Renal Failure Patients NCLEX
Questions with complete solution
The nurse caring for a client in the diuretic phase of acute renal failure (ARF) should
assess for manifestations of
a. dehydration.
b. hypertension.
c. hypokalemia.
d. metabolic acidosis. - correct answer ✔A ~ A gradual or abrupt return to glomerular
filtration and leveling of blood urea nitrogen (BUN) level signal the diuretic phase. Urine
output may be 1000 ml/day, which may lead to dehydration.
Which is the most common cause of acute renal failure in children?
a. Pyelonephritis
b. Tubular destruction
c. Urinary tract obstruction
d. Severe dehydration - correct answer ✔D ~ The most common cause of acute renal
failure in children is dehydration or other causes of poor perfusion that may respond to
restoration of fluid volume. Pyelonephritis and tubular destruction are not common
causes of acute renal failure. Obstructive uropathy may cause acute renal failure, but it
is not the most common cause.
List the GFR rates in the different stages of renal failure. - correct answer ✔Stage 1 =
<90 mL/min
Stage 2 = <60 mL/min
Stage 3 = <45 mL/min
Stage 4 = <30 mL/min
Stage 5 = <15 mL/min
A client with ARF is allowed a specific amount of fluid by mouth during 24 hours in order
to
a. compensate for insensible and measured fluid losses during the previous 24 hours.
b. equal the expected urine output for the next 24 hours.
c. prevent hyperkalemia, which could lead to serious cardiac dysrhythmia.
d. prevent the development of complicating hypostatic pneumonia. - correct answer
✔A ~ Fluid replacement volumes are usually calculated on the basis of some fraction of
the previous days urine output plus an amount (e.g., 400 ml) to account for the usual
insensible loss that occurs during a 24-hour period.
What is the normal lab value for serum ALBUMIN? - correct answer ✔3.5-5.5 g/dL
The nurse is conducting an admission assessment on a school-age child with acute
renal failure. Which are the primary clinical manifestations the nurse expects to find with
this condition?
, a. Oliguria and hypertension
b. Hematuria and pallor
c. Proteinuria and muscle cramps
d. Bacteriuria and facial edema - correct answer ✔A ~ The principal feature of acute
renal failure is oliguria; hypertension is a nonspecific clinical manifestation. Hematuria
and pallor, proteinuria and muscle cramps, and bacteriuria and facial edema are not
principal features of acute renal failure.
The nurse explains that a cation exchange resin such as Kayexalate will
a. decrease diastolic blood pressure.
b. stimulate diuresis by osmosis.
c. increase appetite by decreasing insulin degradation.
d. increase gastrointestinal potassium excretion. - correct answer ✔D ~ Hyperkalemia
is probably the most dangerous imbalance because of its contribution to cardiac
dysrhythmias and arrest. Cation exchange resins such as sodium polystyrene sulfonate
(Kayexalate) may be administered orally or rectally to facilitate excretion of potassium
from the gastrointestinal (GI) tract.
The nurse is caring for a child with acute renal failure. Which clinical manifestation
should the nurse recognize as a sign of hyperkalemia?
a. Dyspnea
b. Seizure
c. Oliguria
d. Cardiac arrhythmia - correct answer ✔D ~ Hyperkalemia is the most common threat
to the life of the child. Signs of hyperkalemia include electrocardiograph anomalies such
as prolonged QRS complex, depressed ST segments, peaked T waves, bradycardia, or
heart block. Dyspnea, seizure, and oliguria are not manifestations of hyperkalemia.
What is the normal lab value for serum PHOSPHORUS? - correct answer ✔2.4-4.1
mg/dL
A client with oliguric ARF would exhibit
a. a BUN/creatinine ratio of 30:1.
b. hematuria.
c. proteinuria.
d. a urine specific gravity of 1.001. - correct answer ✔A ~ In oliguric ARF, urine
production usually falls below 400 ml/day. The BUN/creatinine ratio is significantly
elevated, reaching levels of 10:1 to 40:1.
What is the Normal Osmolality of Urine? - correct answer ✔300-900 mOsm/kg
When a child has chronic renal failure, the progressive deterioration produces a variety
of clinical and biochemical disturbances that eventually are manifested in the clinical
syndrome known as:
a. uremia.
b. oliguria.
Questions with complete solution
The nurse caring for a client in the diuretic phase of acute renal failure (ARF) should
assess for manifestations of
a. dehydration.
b. hypertension.
c. hypokalemia.
d. metabolic acidosis. - correct answer ✔A ~ A gradual or abrupt return to glomerular
filtration and leveling of blood urea nitrogen (BUN) level signal the diuretic phase. Urine
output may be 1000 ml/day, which may lead to dehydration.
Which is the most common cause of acute renal failure in children?
a. Pyelonephritis
b. Tubular destruction
c. Urinary tract obstruction
d. Severe dehydration - correct answer ✔D ~ The most common cause of acute renal
failure in children is dehydration or other causes of poor perfusion that may respond to
restoration of fluid volume. Pyelonephritis and tubular destruction are not common
causes of acute renal failure. Obstructive uropathy may cause acute renal failure, but it
is not the most common cause.
List the GFR rates in the different stages of renal failure. - correct answer ✔Stage 1 =
<90 mL/min
Stage 2 = <60 mL/min
Stage 3 = <45 mL/min
Stage 4 = <30 mL/min
Stage 5 = <15 mL/min
A client with ARF is allowed a specific amount of fluid by mouth during 24 hours in order
to
a. compensate for insensible and measured fluid losses during the previous 24 hours.
b. equal the expected urine output for the next 24 hours.
c. prevent hyperkalemia, which could lead to serious cardiac dysrhythmia.
d. prevent the development of complicating hypostatic pneumonia. - correct answer
✔A ~ Fluid replacement volumes are usually calculated on the basis of some fraction of
the previous days urine output plus an amount (e.g., 400 ml) to account for the usual
insensible loss that occurs during a 24-hour period.
What is the normal lab value for serum ALBUMIN? - correct answer ✔3.5-5.5 g/dL
The nurse is conducting an admission assessment on a school-age child with acute
renal failure. Which are the primary clinical manifestations the nurse expects to find with
this condition?
, a. Oliguria and hypertension
b. Hematuria and pallor
c. Proteinuria and muscle cramps
d. Bacteriuria and facial edema - correct answer ✔A ~ The principal feature of acute
renal failure is oliguria; hypertension is a nonspecific clinical manifestation. Hematuria
and pallor, proteinuria and muscle cramps, and bacteriuria and facial edema are not
principal features of acute renal failure.
The nurse explains that a cation exchange resin such as Kayexalate will
a. decrease diastolic blood pressure.
b. stimulate diuresis by osmosis.
c. increase appetite by decreasing insulin degradation.
d. increase gastrointestinal potassium excretion. - correct answer ✔D ~ Hyperkalemia
is probably the most dangerous imbalance because of its contribution to cardiac
dysrhythmias and arrest. Cation exchange resins such as sodium polystyrene sulfonate
(Kayexalate) may be administered orally or rectally to facilitate excretion of potassium
from the gastrointestinal (GI) tract.
The nurse is caring for a child with acute renal failure. Which clinical manifestation
should the nurse recognize as a sign of hyperkalemia?
a. Dyspnea
b. Seizure
c. Oliguria
d. Cardiac arrhythmia - correct answer ✔D ~ Hyperkalemia is the most common threat
to the life of the child. Signs of hyperkalemia include electrocardiograph anomalies such
as prolonged QRS complex, depressed ST segments, peaked T waves, bradycardia, or
heart block. Dyspnea, seizure, and oliguria are not manifestations of hyperkalemia.
What is the normal lab value for serum PHOSPHORUS? - correct answer ✔2.4-4.1
mg/dL
A client with oliguric ARF would exhibit
a. a BUN/creatinine ratio of 30:1.
b. hematuria.
c. proteinuria.
d. a urine specific gravity of 1.001. - correct answer ✔A ~ In oliguric ARF, urine
production usually falls below 400 ml/day. The BUN/creatinine ratio is significantly
elevated, reaching levels of 10:1 to 40:1.
What is the Normal Osmolality of Urine? - correct answer ✔300-900 mOsm/kg
When a child has chronic renal failure, the progressive deterioration produces a variety
of clinical and biochemical disturbances that eventually are manifested in the clinical
syndrome known as:
a. uremia.
b. oliguria.
