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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

in chronic renal failure.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

D) Incorrect.

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

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

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

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

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

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.

A) Incorrect. Nephrotic syndrome is characterized by increased proteinuria, indicating the loss of proteins from the bloodstream, not increased filtration of proteins into the urine.

B) Incorrect. Thickening of the glomerular basement membrane is a feature of some kidney diseases but is not the primary abnormality in nephrotic syndrome.

C) Incorrect. Nephrotic syndrome is associated with increased permeability of the glomerular capillaries, allowing proteins to pass through into the urinary space.

D) Correct. Disruption of the glomerular filtration barrier, which includes the glomerular endothelium, basement membrane, and podocytes, leads to the key features of nephrotic syndrome, such as proteinuria and hypoalbuminemia.

A) Incorrect. Hyperlipidemia in nephrotic syndrome results from increased hepatic synthesis of lipoproteins and is not directly related to decreased serum albumin levels.

B) Correct. Hypoalbuminemia reduces the colloid osmotic pressure in the blood vessels, causing fluid to leak into the interstitial spaces, leading to edema formation, a hallmark of nephrotic syndrome.

C) Incorrect. Hypertension may occur in nephrotic syndrome due to sodium and water retention, but it is not directly related to decreased serum albumin levels.

D) Incorrect. Hematuria (blood in the urine) is not a direct consequence of hypoalbuminemia but may be present in some cases of nephrotic syndrome due to underlying glomerular damage.

A) Correct. Nephrotic syndrome is associated with the loss of antithrombin III in the urine, which impairs its anticoagulant function, contributing to a hypercoagulable state.

B) Incorrect. Elevated fibrinogen levels are not a primary factor contributing to the hypercoagulability in nephrotic syndrome.

C) Incorrect. While platelet count can be altered in various medical conditions, it is not the primary factor leading to hypercoagulability in nephrotic syndrome.

D) Incorrect. Reduced prothrombin time is not a characteristic feature of nephrotic syndrome but rather a measure of blood clotting.

A) Incorrect. Increased sodium reabsorption in the renal tubules contributes to sodium and water retention but is not the primary cause of generalized edema in nephrotic syndrome.

B) Incorrect. Elevated blood pressure may contribute to capillary leakage, but it is not the primary cause of edema in nephrotic syndrome.

C) Correct. Decreased colloid osmotic pressure in the blood vessels, resulting from hypoalbuminemia due to proteinuria, leads to fluid shifting from the blood vessels into the interstitial spaces, causing generalized edema.

D) Incorrect. Hyperfiltration of glomerular capillaries is not a mechanism directly related to the development of edema in nephrotic syndrome.

A) Incorrect. The glomerular endothelium is part of the glomerular filtration barrier, but it primarily restricts the passage of blood cells and large molecules.

B) Correct. The glomerular basement membrane acts as a selective barrier that prevents the loss of proteins, including albumin, into the urine.

C) Incorrect. Podocytes play a role in maintaining the integrity of the filtration barrier, but they are not the primary component responsible for preventing protein loss.

D) Incorrect. Bowman's capsule is involved in the initial filtration of blood components but does not play a direct role in preventing protein loss.

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.

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.

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.

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.

A) This is not the correct answer. Renal calculi are not bacterial infections but rather solid masses that form from mineral and acid salts in the kidneys.

B) This is the correct answer. Renal calculi, commonly known as kidney stones, are solid masses formed from mineral and acid salts that accumulate in the kidneys.

C) Renal calculi are not benign tumors. They are distinct from tumors and do not have the same characteristics.

D) Renal calculi are not blood clots. Blood clots can block the urinary tract, but they are not the same as kidney stones.

A) Excessive water intake is not a risk factor for kidney stones. In fact, adequate hydration is encouraged to prevent kidney stone formation.

B) Low dietary calcium intake is not a common risk factor for kidney stones. In some cases, excessive calcium supplementation may be a risk factor, but dietary calcium is generally not a concern.

C) This is the correct answer. Family history, a diet high in protein and salt, and dehydration are common risk factors for kidney stones.

D) Kidney stones are not mostly caused by consuming too many fruits and vegetables. Fruits and vegetables are generally considered beneficial for kidney health.

A) Citrus fruits are generally not a concern for calcium oxalate stones. They are a good source of citrate, which may actually help prevent stone formation.

B) Dairy products are not specifically associated with calcium oxalate stones. However, high-calcium supplements might increase the risk, not dietary calcium from dairy products.

C) Red meat is not a significant concern for calcium oxalate stones. It is more associated with uric acid stones.

D) This is the correct answer. Leafy green vegetables are high in oxalates, which can contribute to calcium oxalate stone formation. Clients with calcium oxalate stones should limit their intake of these vegetables.

A) Severe back pain can be a symptom of kidney stones, but it is not the most common one.

B) This is the correct answer. Hematuria, or blood in the urine, is the most common symptom of kidney stones. The blood may be visible or microscopic.

C) Frequent urination can be a symptom of kidney stones, but it is not the most common one.

D) Sudden weight loss is not a symptom commonly associated with kidney stones.

A) Calcium oxalate stones may cause pain, but they do not typically radiate to the groin. They are more likely to cause localized pain in the back or side.

B) This is the correct answer. Uric acid stones can cause sudden and severe pain that radiates from the back to the groin. The pain is often described as colicky and is associated with restlessness.

C) Struvite stones are typically associated with urinary tract infections and may not cause the sudden and severe pain described in the question.

D) Cystine stones are rare and are more likely to cause chronic, dull pain rather than sudden and severe pain.

A) Avoiding all dairy products is not a recommended prevention strategy for kidney stones. In fact, adequate dietary calcium may be beneficial for reducing the risk of certain types of stones.

B) Increasing dietary calcium intake, especially from food sources, may help prevent certain types of kidney stones, such as calcium oxalate stones.

C) Reducing fluid intake is not a recommended prevention strategy for kidney stones. Inadequate hydration can actually increase the risk of stone formation.

D) This is the correct answer. Drinking plenty of water and staying hydrated is one of the most effective ways to prevent kidney stones. Adequate hydration helps dilute urine and reduce the concentration of minerals that can lead to stone formation.

A) ESWL is a non-invasive procedure, and it does not require a hospital stay. It is typically performed on an outpatient basis.

B) This is not entirely accurate. ESWL is a non-invasive procedure that does not require general anesthesia. Instead, the client may be given sedation or local anesthesia.

C) It is essential to maintain adequate hydration after ESWL to help pass the broken-up stone fragments. Avoiding all fluids for 24 hours is not recommended and may lead to dehydration.

D) This is the correct answer. ESWL uses shock waves to break up kidney stones, and the client will need to remain still during the procedure to ensure precise targeting of the stones. The procedure is usually painless, but some discomfort may be experienced during the process.

A) Excessive consumption of fruits and vegetables is not a primary cause of kidney stones. Some specific types of fruits and vegetables may contribute to stone formation, but it is not a general cause.

B) While genetic factors and family history can play a role in kidney stone formation, they are not the primary cause. The presence of minerals and salts in the urine is the main contributing factor.

C) An overactive bladder and frequent urination are not direct causes of kidney stone formation. They may be related to other urinary conditions but not to the formation of kidney stones.

D) This is the correct answer. Kidney stones are formed when certain minerals and salts in the urine form solid crystals that can clump together and grow into stones.

A) This is the correct answer. High dietary calcium intake is a common risk factor for certain types of kidney stones, particularly calcium oxalate stones. However, dietary calcium intake from food sources is not typically associated with an increased risk of kidney stones. Calcium supplements, on the other hand, may contribute to stone formation.

B) A low protein diet is not a significant risk factor for kidney stones. High-protein diets may be associated with an increased risk, but low protein intake is not a concern.

C) Adequate water consumption is essential to prevent kidney stones. Dehydration is a risk factor for stone formation, but excessive water consumption alone is not a significant risk factor.

D) While a sedentary lifestyle may be associated with other health risks, it is not a primary risk factor for kidney stones.

A) This is the correct answer. Calcium oxalate stones are common, and limiting the intake of foods high in oxalate, such as spinach, nuts, and certain other vegetables and fruits, can help reduce the risk of stone recurrence.

B) Increasing the intake of red meat and fish is not recommended to prevent calcium oxalate stones. In fact, high intake of animal protein may increase the risk of certain types of stones, such as uric acid stones.

C) Consuming carbonated beverages is not recommended to improve kidney function or prevent kidney stones. Some carbonated beverages may contain phosphoric acid, which can contribute to stone formation.

D) Avoiding dairy products is not recommended to prevent calcium oxalate stone formation. In fact, adequate dietary calcium intake from food sources may help reduce the risk of these stones.

A) This is not entirely accurate. While family history can be a risk factor for kidney stones, there are still preventive measures that individuals can take to reduce their risk.

B) Avoiding all calcium-rich foods and beverages is not recommended for preventing kidney stones. In fact, adequate dietary calcium from food sources is generally beneficial for kidney health and may help reduce the risk of certain types of stones.

C) This is the correct answer. Maintaining a healthy weight and drinking plenty of water are important lifestyle factors that can help reduce the risk of kidney stones. Adequate hydration helps prevent the concentration of minerals in the urine, reducing the likelihood of stone formation.

D) Surgery is not the only treatment option for kidney stones. Depending on the size and type of stone, other treatment options, such as lithotripsy or medication, may be considered.

A) Uric acid stones may cause pain, but they do not typically present with costovertebral angle tenderness. Uric acid stones are more likely to be associated with gout and hyperuricemia.

B) Calcium oxalate stones are common and can cause pain, but they do not typically cause costovertebral angle tenderness. They are more likely to cause localized pain in the back or side.

C) This is the correct answer. Struvite stones, also known as infection stones, can cause severe pain that radiates to the back and lower abdomen. They are often associated with urinary tract infections, and the presence of an infection can lead to costovertebral angle tenderness.

D) Cystine stones are rare and are more likely to cause chronic, dull pain rather than sudden and severe pain with tenderness.

A) Smoking cessation is important for overall health, but it is not a primary lifestyle factor related to kidney stone formation.

B) Increased alcohol consumption is not recommended as a preventive measure for kidney stones. In fact, excessive alcohol intake can lead to dehydration, which is a risk factor for stone formation.

C) Regular exercise can be beneficial for overall health, but it is not a primary lifestyle factor related to kidney stone formation.

D) This is the correct answer. A high sodium diet can increase the excretion of calcium in the urine, leading to a higher risk of calcium-based kidney stones. Reducing sodium intake can help prevent stone formation.

A) Limiting fluid intake is not recommended to prevent kidney stones. Adequate hydration is essential to prevent stone formation. Dehydration can lead to a higher concentration of minerals in the urine, increasing the risk of stones.

B) Including more foods high in oxalate is not recommended to prevent kidney stones, especially if the client has a history of calcium oxalate stones. Limiting the intake of oxalate-rich foods is a preventive measure.

C) Avoiding all dairy products is not recommended to prevent kidney stones. In fact, adequate dietary calcium intake from food sources may help reduce the risk of certain types of stones, such as calcium oxalate stones.

D) This is the correct answer. Staying hydrated and drinking plenty of water throughout the day is one of the most effective ways to prevent kidney stones. Adequate hydration helps dilute urine and reduce the concentration of minerals that can lead to stone formation.

A) Incorrect. While uric acid stones are one type of kidney stone, they do not represent the primary component of all kidney stones.

B) Correct. The most common types of kidney stones are composed of calcium, oxalate, and phosphate crystals.

C) Incorrect. Cholesterol and fatty deposits are not the primary components of kidney stones.

D) Incorrect. Bacteria do not represent the primary component of kidney stones. Kidney stones are typically mineral or crystal formations.

A) Incorrect. Dehydration actually leads to a decrease in urinary volume, which can contribute to the concentration of minerals in the urine and increase the likelihood of stone formation.

B) Correct. Dehydration reduces the amount of water in the urine, leading to a higher concentration of minerals like calcium, oxalate, and phosphate, which are key components of kidney stones.

C) Incorrect. Dehydration does not increase the production of protective substances that prevent stone formation; in fact, it has the opposite effect.

D) Incorrect. Dehydration does not slow down the filtration process in the kidneys. Instead, it can lead to the concentration of minerals in the urine.

A) Incorrect. While genetics can influence the likelihood of developing kidney stones, it does not guarantee that a person will develop them.

B) Correct. Genetics can influence factors like calcium metabolism, which in turn can affect the likelihood of stone formation.

C) Incorrect. Genetics do play a role in kidney stone formation, particularly in relation to factors like calcium metabolism.

D) Incorrect. Genetics have a broader impact on kidney stone formation beyond just color and shape.

A) Incorrect. Urinary stasis does not increase the volume of urine; in fact, it can lead to the pooling of urine, potentially contributing to stone formation.

B) Correct. Urinary stasis refers to the slowing or cessation of urine flow, which can allow minerals to aggregate and form kidney stones.

C) Incorrect. Urinary stasis does not promote the breakdown of minerals in the urine. Instead, it can lead to the concentration of minerals, potentially contributing to stone formation.

D) Incorrect. Urinary stasis does have a significant impact on the development of kidney stones, as it can lead to the pooling of minerals and the formation of stones.

A) Incorrect. An acidic urine pH actually increases the risk of stone formation by promoting the aggregation and crystallization of minerals.

B) Incorrect. A more alkaline urine pH can actually increase the risk of certain types of kidney stones, particularly those composed of calcium phosphate.

C) Incorrect. The pH of urine does have an influence on the development of kidney stones. An acidic pH can contribute to certain types of stone formation.

D) Correct. An acidic urine pH can lead to the aggregation and crystallization of minerals, increasing the risk of stone formation.

A) Sharp, stabbing pain in the lower abdomen is not typically associated with kidney stones. Kidney stone pain is usually felt in the back and flank regions of the body.

B) This is the correct answer. The pain caused by kidney stones is often described as a dull ache in the upper back and flank region, usually on the affected side where the kidney is located.

C) Burning sensation during urination is more commonly associated with urinary tract infections or inflammation of the urethra, not kidney stones.

D) Constant, generalized abdominal discomfort is not a specific symptom of kidney stones. Kidney stone pain is usually more localized to the back and flank regions.

A) Fever and chills are more commonly associated with a urinary tract infection, which can sometimes be a complication of kidney stones. However, the severe pain described is more likely related to the presence of the stone itself.

B) This is the correct answer. Blood in the urine, also known as hematuria, is a common symptom of kidney stones. As the stone moves through the urinary tract, it may cause irritation and small blood vessels may be damaged, resulting in blood in the urine.

C) Difficulty starting the urine stream is not a specific symptom of kidney stones. It may be seen in other urinary conditions but is not typically associated with stones.

D) The frequent urge to urinate may be experienced if the stone causes irritation in the bladder, but it is not the most common symptom associated with kidney stones.

A) This is the correct answer. Kidney stone pain is often described as colicky, which means it comes and goes in waves of severe pain. The pain can be intense and cramp-like, causing the client to writhe or be restless.

B) Gnawing pain is not typically associated with kidney stones. Gnawing pain is often described as a persistent, dull ache that can be more chronic in nature.

C) Stabbing pain is sharp and localized and is not typically used to describe kidney stone pain.

D) Numbing pain refers to a loss of sensation, which is not characteristic of kidney stone pain.

A) Diarrhea and abdominal cramping are not typically associated with kidney stone pain. These symptoms are more commonly seen in gastrointestinal disorders.

B) Painful and frequent urination may occur if the stone causes irritation in the bladder or urethra, but it is not a direct symptom of kidney stone pain.

C) Fatigue and generalized weakness are not specific symptoms of kidney stone pain. They may be associated with other medical conditions but are not directly related to renal calculus.

D) This is the correct answer. Nausea and vomiting are common symptoms that may accompany kidney stone pain, especially if the stone causes obstruction in the urinary tract. The pain and irritation can trigger a reflex that leads to nausea and vomiting.

A) Limiting fluid intake to 1 liter per day is not recommended to prevent kidney stone formation. Adequate hydration is essential to

help prevent stone formation, as it helps dilute the urine and reduce the concentration of minerals that can lead to stone formation.

B) Decreasing dietary fiber intake is not a preventive measure for kidney stones. In fact, increasing dietary fiber intake can be beneficial for overall health.

C) Reducing calcium intake from all sources is not recommended to prevent kidney stones. In some cases, reducing dietary calcium intake can actually increase the risk of certain types of kidney stones.

D) This is the correct answer. Increasing citric acid intake can help prevent certain types of kidney stones, such as calcium oxalate stones. Citric acid helps to bind calcium in the urine, reducing the risk of stone formation. Citric acid can be found in citrus fruits and juices, and the nurse may advise the client to include more of these foods in their diet.

A) Pain relief is important in managing kidney stone pain, but potassium citrate is not primarily prescribed for this purpose.

B) Acid-base balance regulation may be one of the functions of potassium citrate, but it is not the primary purpose when prescribed to a client with renal calculus.

C) Urinary tract infection treatment is not the primary purpose of potassium citrate. While it may have some benefits in preventing certain types of urinary tract infections associated with stones, its primary purpose is not to treat infections.

D) This is the correct answer. Potassium citrate is prescribed to help dissolve certain types of kidney stones, particularly calcium oxalate stones and uric acid stones. It works by increasing the pH of the urine, making it more alkaline and less conducive to stone formation.

A) Extracorporeal shock wave lithotripsy (ESWL) does not typically require general anesthesia. It is usually done under sedation or with the use of local anesthesia.

B) The procedure does not involve the insertion of a scope into the urinary tract. ESWL is a non-invasive procedure that uses shock waves to break up the stone from outside the body.

C) This is the correct answer. ESWL involves the use of high-energy shock waves that are focused on the stone to break it up into smaller fragments. The fragments are then passed out of the body through the urine.

D) A urinary catheter is not typically required after ESWL. The client may be encouraged to drink plenty of fluids to help flush out the stone fragments, but a catheter is not usually needed.

A) Sharp, stabbing pain in the lower abdomen is not typically associated with kidney stones. Kidney stone pain is usually felt in the back and flank regions of the body.

B) This is the correct answer. The pain caused by kidney stones is often described as a dull ache in the upper back and flank region, usually on the affected side where the kidney is located.

C) Burning sensation during urination is more commonly associated with urinary tract infections or inflammation of the urethra, not kidney stones.

D) Constant, generalized abdominal discomfort is not a specific symptom of kidney stones. Kidney stone pain is usually more localized to the back and flank regions.

A) Fever and chills are more commonly associated with a urinary tract infection, which can sometimes be a complication of kidney stones. However, the severe pain described is more likely related to the presence of the stone itself.

B) This is the correct answer. Blood in the urine, also known as hematuria, is a common symptom of kidney stones. As the stone moves through the urinary tract, it may cause irritation and small blood vessels may be damaged, resulting in blood in the urine.

C) Difficulty starting the urine stream is not a specific symptom of kidney stones. It may be seen in other urinary conditions but is not typically associated with stones.

D) The frequent urge to urinate may be experienced if the stone causes irritation in the bladder, but it is not the most common symptom associated with kidney stones.

A) This is the correct answer. Kidney stone pain is often described as colicky, which means it comes and goes in waves of severe pain. The pain can be intense and cramp-like, causing the client to writhe or be restless.

B) Gnawing pain is not typically associated with kidney stones. Gnawing pain is often described as a persistent, dull ache that can be more chronic in nature.

C) Stabbing pain is sharp and localized and is not typically used to describe kidney stone pain.

D) Numbing pain refers to a loss of sensation, which is not characteristic of kidney stone pain.

A) Diarrhea and abdominal cramping are not typically associated with kidney stone pain. These symptoms are more commonly seen in gastrointestinal disorders.

B) Painful and frequent urination may occur if the stone causes irritation in the bladder or urethra, but it is not a direct symptom of kidney stone pain.

C) Fatigue and generalized weakness are not specific symptoms of kidney stone pain. They may be associated with other medical conditions but are not directly related to renal calculus.

D) This is the correct answer. Nausea and vomiting are common symptoms that may accompany kidney stone pain, especially if the stone causes obstruction in the urinary tract. The pain and irritation can trigger a reflex that leads to nausea and vomiting.

A) Limiting fluid intake to 1 liter per day is not recommended to prevent kidney stone formation. Adequate hydration is essential to

help prevent stone formation, as it helps dilute the urine and reduce the concentration of minerals that can lead to stone formation.

B) Decreasing dietary fiber intake is not a preventive measure for kidney stones. In fact, increasing dietary fiber intake can be beneficial for overall health.

C) Reducing calcium intake from all sources is not recommended to prevent kidney stones. In some cases, reducing dietary calcium intake can actually increase the risk of certain types of kidney stones.

D) This is the correct answer. Increasing citric acid intake can help prevent certain types of kidney stones, such as calcium oxalate stones. Citric acid helps to bind calcium in the urine, reducing the risk of stone formation. Citric acid can be found in citrus fruits and juices, and the nurse may advise the client to include more of these foods in their diet.

A) Pain relief is important in managing kidney stone pain, but potassium citrate is not primarily prescribed for this purpose.

B) Acid-base balance regulation may be one of the functions of potassium citrate, but it is not the primary purpose when prescribed to a client with renal calculus.

C) Urinary tract infection treatment is not the primary purpose of potassium citrate. While it may have some benefits in preventing certain types of urinary tract infections associated with stones, its primary purpose is not to treat infections.

D) This is the correct answer. Potassium citrate is prescribed to help dissolve certain types of kidney stones, particularly calcium oxalate stones and uric acid stones. It works by increasing the pH of the urine, making it more alkaline and less conducive to stone formation.

A) Extracorporeal shock wave lithotripsy (ESWL) does not typically require general anesthesia. It is usually done under sedation or with the use of local anesthesia.

B) The procedure does not involve the insertion of a scope into the urinary tract. ESWL is a non-invasive procedure that uses shock waves to break up the stone from outside the body.

C) This is the correct answer. ESWL involves the use of high-energy shock waves that are focused on the stone to break it up into smaller fragments. The fragments are then passed out of the body through the urine.

D) A urinary catheter is not typically required after ESWL. The client may be encouraged to drink plenty of fluids to help flush out the stone fragments, but a catheter is not usually needed.

A) While increasing fluid intake can help with the passage of small stones, it is not likely to dissolve larger stones. The primary benefit of increased fluid intake is to help prevent the formation of new stones.

B) Drinking more fluids may help alleviate some discomfort, but the primary goal is not pain reduction.

C) This is the correct answer. Adequate fluid intake can help prevent the formation of new kidney stones by diluting the urine and reducing the concentration of minerals that can contribute to stone formation.

D) While adequate fluid intake can help reduce the risk of urinary tract infections, it is not the primary reason for recommending increased fluid intake in clients with kidney stones.

A) This is a correct statement. Drinking plenty of water is important to help flush out any stone fragments that may have resulted from the procedure.

B) This is a correct statement. Strenuous activities should be avoided for a few days after the procedure to allow for proper healing.

C) This is a correct statement. It is common to have some blood in the urine for a short time after ureteroscopy due to irritation and manipulation of the urinary tract during the procedure.

D) This statement is not correct. After the procedure, the client may be advised to follow a specific diet that is low in certain minerals (such as oxalate and calcium) that can contribute to stone formation. The nurse should provide specific dietary guidelines and restrictions to the client.

A) Extracorporeal shock wave lithotripsy (ESWL) is typically used for smaller stones that can be broken up into smaller fragments and passed more easily. It is not usually recommended for large stones.

B) This is the correct answer. Percutaneous nephrolithotomy (PCNL) is a procedure used to remove larger kidney stones. It involves making a small incision in the back and inserting a nephroscope to directly visualize and remove the stone.

C) Ureteroscopy with laser lithotripsy is used for stones in the ureter, not in the kidney itself.

D) Cystoscopy with stent placement is used for conditions involving the lower urinary tract, such as the urethra and bladder, and is not typically used to remove kidney stones.