NCLEX Acute Renal Failure 2023 Practice Exam

NCLEX Acute Renal Failure 2023 Practice Exam With Verified Answers

. Which sign indicated the second phase of acute renal failure?

• Daily doubling of urine output (4 to 5 L/day)
• Urine output less than 400 ml/day
• Urine output less than 100 ml/day
• Stabilization of renal function - ANSWER 28. Answer: 1. Daily doubling of urine output

(4 to 5 L/day)

Daily doubling of the urine output indicates that the nephrons are healing. This means the patient is passing into the second phase (dieresis) of acute renal failure.

. Your patient returns from the operating room after abdominal aortic aneurysm repair.Which symptom is a sign of acute renal failure?

• Anuria
• Diarrhea
• Oliguria

4. Vomiting - ANSWER 41. Answer: 3. Oliguria

Urine output less than 50ml in 24 hours signifies oliguria, an early sign of renal failure.Anuria is uncommon except in obstructive renal disorders.

. Which cause of hypertension is the most common in acute renal failure?

• Pulmonary edema
• Hypervolemia
• Hypovolemia

4. Anemia - ANSWER 42. Answer: 2. Hypervolemia

Acute renal failure causes hypervolemia as a result of overexpansion of extracellular fluid and plasma volume with the hypersecretion of renin. Therefore, hypervolemia causes hypertension.

What nursing measure would be included in the plan of care for a client with acute renal failure?1) Observe for signs of a secondary infection 2) Provide a high protein, low carbohydrate diet 3) In and out catheterization for residual urine 4) Encourage fluids to 2000 mL in 24 hours - ANSWER 1: Secondary infections are the cause of death in 50-90% of clients with acute renal failure. A low protein diet is most often offered. Catheterizations are avoided. Fluids may be limited if the client is in ARF.

A client with acute renal failure develops sever hyperkalemia. What would the nurse anticipate to be used to treat this imbalance?1) Furosemide (Lasix) 2) Amphojel (aluminum hydroxide) 3) 50% glucose and regular insulin 4) Epoetin (Procrit) - ANSWER 3: Hyperkalemia can develop into an emergency situation (Cardia Arrest). It is important to quickly move the potassium back into the cells by administering 50% glucose and regular insulin, usually in conjunction with some type of

base to correct the acidosis, such as sodium bicarbonate or calcium gluconate given IV.Insulin assists in the movement of potassium into the cells and helps to reduce the serum potassium level. Amphojel is used for the treatment of hyperphosphatemia that occurs with ARF. Procrit is used for the treatment of anemia caused by a decrease in erythropoietin production by the kidneys. A diuretic, such as Lasix, may lead to a loss of potassium, but the rate is too slow.

Acute renal failure is potentially reversible in the:

• convalescent phase.
• initiation phase.
• maintenance phase.
• recovery phase. - ANSWER B, initiation phase

Signs and symptoms of acute renal failure include:

• bradycardia, with decreased respiration, low serum bicarbonate, and elevated pH.
• lethargy, tachypnea, and elevated serum bicarbonate.
• slowed respirations and low pH.
• tachypnea, low pH, and low serum bicarbonate. - ANSWER D. tachypnea, low pH, and

low serum bicarbonate.

• A client with glomerulonephritis is at risk of developing acute renal failure. The nurse

monitors the client for which sign of this complication?

• bradycardia
• hypertension

• decreased cardiac output
• decreased central venous pressure - ANSWER 1) B
• Acute renal failure caused by glomerulonephritis is classified as intrinsic or intrarenal

failure. This form of acute renal failure is commonly manifested by hypertension, tachycardia, oliguria, lethargy, edema, and other signs of fluid overload. Acute renal failure from prerenal causes is characterized by decreased blood pressure or a recent history of the same, tachycardia, and decreased cardiac output and central venous pressure. Bradycardia is not part of the clinical picture for renal failure.

• A nurse provides home care instructions to a client hospitalized for a transurethral

resection of the prostate (TURP). Which statement by the client indicates a need for further instructions?

a) I need to avoid strenuous activity for 4 to 6 weeks

b) I need to maintain a daily intake of 6 to 8 glasses of water daily

c) I need to avoid lifting items greater than 30 pounds

d) I need to include prune juice in my diet - ANSWER 2) C

• The client needs to be advised to avoid strenuous activity for 4 to 6 weeks and to avoid

lifting items weighing greater than 20 pounds. The client needs to consume an intake of at least 6 to 8 glasses daily of nonalcoholic fluids to minimize clot formation. Straining during defecation for at least 6 weeks after surgery is avoided to prevent bleeding. Prune juice is a satisfactory bowel stimulant.

• A nurse is caring for a client who has just returned to the nursing unit after an

intravenous pyelogram (IVP). The nurse determines that which of the following is important in the postprocedure care of this client?

• encouraging increased intake of oral fluids
• ambulating the client in the hallway
• encouraging the client to try to avoid frequently