A)This statement is incorrect. Hemodialysis does not use the peritoneal membrane as a filter. Hemodialysis involves the use of a machine that filters the blood outside the body, not the peritoneal membrane.

B) This statement is incorrect. Continuous ambulatory peritoneal dialysis (CAPD) uses the peritoneal membrane as a filter during manual exchanges of dialysate fluid, not with a machine like automated peritoneal dialysis (APD).

C) This statement is accurate. Automated peritoneal dialysis (APD) uses a machine to perform exchanges of dialysate solution through the peritoneal membrane.

D) This statement is incorrect. Peritoneal dialysis uses the peritoneal membrane as a filter. It involves the instillation and drainage of dialysate fluid into the abdominal cavity through a catheter.

A) The client's symptoms of dizziness and weakness may indicate hypotension (low blood pressure). The nurse should first check the client's blood pressure and pulse rate to assess for hypotension before implementing further interventions.

B) This statement is incorrect. Administering an antiemetic medication would not address the reported symptoms of dizziness and weakness, which may be related to changes in blood pressure.

C) This statement is incorrect. Increasing the rate of fluid removal during dialysis may exacerbate the client's symptoms of dizziness and weakness and may lead to hypotension (low blood pressure).

D) This statement is incorrect. Elevating the client's legs may help improve blood flow, but it does not address the underlying cause of the reported symptoms. The nurse should first check the client's blood pressure and pulse rate to assess for hypotension before implementing further interventions.

A) This statement is incorrect. The catheter dressing should be changed regularly as per the healthcare provider's instructions, but it is not typically changed every week.

B) This statement is incorrect. The routine use of antibiotic ointment is not recommended, as it can lead to antibiotic resistance and is not necessary for all clients on peritoneal dialysis.

C) To reduce the risk of infection, the client should avoid touching the catheter site with clean hands. Maintaining proper hand hygiene is essential to prevent infection.

D) This statement is incorrect. Cleaning the catheter site with hydrogen peroxide is not recommended, as it can be too harsh and irritating to the skin. Instead, the site should be cleaned with mild soap and water or as instructed by the healthcare provider.

A) This statement is incorrect. Increasing the dialysis session duration would not address the client's muscle cramps and may lead to further fluid and electrolyte imbalances.

B) Muscle cramps during hemodialysis can be caused by the cooling effect of the dialysate solution. Increasing the temperature of the dialysate can help alleviate the cramps.

C) This statement is incorrect. Decreasing the dialysate solution flow rate may not directly address the muscle cramps and may not be indicated unless there are other clinical indications to do so.

D) This statement is incorrect. Administering an anticoagulant medication is not relevant to address muscle cramps. Muscle cramps during hemodialysis are often caused by the cooling effect of the dialysate solution. Increasing the temperature of the dialysate can help alleviate the cramps.

A) This statement is incorrect. Erythropoietin-stimulating agents (ESAs) are not used to prevent infections during dialysis. They are used to address anemia by stimulating red blood cell production.

B) This statement is accurate. Erythropoietin-stimulating agents (ESAs) stimulate the bone marrow to produce more red blood cells, addressing anemia commonly associated with chronic kidney disease and dialysis.

C) This statement is incorrect. Erythropoietin-stimulating agents (ESAs) do not reduce the risk of blood clot formation. They are specific to stimulating the production of red blood cells.

D) This statement is incorrect. Erythropoietin-stimulating agents (ESAs) do not enhance kidney function and filtration. They target the production of red blood cells to address anemia associated with ESRD and dialysis.

A) This statement is incorrect. Cloudy dialysate drainage may indicate infection or peritonitis, and the nurse should not simply document the finding and continue monitoring without further assessment.

B) This statement is incorrect. Administering an antibiotic medication without a definitive diagnosis is not appropriate. The nurse should assess the client further to determine the cause of the cloudy drainage.

C) This statement is incorrect. Increasing the dialysis exchange frequency would not address the issue of cloudy dialysate drainage and may not be indicated without a proper assessment.

D) This statement is correct. Cloudy dialysate drainage may indicate infection or peritonitis. The nurse should check the client's vital signs and assess for signs of abdominal pain or tenderness, as this requires immediate evaluation.

A) This statement is accurate. Clients on hemodialysis should limit their protein intake to reduce the workload on the kidneys and minimize waste buildup. Excess protein intake can lead to the accumulation of urea and other waste products, which can be challenging for the compromised kidneys to eliminate.

B) This statement is incorrect. While clients on hemodialysis may need to limit sodium intake to manage fluid retention and blood pressure, the primary nutrient that requires limitation in their diet is protein.

C) This statement is incorrect. Clients on hemodialysis may need to monitor their calcium intake, but it is not the primary nutrient that requires limitation in their diet. Calcium levels may be affected by the use of phosphate binders and the avoidance of high-phosphorus foods, but protein restriction is more critical.

D) This statement is incorrect. Iron intake may need to be managed for clients with anemia, which is common in end-stage renal disease (ESRD) and dialysis. However, protein restriction remains a more significant dietary consideration for clients on hemodialysis.

QUESTIONS

A) This statement is incorrect. Hypertension (high blood pressure) is a common complication of kidney disease, but it is not the primary indication for initiating dialysis. Dialysis is primarily indicated to address the impaired filtration and waste removal functions of the kidneys, which can lead to electrolyte imbalances like hyperkalemia.

B) This statement is incorrect. Hypercalcemia (elevated calcium levels) is not a primary indication for initiating dialysis. While calcium imbalances can be associated with kidney disease, hyperkalemia takes precedence as a more critical indication for dialysis initiation.

C) This statement is accurate. Hyperkalemia (elevated potassium levels) is a critical indication for initiating dialysis. Dialysis helps remove excess potassium from the bloodstream when the kidneys are unable to do so, preventing potentially life-threatening complications.

D) This statement is incorrect. Hypokalemia (low potassium levels) is not an indication for initiating dialysis. In fact, dialysis may lead to a reduction in potassium levels, and clients on dialysis are more likely to experience hyperkalemia.

A) This statement is incorrect. Dialysis does not restore normal kidney function. Instead, it serves as a substitute for impaired kidney function, helping to maintain fluid and electrolyte balance.

B) This statement is incorrect. Dialysis is not a surgical procedure to transplant a healthy kidney. Kidney transplantation is a separate procedure that involves replacing a damaged kidney with a healthy one from a living or deceased donor.

C) This statement is incorrect. Dialysis may help manage complications of CKD and prolong life, but it does not prevent the progression of the underlying kidney disease. CKD is a chronic and progressive condition that may eventually require dialysis or kidney transplantation.

D) This statement is accurate. Dialysis is the process of removing waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions adequately.

A) This statement is incorrect. Hypokalemia (low potassium levels) is not an indication for initiating dialysis. In AKI, electrolyte imbalances can occur, but hyperkalemia is more likely due to impaired kidney function.

B) This statement is incorrect. Hyponatremia (low sodium levels) is not a primary indication for initiating dialysis in AKI. It can occur due to fluid shifts, but the primary concern in AKI is the accumulation of waste products like urea, leading to uremia.

C) This statement is incorrect. Hypernatremia (high sodium levels) is not a primary indication for initiating dialysis in AKI. Hypernatremia is rare in AKI and usually occurs when there is a significant loss of free water compared to sodium intake.

D) Uremia, which is characterized by elevated levels of urea and other waste products in the blood, is a critical indication for initiating dialysis in clients with acute kidney injury. Dialysis helps remove these toxic substances from the bloodstream.

A) This statement is incorrect. Hypermagnesemia (elevated magnesium levels) can be a concern in ESRD, but it is not a primary indication for initiating dialysis. Magnesium levels can be managed through dietary restrictions and medications without the need for dialysis.

B) This statement is incorrect. Hyperphosphatemia (elevated phosphorus levels) is a common issue in ESRD, but it is not a primary indication for initiating dialysis. Clients with ESRD may receive phosphate binders to control phosphorus levels without necessarily needing immediate dialysis.

C) This statement is incorrect. Hyperkalemia (elevated potassium levels) is a concern in ESRD, but it is not the primary indication described in the scenario. While hyperkalemia may occur with fluid overload, the primary concern in this case is the hypervolemia and its associated symptoms.

D) Hypervolemia (severe fluid overload) is a critical indication for initiating dialysis in clients with end-stage renal disease. Dialysis helps remove excess fluid from the body and can relieve symptoms such as pulmonary edema and hypertension.

A) This statement is incorrect. Hypernatremia (high sodium levels) is not the primary indication for initiating dialysis in this case. Metabolic acidosis and the inability of the kidneys to excrete acids are the primary concerns.

B) This statement is incorrect. Hyperkalemia (elevated potassium levels) may occur in CKD, but it is not the primary indication described in the scenario. Metabolic acidosis is the primary concern leading to the need for dialysis.

C) This statement is incorrect. Hypocalcemia (low calcium levels) can be a complication of CKD, but it is not the primary indication for initiating dialysis in this scenario. Metabolic acidosis and its associated symptoms take precedence.

D) Severe metabolic acidosis, which results from the kidneys' inability to adequately excrete acids and regulate pH balance, is a critical indication for initiating dialysis in clients with CKD.

A) This statement is incorrect. Hypercalcemia (elevated calcium levels) can be a concern in ESRD, but it is not the primary indication for initiating dialysis in this scenario. Pruritus is more commonly associated with uremia and high levels of other waste products.

B) This statement is incorrect. Hypervolemia (fluid overload) can be a concern in ESRD, but it is not the primary indication described in the scenario. The persistent pruritus is more likely related to uremia and the accumulation of toxins.

C) This statement is incorrect. Hyperkalemia (elevated potassium levels) is not the primary indication described in the scenario. While hyperkalemia may occur in ESRD, the primary concern leading to the need for dialysis in this case is the uremia and its associated symptoms.

D) Uremia, which is the accumulation of urea and other waste products in the blood, can lead to various complications, including pruritus. Dialysis helps remove these waste products from the bloodstream and may alleviate the itching associated with uremia.

A) This statement is incorrect. Hypoglycemia (low blood glucose) is not the primary indication for initiating dialysis. Hypoglycemia can occur in certain situations, but it is not the primary concern in this case.

B) This statement is incorrect. Hyperkalemia (elevated potassium levels) can be a concern in AKI, but it is not the primary indication described in the scenario. The primary concern in AKI with decreased GFR is the impaired filtration and waste removal, leading to the need for dialysis.

C) This statement is incorrect. Hypernatremia (high sodium levels) is not a primary indication for initiating dialysis in AKI. Hypernatremia is rare in AKI and usually occurs when there is a significant loss of free water compared to sodium intake.

D) A significantly decreased glomerular filtration rate (GFR) indicates that the kidneys' ability to filter waste products and excess fluids from the blood is severely impaired. Dialysis can help support kidney function and remove waste products when the GFR is critically low.

A) This statement is incorrect. Hyperkalemia (elevated potassium levels) can be a concern in ESRD, but it is not the primary indication described in the scenario. While hyperkalemia may occur in ESRD, the primary concern leading to the need for dialysis is the uremia and its associated symptoms.

B) This statement is incorrect. Hypophosphatemia (low phosphorus levels) can be a concern in ESRD, but it is not the primary indication for initiating dialysis in this case. Uremia and its associated symptoms are the primary concerns leading to the need for dialysis.

C) Uremia, which is characterized by elevated levels of urea and other waste products in the blood, is a critical indication for initiating dialysis in clients with end-stage renal disease. Dialysis helps remove these toxic substances from the bloodstream and may alleviate symptoms like fatigue, weakness, and decreased urine output.

D) This statement is incorrect. Hyponatremia (low sodium levels) is not the primary indication for initiating dialysis in this scenario. Uremia and the accumulation of waste products are the primary concerns that require dialysis to address.

QUESTIONS

A) This statement is incorrect. Hemodialysis does not involve the removal of the peritoneal membrane; that description is characteristic of peritoneal dialysis.

B) This statement is accurate. Hemodialysis uses a machine called a dialyzer to filter blood outside the body, removing waste products and excess fluid before returning the clean blood to the patient.

C) This statement is incorrect. Hemodialysis does not rely on a catheter inserted into the bladder; that description is characteristic of urinary catheterization.

D) This statement is incorrect. Hemodialysis does not use a pump to circulate dialysate through the intestines; that description is characteristic of peritoneal dialysis.

A) This statement is incorrect. Increasing the rate of fluid removal during dialysis may worsen the client's symptoms of lightheadedness and dizziness, as it can lead to further drops in blood pressure.

B) This statement is incorrect. Administering an antihypertensive medication is not appropriate in this situation, as the client is experiencing symptoms of low blood pressure, not high blood pressure.

C) This statement is accurate. Feeling lightheaded and dizzy during hemodialysis may be a sign of hypotension (low blood pressure), and the nurse should assess the client's blood pressure and pulse rate to determine if intervention is needed.

D) This statement is incorrect. Elevating the client's legs may promote blood flow, but it does not address the immediate issue of lightheadedness and dizziness. Assessing the client's blood pressure and pulse rate is the priority to determine the appropriate intervention.

A) This statement is accurate. Clients on hemodialysis should limit their protein intake to reduce the workload on the kidneys and minimize waste buildup. Excess protein intake can lead to the accumulation of urea and other waste products, which can be challenging for the compromised kidneys to eliminate.

B) This statement is incorrect. While clients on hemodialysis may need to limit sodium intake to manage fluid retention and blood pressure, the primary nutrient that requires limitation in their diet is protein.

C) This statement is incorrect. Clients on hemodialysis may need to monitor their calcium intake, but it is not the primary nutrient that requires limitation in their diet. Calcium levels may be affected by the use of phosphate binders and the avoidance of high-phosphorus foods, but protein restriction is more critical.

D) This statement is incorrect. Iron intake may need to be managed for clients with anemia, which is common in end-stage renal disease (ESRD) and dialysis. However, protein restriction remains a more significant dietary consideration for clients on hemodialysis.

A) This statement is incorrect. Increasing the dialysis session duration would not address the client's muscle cramps and may lead to further fluid and electrolyte imbalances.

B) This statement is accurate. Muscle cramps during hemodialysis are often caused by the cooling effect of the dialysate solution. Increasing the temperature of the dialysate can help alleviate the cramps.

C) This statement is incorrect. Decreasing the dialysate solution flow rate may not directly address the muscle cramps and may impact the effectiveness of the dialysis treatment.

D) This statement is incorrect. Administering an anticoagulant medication is not indicated for muscle cramps during hemodialysis. Anticoagulants are used to prevent blood clots during the procedure but would not alleviate muscle cramps.

A)This statement is incorrect. Administering an analgesic for the headache may provide temporary relief, but it does not address the underlying issue of fluid overload and elevated blood pressure.

B) This statement is incorrect. Notifying the healthcare provider about the blood pressure changes is important, but assessing for fluid overload and taking appropriate actions should be the nurse's priority.

C) This statement is accurate. Headache and restlessness during hemodialysis, along with elevated blood pressure, may indicate fluid overload. The nurse should assess the client's weight and fluid intake during the dialysis session to determine if there is excessive fluid retention.

D) This statement is incorrect. Increasing the dialysate solution flow rate may not be appropriate without further assessment of the client's fluid status. It could worsen the fluid overload and further increase blood pressure.

A) This statement is incorrect. Serum calcium levels are not directly related to ESA therapy for anemia management. ESA therapy focuses on increasing red blood cell production.

B) This statement is incorrect. Blood urea nitrogen (BUN) levels are indicators of kidney function and may be monitored for other reasons in a client on hemodialysis. However, they are not directly related to ESA therapy for anemia management.

C) This statement is accurate. During ESA therapy, the nurse should closely monitor the client's hemoglobin and hematocrit levels. ESAs stimulate the production of red blood cells and can increase hemoglobin and hematocrit levels. Regular monitoring is essential to prevent anemia or excessive increases in these values.

D) This statement is incorrect. Serum potassium levels may be monitored for a client on hemodialysis due to the potential for electrolyte imbalances, but they are not the primary concern during ESA therapy for anemia management.

A) This statement is accurate. Palpating for a thrill or vibration over the AV fistula site is a critical assessment to ensure proper functioning. A thrill indicates adequate blood flow through the fistula, which is essential for effective hemodialysis.

B) This statement is incorrect. Auscultating for bruits over the radial artery is not related to the AV fistula assessment. The bruit is the sound of blood flow in the fistula, which is best assessed directly over the fistula site.

C) This statement is incorrect. Checking for distal pulses in the lower extremities is not related to the assessment of an AV fistula. The AV fistula is typically created in the upper extremity.

D) This statement is incorrect. Assessing for swelling and tenderness in the neck is not related to the AV fistula assessment. Swelling and tenderness may be related to other issues but are not specific to AV fistula functioning.

A) This statement is incorrect. Monitoring hemoglobin levels is essential for clients with ESRD and during hemodialysis, but it is not directly related to the administration of heparin.

B) This statement is accurate. While a drop in platelet count is not uncommon during heparin administration, the nurse should closely monitor the client's platelet count to detect any significant changes or potential complications related to heparin-induced thrombocytopenia.

C) This statement is incorrect. Monitoring blood glucose levels is important, especially for clients with diabetes or those at risk of hypoglycemia during dialysis, but it is not specifically related to heparin administration.

D) This statement is incorrect. Monitoring blood urea nitrogen (BUN) levels is crucial for clients with ESRD, but it is not directly related to the administration of heparin during hemodialysis.

QUESTIONS

A) This statement is incorrect. Peritoneal dialysis does not use a machine to filter blood outside of the body; that description is characteristic of hemodialysis.

B) This statement is incorrect. Peritoneal dialysis does not involve the removal of the peritoneal membrane; instead, it uses the peritoneal membrane in the abdomen to filter waste.

C) This statement is accurate. Peritoneal dialysis uses the peritoneal membrane in the abdomen as a semipermeable membrane to filter waste products and excess fluids from the blood.

D) This statement is incorrect. Peritoneal dialysis does not require a catheter to be inserted into the bladder. Instead, it uses a catheter to infuse and drain dialysate into and out of the peritoneal cavity.

A) This statement is incorrect. While administering an antibiotic may be necessary if peritonitis is confirmed, it should not be done without obtaining a sample for testing first.

B) This statement is incorrect. Measuring vital signs and assessing for pain are essential aspects of client assessment, but they may not provide enough information to determine the cause of the cloudy drainage.

C) This statement is incorrect. Clamping the catheter may be necessary if peritonitis is suspected, but it should not be done without first obtaining a sample of the drainage for testing.

D) This statement is accurate. Cloudy drainage from the catheter site may indicate peritonitis, which is an infection of the peritoneal cavity. Obtaining a sample of the drainage for culture and sensitivity testing can help identify the presence of infection and guide appropriate treatment.

A) This statement is incorrect. Serum calcium levels are not directly related to ESA therapy for anemia management. ESA therapy focuses on increasing red blood cell production.

B) This statement is incorrect. Blood urea nitrogen (BUN) levels are indicators of kidney function and may be monitored for other reasons in a client on peritoneal dialysis. However, they are not directly related to ESA therapy for anemia management.

C) This statement is accurate. During ESA therapy, the nurse should closely monitor the client's hemoglobin and hematocrit levels. ESAs stimulate the production of red blood cells and can increase hemoglobin and hematocrit levels. Regular monitoring is essential to prevent anemia or excessive increases in these values.

D) This statement is incorrect. Serum potassium levels may be monitored for a client on peritoneal dialysis due to the potential for electrolyte imbalances, but they are not the primary concern during ESA therapy for anemia management.

A) This statement is incorrect. Infection is not a rare complication of peritoneal dialysis. It is a common risk that requires proactive measures to prevent.

B) This statement is incorrect. While infections can occur and may be treatable with antibiotics, it is essential to focus on prevention and maintaining aseptic technique.

C) This statement is incorrect. Taking antibiotics regularly to prevent infection is not the standard practice for clients on peritoneal dialysis. Antibiotics are typically prescribed to treat infections when they occur, not as a preventive measure.

D) This statement is accurate. Infection is a significant risk for clients on peritoneal dialysis due to the direct access to the peritoneal cavity through the catheter. Strict aseptic technique is crucial to prevent infections.

A) This statement is incorrect. Administering an analgesic for the abdominal pain may provide temporary relief, but it does not address the underlying cause of the symptoms.

B) This statement is incorrect. Measuring blood pressure and pulse rate is essential for client assessment, but it may not provide enough information to determine the cause of the symptoms.

C) This statement is accurate. Abdominal pain and fever in a client on peritoneal dialysis may indicate peritonitis, which can result from infection or catheter issues. The nurse should first check the catheter for kinks or obstructions to ensure proper drainage and prevent complications.

D) This statement is incorrect. Notifying the healthcare provider about the symptoms is important, but the nurse should first assess the catheter for possible issues to determine if immediate intervention is needed.

A) This statement is incorrect. Peritoneal dialysis does not require extended hospital stays, as it can be performed at home.

B) This statement is incorrect. While some modifications to daily activities may be necessary, peritoneal dialysis does not generally require clients to limit their daily activities or avoid physical exertion.

C) This statement is accurate. Peritoneal dialysis is a form of dialysis that can be performed by the client at home, allowing them to continue with their daily activities without the need for hospitalization or daily clinic visits.

D) This statement is incorrect. Peritoneal dialysis is performed by the client at home, not at the outpatient clinic every day. The client may visit the clinic for periodic follow-up and assessment, but the actual dialysis is performed at home.

A) This statement is accurate. Hypertonic dialysate has a higher concentration of glucose, which results in increased fluid removal from the client's peritoneal cavity. This type of dialysate is often used for more effective ultrafiltration.

B) This statement is incorrect. Infusing hypertonic dialysate does not result in decreased urine output. Peritoneal dialysis is a process of exchanging fluids and waste products through the peritoneal membrane, but it does not directly affect urine production.

C) This statement is incorrect. Infusing hypertonic dialysate would not lead to hydration overload, as it causes fluid to be removed from the body.

D) This statement is incorrect. Hypertonic dialysate would not cause hypotension. In fact, it may lead to a decrease in blood pressure due to fluid removal, but it would not be considered a primary cause of hypotension.

A) This statement is incorrect. Increasing the intake of potassium-rich foods is not related to managing constipation. In fact, clients on peritoneal dialysis may need to restrict potassium intake due to the potential for electrolyte imbalances.

B) This statement is accurate. Constipation can be a common issue for clients on peritoneal dialysis due to the presence of glucose in the dialysate, which can draw fluid into the peritoneal cavity and lead to decreased bowel movement. Administering a stool softener as needed can help alleviate constipation.

C) This statement is incorrect. Decreasing fluid intake during dialysis is not recommended for managing constipation. Fluid intake should be maintained as prescribed to achieve adequate ultrafiltration.

D) This statement is incorrect. Encouraging the client to consume dairy products is not directly related to managing constipation. While calcium intake may be important for bone health in clients with ESRD, it is not a primary intervention for constipation.

QUESTIONS

A. Incorrect. Protein intake is essential for maintaining body functions, but clients on dialysis may need to adjust their protein intake based on their individual needs and dialysis prescription.

B. Incorrect. Clients on dialysis may need to limit their sodium intake to manage fluid retention and blood pressure.

C. Correct. Clients on dialysis often need to avoid potassium-rich foods to prevent hyperkalemia, as the kidneys are unable to adequately remove excess potassium from the blood.

D. Incorrect. Clients on dialysis typically need to restrict their phosphorus intake to prevent complications related to high phosphorus levels, such as bone disease and cardiovascular issues.

A. Correct. Monitoring the client's blood pressure and heart rate is a priority during dialysis to assess the client's hemodynamic status and detect any potential complications, such as hypotension or arrhythmias.

B. Incorrect. While assisting with dietary s is important, it is not the priority during the dialysis procedure.

C. Incorrect. Providing emotional support is essential, but the nurse's priority during dialysis is to monitor the client's vital signs and ensure their safety during the procedure.

D. Incorrect. Administering prescribed intravenous medications may be necessary during dialysis, but it is not the priority action stated in this question.

A. Incorrect. Using sterile technique when handling the catheter is essential to prevent infection. Clients and caregivers should be taught the proper aseptic technique for catheter care.

B. Incorrect. Alcohol wipes can dry out the skin and are not recommended for cleaning the catheter insertion site. A more appropriate solution is provided in the correct answer.

C. Correct. Changing the dressing over the catheter daily using clean gloves helps maintain a clean and dry site, reducing the risk of infection during peritoneal dialysis.

D. Incorrect. The catheter should not be immersed in water during bathing or showering, as this can introduce pathogens and increase the risk of infection.

A. Incorrect. Limiting fluid intake is important for some clients with renal issues, but clients on dialysis typically need to maintain adequate hydration due to fluid removal during the procedure.

B. Correct. Clients on dialysis often need to consume plenty of fluids to compensate for the fluid removal that occurs during dialysis treatment, preventing dehydration and maintaining hemodynamic stability.

C. Incorrect. Increasing salt intake is not recommended for clients on dialysis, as it can contribute to fluid retention and worsen hypertension.

D. Incorrect. Limiting fluid intake only on the day of dialysis treatment is not sufficient to maintain overall hydration and may lead to imbalances and complications between dialysis sessions.

A. Correct. Avoiding heavy lifting can help prevent trauma or dislodgement of the peritoneal catheter, which can be a risk factor for infection or complications.

B. Correct. Cleaning the catheter exit site with soap and water daily helps maintain cleanliness and reduce the risk of infection.

C. Incorrect. The dressing around the catheter insertion site should be changed more frequently than weekly, ideally every 2-3 days, to ensure proper hygiene and reduce the risk of infection.

D. Correct. Notifying the healthcare provider about any redness or drainage at the catheter site is essential, as these can be signs of infection or other complications that require prompt evaluation and treatment.

A. Incorrect. Warming the dialysate fluid to body temperature before instilling it into the peritoneal cavity is a standard procedure in continuous ambulatory peritoneal dialysis (CAPD. .

B. Correct. Performing the exchanges in a clean, dry environment free from pets is crucial to prevent contamination and reduce the risk of infection during CAPD.

C. Incorrect. Using tap water to cleanse the catheter insertion site before the exchange is not recommended. The catheter exit site should be cleaned with an appropriate antiseptic solution as instructed by the healthcare provider.

D. Incorrect. While daily dressing changes are important, using sterile technique for catheter dressing changes may not be necessary, as the dressing does not directly contact the peritoneal cavity during CAPD exchanges.

A. Correct. Using the arm with the AV fistula for blood pressure measurements can compress the vascular access and compromise blood flow. It is important to avoid using the fistula arm for blood pressure measurements and venipuncture.

B. Incorrect. The AV fistula should not be used for intravenous catheter insertion to prevent potential damage and infection to the access site.

C. Incorrect. Self-cannulation of the AV graft is typically performed by healthcare professionals, and clients should not attempt to self-cannulate their vascular access.

D. Incorrect. If an AV fistula starts bleeding, the client should not apply pressure to the site. Instead, they should immediately elevate the arm and apply pressure to the bleeding site with a clean cloth or bandage while seeking medical attention.

QUESTIONS

A. Incorrect. Increasing the dialysate temperature can lead to vasodilation and potentially exacerbate hypotension during dialysis.

B. Correct. Limiting fluid removal during dialysis is essential to prevent excessive fluid loss, which can cause hypotension and potentially lead to intradialytic hypotension.

C. Incorrect. Encouraging a high-sodium diet is not the primary intervention to prevent dialysis-related hypotension. It may be recommended for some clients to manage hyponatremia, but fluid management is more critical.

D. Incorrect. Administering intravenous hypertonic saline during dialysis is not a routine intervention to prevent hypotension. It may be used in specific cases, but fluid management is the primary approach.

A. Incorrect. Collecting a sample of the effluent for culture and sensitivity testing may be necessary, but notifying the healthcare provider about the finding should be done first.

B. Incorrect. Stopping the exchange immediately may be necessary in some cases, but the nurse should first communicate the finding to the healthcare provider for further assessment and guidance.

C. Correct. Cloudy dialysate effluent may indicate peritonitis, an infection of the peritoneal cavity, which requires immediate attention and treatment by the healthcare provider.

D. Incorrect. Encouraging the client to perform another exchange without further assessment can potentially exacerbate any underlying issue causing the cloudy effluent.

A. Incorrect. While administering an antiepileptic medication may be necessary if the client is experiencing seizures, it is essential to identify the underlying cause first.

B. Correct. The client's severe headache, confusion, and seizures may be indicative of dialysis disequilibrium syndrome, which is a complication of rapid solute removal during hemodialysis. Hypoglycemia can also present with similar symptoms, so assessing blood glucose levels is crucial to differentiate between the two conditions.

C. Incorrect. Documenting the findings and monitoring the client's condition are important, but addressing the acute symptoms and potential cause should be the priority.

D. Incorrect. Checking the client's pre-dialysis weight is not the priority when the client is experiencing severe neurological symptoms. Immediate assessment and intervention are needed.

A. Incorrect. Administering a calcium channel blocker is not the first-line intervention for muscle cramps during dialysis.

B. Incorrect. Slowing down the blood flow rate during dialysis may be necessary in some cases, but it is not the first action to address muscle cramps.

C. Correct. Muscle cramps during dialysis can be caused by electrolyte imbalances, such as low potassium levels. Offering the client a sports drink with electrolytes can help alleviate the cramps.

D. Incorrect. Applying a heating pad to the affected muscles is not recommended during dialysis, as it may cause burns or worsen the cramps.

A. Incorrect. Administering a prescribed analgesic may be necessary, but it is not the priority when the client is experiencing sudden chest pain and dyspnea.

B. Correct. The sudden onset of chest pain and dyspnea can be indicative of potential complications, such as dialysis-related hypotension, cardiac issues, or fluid overload. Assessing the client's blood pressure and heart rate is the priority to identify any acute changes or abnormalities.

C. Incorrect. Monitoring the client's weight is important to assess fluid status, but it is not the immediate priority when the client presents with acute chest pain and dyspnea.

D. Incorrect. Placing the client in a semi-Fowler's position may be appropriate for respiratory distress, but the nurse should first assess the client's vital signs and overall condition before implementing positioning changes.

A. Incorrect. Instructing the client to increase fluid intake may not address the underlying cause of abdominal pain and fever in a client on peritoneal dialysis.

B. Incorrect. Assisting the client with a peritoneal fluid exchange is not the priority when the client is experiencing abdominal pain and fever, as it may exacerbate the symptoms.

C. Incorrect. Administering an over-the-counter pain reliever may provide temporary relief, but it does not address the underlying cause of the symptoms.

D. Correct. Abdominal pain and fever in a client on peritoneal dialysis may indicate peritonitis, an infection of the peritoneal cavity. Obtaining a peritoneal fluid sample for testing is essential to confirm the diagnosis and initiate appropriate treatment promptly.

A. Incorrect. Offering hard candies or mints may provide temporary relief from the metallic taste, but it does not address the underlying cause.

B. Correct. A persistent metallic taste in the mouth can be caused by various factors, such as dietary changes, medication side effects, or biochemical imbalances. Assessing the client's recent dietary and medication changes can help identify the potential cause.

C. Incorrect. Providing an oral rinse may offer temporary relief, but it does not address the underlying cause of the metallic taste.

D. Incorrect. Administering an antiemetic medication is not indicated for a metallic taste in the mouth, as it is not associated with nausea or vomiting.

A. Correct. Applying pressure to the bleeding site is the first action to control the bleeding and prevent excessive blood loss.

B. Incorrect. Elevating the arm above heart level may not be effective in controlling bleeding from the access site and could cause unnecessary discomfort.

C. Incorrect. Administering a prescribed antiplatelet medication is not the first action to take when the client experiences bleeding from the access site, as it may further increase bleeding risk.

D. Incorrect. While checking the client's platelet count is important, it is not the first action to address active bleeding. Applying pressure to the bleeding site takes priority to control the bleeding.

QUESTIONS

A. Correct. Nephrotic syndrome is characterized by increased protein loss in the urine, leading to hypoalbuminemia and a weakened immune system. Clients with nephrotic syndrome are at a higher risk of infection, so the priority nursing intervention is to assess for signs of infection and initiate appropriate treatment promptly.

B. Incorrect. While monitoring blood glucose levels is essential in some conditions, it is not the priority for a client with nephrotic syndrome.

C. Incorrect. Dietary education may be necessary, but increasing protein intake is not appropriate for clients with nephrotic syndrome due to the increased protein loss in the urine.

D. Incorrect. Diuretics may be used to manage edema in nephrotic syndrome, but the priority intervention is to assess for infection, as it poses a more immediate threat to the client's health.

A. Incorrect. Corticosteroids should be taken with food to reduce the risk of gastrointestinal side effects.

B. Incorrect. While corticosteroids may improve proteinuria over time, it is unlikely to see an immediate improvement after starting the medication.

C. Correct. Corticosteroids can suppress the immune system and increase the risk of infection, so the client should avoid crowded places and contact with individuals who are sick to minimize the risk of infections.

D. Incorrect. Corticosteroids do not specifically affect potassium levels, so there is no need for a diet high in potassium to offset potential electrolyte imbalances.

A. Incorrect. Restricting fluid intake may not be appropriate for clients with nephrotic syndrome, as they may already have reduced fluid intake due to decreased glomerular filtration.

B. Incorrect. Elevating the client's legs can help reduce edema, but a low-sodium diet is a more direct and essential intervention for managing fluid retention in nephrotic syndrome.

C. Correct. A low-sodium diet is crucial in managing edema in nephrotic syndrome. Sodium intake can lead to fluid retention, and reducing sodium intake helps decrease edema.

D. Incorrect. Monitoring blood glucose levels is important for clients with diabetes, but it is not directly related to managing edema in nephrotic syndrome.

A. Incorrect. Frothy, foamy urine is not characteristic of increased glucose levels in the urine.

B. Incorrect. While blood in the urine may cause changes in urine color, it does not result in frothy, foamy appearance.

C. Correct. Nephrotic syndrome is characterized by increased protein excretion in the urine (proteinuriA. . The presence of protein in the urine can cause it to appear frothy and foamy.

D. Incorrect. Creatinine levels reflect kidney function, but they do not cause changes in urine appearance.

A. Correct. ACE inhibitors are commonly prescribed in nephrotic syndrome to reduce proteinuria by dilating blood vessels and decreasing pressure in the glomerulus. This helps preserve kidney function and slow the progression of kidney damage.

B. Incorrect. ACE inhibitors are not primarily used to manage blood glucose levels in diabetes, although they may have some impact on blood pressure control in clients with both diabetes and nephrotic syndrome.

C. Incorrect. ACE inhibitors do not directly impact calcium absorption or bone health in nephrotic syndrome.

D. Incorrect. ACE inhibitors do not specifically increase potassium excretion. In fact, they may lead to potassium retention, so clients may need to be cautious about potassium intake while on ACE inhibitors.

A. Correct. Diuretics can lead to potassium loss, potentially causing hypokalemia. Monitoring serum potassium levels is essential to prevent complications related to potassium imbalances.

B. Incorrect. Diuretics may affect blood glucose levels indirectly, but their primary impact is not related to glucose control.

C. Incorrect. Diuretics do not directly impact calcium levels

in nephrotic syndrome.

D. Incorrect. While monitoring blood pressure is important in nephrotic syndrome, it is not the primary focus when clients are on diuretic therapy.

A. Incorrect. While increased proteinuria can increase the risk of clot formation in the urinary tract, anticoagulant therapy is not typically prescribed for this reason in nephrotic syndrome.

B. Incorrect. Anticoagulants are not primarily used to reduce inflammation and pain associated with kidney damage.

C. Incorrect. Anticoagulants do not directly impact the risk of infection related to hypoalbuminemia.

D. Correct. Nephrotic syndrome can cause damage to the glomerular capillaries, leading to clot formation. Anticoagulant therapy is prescribed to prevent clot formation in the kidneys and reduce the risk of complications such as renal vein thrombosis.

QUESTIONS

A. Incorrect. Hematuria (blood in the urinE. and dysuria (painful urination) are not characteristic manifestations of nephrotic syndrome. Instead, they may indicate other kidney conditions or infections.

B. Incorrect. While clients with nephrotic syndrome may experience increased urine output (polyuriA. and nighttime urination (nocturiA. due to fluid imbalances, these are not the primary clinical manifestations.

C. Correct. Frothy, foamy urine output is a classic sign of nephrotic syndrome due to the presence of excessive protein (proteinuriA. in the urine. This foamy appearance is caused by the high levels of protein, mainly albumin, in the urine.

D. Incorrect. Suprapubic tenderness and urgency are not typical manifestations of nephrotic syndrome and may indicate other urinary tract or bladder issues.

A. Incorrect. Increased renal blood flow and fluid overload would lead to excessive urine output and reduced edema, which is not consistent with nephrotic syndrome.

B. Incorrect. Excessive sodium excretion and dehydration would lead to reduced fluid retention and edema, which is not consistent with nephrotic syndrome.

C. Correct. Nephrotic syndrome is characterized by glomerular damage, leading to increased permeability of the glomerular capillaries and loss of protein (mainly albumin) in the urine. This results in decreased oncotic pressure in the blood vessels, leading to edema in various parts of the body.

D. Incorrect. Elevated blood pressure and vascular leakage would lead to a different set of clinical manifestations, not characteristic of nephrotic syndrome.

A. Correct. Periorbital edema is a common manifestation of nephrotic syndrome, especially in the morning after fluid accumulation overnight. Elevated blood pressure and headache may accompany this edema, indicating fluid retention and hypertension, which are frequently associated with nephrotic syndrome.

B. Incorrect. Yellowish discoloration of the skin and sclera (jaundicE. is not a typical manifestation of nephrotic syndrome and is more indicative of liver dysfunction or bile flow obstruction.

C. Incorrect. Pain and tenderness over the lower back are not directly related to periorbital edema and may suggest a separate issue, such as musculoskeletal pain.

D. Incorrect. Shortness of breath and crackles in the lungs are not specific to nephrotic syndrome and may suggest other respiratory or cardiac issues.

A. Incorrect. Elevated blood pressure and fluid overload are more indicative of fluid retention and hypertension in nephrotic syndrome, not hypoalbuminemia.

B. Correct. Hypoalbuminemia, a common feature of nephrotic syndrome, results from the loss of albumin (a protein) in the urine. Low albumin levels can lead to muscle weakness and fatigue due to decreased oncotic pressure in the blood vessels, resulting in fluid shifting from the blood vessels to the interstitial spaces.

C. Incorrect. Hyperactivity and restlessness are not typical manifestations of hypoalbuminemia and nephrotic syndrome.

D. Incorrect. Pallor and cold extremities are not directly related to hypoalbuminemia and are not specific to nephrotic syndrome.

A. Incorrect. Elevated platelet count and clotting factors are not characteristic of nephrotic syndrome. Clients with nephrotic syndrome tend to have normal platelet counts.

B. Incorrect. Decreased blood viscosity and enhanced blood flow would not directly lead to an increased risk of thromboembolic events in nephrotic syndrome.

C. Incorrect. While impaired liver function may impact clotting factors, it is not a common manifestation of nephrotic

syndrome.

D. Correct. Nephrotic syndrome is associated with a loss of anticoagulant proteins, particularly antithrombin III, in the urine. This loss of anticoagulant proteins contributes to a state of hypercoagulability, increasing the risk of thromboembolic events, such as deep vein thrombosis and pulmonary embolism.

A. Incorrect. Abdominal distension and discomfort are not typical manifestations of a urinary tract infection, even in the presence of proteinuria.

B. Correct. Nephrotic syndrome often results in hypoalbuminemia due to significant protein loss in the urine. Hypoalbuminemia leads to decreased oncotic pressure in the blood vessels, causing fluid to leak into the peritoneal cavity and resulting in abdominal distension and discomfort, known as ascites.

C. Incorrect. Hyperkalemia may occur in chronic kidney disease, including nephrotic syndrome, but it is not directly related to abdominal distension and discomfort.

D. Incorrect. Renal vein thrombosis is a complication of nephrotic syndrome but is not typically associated with acute abdominal distension and discomfort.

A. Incorrect. While increased cholesterol synthesis in the liver can contribute to hyperlipidemia, it is not the primary reason for elevated lipid levels in nephrotic syndrome.

B. Incorrect. Impaired fat absorption in the small intestine is not a significant factor contributing to hyperlipidemia in nephrotic syndrome.

C. Correct. Nephrotic syndrome results in increased protein loss, including proteins involved in lipid transport and metabolism. Reduced clearance of lipids by the kidneys leads to elevated lipid levels in the bloodstream.

D. Incorrect. Elevated blood glucose levels and insulin resistance are not directly related to hyperlipidemia in nephrotic syndrome.

QUESTIONS

A. Incorrect. While a renal biopsy may provide information about kidney function and glomerular filtration rate, its primary purpose in diagnosing nephrotic syndrome is to identify the specific histopathological changes in the kidney, which can help confirm the diagnosis and guide treatment decisions.

B. Incorrect. The response to diuretic therapy can be monitored through other means, such as assessing urine output and fluid balance. A renal biopsy is not performed primarily to evaluate the response to diuretics.

C. Incorrect. Renal biopsy is not typically used to evaluate the extent of renal inflammation and infection. Other imaging or laboratory tests are more suitable for assessing renal inflammation and infection.

D. Correct. A renal biopsy is the definitive diagnostic procedure for nephrotic syndrome. It allows the pathologist to examine a small tissue sample from the kidney and identify the specific histopathological changes, such as glomerular changes, that confirm the diagnosis.

A. Incorrect. Decreased serum albumin levels may contribute to fluid overload and hypertension in nephrotic syndrome, but they are not the primary indicators of these complications.

B. Incorrect. A decreased serum albumin level alone does not confirm the presence of proteinuria, which requires additional tests, such as a 24-hour urine collection for protein quantification.

C. Incorrect. Decreased serum albumin levels are not directly related to the presence of renal vein thrombosis, although nephrotic syndrome can increase the risk of thromboembolic events.

D. Correct. In nephrotic syndrome, the glomerular damage results in significant proteinuria, leading to decreased serum albumin levels. The loss of albumin in the urine contributes to hypoalbuminemia, a hallmark feature of nephrotic syndrome.

A. Incorrect. Glomerular filtration rate and kidney function are typically assessed through blood tests, such as serum creatinine and blood urea nitrogen (BUN) levels. A 24-hour urine collection is not used to assess these parameters.

B. Incorrect. The presence of glucose and ketones in the urine is typically assessed using a urinalysis or dipstick test. A 24-hour urine collection is not used to determine glucose and ketone levels.

C. Correct. A 24-hour urine collection measures the amount of protein excreted in the urine over a 24-hour period. This test is essential in diagnosing and monitoring nephrotic syndrome, as significant proteinuria is a hallmark feature of the condition.

D. Incorrect. The concentration of electrolytes in the urine is not typically assessed through a 24-hour urine collection. Urinary electrolyte levels are more commonly evaluated through spot urine samples or blood tests.

A. Incorrect. Monitoring lipid levels is not primarily aimed at identifying liver dysfunction in clients with nephrotic syndrome.

B. Incorrect. While nephrotic syndrome can lead to secondary diabetes mellitus in some cases, monitoring lipid levels is not a direct indicator of diabetes.

C. Correct. Nephrotic syndrome is associated with increased levels of lipids, including cholesterol and triglycerides, in the blood (hyperlipidemiA. . Monitoring lipid levels helps detect this common complication of nephrotic syndrome and informs treatment decisions.

D. Incorrect. Monitoring lipid levels is not directly related to evaluating electrolyte imbalances in clients with nephrotic syndrome. Electrolyte imbalances are typically assessed through separate blood tests.

QUESTIONS

A. Correct. Diuretics are commonly used to manage edema in clients with nephrotic syndrome. They help increase urine output and reduce fluid retention, which can alleviate severe edema and fluid overload.

B. Incorrect. Restricting fluid intake is not typically recommended for clients with nephrotic syndrome, as it may lead to dehydration and worsen the hypoalbuminemia.

C. Incorrect. While adequate protein intake is essential, a high-protein diet may not be appropriate for clients with nephrotic syndrome due to increased protein loss in the urine.

D. Incorrect. Monitoring blood glucose levels is important, but it is not directly related to managing edema and hypoalbuminemia in nephrotic syndrome.

A. Incorrect. Corticosteroids should be taken with food to reduce the risk of gastrointestinal side effects.

B. Incorrect. While corticosteroids may improve proteinuria over time, it is unlikely to see an immediate improvement after starting the medication.

C. Correct. Corticosteroids can suppress the immune system and increase the risk of infection, so the client should avoid crowded places and contact with individuals who are sick to minimize the risk of infections.

D. Incorrect. Corticosteroids do not specifically affect potassium levels, so there is no need for a diet high in potassium to offset potential electrolyte imbalances.

A. Incorrect. Increasing sodium intake would worsen edema and fluid retention in clients with nephrotic syndrome, as sodium contributes to fluid retention.

B. Incorrect. While protein intake may need to be adjusted in nephrotic syndrome, a low-protein diet is not typically indicated, as clients may already have protein loss in the urine.

C. Incorrect. Encouraging fluid restriction is not recommended in nephrotic syndrome, as it may lead to dehydration and worsen edema due to hypoalbuminemia.

D. Correct. A low-sodium diet is crucial in managing edema in nephrotic syndrome. Sodium intake can lead to fluid retention, and reducing sodium intake helps decrease edema.

A. Correct. ACE inhibitors are commonly prescribed in nephrotic syndrome to reduce proteinuria by dilating blood vessels and decreasing pressure in the glomerulus. This helps preserve kidney function and slow the progression of kidney damage.

B. Incorrect. ACE inhibitors are not primarily used to manage blood glucose levels in diabetes, although they may have some impact on blood pressure control in clients with both diabetes and nephrotic syndrome.

C. Incorrect. ACE inhibitors do not directly impact calcium absorption or bone health in nephrotic syndrome.

D. Incorrect. ACE inhibitors do not specifically increase potassium excretion. In fact, they may lead to potassium retention, so clients may need to be cautious about potassium intake while on ACE inhibitors.

A. Incorrect. Elevated platelet count and clotting factors are not characteristic of nephrotic syndrome. Clients with nephrotic syndrome tend to have normal platelet counts.

B. Incorrect. Decreased blood viscosity and enhanced blood flow would not directly lead to an increased risk of thromboembolic events in nephrotic syndrome.

C. Incorrect. While impaired liver function may impact clotting factors, it is not a common manifestation of nephrotic syndrome.

D. Correct. Nephrotic syndrome is associated with a loss of anticoagulant proteins, particularly antithrombin III, in the urine. This loss of anticoagulant proteins contributes to a state of hypercoagulability, increasing the risk of thromboembolic events, such as deep vein thrombosis and pulmonary embolism.

A. Incorrect. While increased cholesterol synthesis in the liver can contribute to hyperlipidemia, it is not the primary reason for elevated lipid levels in nephrotic syndrome.

B. Incorrect. Impaired fat absorption in the small intestine is not a significant factor contributing to hyperlipidemia in nephrotic syndrome.

C. Correct. Nephrotic syndrome results in increased protein loss, including proteins involved in lipid transport and metabolism. Reduced clearance of lipids by the kidneys leads to elevated lipid levels in the bloodstream.

D. Incorrect. Elevated blood glucose levels and insulin resistance are not directly related to hyperlipidemia in nephrotic syndrome.

QUESTIONS

A. Correct. Monitoring blood pressure regularly is essential for clients with nephrotic syndrome, as they are at risk of hypertension due to fluid retention.

B. Incorrect. Restricting fluid intake is not typically recommended for clients with nephrotic syndrome, as it may lead to dehydration and worsen edema due to hypoalbuminemia.

C. Correct. Clients with nephrotic syndrome are at increased risk of infections due to immunosuppression from protein loss in the urine. Reporting any signs of infection is crucial to ensure timely intervention.

D. Correct. Daily weight monitoring is essential for clients with nephrotic syndrome to assess for fluid retention. Sudden weight changes can indicate worsening edema and fluid overload.

A. Incorrect. Increased urine output and dehydration are not common side effects of corticosteroid therapy. Instead, clients may experience fluid retention and edema due to the medication's effects.

B. Correct. Corticosteroids can cause increased appetite, leading to weight gain, which is a common side effect that clients should be aware of.

C. Incorrect. Frequent bruising and prolonged bleeding are not typical side effects of corticosteroids. Instead, clients on corticosteroid therapy may experience increased susceptibility to infections and impaired wound healing.

D. Incorrect. Corticosteroids are more likely to cause fluid retention and increased blood pressure, leading to potential hypertension, rather than low blood pressure and dizziness.

A. Incorrect. While protein intake may need to be adjusted in nephrotic syndrome, increasing protein intake is not typically recommended, as clients may already have significant protein loss in the urine.

B. Incorrect. Limiting potassium-rich foods is not a primary dietary concern in nephrotic syndrome. Clients should consume a balanced diet unless instructed otherwise by their healthcare provider.

C. Correct. A low-sodium diet is crucial in managing fluid retention and edema in clients with nephrotic syndrome. Sodium intake contributes to fluid retention, so reducing sodium intake helps decrease edema.

D. Incorrect. Restricting fluid intake is not typically recommended in nephrotic syndrome, as it may lead to dehydration and worsen fluid imbalances due to hypoalbuminemia.

A. Incorrect. While some clients on ACE inhibitors may need to be cautious about potassium intake, this instruction is not universally applicable to all clients with nephrotic syndrome on this medication.

B. Incorrect. ACE inhibitors should be taken with food to reduce the risk of gastrointestinal side effects.

C. Incorrect. Monitoring blood glucose levels is important, but it is not directly related to ACE inhibitor use in nephrotic syndrome.

D. Correct. ACE inhibitors can cause a drop in blood pressure, leading to dizziness, especially when changing positions (orthostatic hypotension). Clients should be instructed to change positions slowly to prevent falls and injuries.

A. Incorrect. While some clients may be at increased risk of certain infections, avoiding close contact with family members is not practical and not recommended in general.

B. Correct. Good hand hygiene is essential in reducing the risk of infections in clients with nephrotic syndrome, as they are immunocompromised due to protein loss in the urine. Regular handwashing with soap and water, especially before meals and after using the bathroom, can help prevent the spread of pathogens.

C. Incorrect. Avoiding outdoor activities and crowded places is not necessary for all clients with nephrotic syndrome and may negatively impact their quality of life.

D. Incorrect. While physical activity is generally beneficial for overall health, it is not directly related to enhancing the immune system's response in clients with nephrotic syndrome.

A. Incorrect. While monitoring urine output and kidney function is important in nephrotic syndrome, it is not directly related to addressing skin breakdown.

B. Correct. Skin breakdown in clients with nephrotic syndrome can lead to an increased risk of infection. The nurse should assess the affected skin areas for signs of infection, such as redness, warmth, swelling, and drainage.

C. Incorrect. Providing pain medication may be necessary for managing discomfort, but the priority is to prevent infection and promote wound healing.

D. Incorrect. While reducing edema is important, it is not the immediate priority in managing skin breakdown and preventing infection.

A. Correct. Immunosuppressive medications are prescribed in nephrotic syndrome to reduce inflammation in the kidneys and prevent further damage, including kidney scarring. They help slow the progression of the disease and preserve kidney function.

B. Incorrect. Immunosuppressive medications are not primarily used to address fluid overload or improve urinary output in nephrotic syndrome.

C. Incorrect. While some immunosuppressive medications may have an impact on blood glucose levels, they are not typically used to manage diabetes in nephrotic syndrome.

D. Incorrect. Immunosuppressive medications do not directly alleviate pain and discomfort associated with edema in nephrotic syndrome. Other interventions, such as diuretics, are used for managing edema.

QUESTIONS

A. Incorrect. Acute renal failure is not a chronic condition; it is an acute condition that develops rapidly and is typically reversible with prompt treatment.

B. Incorrect. While long-term uncontrolled diabetes can lead to chronic kidney disease, acute renal failure is not caused by chronic kidney damage related to diabetes.

C. Correct. Acute renal failure, also known as acute kidney injury (AKI), is characterized by a sudden and temporary loss of kidney function. It is often caused by factors such as decreased blood flow to the kidneys, kidney damage, or obstruction of the urinary tract.

D. Incorrect. While the statement is partially true, it does not capture the acute and sudden nature of acute renal failure. The inability of the kidneys to filter waste products from the blood is one of the manifestations of AKI.

A. Incorrect. Elevated blood pressure is not typically an initial assessment finding in acute renal failure. In fact, it is more common to see low blood pressure (hypotension) due to decreased blood flow to the kidneys.

B. Correct. One of the hallmark manifestations of acute renal failure is decreased urine output (oliguriA. or even no urine output (anuriA. . This is often accompanied by low blood pressure as a result of decreased kidney function.

C. Incorrect. Acute renal failure usually leads to changes in blood pressure and urine output. Stable blood pressure and urine output are not typical initial assessment findings in this condition.

D. Incorrect. High blood sugar levels and frequent urination are not directly related to acute renal failure. These symptoms are more characteristic of diabetes mellitus.

A. Correct. Hypertension (high blood pressurE. is a significant risk factor for the development of acute renal failure. Elevated blood pressure can damage the blood vessels in the kidneys and impair kidney function.

B. Incorrect. Osteoporosis is not directly related to the development of acute renal failure. Osteoporosis is a condition characterized by weak and brittle bones.

C. Incorrect. While type 2 diabetes is a risk factor for chronic kidney disease, it is not a common risk factor for the development of acute renal failure.

D. Incorrect. Seasonal allergies are not associated with an increased risk of acute renal failure.

A. Incorrect. Hypotension and tachycardia are more commonly associated with fluid depletion, not fluid overload.

B. Incorrect. Dry mucous membranes and decreased skin turgor are signs of dehydration, which is not indicative of fluid overload.

C. Correct. Fluid overload in acute renal failure can lead to pulmonary congestion and edema in the extremities. Crackles in the lungs (rales) are auscultated when there is fluid accumulation in the lung tissue, and edema in the extremities is visible swelling caused by excessive fluid retention.

D. Incorrect. Hypoactive bowel sounds and constipation are not directly related to fluid overload in acute renal failure.

A. Incorrect. While protein intake may need to be adjusted in acute renal failure, increasing protein intake is not typically recommended during the acute phase, as it may place additional stress on the kidneys.

B. Correct. Limiting potassium-rich foods is essential for clients with acute renal failure, as impaired kidney function can lead to hyperkalemia (high potassium levels), which can be life-threatening.

C. Incorrect. A high-sodium diet is not recommended in acute renal failure, as it can exacerbate fluid retention and fluid overload.

D. Incorrect. Fluid restriction is not typically recommended in acute renal failure, especially if the client is experiencing fluid depletion and dehydration.

A. Incorrect. Loop diuretics are used to increase urine output, not decrease it. They help reduce fluid overload and prevent dehydration.

B. Incorrect. Loop diuretics typically lead to a decrease in blood pressure, not an increase. They are often prescribed to address hypertension in acute renal failure.

C. Incorrect. Loop diuretics promote the excretion of sodium and water from the kidneys, not their reabsorption.

D. Correct. Loop diuretics are prescribed in acute renal failure to increase urine output and promote fluid excretion. This helps reduce fluid overload and decrease edema.

A. Correct. In acute renal failure, when the kidneys are unable to excrete acids properly, metabolic acidosis can occur. Administering bicarbonate intravenously helps raise the pH levels and correct the acid-base imbalance.

B. Incorrect. Encouraging the client to consume more acidic foods would worsen metabolic acidosis and is not a suitable intervention.

C. Incorrect. Increasing fluid intake is not a specific intervention for correcting metabolic acidosis. The focus should be on addressing the underlying acid-base imbalance.

D. Incorrect. Promoting shallow breathing to retain carbon dioxide is not a recommended intervention for correcting metabolic acidosis. Respiratory acidosis and metabolic acidosis are different types of acid-base imbalances with distinct causes and treatments.

A. Incorrect. While administering prescribed medications is important, the priority in acute renal failure is to closely monitor the client's intake and output to assess kidney function and fluid balance.

B. Correct. Monitoring intake and output is a priority nursing intervention in acute renal failure. Accurate assessment of urine output helps determine the client's kidney function and the effectiveness of treatment.

C. Incorrect. Providing emotional support is essential, but it is not the priority over monitoring kidney function and fluid balance.

D. Incorrect. Preventing infection and complications is important, but it is not the priority over assessing kidney function in acute renal failure.

QUESTIONS

A. Incorrect. While long-term use of NSAIDs can contribute to kidney damage and chronic kidney disease, it is not the primary cause of acute renal failure.

B. Incorrect. Acute renal failure is a sudden and abrupt loss of kidney function, and it is distinct from chronic kidney disease, which develops gradually over time.

C. Correct. Acute renal failure is characterized by a rapid and sudden decline in kidney function, often caused by a sudden decrease in blood flow to the kidneys (prerenal), kidney injury (intrinsiC. , or obstruction of the urinary tract (postrenal).

D. Incorrect. While UTIs and kidney stones can cause kidney injury, they are not the exclusive causes of acute renal failure, which can have various underlying etiologies.

A. Correct. Dehydration is a significant risk factor for prerenal acute renal failure. Insufficient fluid intake or excessive fluid loss (e.g., vomiting, diarrheA. can lead to decreased blood volume and decreased blood flow to the kidneys, impairing kidney function.

B. Incorrect. A UTI can cause kidney injury but is not specifically associated with prerenal acute renal failure.

C. Incorrect. Chronic kidney disease (CKD. is a risk factor for the development of intrinsic acute renal failure, but it is not directly related to prerenal causes.

D. Incorrect. Diabetes mellitus is a risk factor for chronic kidney disease, but it is not a specific risk factor for prerenal acute renal failure.

A. Incorrect. Hypovolemia is associated with prerenal acute renal failure, not intrinsic acute renal failure.

B. Correct. Glomerulonephritis is one of the common causes of intrinsic acute renal failure. It is characterized by inflammation of the glomeruli in the kidneys, which can lead to kidney damage and impaired function.

C. Incorrect. Prostate enlargement is associated with postrenal acute renal failure due to urinary tract obstruction, not intrinsic causes.

D. Incorrect. Urinary tract obstruction is also associated with postrenal acute renal failure, not intrinsic causes.

A. Correct. Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, are known to cause kidney damage and are a common cause of intrinsic acute renal failure, especially when used in high doses or for extended periods.

B. Incorrect. Loop diuretics, such as furosemide, are not typically associated with intrinsic acute renal failure.

C. Incorrect. Metformin is not a common cause of intrinsic acute renal failure. However, it is contraindicated in individuals with severe kidney impairment.

D. Incorrect. While ciprofloxacin and other antibiotics may have renal-related side effects, they are not a common cause of intrinsic acute renal failure.

A. Incorrect. Hypertension is a risk factor for prerenal acute renal failure, not postrenal.

B. Incorrect. While a UTI can cause kidney injury, it is not directly related to postrenal acute renal failure.

C. Correct. An enlarged prostate, also known as benign prostatic hyperplasia (BPH), can cause obstruction of the urinary tract and lead to postrenal acute renal failure. The obstruction prevents urine flow, causing pressure buildup in the kidneys and impairing kidney function.

D. Incorrect. Chronic kidney disease (CKD. is a risk factor for intrinsic acute renal failure, not postrenal.

A. Correct. Hypertension, or high blood pressure, is a significant risk factor for the development of acute renal failure. Chronic hypertension can lead to kidney damage and impaired kidney function over time.

B. Incorrect. Seasonal allergies, osteoarthritis, and anemia are not direct risk factors for acute renal failure.

C. Incorrect. Osteoarthritis is not directly related to acute renal failure.

D. Incorrect. While anemia can be associated with chronic kidney disease, it is not a specific risk factor for acute renal failure.

A. Correct. Angiotensin-converting enzyme (ACE. inhibitors can contribute to prerenal acute renal failure, especially in clients with preexisting cardiovascular disease. These medications may cause vasodilation and decrease blood flow to the kidneys, leading to impaired kidney function.

B. Incorrect. Beta-blockers are not directly associated with prerenal acute renal failure.

C. Incorrect. Calcium channel blockers are not typically associated with prerenal acute renal failure.

D. Incorrect. Thiazide diuretics may cause electrolyte imbalances and metabolic disturbances, but they are not a common cause of prerenal acute renal failure.

QUESTIONS

A. Incorrect. Increased glomerular filtration rate (GFR) would lead to increased urine output, not decreased urine output.

B. Incorrect. Obstruction of the urethra would cause postrenal acute renal failure and may lead to urinary retention, but it would not cause decreased urine output in prerenal or intrinsic acute renal failure.

C. Correct. In prerenal and intrinsic acute renal failure, impaired blood flow to the kidneys reduces the perfusion of nephrons, leading to decreased urine output.

D. Incorrect. Excessive fluid intake may contribute to fluid overload and decreased urine output in prerenal acute renal failure, but it is not the primary pathophysiological process that leads to decreased urine output.

A. Incorrect. Constipation and abdominal pain are not typical manifestations of the fluid and electrolyte imbalance seen in acute renal failure.

B. Correct. Acute renal failure can lead to imbalances in electrolytes, particularly potassium and sodium. Muscle weakness and fatigue are common manifestations of these electrolyte imbalances.

C. Incorrect. Decreased heart rate and blood pressure are more commonly associated with fluid volume depletion in prerenal acute renal failure, rather than electrolyte imbalances.

D. Incorrect. Increased respiratory rate and depth are not typically associated with acute renal failure or its fluid and electrolyte imbalances.

A. Incorrect. Elevated creatinine levels are not specific to dehydration and fluid deficit, although dehydration can contribute to prerenal acute renal failure.

B. Incorrect. Elevated creatinine levels do not suggest normal kidney function. Instead, they indicate impaired kidney function and acute kidney injury.

C. Correct. Creatinine is a waste product produced by muscles and excreted by the kidneys. Elevated creatinine levels are a reliable indicator of acute kidney injury and impaired kidney function.

D. Incorrect. Elevated creatinine levels can be seen in both acute and chronic kidney diseases, but they are not exclusively seen in chronic kidney disease.

A. Incorrect. Increased heart rate and blood pressure are more commonly associated with metabolic alkalosis, not metabolic acidosis.

B. Correct. Muscle twitching and irritability are common clinical manifestations of metabolic acidosis. Acidosis can lead to an increase in excitability of nerve cells, causing muscle twitching and irritability.

C. Incorrect. Excessive thirst and frequent urination are not typically associated with metabolic acidosis.

D. Incorrect. Warm, flushed skin and headache are not directly related to metabolic acidosis.

A. Incorrect. Muscle weakness and fatigue are manifestations of hyperkalemia, but they are not the most critical indicators of severe hyperkalemia.

B. Incorrect. Tingling sensations in the extremities are not the most critical indicator of severe hyperkalemia.

C. Correct. The most critical manifestation of severe hyperkalemia is an irregular heart rhythm (dysrhythmiA. , which can be life-threatening.

D. Incorrect. Excessive thirst and dry mucous membranes are not specific to hyperkalemia and are not the most critical indicators of severe hyperkalemia.

A. Incorrect. Increased urine output and polyuria are not associated with uremia. In fact, acute renal failure often leads to decreased urine output (oliguria or anuriA. .

B. Incorrect. Hypertension and bradycardia are not typical manifestations of uremia.

C. Correct. Uremia is a condition characterized by the buildup of waste products and toxins in the blood due to impaired kidney function. Clinical manifestations of uremia include confusion (encephalopathy), nausea and vomiting, and pericarditis (inflammation of the pericardium, the sac surrounding the heart).

D. Incorrect. Decreased respiratory rate and shallow breathing are not directly associated with uremia.

A. Incorrect. Decreased blood volume and hypovolemia may contribute to prerenal acute renal failure, but they are not the primary pathophysiological processes that lead to edema in acute renal failure.

B. Incorrect. Increased vascular permeability and leakage of fluid into tissues are not the primary mechanisms of edema in acute renal failure.

C. Correct. In acute renal failure, the impaired filtration and reduced excretion of fluid by the kidneys lead to fluid retention and edema in various parts of the body.

D. Incorrect. Excessive fluid intake and fluid overload may contribute to fluid retention and edema in prerenal acute renal failure, but they are not the primary pathophysiological process in acute renal failure.

A. Incorrect. Bradypnea (slow respiratory ratE. is not typically associated with acute renal failure.

B. Correct. Kussmaul respirations are rapid and deep respirations seen in metabolic acidosis, a common complication of acute renal failure. The body tries to compensate for the acidosis by increasing the elimination of carbon dioxide through rapid and deep breathing.

C. Incorrect. Dyspnea and crackles in the lungs are not directly related to acute renal failure.

D. Incorrect. Increased respiratory rate and shallow breathing are not typical respiratory manifestations of acute renal failure.

QUESTIONS

A. Incorrect. A complete blood count (CBC. provides information about the number and types of blood cells but does not assess kidney function.

B. Correct. Serum creatinine level is a commonly used blood test to assess kidney function. Elevated levels of creatinine in the blood indicate impaired glomerular filtration and decreased kidney function.

C. Incorrect. Urinalysis provides information about the presence of substances such as protein, blood, and glucose in the urine but does not directly assess GFR.

D. Incorrect. Renal ultrasound is an imaging test that provides information about the structure of the kidneys but does not directly measure GFR.

A. Correct. A renal ultrasound is an imaging test that uses sound waves to create images of the kidneys. It can help identify kidney stones, obstructions, and other structural abnormalities in the urinary tract.

B. Incorrect. The renal ultrasound does not directly measure the glomerular filtration rate (GFR), which is typically assessed through blood tests.

C. Incorrect. A renal ultrasound does not provide information about the number and types of blood cells in the bloodstream.

D. Incorrect. While a renal ultrasound can visualize the blood vessels in the kidneys, its primary purpose is to assess kidney structure, not blood flow.

A. Incorrect. Fasting is not typically required before a renal biopsy.

B. Incorrect. The renal biopsy does not directly measure the glomerular filtration rate (GFR), which is usually assessed through blood tests.

C. Correct. A renal biopsy is a procedure in which a needle is inserted through the skin and into the kidneys to obtain a small tissue sample for examination. This allows for a direct assessment of kidney tissue and helps identify the cause of kidney dysfunction.

D. Incorrect. While a renal biopsy can provide information about the kidney's structure, its primary purpose is to obtain a tissue sample for histological examination, not to assess blood flow.

A. Incorrect. Withholding food and drink for 24 hours is not necessary for a CT scan with contrast dye.

B. Correct. Before a CT scan with contrast dye, it is essential to assess the client for allergies, especially to iodine and shellfish. Contrast dyes used in CT scans contain iodine, and clients with allergies to iodine or shellfish may have an allergic reaction to the contrast dye.

C. Incorrect. While administering intravenous fluids may be beneficial in certain situations, it is not a specific precaution for a CT scan with contrast dye.

D. Incorrect. Removing jewelry and metallic objects is a standard precaution for all imaging procedures, but it is not specific to a CT scan with contrast dye.

A. Incorrect. Unlike computed tomography (CT) scans, MRI scans do not typically require the ingestion of a contrast solution.

B. Incorrect. The MRI scan does not directly measure the glomerular filtration rate (GFR), which is typically assessed through blood tests.

C. Incorrect. A renal biopsy involves inserting a needle through the back to obtain a tissue sample from the kidneys, not an MRI scan.

D. Correct. Before an MRI scan, clients need to remove all metal objects and devices, including jewelry, piercings, hearing aids, and certain medical implants. Metal can interfere with the MRI's magnetic field and cause safety concerns during the procedure.

A. Incorrect. Fasting is not typically required before a renal nuclear scan.

B. Incorrect. The renal nuclear scan does not directly measure the glomerular filtration rate (GFR), which is typically assessed through blood tests.

C. Incorrect. A renal nuclear scan does not involve inserting a catheter into the bladder to obtain a urine sample.

D. Correct. A renal nuclear scan, also known as a renal scintigraphy, involves injecting a small amount of radioactive material intravenously. The radioactive material is taken up by the kidneys, and the scan creates images that assess kidney function and blood flow.

QUESTIONS

A. Incorrect. While fluid restriction may be necessary in certain cases of acute renal failure, it should be prescribed and monitored by the healthcare provider based on the client's specific needs.

B. Incorrect. A high-protein diet can put additional strain on the kidneys, and it is not recommended for clients with acute renal failure.

C. Incorrect. Over-the-counter diuretics may not be safe for clients with acute renal failure and can lead to further electrolyte imbalances.

D. Correct. The nurse's best response is to encourage the client to follow their healthcare provider's instructions and avoid medications that may harm the kidneys. Compliance with prescribed treatment plans and avoiding nephrotoxic medications are essential to support kidney function and prevent further damage.

A. Incorrect. Hemodialysis is not a procedure for kidney transplantation.

B. Correct. Hemodialysis is a treatment that helps remove waste products, toxins, and excess fluids from the blood when the kidneys are not functioning properly. It helps maintain the body's internal environment and prevent complications of acute renal failure.

C. Incorrect. While hemodialysis can improve kidney function temporarily, its primary purpose is to provide kidney support and replace some of the kidney's functions.

D. Incorrect. The description provided refers to the insertion of a urinary catheter for bladder drainage, not hemodialysis.

A. Incorrect. Continuous renal replacement therapy (CRRT) provides gradual and continuous removal of waste products and excess fluids from the blood, but it may not be as rapid as intermittent hemodialysis.

B. Incorrect. CRRT typically requires continuous sessions, which may last 24 hours or more. Intermittent hemodialysis involves shorter but more frequent sessions.

C. Correct. One of the primary advantages of CRRT is that it does not require the use of anticoagulants to prevent blood clotting in the machine. This reduces the risk of bleeding and other complications associated with anticoagulant use during hemodialysis.

D. Incorrect. The cost of CRRT and intermittent hemodialysis can vary based on the healthcare setting and the client's needs. The cost-effectiveness depends on individual factors and resource availability.

A. Incorrect. Cloudy dialysis fluid may indicate infection or peritonitis, which requires immediate attention and intervention.

B. Correct. Cloudy dialysis fluid may indicate infection or peritonitis, which can be a severe complication of peritoneal dialysis. The nurse should stop the procedure immediately and notify the healthcare provider for further assessment and management.

C. Incorrect. Administering antibiotics without a proper diagnosis and healthcare provider's order is not appropriate.

D. Incorrect. Increasing the dwell time would not address the issue of cloudy dialysis fluid and potential infection.

A. Incorrect. Increasing the rate of dialysis may further lower the client's blood pressure and worsen the situation.

B. Incorrect. Administering an antihypertensive medication during a hypotensive episode could exacerbate the client's low blood pressure.

C. Correct. The nurse's priority action is to stop the dialysis procedure immediately and notify the healthcare provider of the significant drop in blood pressure. The client may be experiencing a hypotensive episode, which requires prompt evaluation and intervention.

D. Incorrect. Increasing the client's

fluid intake is not appropriate during a hypotensive episode, as it may not rapidly improve blood pressure and could lead to fluid overload.

A. Correct. Loop diuretics can cause potassium loss and potentially lead to hypokalemia. The nurse should monitor the client's serum potassium levels frequently to assess for any imbalances.

B. Incorrect. While loop diuretics can be given intravenously for rapid action, the administration route depends on the client's condition and the healthcare provider's order.

C. Incorrect. Loop diuretics are used to promote diuresis and fluid removal from the body. Encouraging fluid restriction while on diuretic therapy may exacerbate dehydration and electrolyte imbalances.

D. Incorrect. The timing of loop diuretic administration is determined by the healthcare provider's order and the client's specific needs. Taking diuretics at bedtime may result in increased nighttime urination and sleep disruption.

QUESTIONS

A. Incorrect. Increasing sodium intake would exacerbate fluid retention and worsen the client's fluid overload.

B. Correct. Limiting fluid intake to the prescribed amount helps manage fluid balance in clients with acute renal failure, especially those experiencing fluid overload.

C. Incorrect. Rapid administration of intravenous fluids may worsen fluid overload and increase the risk of edema and hypertension.

D. Incorrect. Encouraging the client to drink water freely would exacerbate fluid overload and impair the body's ability to eliminate excess fluids.

A. Correct. Bananas and oranges are high-potassium fruits that the client should avoid on a potassium-restricted diet.

B. Incorrect. Bread and pasta are not typically high in potassium and are usually acceptable in a potassium-restricted diet.

C. Incorrect. Eggs and cheese are not significant sources of potassium and are usually allowed in a potassium-restricted diet.

D. Incorrect. Chicken and fish are sources of protein and do not have high potassium content that would require restriction in most cases.

A. Incorrect. Encouraging the client to sit up in a chair for extended periods can increase pressure on certain areas and contribute to skin breakdown.

B. Incorrect. Applying a heating pad to areas at risk for skin breakdown can lead to thermal injury and exacerbate skin issues.

C. Correct. Regular repositioning and skin assessments are essential in preventing pressure ulcers and maintaining skin integrity in clients with acute renal failure who may be bedridden or have limited mobility.

D. Incorrect. Adhesive tape can cause skin irritation and damage when removed, especially in clients at risk for impaired skin integrity.

A. Incorrect. Encouraging a low-carbohydrate diet is not the appropriate intervention for correcting metabolic acidosis.

B. Correct. Sodium bicarbonate is an alkalizing agent that can help correct metabolic acidosis by increasing the body's bicarbonate levels, which buffers excess acids.

C. Incorrect. Fluid restriction would not directly correct metabolic acidosis and may be detrimental to the client's overall fluid balance.

D. Incorrect. Deep breathing exercises are not specific interventions for correcting metabolic acidosis.

A. Correct. Encouraging the client to perform active range-of-motion exercises can help prevent complications of immobility, such as muscle wasting and joint contractures.

B. Incorrect. Elevating the head of the bed primarily benefits respiratory function and does not directly address the complications of immobility.

C. Incorrect. Limiting fluid intake would not prevent complications of immobility and may lead to dehydration.

D. Incorrect. Administering pain medication before passive range-of-motion exercises is not a standard practice and does not directly prevent complications of immobility.

:

A. Incorrect. Cheese and yogurt are high in phosphate and should be avoided in a low-phosphate diet.

B. Incorrect. Beans and lentils are also high in phosphate and are not suitable for a low-phosphate diet.

C. Incorrect. Eggs and poultry are significant sources of phosphate and are not recommended in a low-phosphate diet.

D. Correct. Fresh fruits and vegetables are generally low in phosphate and are suitable for a low-phosphate diet. These foods can help meet the client's nutritional needs while adhering to the dietary restriction.

A. Incorrect. Muscle cramps in acute renal failure are often related to electrolyte imbalances, including high potassium levels. Encouraging the consumption of potassium-rich foods would exacerbate the issue.

B. Incorrect. Muscle relaxants may not be appropriate for all clients, and the underlying cause of the muscle cramps should be addressed first.

C. Correct. Applying warm compresses to the affected muscles can help relax muscle tension and provide relief from muscle cramps.

D. Incorrect. Gentle stretching exercises may not be appropriate for a client experiencing muscle cramps, as stretching could exacerbate the discomfort.

A. Correct. Erythropoietin-stimulating agents (ESAs) are commonly used to treat anemia in clients with renal failure. These medications stimulate the production of red blood cells and help manage anemia associated with kidney dysfunction.

B. Incorrect. Anticoagulants such as heparin are not used to treat anemia; they are prescribed to prevent blood clotting and thrombosis.

C. Incorrect. Loop diuretics are used to promote diuresis and manage fluid overload in clients with acute renal failure; they do not treat anemia.

D. Incorrect. Antihypertensive agents are prescribed to manage hypertension and do not treat anemia in clients with renal failure.

QUESTIONS

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.

QUESTIONS

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.

QUESTIONS

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.

QUESTIONS

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.

QUESTIONS

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 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.

QUESTIONS

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.

Questions

A. This is incorrect because ESRD is not a reversible condition. Once the kidneys have reached this stage, their ability to function is permanently lost, and treatment focuses on managing the condition and replacing kidney function through dialysis or transplantation.

B. This is correct. ESRD is the final stage of chronic kidney disease, where the kidneys have lost their ability to function adequately to sustain life. At this stage, the client requires renal replacement therapy such as dialysis or kidney transplantation to survive.

C. This is incorrect because ESRD is not a temporary condition caused by an infection; it is a chronic and irreversible condition.

D. This is incorrect because ESRD is not a condition where the kidneys can recover with proper management. Once the kidneys have reached end-stage, their ability to function is permanently compromised.

A. This is incorrect because while kidney transplantation is an essential treatment option for ESRD, it is not the only option. Dialysis (hemodialysis or peritoneal dialysis) is also a viable treatment to replace kidney function for clients who are not transplant candidates or awaiting transplantation.

B. This is correct. Dialysis is the primary treatment for ESRD, providing renal replacement therapy by removing waste products and excess fluid from the blood. Kidney transplantation is another treatment option for eligible candidates who may benefit from a functioning kidney.

C. This is incorrect because effective treatment options, such as dialysis and kidney transplantation, are available for ESRD. There is ongoing research and development in nephrology, but new therapies have not replaced the standard treatments.

D. This is incorrect because ESRD is a severe condition where the kidneys have permanently lost their ability to function, and treatment options such as dialysis or transplantation are necessary to sustain life.

A. This is correct. Family history of diabetes is a significant risk factor for the development of ESRD. Diabetes is one of the leading causes of ESRD, and individuals with a family history of diabetes are at increased risk of kidney complications.

B. This is incorrect because being physically active and maintaining a healthy lifestyle do not increase the risk of ESRD. In fact, a healthy lifestyle can help reduce the risk of developing kidney disease.

C. This is incorrect because having a history of frequent kidney stones is not associated with a decreased risk of ESRD. In some cases, recurrent kidney stones may lead to chronic kidney disease, which can progress to ESRD.

D. This is incorrect because high blood pressure (hypertension) is a significant risk factor for the development and progression of ESRD. Uncontrolled hypertension can lead to damage to the blood vessels in the kidneys, contributing to kidney disease.

A. This is correct. Clients with ESRD need to limit their fluid intake to prevent fluid overload, which can lead to swelling, shortness of breath, and heart-related issues.

B. This is incorrect. Protein intake needs to be monitored and adjusted, but it is not restricted entirely. Protein is essential for the body, and malnutrition should be avoided in clients with ESRD. However, high protein intake can put additional strain on the kidneys, so moderation is key.

C. This is correct. Clients with ESRD should avoid foods high in potassium, as elevated potassium levels can lead to life-threatening cardiac arrhythmias. Limiting potassium intake helps maintain potassium levels within a safe range.

D. This is correct. Consuming foods low in phosphorus is crucial for clients with ESRD. High phosphorus levels can lead to complications such as bone disease, so managing phosphorus intake is essential.

A. This is correct. Hemodialysis is a renal replacement therapy that uses a dialysis machine to remove waste products, toxins, and excess fluid from the bloodstream when the kidneys are no longer able to do so effectively.

B. This is incorrect. While hemodialysis may have some effect on blood pressure, its primary purpose is to replace kidney function in filtering waste products

and maintaining fluid balance.

C. This is incorrect. Hemodialysis does not stimulate the kidneys to produce more urine. It directly filters the blood to remove toxins and fluid.

D. This is incorrect. Hemodialysis does not involve surgical replacement of damaged kidneys. It is a non-surgical procedure performed in a dialysis center using a dialysis machine.

A. This is incorrect. Peritoneal dialysis is typically performed at home, providing more flexibility and convenience for clients compared to hemodialysis, which requires regular visits to a dialysis center.

B. This is correct. Peritoneal dialysis is performed at home, which allows clients to have more control over their treatment schedule. It can be done during the day or overnight, providing greater flexibility for clients to continue with their daily activities.

C. This is incorrect. Peritoneal dialysis involves the insertion of a catheter into the peritoneal cavity, not the bladder. The catheter allows the dialysis solution to be infused and drained from the peritoneal cavity.

D. This is incorrect. While peritoneal dialysis does carry some risk of infection, it is generally considered to have a lower risk of infection compared to hemodialysis, where blood is exposed to an external machine.

A. This is incorrect. While kidney transplantation does require the use of immunosuppressant medications to prevent organ rejection, it eliminates the need for dialysis and provides a better chance of long-term survival compared to dialysis alone.

B. This is incorrect. While there is a risk of infection after kidney transplantation, the overall risk of infection is generally higher in clients on long-term dialysis.

C. This is incorrect. Kidney transplantation is associated with improved quality of life compared to dialysis. Transplant recipients often experience increased energy, better dietary freedom, and a decreased reliance on medical appointments compared to dialysis patients.

D. This is correct. Kidney transplantation offers the best chance for long-term survival and eliminates the need for ongoing dialysis. It provides improved quality of life and potential freedom from dietary restrictions, fluid restrictions, and the time-consuming dialysis procedure.

Questions

A. This is incorrect. While acute kidney injury (AKI) can contribute to the development of ESRD, it is not the primary cause. ESRD typically results from chronic kidney diseases that progress over time, such as diabetes and hypertension.

B. This is correct. The most common causes of ESRD are diabetes mellitus and uncontrolled hypertension. These conditions can lead to chronic kidney disease and eventual kidney failure if not well managed.

C. This is incorrect. While kidney stones can cause kidney damage and contribute to kidney disease, they are not a common cause of ESRD.

D. This is incorrect. While genetic factors and family history may play a role in some cases of kidney disease, they are not the primary causes of ESRD. ESRD is most commonly associated with chronic conditions like diabetes and hypertension.