Nokea
The nurse is caring for a client with peritoneal dialysis. The client reports an outflow of only one-half of the dialysate solution that was dwelled. The nurse should instruct the client to do which of the following?
- A. Apply heat to the abdomen.
- B. Encourage the client to have a bowel movement.
- C. Strip the dialysis catheter.
- D. Instill more dialysate solution.
Correct Answer: B
Rationale: Constipation can obstruct dialysate outflow; encouraging a bowel movement may resolve the issue.
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The nurse is reviewing the concept of acute kidney injury (AKI) with a student nurse. Which of the following would be correct as a cause of prerenal AKI?
- A. nephrotoxicity
- B. bladder cancer
- C. contrast media
- D. hypovolemia
Correct Answer: D
Rationale: Hypovolemia causes prerenal AKI by reducing renal perfusion.
The nurse is caring for a client with a kidney injury with a serum potassium level of 6.1 mEq/L (mmol/L) [3.5-5 mEq/L, mmol/L]. Which of the following actions is a priority?
- A. Obtain a prescription for a diuretic to increase urine output
- B. Check the client's sodium level
- C. Place the client on a cardiac monitor
- D. Encourage oral fluid intake
Correct Answer: C
Rationale: Hyperkalemia (6.1 mEq/L) poses a risk for cardiac dysrhythmias, making cardiac monitoring a priority.
The nurse is reviewing labs for a client with a serum potassium level of 3.3 mEq/L (mmol/L) [3.5-5 mEq/L, mmol/L]. The nurse should take which essential action based on this laboratory result?
- A. Educate the client on potassium-rich foods
- B. Implement continuous telemetry monitoring
- C. Obtain an order for calcium gluconate
- D. Assess the client's neurological status
Correct Answer: A
Rationale: Hypokalemia (low potassium) requires dietary education to increase potassium intake, as it does not typically necessitate telemetry or calcium.
As a nurse, you are administering intravenous fluids to a client. Which of the following types of IV fluids would be classified as isotonic? Select all that apply.
- A. Normal saline
- B. 1/2 Normal saline
- C. Lactated ringers
- D. D10W
- E. 3% NaCl
Correct Answer: A,C
Rationale: Normal saline and lactated ringers are isotonic, matching plasma osmolality, unlike hypotonic (1/2 NS) or hypertonic (D10W, 3% NaCl) fluids.
The client is diagnosed with acute kidney failure. Which of the following is an appropriate psychosocial problem for the nurse to include in the care plan?
- A. Imbalanced nutrition: less than body requirements related to altered metabolic state and dietary restrictions.
- B. Anxiety related to the disease process and uncertainty of prognosis.
- C. Excess fluid volume related to compromised regulatory mechanisms secondary to acute renal failure.
- D. Risk for infection related to invasive procedures and an altered immune response secondary to renal failure.
Correct Answer: B
Rationale: Anxiety is a psychosocial issue related to the uncertainty and stress of acute kidney failure, unlike the other physiological options.