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A patient with chronic renal failure and a blood pressure of 158/98
mm Hg refuses to take medication for the blood pressure. What
information should the nurse provide for this patient?
1. One of the problems associated with high blood pressure in people
with renal failure is the development of heart failure.
2. Some people with chronic renal failure and high blood pressure
end up with an infection around their heart.
3. You must realize that untreated hypertension may cause you to
develop pneumonia.
4. There is a significant increase in risk for anemia if hypertension is
not treated.
Answer: 1 Explanation: 1. Hypertension, commonly seen in chronic
renal failure, can progress to heart failure if left untreated. 2.
Pericarditis is a complication of end-stage renal disease, but it is
inflammatory and not infectious. 3. Pneumonia is not a potential
problem because of untreated hypertension. 4. The patient with
chronic renal failure is at high risk for anemia, but this complication is
not due to the presence of untreated hypertension.
,A patient's potassium level is 6.5 mEq/L. The nurse would prepare for
which intervention?
1. Administration of intravenous fluids supplemented with 40 mEq of
potassium in each liter of fluid
2. Administration of oral potassium 2 or 3 times daily until levels are
normal
3. Administration of Kayexalate
4. Administration of a D50W bolus
Answer: 3 Explanation: 1. This patient does not require additional
intravenous potassium. 2. This patient does not require administration
of oral potassium. 3. Kayexalate is a sodium polystyrene sulfonate
used to bind to and eliminate excess potassium. It is given orally or by
enema. Since this patient's potassium level is elevated, this
intervention is indicated. 4. D50W is not given to reduce potassium.
,A patient tells the nurse that chronic kidney disease is in his family and
his father died within a few months after having a kidney transplant in
the late 1940s. What information should the nurse provide?
1. Your chances of a successful transplant depend on finding a healthy
family member who is a match and will agree to provide an organ.
2. The most successful transplants have always been the heart and
lungs.
3. Many of the earlier failures of kidney transplants had to do with
suturing technique.
4. Medications to prevent problems associated with organ
transplantation are now widely available.
Answer: 4 Explanation: 1. Many nonfamily transplants are performed
and are successful. 2. Transplanting the heart and lungs did not
receive the focus of transplantable organs until the 1980s. There is no
evidence that transplant of these organs is more successful than
transplant of other organs. 3. The major problem associated with
transplant has always been rejection. 4. Cyclosporine and other
antirejection drugs are now available and have made transplant
surgeries much more successful.
, The older brother of a patient in renal failure has agreed to donate a
kidney. Testing reveals that the brothers are a good match for this
procedure. How would the nurse describe this treatment plan?
1. Heterograft living donor
2. Histograft living donor
3. Allograft living donor
4. Isograft living donor
Answer: 3 Explanation: 1. Heterograft is the transplantation of tissue
between two different species. 2. Histograft is not a term used to
describe status of the donor. Histocompatible refers to the
compatibility between donor and recipient. 3. An allograft refers to
tissue that is transplanted within the same species. A living donor is
someone who agrees to have body parts transplanted into another
person while alive. The patient's brother is an allograft living donor. 4.
Isograft refers to tissue transplanted between twins.
During the posttransplantation period, a patient received tacrolimus
(Prograf). The nurse would monitor this patient for the development of
which adverse effects?
Select all that apply.
1. Congestive heart failure
2. Nausea and vomiting
3. Hyperglycemia
4. Hair loss
5. Infection
Answer: 3, 5 Explanation: 1. Tacrolimus is not associated with the
development of congestive heart failure. 2. Tacrolimus is not
associated with the development of nausea and vomiting. 3.
Tacrolimus, a macrolide antibody, has the development of
hyperglycemia as a potential adverse reaction. 4. Tacrolimus is
associated with hirsutism, not hair loss. 5. Tacrolimus increases risk for
infection.