Nokea
A high-carbohydrate, low-protein diet is prescribed for the client with acute renal failure. The intended outcome of this diet is to:
- A. Act as a diuretic.
- B. Reduce demands on the liver.
- C. Help maintain urine acidity.
- D. Prevent the development of ketosis.
Correct Answer: D
Rationale: A high-carbohydrate, low-protein diet provides energy and prevents ketosis by reducing protein breakdown in acute renal failure.
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A 66-year-old female who is usually meticulous about her appearance and dress arrives today for her 23rd day of radiation therapy and appears disheveled and emotionally labile, and her responses to the usual questions are a little inappropriate. Her heart rate is 124 bpm, her respirations are 32 breaths/minute, and her skin is cold and clammy. These findings would suggest that the nurse should further assess the client for which of the following conditions?
- A. Schizophrenia.
- B. Panic disorder.
- C. Depression.
- D. Delirium.
Correct Answer: D
Rationale: Disheveled appearance, emotional lability, inappropriate responses, and physical symptoms (tachycardia, tachypnea, clammy skin) suggest delirium, a medical emergency requiring urgent assessment.
The nurse is administering a saturated solution of potassium iodide (SSKI). The nurse should:
- A. Pour the solution over ice chips.
- B. Mix the solution with an antacid.
- C. Dilute the solution with water, milk, or fruit juice and have the client drink it with a straw.
- D. Disguise the solution in a pureed fruit or vegetable.
Correct Answer: C
Rationale: SSKI has an unpleasant taste and can stain teeth. Diluting it with water, milk, or juice and using a straw minimizes discomfort and staining.
Following a gastrectomy, the nurse should position the client in which of the following positions?
- A. Prone.
- B. Supine.
- C. Right or left Sims.
- D. Fowler's.
Correct Answer: D
Rationale: Fowler's position (semi-upright) promotes lung expansion, reduces aspiration risk, and aids drainage post-gastrectomy. The other positions are less optimal for postoperative recovery.
A client has a ureteral catheter in place after renal surgery. A priority nursing action for care of the ureteral catheter would be to:
- A. Irrigate the catheter with 30 mL of normal saline every 8 hours.
- B. Ensure that the catheter is draining freely.
- C. Clamp the catheter every 2 hours for 30 minutes.
- D. Ensure that the catheter drains at least 30 mL/hour.
Correct Answer: B
Rationale: Ensuring free drainage prevents obstruction or pressure buildup, which could harm the surgical site or kidney function.
In the oliguric phase of acute renal failure, the nurse should assess the client for:
- A. Pulmonary edema.
- B. Metabolic alkalosis.
- C. Hypotension.
- D. Hypokalemia.
Correct Answer: A
Rationale: Pulmonary edema is a risk in the oliguric phase due to fluid overload from reduced urine output.