NCLEX STYLE PRACTICE QUESTIONS WITH CORRECT ANSWERS GRADED TO PASS: ACUTE RENAL FAILURE

Which sign indicated the second phase of acute renal failure? 1. Daily doubling of urine output (4 to 5 L/day) 2. Urine output less than 400 ml/day 3. Urine output less than 100 ml/day 4. Stabilization of renal function -CORECT ANSWER28. Answer: 1. Daily doubling of urine output (4 to 5 L/day) Daily doubling of the urine output indicates that the nephrons are healing. This means the patient is passing into the second phase (dieresis) of acute renal failure. Your patient returns from the operating room after abdominal aortic aneurysm repair. Which symptom is a sign of acute renal failure? 1. Anuria 2. Diarrhea 3. Oliguria 4. Vomiting -CORECT ANSWER41. Answer: 3. Oliguria Urine output less than 50ml in 24 hours signifies oliguria, an early sign of renal failure. Anuria is uncommon except in obstructive renal disorders. Which cause of hypertension is the most common in acute renal failure? 1. Pulmonary edema 2. Hypervolemia 3. Hypovolemia 4. Anemia -CORECT ANSWER42. Answer: 2. Hypervolemia Acute renal failure causes hypervolemia as a result of overexpansion of extracellular fluid and plasma volume with the hypersecretion of renin. Therefore, hypervolemia causes hypertension. What nursing measure would be included in the plan of care for a client with acute renal failure? 1) Observe for signs of a secondary infection 2) Provide a high protein, low carbohydrate diet 3) In and out catheterization for residual urine 4) Encourage fluids to 2000 mL in 24 hours -CORECT ANSWER1: Secondary infections are the cause of death in 50-90% of clients with acute renal failure. A low protein diet is most often offered. Catheterizations are avoided. Fluids may be limited if the client is in ARF. A client with acute renal failure develops sever hyperkalemia. What would the nurse anticipate to be used to treat this imbalance? 1) Furosemide (Lasix) 2) Amphojel (aluminum hydroxide) 3) 50% glucose and regular insulin 4) Epoetin (Procrit) -CORECT ANSWER3: Hyperkalemia can develop into an emergency situation (Cardia Arrest). It is important to quickly move the potassium back into the cells by administering 50% glucose and regular insulin, usually in conjunction with some type of base to correct the acidosis, such as sodium bicarbonate or calcium gluconate given IV. Insulin assists in the movement of potassium into the cells and helps to reduce the serum potassium level. Amphojel is used for the treatment of hyperphosphatemia that occurs with ARF. Procrit is used for the treatment of anemia caused by a decrease in erythropoietin production by the kidneys. A diuretic, such as Lasix, may lead to a loss of potassium, but the rate is too slow. Acute renal failure is potentially reversible in the: A. convalescent phase. B. initiation phase. C. maintenance phase. D. recovery phase. -CORECT ANSWERB, initiation phase Signs and symptoms of acute renal failure include: A. bradycardia, with decreased respiration, low serum bicarbonate, and elevated pH. B. lethargy, tachypnea, and elevated serum bicarbonate. C. slowed respirations and low pH. D. tachypnea, low pH, and low serum bicarbonate. -CORECT ANSWERD. tachypnea, low pH, and low serum bicarbonate.