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.

A) Incorrect. Acute renal failure is characterized by a rapid onset of symptoms over a short period of time, not a gradual onset.

B) Incorrect. Unlike chronic renal failure, acute renal failure is often reversible with timely intervention and does not result in irreversible loss of kidney function.

C) Correct. Acute renal failure is defined by a sudden and rapid decline in kidney function, typically occurring within hours to days.

D) Incorrect. Genetic factors are not the primary cause of acute renal failure; it is more commonly triggered by various factors such as ischemia, nephrotoxic agents, or obstructive conditions.

A) Incorrect. In acute renal failure, there is impaired filtration and excretion of waste products by the kidneys, not enhanced filtration.

B) Correct. Elevated BUN and creatinine levels in acute renal failure result from the kidneys' reduced ability to filter and excrete waste products, leading to their accumulation in the blood.

C) Incorrect. The liver produces waste products like ammonia, but elevated BUN and creatinine levels are primarily related to kidney dysfunction, not increased production by the liver.

D) Incorrect. Decreased reabsorption of waste products by the renal tubules can contribute to elevated levels, but the primary issue in acute renal failure is impaired filtration and excretion.

A) Correct. Hyperkalemia (high potassium levels) is a common electrolyte imbalance in acute renal failure. Elevated potassium levels can lead to cardiac arrhythmias and other serious complications.

B) Incorrect. While electrolyte imbalances such as hyponatremia can occur in acute renal failure, hyperkalemia is more commonly associated with severe consequences.

C) Incorrect. Hypocalcemia (low calcium levels) can occur but is not the primary electrolyte imbalance associated with cardiac arrhythmias in acute renal failure.

D) Incorrect. Hyperphosphatemia (high phosphate levels) can occur in acute renal failure, but it is not the primary electrolyte imbalance leading to cardiac arrhythmias.

A) Correct. Pre-renal causes of acute renal failure involve reduced blood flow to the kidneys, often due to factors like dehydration or hypovolemia.

B) Incorrect. Intrinsic renal causes involve direct damage to the renal parenchyma, which is not the primary issue in cases of dehydration.

C) Incorrect. Post-renal causes result from urinary tract obstructions, which do not apply to this scenario.

D) Incorrect. "Metabolic renal" is not a recognized category of acute renal failure.

A) Incorrect. Hyperglycemia is an increase in blood glucose levels and is not a typical complication of untreated acute renal failure.

B) Incorrect. Anemia can occur in acute renal failure but is not a direct consequence of the accumulation of waste products.

C) Incorrect. Metabolic alkalosis is not a typical complication of acute renal failure; metabolic acidosis is more common.

D) Correct. Uremia is a syndrome that results from the accumulation of waste products in the body due to impaired kidney function. It can lead to a wide range of symptoms and complications, including nausea, vomiting, fatigue, and neurological disturbances.

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) Incorrect. Kidney stones are not a common cause of prerenal acute renal failure. They may cause postrenal acute renal failure if they

obstruct the urinary tract.

B) Incorrect. Bladder infection (cystitis) is not directly related to prerenal acute renal failure.

C) Correct. Severe dehydration, often caused by decreased fluid intake or excessive fluid loss (e.g., vomiting, diarrhea), is a common cause of prerenal acute renal failure. Dehydration leads to decreased blood volume and decreased blood flow to the kidneys, resulting in impaired kidney function.

D) Incorrect. Kidney infection (pyelonephritis) is associated with intrinsic acute renal failure due to kidney inflammation and damage.

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.

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.

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.

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.

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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

bone health.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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