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A client with acute renal failure has a low calcium level. The nurse should monitor for:
- A. Tetany.
- B. Hypertension.
- C. Bradycardia.
- D. Edema.
Correct Answer: A
Rationale: Low calcium can cause tetany, manifesting as muscle cramps or spasms.
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Which lab result indicates worsening acute renal failure?
- A. Creatinine 3.5 mg/dL.
- B. BUN 20 mg/dL.
- C. Potassium 4.0 mEq/L.
- D. Sodium 140 mEq/L.
Correct Answer: A
Rationale: Elevated creatinine indicates reduced kidney function in acute renal failure.
The nurse is planning care for a client who had surgery for abdominal aortic aneurysm repair 2 days ago. The pain medication and the use of relaxation and imagery techniques are not relieving the client's pain and the client refuses to get out of bed to ambulate as ordered. The nurse contacts the physician, explains the situation, and provides information about drug dose, frequency of administration, the client's vital signs, and the client's score on the pain scale. The physician tells the nurse that the current order for pain medication is sufficient and the client will be fine in a few days. The nurse should next:
- A. Explain to the physician that the current pain medication and other strategies are not helping the client and it is making it difficult for the client to ambulate as ordered
- B. Ask the hospitalist to write an order for a stronger pain medication
- C. Wait until the next shift and ask the nurse on that shift to contact the physician
- D. Report the incident to the team leader
Correct Answer: A
Rationale: The nurse should advocate for the client by reiterating to the physician that the current pain management is ineffective, preventing ambulation, which is critical for recovery post-AAA repair. This aligns with ethical and professional standards. Asking another provider, waiting, or reporting to the team leader delays care.
Doxorubicin (Adriamycin) is prescribed for a female client with breast cancer. The client is distressed about hair loss. The nurse should do which of the following?
- A. Have the client wash and massage the scalp daily to stimulate hair growth.
- B. Explain that hair loss is temporary and will quickly grow back to its original appearance.
- C. Provide resources for a wig selection before hair loss begins.
- D. Recommend that the client limit social contacts until hair regrows.
Correct Answer: C
Rationale: Providing resources for wig selection before hair loss begins helps the client prepare for and cope with chemotherapy-induced alopecia, maintaining her self-esteem.
The client's serum potassium level is elevated in acute renal failure, and the nurse administers sodium polystyrene sulfonate (Kayexalate). This drug acts to:
- A. Increase potassium excretion from the colon.
- B. Release hydrogen ions for sodium ions.
- C. Increase calcium absorption in the colon.
- D. Exchange sodium for potassium ions in the colon.
Correct Answer: D
Rationale: Kayexalate exchanges sodium for potassium in the colon, reducing serum potassium levels in acute renal failure.
The nurse receives the following critical laboratory results for a client with end-stage renal disease. The nurse anticipates the physician to prescribe which blood product? See the image below.
- A. Packed Red Blood Cells (PRBCs)
- B. Fresh Frozen Plasma (FFP)
- C. Albumin
- D. Platelets
Correct Answer: A
Rationale: End-stage renal disease often leads to anemia due to decreased erythropoietin production, making PRBCs the likely prescribed blood product to correct severe anemia. FFP, albumin, and platelets address other issues not typically primary in this context.