Nokea
The nurse is caring for a client diagnosed with ARF. Which laboratory values are most significant for diagnosing ARF?
- A. BUN and creatinine.
- B. WBC and hemoglobin.
- C. Potassium and sodium.
- D. Bilirubin and ammonia level.
Correct Answer: A
Rationale: Elevated blood urea nitrogen (BUN) and creatinine levels indicate impaired kidney function, making them the primary markers for diagnosing ARF. Other labs like WBC, electrolytes, or liver function tests are less specific for ARF diagnosis.
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The nurse caring for a client diagnosed with CKD writes a client problem of 'noncompliance with dietary restrictions.' Which intervention should be included in the plan of care?
- A. Teach the client the proper diet to eat while undergoing dialysis.
- B. Refer the client and significant other to the dietitian.
- C. Explain the importance of eating the proper foods.
- D. Determine the reason for the client not adhering to the diet.
Correct Answer: D
Rationale: Determining the reason for noncompliance (e.g., lack of understanding, financial barriers) is the first step to tailor interventions effectively. Teaching, referrals, or explaining importance are secondary until the root cause is identified.
The client diagnosed with chronic renal failure (CRF) is prescribed hemodialysis on Monday, Wednesday, and Friday. Which interventions should the nurse implement? Select all that apply.
- A. Weigh the client before and after each treatment.
- B. Discuss the recommended fluid restriction.
- C. Provide potato chips or pretzels as a snack.
- D. Monitor the hemodialysis access site continuously.
- E. Keep up a lively conversation during the treatments.
Correct Answer: A,B,D
Rationale: Weighing pre/post-dialysis assesses fluid removal, fluid restriction education prevents overload, and monitoring the access site prevents complications. Salty snacks increase thirst, and conversation is not a priority intervention.
The client is diagnosed with an acute episode of ureteral calculi. Which client problem is priority when caring for this client?
- A. Fluid volume loss.
- B. Knowledge deficit.
- C. Impaired urinary elimination.
- D. Alteration in comfort.
Correct Answer: D
Rationale: Severe pain (alteration in comfort) is the priority in acute ureteral calculi, as it affects the client’s immediate well-being and requires prompt management. Fluid loss, urinary elimination, and knowledge are secondary.
The nurse is caring for a client with chronic pyelonephritis. Which assessment data support the diagnosis of chronic pyelonephritis?
- A. The client has fever, chills, flank pain, and dysuria.
- B. The client complains of fatigue, headaches, and increased urination.
- C. The client had a group B beta-hemolytic strep infection last week.
- D. The client has an acute viral pneumonia infection.
Correct Answer: B
Rationale: Chronic pyelonephritis presents with subtle symptoms like fatigue, headaches, and polyuria due to long-term renal damage. Acute symptoms (fever, chills) are more typical of acute pyelonephritis. Strep or pneumonia are unrelated.
The nurse in the dialysis center is initiating the morning dialysis run. Which client should the nurse assess first?
- A. The client who has hemoglobin of 9.8 g/dL and hematocrit of 30%.
- B. The client who does not have a palpable thrill or auscultated bruit.
- C. The client who is complaining of being exhausted and is sleeping.
- D. The client who did not take antihypertensive medication this morning.
Correct Answer: B
Rationale: Absence of a thrill or bruit indicates a non-functioning dialysis access (e.g., AV fistula), which is critical for dialysis and requires immediate assessment to prevent treatment delays or complications. Anemia, exhaustion, or missed medication are less urgent.