes because of the fluid volume deficit; however, this body system does not cause the deficit. The client may demonstrate genitourinary system changes because of the fluid volume deficit; however, this body system does not cause the deficit. The client may demonstrate musculoskeletal system changes because of the fluid volume deficit; however, this body system does not cause the deficit.
B) The most common cause of fluid volume deficit is excessive loss of gastrointestinal fluids, which can result from vomiting, diarrhea, suctioning, intestinal fistulas, or intestinal drainage. Other causes of fluid losses include chronic abuse of laxatives and/or enemas. The client may demonstrate cardiovascular system changes because of the fluid volume deficit; however, this body system does not cause the deficit. The client may demonstrate genitourinary system changes because of the fluid volume deficit; however, this body system does not cause the deficit. The client may demonstrate musculoskeletal system changes because of the fluid volume deficit; however, this body system does not cause the deficit.
C) The most common cause of fluid volume deficit is excessive loss of gastrointestinal fluids, which can result from vomiting, diarrhea, suctioning, intestinal fistulas, or intestinal drainage. Other causes of fluid losses include chronic abuse of laxatives and/or enemas. The client may demonstrate cardiovascular system changes because of the fluid volume deficit; however, this body system does not cause the deficit. The client may demonstrate genitourinary system changes because of the fluid volume deficit; however, this body system does not cause the deficit. The client may demonstrate musculoskeletal system changes because of the fluid volume deficit; however, this body system does not cause the deficit.
D) The most common cause of fluid volume deficit is excessive loss of gastrointestinal fluids, which can result from vomiting, diarrhea, suctioning, intestinal fistulas, or intestinal drainage. Other causes of fluid losses include chronic abuse of laxatives and/or enemas. The client may demonstrate cardiovascular system changes because of the fluid volume deficit; however, this body system does not cause the deficit. The client may demonstrate genitourinary system changes because of the fluid volume deficit; however, this body system does not cause the deficit. The client may demonstrate musculoskeletal system changes because of the fluid volume deficit; however, this body system does not cause the deficit.

Question 2

The nurse is instructing a client with heart failure about a prescribed sodium-restricted diet.Which client statement indicates that additional teaching is required?

Accepted Answer

A) Low-sodium salt substitutes are not really sodium-free. They may contain half as much sodium as regular salt. The client should be instructed to use salt substitutes sparingly because larger amounts often taste bitter instead of salty. Clients should be instructed to read food labels for the amount of sodium in the food item. Baking soda and baking powder contain sodium and should be restricted on a sodium-restricted diet. In place of salt or salt substitutes, the client should be instructed to use herbs, spices, lemon juice, vinegar, and wine as flavoring when cooking.
B) Low-sodium salt substitutes are not really sodium-free. They may contain half as much sodium as regular salt. The client should be instructed to use salt substitutes sparingly because larger amounts often taste bitter instead of salty. Clients should be instructed to read food labels for the amount of sodium in the food item. Baking soda and baking powder contain sodium and should be restricted on a sodium-restricted diet. In place of salt or salt substitutes, the client should be instructed to use herbs, spices, lemon juice, vinegar, and wine as flavoring when cooking.
C) Low-sodium salt substitutes are not really sodium-free. They may contain half as much sodium as regular salt. The client should be instructed to use salt substitutes sparingly because larger amounts often taste bitter instead of salty. Clients should be instructed to read food labels for the amount of sodium in the food item. Baking soda and baking powder contain sodium and should be restricted on a sodium-restricted diet. In place of salt or salt substitutes, the client should be instructed to use herbs, spices, lemon juice, vinegar, and wine as flavoring when cooking.
D) Low-sodium salt substitutes are not really sodium-free. They may contain half as much sodium as regular salt. The client should be instructed to use salt substitutes sparingly because larger amounts often taste bitter instead of salty. Clients should be instructed to read food labels for the amount of sodium in the food item. Baking soda and baking powder contain sodium and should be restricted on a sodium-restricted diet. In place of salt or salt substitutes, the client should be instructed to use herbs, spices, lemon juice, vinegar, and wine as flavoring when cooking.

Question 3

A child weighing 33 lbs.who is diagnosed with dehydration is prescribed to receive 50 mL/kg of oral fluids for the next 4 hours.How many total mL of fluid should the nurse provide to the client? Calculate to the nearest whole number.

Accepted Answer

The answer of A child weighing 33 lbs.who is diagnosed...

Question 4

A client with renal failure is receiving peritoneal dialysis.The nurse is explaining the process to the client.Which statement would the nurse include in a discussion with the client and family?

Accepted Answer

A) The peritoneum acts as a semipermeable membrane, allowing substances to move from an area of high concentration (the blood) to an area of lower concentration (the dialysate). Metabolic waste products and excess water can be eliminated through osmosis and diffusion utilizing the peritoneum as the semipermeable membrane.
B) The peritoneum acts as a semipermeable membrane, allowing substances to move from an area of high concentration (the blood) to an area of lower concentration (the dialysate). Metabolic waste products and excess water can be eliminated through osmosis and diffusion utilizing the peritoneum as the semipermeable membrane.
C) The peritoneum acts as a semipermeable membrane, allowing substances to move from an area of high concentration (the blood) to an area of lower concentration (the dialysate). Metabolic waste products and excess water can be eliminated through osmosis and diffusion utilizing the peritoneum as the semipermeable membrane.
D) The peritoneum acts as a semipermeable membrane, allowing substances to move from an area of high concentration (the blood) to an area of lower concentration (the dialysate). Metabolic waste products and excess water can be eliminated through osmosis and diffusion utilizing the peritoneum as the semipermeable membrane.

Question 5

The nurse is caring for a client who is receiving intravenous fluids postoperatively following cardiac surgery.The nurse is aware that this client is at risk for fluid volume excess.The family asks why the client is at risk for this condition.Which response by the nurse is the most appropriate?

Accepted Answer

A) Antidiuretic hormone (ADH) and aldosterone levels are commonly increased following the stress response before, during, and immediately after surgery. This increase leads to sodium and water retention. Adding more fluids intravenously can cause a fluid volume excess and stress upon the heart and circulatory system. A fluid volume deficit would not occur with the administration of intravenous fluids. Liver failure is not caused by the surgery. Fluid volume excess is not caused by inactivity.
B) Antidiuretic hormone (ADH) and aldosterone levels are commonly increased following the stress response before, during, and immediately after surgery. This increase leads to sodium and water retention. Adding more fluids intravenously can cause a fluid volume excess and stress upon the heart and circulatory system. A fluid volume deficit would not occur with the administration of intravenous fluids. Liver failure is not caused by the surgery. Fluid volume excess is not caused by inactivity.
C) Antidiuretic hormone (ADH) and aldosterone levels are commonly increased following the stress response before, during, and immediately after surgery. This increase leads to sodium and water retention. Adding more fluids intravenously can cause a fluid volume excess and stress upon the heart and circulatory system. A fluid volume deficit would not occur with the administration of intravenous fluids. Liver failure is not caused by the surgery. Fluid volume excess is not caused by inactivity.
D) Antidiuretic hormone (ADH) and aldosterone levels are commonly increased following the stress response before, during, and immediately after surgery. This increase leads to sodium and water retention. Adding more fluids intravenously can cause a fluid volume excess and stress upon the heart and circulatory system. A fluid volume deficit would not occur with the administration of intravenous fluids. Liver failure is not caused by the surgery. Fluid volume excess is not caused by inactivity.

Question 6

The nurse is administering peritoneal dialysis to a client with acute renal failure.The nurse notes the presence of a cloudy dialysate return.After notifying the health care provider,which action by the nurse is the most appropriate?

Accepted Answer

A) The return should be clear. The presence of cloudy drainage might indicate peritonitis, and the nurse should culture the return in order to help identify the presence and type of organism that could be causing the infection. Documenting the cloudy dialysate and nursing actions taken would be necessary, but is not the next-priority action. Measurement of abdominal girth is performed prior to the dialysis procedure, and although increased girth could indicate peritonitis, culturing the return is more important. The instillation part of the procedure is completed prior to the collection of the dialysate return, and the rate of the instillation has no relationship to the development of an infection.
B) The return should be clear. The presence of cloudy drainage might indicate peritonitis, and the nurse should culture the return in order to help identify the presence and type of organism that could be causing the infection. Documenting the cloudy dialysate and nursing actions taken would be necessary, but is not the next-priority action. Measurement of abdominal girth is performed prior to the dialysis procedure, and although increased girth could indicate peritonitis, culturing the return is more important. The instillation part of the procedure is completed prior to the collection of the dialysate return, and the rate of the instillation has no relationship to the development of an infection.
C) The return should be clear. The presence of cloudy drainage might indicate peritonitis, and the nurse should culture the return in order to help identify the presence and type of organism that could be causing the infection. Documenting the cloudy dialysate and nursing actions taken would be necessary, but is not the next-priority action. Measurement of abdominal girth is performed prior to the dialysis procedure, and although increased girth could indicate peritonitis, culturing the return is more important. The instillation part of the procedure is completed prior to the collection of the dialysate return, and the rate of the instillation has no relationship to the development of an infection.
D) The return should be clear. The presence of cloudy drainage might indicate peritonitis, and the nurse should culture the return in order to help identify the presence and type of organism that could be causing the infection. Documenting the cloudy dialysate and nursing actions taken would be necessary, but is not the next-priority action. Measurement of abdominal girth is performed prior to the dialysis procedure, and although increased girth could indicate peritonitis, culturing the return is more important. The instillation part of the procedure is completed prior to the collection of the dialysate return, and the rate of the instillation has no relationship to the development of an infection.

Question 7

The nurse is caring for a client with congestive heart failure who is admitted to the medical-surgical unit with acute hypokalemia.Which medication on the client's medication administration record may have contributed to the client's current hypokalemic state?

Accepted Answer

A) Excess potassium loss through the kidneys is often caused by such medications as corticosteroids, potassium-wasting (loop) diuretics, amphotericin B, and large doses of some antibiotics. Cortisol is a type of corticosteroid and can cause hypokalemia. Thiazide diuretics, narcotics, and muscle relaxers would not bring about potassium loss to cause hypokalemia.
B) Excess potassium loss through the kidneys is often caused by such medications as corticosteroids, potassium-wasting (loop) diuretics, amphotericin B, and large doses of some antibiotics. Cortisol is a type of corticosteroid and can cause hypokalemia. Thiazide diuretics, narcotics, and muscle relaxers would not bring about potassium loss to cause hypokalemia.
C) Excess potassium loss through the kidneys is often caused by such medications as corticosteroids, potassium-wasting (loop) diuretics, amphotericin B, and large doses of some antibiotics. Cortisol is a type of corticosteroid and can cause hypokalemia. Thiazide diuretics, narcotics, and muscle relaxers would not bring about potassium loss to cause hypokalemia.
D) Excess potassium loss through the kidneys is often caused by such medications as corticosteroids, potassium-wasting (loop) diuretics, amphotericin B, and large doses of some antibiotics. Cortisol is a type of corticosteroid and can cause hypokalemia. Thiazide diuretics, narcotics, and muscle relaxers would not bring about potassium loss to cause hypokalemia.

Question 8

A client with frequent urinary tract infections in seen in the urology clinic and is at risk for acute renal failure.The nurse reviews the client's medical history.Which item support the client's being at risk for acute renal failure? Select all that apply.

Accepted Answer

A) Dehydration, renal calculi, and hypertension can all precipitate acute renal failure (ARF). Ineffective wound healing has not been shown to cause renal failure unless the infection becomes systemic. A low serum albumin does not cause ARF.
B) Dehydration, renal calculi, and hypertension can all precipitate acute renal failure (ARF). Ineffective wound healing has not been shown to cause renal failure unless the infection becomes systemic. A low serum albumin does not cause ARF.
C) Dehydration, renal calculi, and hypertension can all precipitate acute renal failure (ARF). Ineffective wound healing has not been shown to cause renal failure unless the infection becomes systemic. A low serum albumin does not cause ARF.
D) Dehydration, renal calculi, and hypertension can all precipitate acute renal failure (ARF). Ineffective wound healing has not been shown to cause renal failure unless the infection becomes systemic. A low serum albumin does not cause ARF.
E) Dehydration, renal calculi, and hypertension can all precipitate acute renal failure (ARF). Ineffective wound healing has not been shown to cause renal failure unless the infection becomes systemic. A low serum albumin does not cause ARF.

Question 9

The nurse is caring for a client following hemodialysis.The nursing assessment reveals the client is tachycardic; has pale,cool skin; and has a decreased urine output.Based on this data,the nurse determines that the client has not met which expected outcome associated with hemodialysis?

Accepted Answer

A) The client on hemodialysis is expected to have a reduction of extracellular fluid, not a fluid deficit that puts the client at risk. Diuretics and IV fluids are not administered during hemodialysis. Cardiac decompensation would not be an expected outcome of treatment.
B) The client on hemodialysis is expected to have a reduction of extracellular fluid, not a fluid deficit that puts the client at risk. Diuretics and IV fluids are not administered during hemodialysis. Cardiac decompensation would not be an expected outcome of treatment.
C) The client on hemodialysis is expected to have a reduction of extracellular fluid, not a fluid deficit that puts the client at risk. Diuretics and IV fluids are not administered during hemodialysis. Cardiac decompensation would not be an expected outcome of treatment.
D) The client on hemodialysis is expected to have a reduction of extracellular fluid, not a fluid deficit that puts the client at risk. Diuretics and IV fluids are not administered during hemodialysis. Cardiac decompensation would not be an expected outcome of treatment.

Question 10

A young school-age client is in the hospital with acute renal failure following a streptococcus infection.The parents are Spanish-speaking and speak little English.The parents,through an interpreter,ask the nurse what mistake they made that caused the child to be so sick.Which response by the nurse is the most appropriate?

Accepted Answer

A) Clients with streptococcus are at risk for kidney and cardiac sequelae. In this case, the child has no evidence of a congenital defect leading to acute renal failure (ARF). A low-protein or low-calcium diet will not lead to ARF.
B) Clients with streptococcus are at risk for kidney and cardiac sequelae. In this case, the child has no evidence of a congenital defect leading to acute renal failure (ARF). A low-protein or low-calcium diet will not lead to ARF.
C) Clients with streptococcus are at risk for kidney and cardiac sequelae. In this case, the child has no evidence of a congenital defect leading to acute renal failure (ARF). A low-protein or low-calcium diet will not lead to ARF.
D) Clients with streptococcus are at risk for kidney and cardiac sequelae. In this case, the child has no evidence of a congenital defect leading to acute renal failure (ARF). A low-protein or low-calcium diet will not lead to ARF.

Question 11

The nurse is caring for a client with a potassium level of 5.9 mEq/L.The health care provider prescribes both glucose and insulin for the client.The client's spouse asks,"Why is insulin needed?" Which response by the nurse is the most appropriate?

Accepted Answer

A) Serum potassium levels may be temporarily lowered by administering glucose and insulin, which cause potassium to leave the extracellular fluid and enter cells. Giving insulin to decrease serum potassium levels is not considered a safer method than other medications that can be used. Insulin does not promote renal excretion of potassium. Serum potassium is lowered by entering the cells; this is not controlled by serum glucose.
B) Serum potassium levels may be temporarily lowered by administering glucose and insulin, which cause potassium to leave the extracellular fluid and enter cells. Giving insulin to decrease serum potassium levels is not considered a safer method than other medications that can be used. Insulin does not promote renal excretion of potassium. Serum potassium is lowered by entering the cells; this is not controlled by serum glucose.
C) Serum potassium levels may be temporarily lowered by administering glucose and insulin, which cause potassium to leave the extracellular fluid and enter cells. Giving insulin to decrease serum potassium levels is not considered a safer method than other medications that can be used. Insulin does not promote renal excretion of potassium. Serum potassium is lowered by entering the cells; this is not controlled by serum glucose.
D) Serum potassium levels may be temporarily lowered by administering glucose and insulin, which cause potassium to leave the extracellular fluid and enter cells. Giving insulin to decrease serum potassium levels is not considered a safer method than other medications that can be used. Insulin does not promote renal excretion of potassium. Serum potassium is lowered by entering the cells; this is not controlled by serum glucose.

Question 12

A client with heart failure is prescribed an oral fluid restriction of 1,200 mL per day.How many ounces of fluid should the nurse teach the client is permitted during the daylight shift?

Accepted Answer

A) When calculating a fluid restriction, 50% of the total amount is allocated to the day shift. The remaining 50% can be either divided equally between the evening and night shift or 33% of the remaining volume can be provided on the evening shift with the balance used during the night shift. For a fluid restriction of 1,200 mL, the client is permitted 600 mL of fluid on the day shift. The balance of 600 mL would be split over the evening and night shifts. Depending upon the allocation, the client would either receive 300 mL for both the evening and night shifts or 400 mL of fluid for the evening shift and 200 mL for the night shift.
B) When calculating a fluid restriction, 50% of the total amount is allocated to the day shift. The remaining 50% can be either divided equally between the evening and night shift or 33% of the remaining volume can be provided on the evening shift with the balance used during the night shift. For a fluid restriction of 1,200 mL, the client is permitted 600 mL of fluid on the day shift. The balance of 600 mL would be split over the evening and night shifts. Depending upon the allocation, the client would either receive 300 mL for both the evening and night shifts or 400 mL of fluid for the evening shift and 200 mL for the night shift.
C) When calculating a fluid restriction, 50% of the total amount is allocated to the day shift. The remaining 50% can be either divided equally between the evening and night shift or 33% of the remaining volume can be provided on the evening shift with the balance used during the night shift. For a fluid restriction of 1,200 mL, the client is permitted 600 mL of fluid on the day shift. The balance of 600 mL would be split over the evening and night shifts. Depending upon the allocation, the client would either receive 300 mL for both the evening and night shifts or 400 mL of fluid for the evening shift and 200 mL for the night shift.
D) When calculating a fluid restriction, 50% of the total amount is allocated to the day shift. The remaining 50% can be either divided equally between the evening and night shift or 33% of the remaining volume can be provided on the evening shift with the balance used during the night shift. For a fluid restriction of 1,200 mL, the client is permitted 600 mL of fluid on the day shift. The balance of 600 mL would be split over the evening and night shifts. Depending upon the allocation, the client would either receive 300 mL for both the evening and night shifts or 400 mL of fluid for the evening shift and 200 mL for the night shift.

Question 13

The nurse is planning care for a client admitted to the unit with dehydration.The client's lab values indicate a low level of serum sodium.Based on the assessment finding,the nurse determines an appropriate nursing diagnosis to be electrolyte imbalance.Which medical condition supports this nursing diagnosis?

Accepted Answer

A) Hypotonic dehydration occurs when fluid loss is characterized by a proportionately greater loss of sodium than water, causing serum sodium to fall below normal levels. Isotonic dehydration occurs when fluid loss is not balanced by intake, and the losses of water and sodium are in proportion. Hydrostatic pressure occurs when extracellular fluid volume excess occurs; the increased fluid volume in the vascular compartment congests the veins. Osmotic pressure pulls fluid into the capillaries, usually in response to the presence of albumin and other plasma proteins made by the liver.
B) Hypotonic dehydration occurs when fluid loss is characterized by a proportionately greater loss of sodium than water, causing serum sodium to fall below normal levels. Isotonic dehydration occurs when fluid loss is not balanced by intake, and the losses of water and sodium are in proportion. Hydrostatic pressure occurs when extracellular fluid volume excess occurs; the increased fluid volume in the vascular compartment congests the veins. Osmotic pressure pulls fluid into the capillaries, usually in response to the presence of albumin and other plasma proteins made by the liver.
C) Hypotonic dehydration occurs when fluid loss is characterized by a proportionately greater loss of sodium than water, causing serum sodium to fall below normal levels. Isotonic dehydration occurs when fluid loss is not balanced by intake, and the losses of water and sodium are in proportion. Hydrostatic pressure occurs when extracellular fluid volume excess occurs; the increased fluid volume in the vascular compartment congests the veins. Osmotic pressure pulls fluid into the capillaries, usually in response to the presence of albumin and other plasma proteins made by the liver.
D) Hypotonic dehydration occurs when fluid loss is characterized by a proportionately greater loss of sodium than water, causing serum sodium to fall below normal levels. Isotonic dehydration occurs when fluid loss is not balanced by intake, and the losses of water and sodium are in proportion. Hydrostatic pressure occurs when extracellular fluid volume excess occurs; the increased fluid volume in the vascular compartment congests the veins. Osmotic pressure pulls fluid into the capillaries, usually in response to the presence of albumin and other plasma proteins made by the liver.

Question 14

The nurse identifies the diagnosis Risk for Impaired Skin Integrity as applicable for a client with heart failure.Which assessment finding supports the use of this diagnosis for the client?

Accepted Answer

A) Edema of the feet increases the client's risk for impaired skin integrity. Activity Intolerance would be a diagnosis applicable for shortness of breath with ambulation. Risk for Impaired Gas Exchange would be a diagnosis applicable for a productive cough. Risk for Impaired Perfusion would be a diagnosis applicable for a heart rate of 104 and regular.
B) Edema of the feet increases the client's risk for impaired skin integrity. Activity Intolerance would be a diagnosis applicable for shortness of breath with ambulation. Risk for Impaired Gas Exchange would be a diagnosis applicable for a productive cough. Risk for Impaired Perfusion would be a diagnosis applicable for a heart rate of 104 and regular.
C) Edema of the feet increases the client's risk for impaired skin integrity. Activity Intolerance would be a diagnosis applicable for shortness of breath with ambulation. Risk for Impaired Gas Exchange would be a diagnosis applicable for a productive cough. Risk for Impaired Perfusion would be a diagnosis applicable for a heart rate of 104 and regular.
D) Edema of the feet increases the client's risk for impaired skin integrity. Activity Intolerance would be a diagnosis applicable for shortness of breath with ambulation. Risk for Impaired Gas Exchange would be a diagnosis applicable for a productive cough. Risk for Impaired Perfusion would be a diagnosis applicable for a heart rate of 104 and regular.

Question 15

The school nurse is preparing a class session for high school students on ways to maintain fluid balance during the summer months.Which interventions should the nurse recommend to decrease the risk of fluid imbalance? Select all that apply.

Accepted Answer

A) Actions to prevent fluid volume deficit during the summer months include increasing fluid intake, drinking flat cola or ginger ale if vomiting, and reducing the intake of coffee and tea. Diet soda often contains caffeine. Exercising between the hours of 10 am and 2 pm, considered the hottest time of the day, should be avoided.
B) Actions to prevent fluid volume deficit during the summer months include increasing fluid intake, drinking flat cola or ginger ale if vomiting, and reducing the intake of coffee and tea. Diet soda can contain caffeine. Exercising between the hours of 10 am and 2 pm, considered the hottest time of the day, should be avoided.
C) Actions to prevent fluid volume deficit during the summer months include increasing fluid intake, drinking flat cola or ginger ale if vomiting, and reducing the intake of coffee and tea. Diet soda can contain caffeine. Exercising between the hours of 10 am and 2 pm, considered the hottest time of the day, should be avoided.
D) Actions to prevent fluid volume deficit during the summer months include increasing fluid intake, drinking flat cola or ginger ale if vomiting, and reducing the intake of coffee and tea. Diet soda can contain caffeine. Exercising between the hours of 10 am and 2 pm, considered the hottest time of the day, should be avoided.
E) Actions to prevent fluid volume deficit during the summer months include increasing fluid intake, drinking flat cola or ginger ale if vomiting, and reducing the intake of coffee and tea. Diet soda can contain caffeine. Exercising between the hours of 10 am and 2 pm, considered the hottest time of the day, should be avoided.

Question 16

The nurse is caring for a client who is diagnosed with acute renal failure.When reviewing the client's laboratory data,which findings indicate that a client has met the expected outcomes? Select all that apply.

Accepted Answer

A) Creatinine is the metabolic end product of creatine phosphate and is excreted via the kidneys in relatively constant amounts. BUN, a measurement of the nitrogen portion of urea, is also excreted in urine and is a good indicator of renal function. Neutrophils, lymphocytes, and erythrocytes are not used to monitor the return of renal function.
B) Creatinine is the metabolic end product of creatine phosphate and is excreted via the kidneys in relatively constant amounts. BUN, a measurement of the nitrogen portion of urea, is also excreted in urine and is a good indicator of renal function. Neutrophils, lymphocytes, and erythrocytes are not used to monitor the return of renal function.
C) Creatinine is the metabolic end product of creatine phosphate and is excreted via the kidneys in relatively constant amounts. BUN, a measurement of the nitrogen portion of urea, is also excreted in urine and is a good indicator of renal function. Neutrophils, lymphocytes, and erythrocytes are not used to monitor the return of renal function.
D) Creatinine is the metabolic end product of creatine phosphate and is excreted via the kidneys in relatively constant amounts. BUN, a measurement of the nitrogen portion of urea, is also excreted in urine and is a good indicator of renal function. Neutrophils, lymphocytes, and erythrocytes are not used to monitor the return of renal function.
E) Creatinine is the metabolic end product of creatine phosphate and is excreted via the kidneys in relatively constant amounts. BUN, a measurement of the nitrogen portion of urea, is also excreted in urine and is a good indicator of renal function. Neutrophils, lymphocytes, and erythrocytes are not used to monitor the return of renal function.

Question 17

The nurse is planning care for a client admitted with heart failure.Based on this diagnosis,which type of renal failure is the client at an increased risk for experiencing?

Accepted Answer

A) One cause of prerenal kidney failure due to low cardiac output is heart failure. Causes of prerenal kidney failure due to hypovolemia include hemorrhage, dehydration, excess fluid loss from the gastrointestinal tract, burns, and wounds. Causes of intrarenal kidney failure due to glomerular injury include glomerulonephritis, disseminated intravascular coagulation, vasculitis, hypertension, toxemia of pregnancy, and hemolytic uremic syndrome. Causes of intrarenal kidney failure due to acute tubular necrosis include ischemia resulting from conditions associated with prerenal failure, toxins, hemolysis, and rhabdomyolysis.
B) One cause of prerenal kidney failure due to low cardiac output is heart failure. Causes of prerenal kidney failure due to hypovolemia include hemorrhage, dehydration, excess fluid loss from the gastrointestinal tract, burns, and wounds. Causes of intrarenal kidney failure due to glomerular injury include glomerulonephritis, disseminated intravascular coagulation, vasculitis, hypertension, toxemia of pregnancy, and hemolytic uremic syndrome. Causes of intrarenal kidney failure due to acute tubular necrosis include ischemia resulting from conditions associated with prerenal failure, toxins, hemolysis, and rhabdomyolysis.
C) One cause of prerenal kidney failure due to low cardiac output is heart failure. Causes of prerenal kidney failure due to hypovolemia include hemorrhage, dehydration, excess fluid loss from the gastrointestinal tract, burns, and wounds. Causes of intrarenal kidney failure due to glomerular injury include glomerulonephritis, disseminated intravascular coagulation, vasculitis, hypertension, toxemia of pregnancy, and hemolytic uremic syndrome. Causes of intrarenal kidney failure due to acute tubular necrosis include ischemia resulting from conditions associated with prerenal failure, toxins, hemolysis, and rhabdomyolysis.
D) One cause of prerenal kidney failure due to low cardiac output is heart failure. Causes of prerenal kidney failure due to hypovolemia include hemorrhage, dehydration, excess fluid loss from the gastrointestinal tract, burns, and wounds. Causes of intrarenal kidney failure due to glomerular injury include glomerulonephritis, disseminated intravascular coagulation, vasculitis, hypertension, toxemia of pregnancy, and hemolytic uremic syndrome. Causes of intrarenal kidney failure due to acute tubular necrosis include ischemia resulting from conditions associated with prerenal failure, toxins, hemolysis, and rhabdomyolysis.

Question 18

A client with renal failure will be discharged to home in the next few days.When conducting dietary instruction,the nurse teaches the client to choose proteins that are high in biological value.Which client statement indicates that teaching has been effective?

Accepted Answer

A) Eggs are an excellent source of essential amino acids and are recommended as part of the diet for a client with renal failure who is on a protein-restricted diet. Legumes, nuts, and vegetables do contain protein, but they are incomplete proteins and are not as good protein sources as are eggs.
B) Eggs are an excellent source of essential amino acids and are recommended as part of the diet for a client with renal failure who is on a protein-restricted diet. Legumes, nuts, and vegetables do contain protein, but they are incomplete proteins and are not as good protein sources as are eggs.
C) Eggs are an excellent source of essential amino acids and are recommended as part of the diet for a client with renal failure who is on a protein-restricted diet. Legumes, nuts, and vegetables do contain protein, but they are incomplete proteins and are not as good protein sources as are eggs.
D) Eggs are an excellent source of essential amino acids and are recommended as part of the diet for a client with renal failure who is on a protein-restricted diet. Legumes, nuts, and vegetables do contain protein, but they are incomplete proteins and are not as good protein sources as are eggs.

Question 19

The nurse is caring for a client admitted with a diagnosis of acute renal failure.The client asks the nurse,"Are my kidneys failing? Will I need a kidney transplant?" Which response by the nurse is the most appropriate?

Accepted Answer

A) Acute renal failure is often resolved without the need for transplant if treatment is initiated quickly. There is no need to start lining up donors or wait for the provider to arrive to explore options. Telling the client that everything will be fine is condescending, provides no information, and is not within the nurse's ability to know.
B) Acute renal failure is often resolved without the need for transplant if treatment is initiated quickly. There is no need to start lining up donors or wait for the provider to arrive to explore options. Telling the client that everything will be fine is condescending, provides no information, and is not within the nurse's ability to know.
C) Acute renal failure is often resolved without the need for transplant if treatment is initiated quickly. There is no need to start lining up donors or wait for the provider to arrive to explore options. Telling the client that everything will be fine is condescending, provides no information, and is not within the nurse's ability to know.
D) Acute renal failure is often resolved without the need for transplant if treatment is initiated quickly. There is no need to start lining up donors or wait for the provider to arrive to explore options. Telling the client that everything will be fine is condescending, provides no information, and is not within the nurse's ability to know.

Question 20

The nurse is planning care for the client with acute renal failure.The nurse plans the client's care based on the nursing diagnosis of Excess Fluid Volume.Which assessment data supports this nursing diagnosis?

Accepted Answer

A) The client in acute renal failure will likely be edematous, as the kidneys are not producing urine. Wheezing in the lungs is an assessment consistent with asthma. Bowel sounds in 4 quadrants is a normal assessment finding. Generalized weakness may be due to whatever disease process precipitated the renal failure.
B) The client in acute renal failure will likely be edematous, as the kidneys are not producing urine. Wheezing in the lungs is an assessment consistent with asthma. Bowel sounds in 4 quadrants is a normal assessment finding. Generalized weakness may be due to whatever disease process precipitated the renal failure.
C) The client in acute renal failure will likely be edematous, as the kidneys are not producing urine. Wheezing in the lungs is an assessment consistent with asthma. Bowel sounds in 4 quadrants is a normal assessment finding. Generalized weakness may be due to whatever disease process precipitated the renal failure.
D) The client in acute renal failure will likely be edematous, as the kidneys are not producing urine. Wheezing in the lungs is an assessment consistent with asthma. Bowel sounds in 4 quadrants is a normal assessment finding. Generalized weakness may be due to whatever disease process precipitated the renal failure.

Quiz 6: Fluids and Electrolytes