A) Incorrect. Being physically active and maintaining a healthy weight can actually reduce the risk of chronic renal failure, as it helps to control blood pressure and blood sugar levels, which are risk factors for kidney disease.

B) Incorrect. Having a family history of kidney disease can increase the risk of chronic renal failure, as genetics can play a role in the development of kidney problems.

C) Incorrect. Consuming a high-sodium diet can actually be harmful to the kidneys, as it can lead to hypertension and contribute to kidney damage.

D) Correct. Conditions such as hypertension and diabetes are well-established risk factors for chronic renal failure. These conditions can cause damage to the blood vessels and filtering units of the kidneys over time, leading to kidney dysfunction.

A) Incorrect. The volume of urine produced in 24 hours is measured through a different test called the 24-hour urine collection, not the GFR test.

B) Incorrect. The GFR test does not assess blood glucose levels; it is primarily used to evaluate kidney function.

C) Correct. The GFR test measures how well the kidneys are filtering waste and fluids from the blood. It is an important indicator of kidney function and is commonly used to stage chronic renal failure.

D) Incorrect. The GFR test does not specifically measure the excretion of potassium and sodium in the urine; instead, it focuses on overall kidney function and filtration rate.

A) Incorrect. While chronic renal failure is often irreversible, the rate of decline in kidney function can vary depending on the underlying cause and the effectiveness of treatment and management.

B) Incorrect. While appropriate lifestyle changes and medications can improve the client's quality of life and slow the progression of the disease, chronic renal failure is a chronic condition that may require ongoing management.

C) Incorrect. Chronic renal failure is generally not curable, but proper management can help stabilize the condition and slow the progression of kidney damage.

D) Correct. The prognosis for chronic renal failure can vary widely depending on factors such as the cause of kidney disease, the stage of kidney damage, and the client's response to treatment. Early intervention, such as controlling blood pressure and blood sugar levels, can help slow the progression of kidney damage and improve long-term outcomes.

A) Correct. An increase in blood pressure readings can be an early indication of fluid retention in a client with chronic renal failure. Fluid overload can lead to hypertension as the kidneys struggle to excrete excess fluids.

B) Incorrect. Shortness of breath and crackles in the lungs are signs of fluid overload but are considered more advanced symptoms. These indicate that fluid has accumulated in the lungs, leading to pulmonary edema.

C) Incorrect. Decreased serum potassium levels (hypokalemia) are not typically associated with fluid overload. Instead, chronic renal failure often leads to hyperkalemia due to impaired potassium excretion.

D) Incorrect. Rapid weight loss over a few days is not indicative of fluid retention; rather, it may suggest dehydration or inadequate caloric intake.

A) Incorrect. While assessing vital signs and blood pressure is important, it is not the first action when the client reports cloudy dialysate effluent during an exchange.

B) Correct. Cloudy dialysate effluent may indicate peritonitis, an infection of the peritoneal cavity. Obtaining a sample of the effluent for testing is the first action to determine if an infection is present and requires immediate treatment.

C) Incorrect. Instructing the client to stop the exchange immediately may be necessary if there are signs of infection or other complications, but obtaining a sample of the effluent should be done first to determine the cause.

D) Incorrect. Providing the client with an analgesic is not the priority when the client reports cloudy dialysate effluent; the focus is on identifying the cause of the cloudiness.

A) Incorrect. Reducing protein intake can lead to calcium loss and bone fractures in clients with chronic renal failure, as it may affect

bone health.

B) Correct. Limiting protein intake is a common dietary recommendation for clients with chronic renal failure to reduce the workload on the kidneys and slow the progression of kidney damage. Protein metabolism produces waste products that the kidneys must filter and excrete, and reducing protein intake can help alleviate this burden on the already compromised kidneys.

C) Incorrect. Decreasing protein intake may not necessarily improve appetite or overall nutritional status, as protein is essential for maintaining body functions and tissue repair.

D) Incorrect. While reducing protein intake can result in fewer waste products being generated, the primary reason for limiting protein intake in chronic renal failure is to reduce the strain on the kidneys, not solely to decrease waste production.

A) Incorrect. Chronic renal failure often leads to hypertension (high blood pressure), not decreased blood pressure.

B) Incorrect. Chronic renal failure typically results in decreased urine production due to impaired kidney function.

C) Incorrect. Chronic renal failure is more likely to cause hyperkalemia (high potassium levels) rather than hypokalemia.

D) Correct. Anemia is a common complication of chronic renal failure because the kidneys play a crucial role in producing erythropoietin, a hormone that stimulates red blood cell production. When the kidneys are damaged, erythropoietin production decreases, leading to anemia.

A) Incorrect. Limiting protein intake can help manage nitrogenous waste products, but it is not the primary reason for a low-protein diet.

B) Incorrect. Fluid overload is managed by restricting fluid intake, not protein intake.

C) Incorrect. The primary treatment for metabolic acidosis in chronic renal failure is bicarbonate supplementation, not a low-protein diet.

D) Correct. A low-protein diet is prescribed to reduce the production of nitrogenous waste products, such as urea and creatinine, which the damaged kidneys are unable to efficiently excrete. This helps prevent the buildup of waste products in the body.

A) Incorrect. Hyponatremia (low sodium levels) is not typically associated with chronic renal failure.

B) Incorrect. Hypocalcemia (low calcium levels) can occur in chronic renal failure, but hyperkalemia is more common.

C) Correct. Hyperkalemia (high potassium levels) is a common electrolyte imbalance in chronic renal failure because the kidneys are responsible for excreting excess potassium from the body, and impaired kidney function can lead to potassium retention.

D) Incorrect. Hypophosphatemia (low phosphate levels) is not a typical electrolyte imbalance in chronic renal failure.

A) Correct. Metabolic bone disease, such as renal osteodystrophy, is primarily due to the imbalances of calcium and parathyroid hormone (PTH) in chronic renal failure. Kidney dysfunction can lead to impaired calcium regulation and increased PTH secretion.

B) Incorrect. Hypokalemia and decreased thyroid-stimulating hormone (TSH) are not typically associated with metabolic bone disease in chronic renal failure.

C) Incorrect. Hypernatremia and elevated insulin levels are not directly related to metabolic bone disease.

D) Incorrect. Hypermagnesemia and decreased cortisol production are not the primary factors contributing to metabolic bone disease in chronic renal failure.

A) Correct. Hemodialysis is a treatment modality that uses a machine (dialyzer) to filter waste products and excess fluid from the blood, compensating for the impaired kidney function in chronic renal failure.

B) Incorrect. Peritoneal dialysis uses the peritoneal membrane within the abdomen to remove waste products and excess fluid, rather than a machine.

C) Incorrect. Kidney transplant involves replacing a damaged kidney with a healthy one from a donor and is not a form of dialysis.

D) Incorrect. Pharmacological therapy may be part of the treatment plan for chronic renal failure, but it does not focus on removing waste products and excess fluid from the blood like dialysis does.

A) Incorrect. Chronic renal failure is characterized by a gradual and progressive loss of kidney function, not a sudden and rapid decline.

B) Incorrect. While infections can lead to kidney damage, they are not the primary cause of chronic renal failure.

C) Correct. Chronic renal failure is marked by a slow, continuous decline in kidney function that is typically irreversible.

D) Incorrect. Chronic renal failure is not a result of temporary stress on the kidneys; it is a chronic condition with irreversible kidney damage.

A) Incorrect. Reabsorption of filtered waste products occurs primarily in the renal tubules, not the glomerulus.

B) Correct. The glomerulus is a key component of the nephron and functions to filter blood, removing waste products and excess substances to form urine.

C) Incorrect. The release of renin is primarily regulated by specialized cells in the kidney called juxtaglomerular cells, not the glomerulus itself.

D) Incorrect. Urine storage occurs in the bladder, not the glomerulus

A) Incorrect. Smoking and tobacco use are harmful to the kidneys and can increase the risk of chronic renal failure.

B) Incorrect. While genetic factors may play a role in some cases of chronic renal failure, lifestyle changes can significantly impact the risk and progression of kidney disease.

C) Incorrect. While a history of kidney stones may be associated with an increased risk of kidney damage, it is not a primary risk factor for chronic renal failure.

D) Correct. Conditions such as hypertension and diabetes are two of the leading causes of chronic renal failure. Uncontrolled high blood pressure and elevated blood sugar levels can damage the blood vessels and filtering units of the kidneys, leading to chronic kidney disease over time.

A) Incorrect. Age is a non-modifiable risk factor for chronic renal failure. While the risk of kidney disease may increase with age, it is not something that individuals can control or change.

B) Incorrect. Gender is also a non-modifiable risk factor, as both males and females can develop chronic renal failure. It does not impact an individual's ability to modify their risk.

C) Correct. Smoking is a modifiable risk factor for chronic renal failure. Smoking can damage blood vessels, leading to reduced blood flow to the kidneys and an increased risk of kidney disease.

D) Incorrect. Family history of kidney disease is a non-modifiable risk factor. While individuals cannot change their family history, they can modify other lifestyle factors, such as smoking, to reduce their overall risk of kidney disease.

A) Incorrect. Hyperthyroidism is not a known risk factor for chronic renal failure. However, uncontrolled thyroid disease may contribute to cardiovascular issues that can impact kidney health.

B) Incorrect. Peptic ulcer disease is not a risk factor for chronic renal failure.

C) Incorrect. Chronic obstructive pulmonary disease (COPD) is not directly associated with an increased risk of chronic renal failure. However, chronic illnesses can place additional stress on the kidneys over time.

D) Correct. Hypertension, or high blood pressure, is a significant risk factor for chronic renal failure. Long-term uncontrolled hypertension can damage the blood vessels in the kidneys, leading to chronic kidney disease.

A) Incorrect. Diabetes is strongly associated with an increased risk of chronic renal failure. Chronic kidney disease related to diabetes is known as diabetic nephropathy.

B) Correct. Diabetes is a leading cause of chronic renal failure. Uncontrolled high blood sugar levels can damage the blood vessels in the kidneys over time, leading to kidney disease.

C) Incorrect. Both Type 1 and Type 2 diabetes are associated with an increased risk of chronic renal failure. It is essential for individuals with either type of diabetes to manage their blood sugar levels to reduce the risk of kidney complications.

D) Incorrect. Chronic renal failure can be caused by various factors, but diabetes is a significant and common cause of kidney disease, especially in individuals with uncontrolled diabetes.

A) Incorrect. Antibiotics are generally safe and are not known to be a risk factor for chronic renal failure.

B) Incorrect. Antihypertensive medications are essential for managing high blood pressure and reducing the risk of kidney damage in individuals with hypertension. They are not considered a risk factor for chronic renal failure.

C) Correct. Proton pump inhibitors (PPIs) are commonly used to treat conditions such as acid reflux and peptic ulcers. Prolonged and high-dose use of PPIs has been associated with an increased risk of kidney disease, including acute interstitial nephritis and chronic kidney disease.

D) Incorrect. Antipyretics such as acetaminophen are generally safe when used appropriately and are not considered a risk factor for chronic renal failure.

A) Incorrect. Cardiovascular disease can impact kidney health. The heart and kidneys are closely connected, and conditions that affect the heart can also have implications for kidney function.

B) Incorrect. High cholesterol levels can contribute to cardiovascular disease, and cardiovascular disease is a significant risk factor for chronic renal failure. Therefore, high cholesterol indirectly impacts kidney health.

C) Correct. Cardiovascular disease, including conditions like heart failure or atherosclerosis, can lead to decreased blood flow to the kidneys, impairing kidney function and contributing to chronic renal failure.

D) Incorrect. High blood pressure is a well-established risk factor for chronic renal failure. Uncontrolled hypertension can damage the blood vessels in the kidneys, leading to kidney dysfunction over time.

A) Correct. Fatigue and weakness are early clinical manifestations of chronic renal failure, often due to anemia and the accumulation of waste products in the blood.

B) Incorrect. Hematuria may be present in some cases of kidney dysfunction, but it is not typically an early symptom of chronic renal failure.

C) Incorrect. Shortness of breath and chest pain are more likely to be associated with fluid overload or cardiac issues, which may occur in advanced stages of chronic renal failure.

D) Incorrect. Hyperkalemia is a complication of chronic renal failure but may not be an early clinical manifestation. It is more likely to occur as kidney function declines and potassium excretion becomes impaired.

A) Incorrect. Pruritus (itching) is a common symptom of chronic renal failure and is related to the buildup of waste products and toxins in the blood, leading to skin irritation.

B) Correct. Pruritus is a common and distressing symptom of chronic renal failure, caused by the retention of uremic toxins in the blood. These toxins can irritate the skin and lead to itching.

C) Incorrect. While medications can sometimes cause pruritus as a side effect, it is not the primary cause of itching in clients with chronic renal failure.

D) Incorrect. Persistent pruritus in a client with chronic renal failure is not necessarily indicative of an allergic reaction to medications. It is more likely related to the buildup of waste products in the blood.

A) Incorrect. Administering an antiemetic medication may help relieve nausea, but it is not the priority action in a client with chronic renal failure experiencing anorexia and nausea.

B) Incorrect. Encouraging the client to increase protein intake is not appropriate if they are experiencing anorexia and nausea. Protein intake may need to be adjusted based on the client's symptoms and kidney function.

C) Incorrect. While assessing serum electrolyte levels is important in chronic renal failure, it is not the priority action in this situation. The client's anorexia and nausea require immediate attention.

D) Correct. Monitoring the client's weight and fluid intake is the priority action when the client is experiencing anorexia and nausea. These symptoms may indicate fluid and electrolyte imbalances that need to be addressed promptly.

A) Correct. Increased blood pressure readings can be an early clinical manifestation of fluid overload in clients with chronic renal failure. Fluid retention can lead to hypertension as the kidneys struggle to excrete excess fluids.

B) Incorrect. Hyperkalemia may occur in chronic renal failure, but it is not an early clinical manifestation of fluid overload.

C) Incorrect. Dry and cracked skin is more commonly associated with dehydration rather than fluid overload.

D) Incorrect. Polyuria is not typically associated with fluid overload. Instead, it may be present in early stages of chronic renal failure due to the inability of the kidneys to concentrate urine properly.

A) Incorrect. Applying compression stockings may help reduce swelling but does not address the underlying cause. Additionally, compression stockings should not be used if the client has arterial insufficiency.

B) Incorrect. Elevation may provide temporary relief from swelling, but it does not address the underlying cause of fluid retention

in chronic renal failure.

C) Correct. The nurse should measure the client's blood pressure and pulse rate to assess for fluid overload and possible hypertension, which can be associated with chronic renal failure.

D) Incorrect. Assessing the client's daily protein intake is not the priority when the client presents with swelling in the ankles and legs. Fluid retention is a more immediate concern that requires assessment and intervention.

A) Incorrect. Applying a heating pad may provide temporary relief for muscle cramps, but it does not address the underlying cause.

B) Correct. Muscle cramps in clients with chronic renal failure can be caused by dehydration and electrolyte imbalances. Encouraging the client to increase fluid intake can help alleviate muscle cramps and maintain adequate hydration.

C) Incorrect. While calcium supplements may be prescribed in certain situations, they are not the first-line intervention for muscle cramps in chronic renal failure.

D) Incorrect. Educating the client about potassium-rich foods is important for managing potassium levels, but it is not the priority in this situation. Muscle cramps are more likely related to fluid and electrolyte imbalances rather than potassium intake.

A) Incorrect. Peripheral edema and weight gain are more commonly associated with fluid retention in later stages of chronic renal failure when the kidneys are unable to effectively remove excess fluids from the body.

B) Incorrect. Frothy urine and increased urination may indicate proteinuria, a condition where excessive protein is excreted in the urine. While proteinuria can be a symptom of kidney dysfunction, it is not an early symptom.

C) Incorrect. Hypertension and headache can be associated with chronic renal failure, but they are not specific to early stages of kidney dysfunction.

D) Correct. Fatigue and decreased appetite are early clinical manifestations of kidney dysfunction in chronic renal failure. The kidneys play a vital role in filtering waste products and toxins from the blood, and when kidney function is compromised, it can lead to a buildup of waste products in the body, causing fatigue and decreased appetite.

A) Incorrect. Excess production of calcium in the body is not a typical cause of bone pain in chronic renal failure.

B) Correct. Chronic renal failure can lead to impaired phosphorus excretion, resulting in elevated levels of phosphorus in the blood. High phosphorus levels can lead to bone demineralization, weakening the bones and causing bone pain.

C) Incorrect. While some medications used in the management of chronic renal failure may have side effects, frequent bone pain is not commonly associated with these medications.

D) Incorrect. Kidney dysfunction in chronic renal failure does not typically lead to low levels of calcium in the bones. Instead, it can lead to abnormalities in phosphorus levels, which affect bone health.

A) Correct. Peripheral neuropathy, characterized by tingling sensations or "pins and needles" in the hands and feet, is a common neurological complication of chronic renal failure. Uremic toxins build up in the blood when the kidneys are unable to adequately filter waste products, leading to nerve damage and peripheral neuropathy.

B) Incorrect. Increased blood flow to the extremities is not typically associated with the "pins and needles" sensation described by the client.

C) Incorrect. Adequate nerve conduction related to calcium levels would not cause the "pins and needles" sensation; instead, disturbances in calcium levels can lead to other neurological symptoms.

D) Incorrect. Hypokalemia, or low potassium levels, can cause muscle weakness or cramps but is not typically associated with peripheral neuropathy.

A) Incorrect. Hyperkalemia, or high potassium levels, can cause muscle weakness and potentially cardiac arrhythmias, but it is not typically associated with difficulty concentrating or irritability.

B) Incorrect. Hyponatremia, or low sodium levels, can cause neurological symptoms such as confusion and headache, but it is not typically associated with muscle cramps.

C) Incorrect. Hypocalcemia, or low calcium levels, can cause muscle cramps and neurological symptoms, but it is not specifically associated with difficulty concentrating and irritability.

D) Correct. Hyperphosphatemia, or high phosphorus levels, is common in chronic renal failure due to impaired kidney function. Elevated phosphorus levels can lead to the binding of calcium, resulting in decreased ionized calcium in the blood. This can cause neuromuscular irritability, difficulty concentrating, and muscle cramps.

A) Incorrect. Proteinuria, or the presence of excessive protein in the urine, may be a symptom of kidney dysfunction, but it is not directly related to periorbital edema and swelling of the ankles and feet.

B) Incorrect. Hypokalemia, or low potassium levels, may cause muscle weakness and other symptoms but is not associated with the specific edema described.

C) Incorrect. Hypernatremia, or high sodium levels, may lead to symptoms such as thirst and confusion but does not typically cause peripheral edema.

D) Correct. Periorbital edema (swelling around the eyes) and edema in the ankles and feet are classic signs of fluid overload in chronic renal failure. The impaired kidney function in chronic renal failure leads to the retention of fluid and sodium in the body, resulting in edema.

A) Incorrect. Increasing the intake of potassium-rich foods may not be appropriate, especially if the client's potassium levels are already elevated due to chronic renal failure. High potassium levels can lead to muscle cramps.

B) Incorrect. While regular weight-bearing exercises are beneficial for overall health, they may not specifically address or alleviate muscle cramps in chronic renal failure.

C) Correct. Engaging in stretching exercises before bedtime can help reduce the frequency of muscle cramps in clients with chronic renal failure. Stretching can help relax and lengthen muscles, reducing the risk of cramping.

D) Incorrect. Taking over-the-counter calcium supplements without proper evaluation of calcium levels can be dangerous and may contribute to other imbalances in chronic renal failure.

A) Incorrect. Severe anemia in chronic renal failure is characterized by low hemoglobin levels, not elevated levels.

B) Incorrect. Chronic renal failure can lead to decreased red blood cell production, resulting in a reduced red blood cell count.

C) Correct. Chronic renal failure often leads to decreased production of erythropoietin, a hormone that stimulates red blood cell production. This deficiency results in low hematocrit levels and severe anemia.

D) Incorrect. Chronic renal failure is not typically associated with elevated platelet counts; in fact, it can lead to platelet dysfunction and an increased risk of bleeding.

A) Correct. The GFR test measures how well the kidneys are filtering waste and fluids from the blood. It is an essential indicator of kidney function and is commonly used to diagnose and stage chronic renal failure.

B) Incorrect. The volume of urine produced in 24 hours is measured through a different test called the 24-hour urine collection, not the GFR test.

C) Incorrect. While the GFR test is used to assess kidney function, it is not specific to diagnosing particular kidney diseases like glomerulonephritis.

D) Incorrect. The GFR test does not specifically assess the excretion of potassium and sodium in the urine; instead, it focuses on overall kidney function and filtration rate.

A) Incorrect. A GFR value of 50 mL/min/1.73m² indicates some level of kidney dysfunction, not normal kidney function.

B) Incorrect. A GFR value of 50 mL/min/1.73m² indicates moderate kidney dysfunction, not mild impairment.

C) Correct. A GFR value of 50 mL/min/1.73m² is considered to represent moderate kidney dysfunction. This level of GFR indicates that the kidneys are not effectively filtering waste and fluids from the blood.

D) Incorrect. While a GFR value of 50 mL/min/1.73m² indicates kidney dysfunction, it does not represent severe kidney damage. Severe kidney dysfunction would have a much lower GFR value.

A) Incorrect. Converting the creatinine level to micromoles per liter is not necessary for the GFR calculation.

B) Incorrect. While a 24-hour urine sample can be used to measure creatinine clearance, it is not required for the GFR calculation, which can be estimated using formulas.

C) Incorrect. Calculating the body surface area is not necessary for the GFR calculation.

D) Correct. The GFR can be estimated using formulas that include the serum creatinine level, such as the Modification of Diet in Renal Disease (MDRD) formula or the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.

A) Incorrect. Fasting is not required for a GFR test.

B) Incorrect. While staying hydrated is essential for overall health, there are no specific hydration requirements before a GFR test.

C) Incorrect. While dietary changes may be necessary for other tests, such as creatinine clearance, there are no specific dietary restrictions for the GFR test.

D) Correct. There are no special preparations needed for a GFR test. The test can be done at any time, regardless of food intake or hydration status.

A) Incorrect. A GFR value of 10 mL/min/1.73m² indicates severe kidney dysfunction, not mild impairment.

B) Correct. A GFR value of 10 mL/min/1.73m² is considered very low and indicates severe kidney dysfunction. At this level, the kidneys are severely damaged and unable to effectively filter waste and fluids from the blood.

C) Incorrect. A GFR value of 10 mL/min/1.73m² is much lower than the threshold for moderate kidney dysfunction.

D) Incorrect. A GFR value of 10 mL/min/1.73m² is far below the normal range and indicates significant kidney dysfunction, not normal kidney function.

A) Incorrect. While a GFR value of 60 mL/min/1.73m² is within the normal range for some populations, it is considered below the normal range for adults and indicates some level of kidney dysfunction.

B) Correct. A GFR value of 60 mL/min/1.73m² indicates mild kidney impairment. While it may not be severely compromised, it still represents some level of kidney dysfunction.

C) Incorrect. A GFR value of 60 mL/min/1.73m² is not considered moderate kidney dysfunction. It is within the mild impairment range.

D) Incorrect. A GFR value of 60 mL/min/1.73m² is not indicative of severely damaged kidneys. Severe kidney dysfunction would have a much lower GFR value.

A) Incorrect. Pain medication is not typically administered for a GFR test as the test itself is not painful.

B) Correct. The GFR test is painless and non-invasive. It involves a blood test to measure creatinine levels and does not cause discomfort.

C) Incorrect. While relaxation techniques can be helpful for other procedures, they are not necessary for the GFR test as it does not cause discomfort.

D) Incorrect. Reassuring the client about the brief and tolerable nature of discomfort would be misleading, as the GFR test does not cause discomfort.

A) Incorrect. In chronic renal failure, the kidneys may have difficulty processing excess protein, so protein intake should be limited to reduce the workload on the kidneys.

B) Correct. Limiting fluid intake is crucial in managing chronic renal failure. The kidneys' reduced ability to filter waste products can lead to fluid retention and electrolyte imbalances, so restricting fluid intake helps prevent overload and complications.

C) Incorrect. In chronic renal failure, high-potassium foods should be limited to prevent hyperkalemia, a condition in which potassium levels in the blood become too high.

D) Incorrect. Foods high in phosphorus should be restricted in chronic renal failure because the kidneys may have difficulty excreting excess phosphorus, leading to hyperphosphatemia, which can contribute to bone and mineral disorders.

A) Incorrect. Phosphate binders are not used to reduce calcium absorption. They are specifically prescribed to control phosphate levels in the blood.

B) Correct. Phosphate binders are medications that bind to dietary phosphorus in the digestive tract, preventing its absorption and reducing phosphate levels in the blood. This helps manage hyperphosphatemia, a common complication in chronic renal failure.

C) Incorrect. Phosphate binders do not improve iron absorption or manage anemia. They are not related to iron metabolism.

D) Incorrect. Phosphate binders do not affect potassium excretion. They are specific to phosphate control in the body and do not impact potassium levels.

A) Incorrect. While proper medication adherence can help prevent drug interactions, it is not the primary reason for advising clients to take medications as prescribed in chronic renal failure.

B) Incorrect. Medication adherence may or may not directly impact the cost of treatment, but the main reason for consistent use is to manage the condition effectively.

C) Correct. Adhering to medication regimens in chronic renal failure is crucial for slowing the progression of kidney damage. Medications are prescribed to control blood pressure, manage complications, and reduce the strain on the kidneys.

D) Incorrect. Medication adherence is essential, but it does not eliminate the need for dietary restrictions in chronic renal failure. Dietary modifications are also a vital part of managing the condition effectively.

A) Incorrect. ESA therapy is not directly related to dehydration or thirst. It is used to manage anemia by stimulating red blood cell production.

B) Correct. ESA therapy can increase red blood cell production, which may elevate blood pressure. Regular blood pressure monitoring is essential to ensure it remains within a safe range.

C) Incorrect. Increased appetite and weight gain are not typical side effects of ESA therapy.

D) Incorrect. ESA therapy is not associated with an increased risk of bleeding or restrictions on engaging in strenuous activities. It is used to manage anemia and improve overall blood cell counts.

A) Incorrect. Encouraging the client to drink 3 liters of fluid daily may be excessive and can contribute to fluid overload in individuals on hemodialysis. Fluid intake needs to be limited and closely monitored.

B) Correct. Monitoring the vascular access site is crucial to detect early signs of infection or clotting, which can lead to serious complications such as sepsis or thrombosis.

C) Incorrect. Phosphate binders are used to control phosphate levels in the blood and are generally taken with meals, not specifically before hemodialysis sessions.

D) Incorrect. Promoting a high-potassium diet is not appropriate for individuals on hemodialysis, as it can lead to hyperkalemia. Clients on hemodialysis typically need to restrict potassium intake.

A) Incorrect. Encouraging the client to drink more fluids may not immediately resolve the cloudy dialysate drainage. The nurse needs to assess the client's dialysis technique and the potential cause of the cloudiness.

B) Incorrect. Administering intravenous antibiotics is not the initial intervention for cloudy dialysate drainage. First, the nurse should assess the client's technique and position during dialysis.

C) Correct. Cloudy dialysate drainage may indicate improper dialysate exchange, infection, or other complications. The nurse should first assess the client's dialysis technique and ensure proper positioning to identify the cause.

D) Incorrect. Discontinuing peritoneal dialysis should be considered if there is clear evidence of infection or other serious complications, but it is not the initial intervention for cloudy drainage without further assessment.

A) Incorrect. Calcitriol is not given to enhance appetite or improve nutrition. Its primary role is in regulating calcium and phosphate levels.

B) Incorrect. Calcitriol does not directly impact urine output or prevent kidney stones.

C) Incorrect. While some medications may be prescribed to manage blood pressure in chronic renal failure, calcitriol is not one of them.

D) Correct. Calcitriol is the active form of vitamin D and plays a crucial role in regulating calcium and phosphate levels in the body. It helps maintain bone health by promoting the absorption of calcium from the digestive tract and preventing bone demineralization.

A) Correct. ACE inhibitors are commonly prescribed to manage hypertension and fluid overload in clients with chronic renal failure. These medications help relax blood vessels, reduce fluid retention, and lower blood pressure.

B) Incorrect. Phosphate binders are prescribed to control phosphate levels, but they do not directly address fluid overload and hypertension.

C) Incorrect. Erythropoietin-stimulating agents (ESA) are used to manage anemia in chronic renal failure and do not specifically address hypertension or fluid overload.

D) Incorrect. Potassium-sparing diuretics may not be the first choice for managing fluid overload and hypertension in chronic renal failure, especially if the client has elevated potassium levels. ACE inhibitors are a more suitable option in this scenario.

A) Correct. Touching the dialysis catheter site increases the risk of infection, and clients receiving peritoneal dialysis must practice meticulous catheter care to minimize this risk.

B) Incorrect. While daily weight monitoring is essential for clients on peritoneal dialysis, it is not specifically related to peritoneal dialysis care.

C) Incorrect. Peritoneal dialysis is a home-based treatment, and the client performs the dialysis exchanges themselves. There is no need for frequent visits to the dialysis center.

D) Incorrect. Pain medication is not typically needed before starting a peritoneal dialysis exchange, as the procedure itself is not painful. Proper technique and sterile care are the main focus of peritoneal dialysis education.

A) Correct. In chronic renal failure, limiting protein intake is essential to reduce the workload on the kidneys and slow the progression of kidney damage.

B) Incorrect. Increasing sodium intake is not recommended in chronic renal failure, as it can lead to fluid retention and hypertension.

C) Incorrect. While potassium intake may need to be adjusted based on blood levels, there is no indication to consume potassium-rich foods to prevent deficiency.

D) Incorrect. Fluid restrictions are typically necessary in chronic renal failure to prevent fluid overload and related complications.

A) Incorrect. While physical activity is essential for overall health, the client's fatigue may be related to anemia, not lack of physical activity.

B) Correct. Fatigue and lethargy are common symptoms of anemia, which is a common complication of chronic renal failure. Iron supplements can help address anemia-related fatigue.

C) Incorrect. Increasing protein intake may not directly address the underlying cause of the client's fatigue, which is likely anemia.

D) Incorrect. Caffeine-containing beverages can contribute to fluid overload and hypertension in chronic renal failure and are not a suitable intervention for addressing fatigue.

A) Correct. Phosphate binders are most effective when taken with meals because they bind to dietary phosphorus, preventing its absorption in the digestive tract.

B) Incorrect. While constipation can be a side effect of some phosphate binders, drinking plenty of fluids is not directly related to this issue.

C) Incorrect. Phosphate binders should be taken with meals, and calcium supplements should be taken separately to prevent interactions between the two medications.

D) Incorrect. Phosphate binders do not typically lower potassium levels, and monitoring potassium intake is not specifically related to their use.

A) Incorrect. Dairy products are high in potassium and should be limited in clients at risk for hyperkalemia.

B) Incorrect. Fruits and vegetables are also high in potassium and should be limited in clients with chronic renal failure and hyperkalemia risk.

C) Correct. Nuts and seeds are rich sources of potassium and should be restricted in the diet of clients at risk for hyperkalemia.

D) Incorrect. Poultry is a good protein source, but the type of protein is not the main concern for clients at risk for hyperkalemia; it is the overall potassium content of the diet that needs to be reduced.

A) Incorrect. While dietary modifications are often necessary in chronic renal failure, this response does not address the client's concerns about lifestyle impact.

B) Correct. Hemodialysis requires a significant time commitment, and clients must plan their activities around the dialysis schedule. It is important for the client to understand the need for regular dialysis sessions to manage their condition effectively.

C) Incorrect. While hemodialysis does require regular sessions, it should not necessarily limit a client's ability to travel or participate in social events. Many individuals on hemodialysis can adjust their activities and still engage in meaningful experiences.

D) Incorrect.

Physical activity is generally encouraged in clients with chronic renal failure, as it contributes to overall well-being. Hemodialysis may increase energy levels and improve the client's ability to engage in physical activity.

A) Incorrect. Calcium-based phosphate binders should not be taken with milk or calcium-rich foods, as this can lead to an excessive calcium load and increase the risk of hypercalcemia.

B) Incorrect. Calcium-based phosphate binders are most effective when taken with meals to bind to dietary phosphorus.

C) Incorrect. While vitamin D plays a role in calcium metabolism, its supplementation is not directly related to the use of calcium-based phosphate binders.

D) Correct. Constipation is a common side effect of calcium-based phosphate binders. Increasing fluid intake can help alleviate constipation and promote bowel regularity.