Question 1

A client had an episode of acute renal failure after heart surgery but seems to have recovered now. What is an important health promotion strategy the nurse could teach the client? The nurse should teach the client to

Accepted Answer

A)  avoid aminoglycosides and IVP dye in the future. 
B)  drink lots of fluids on an ongoing basis. 
C)  have a BUN and creatinine drawn every 6 months. 
D)  monitor his/her temperature daily.

Question 2

A client is at a follow-up appointment and confesses that s/he does not take medications as prescribed. When planning a teaching strategy to address this problem, the nurse understands that clients often do not adhere to self-care guidelines because (Select all that apply)

Accepted Answer

A)  a good understanding of the consequences leads them to skip meds. 
B)  clients may believe they no longer need the medications. 
C)  side effects may be disruptive and unpleasant. 
D)  the economic costs are too high for them to absorb.

Question 3

A client has been on dialysis for 6 weeks. The family is complaining that instead of feeling grateful at this second chance at life, the client has become irritable with them and seems depressed. The most helpful response by the nurse would be

Accepted Answer

A)  "Depression is very common at this time; it is hard to adapt to the losses s/he feels." 
B)  "I am surprised that your loved one doesn't feel happier about being alive." 
C)  "This must be very hard on you for your loved one to be so unappreciative." 
D)  "We can arrange a psychiatric consultation if you think it will help."

Question 4

The nurse teaching a client about continuous ambulatory peritoneal dialysis (CAPD) would include the information that

Accepted Answer

A)  a small, lightweight pump must be carried in a pocket or on a belt. 
B)  CAPD eliminates the need for strict aseptic technique when handling the catheter. 
C)  the procedure involves instilling 250 to 500 ml of fluid at a time. 
D)  there are four daily cycles with an 8-hour dwell for one cycle during the night.

Question 5

A client with oliguric ARF would exhibit

Accepted Answer

A)  a BUN/creatinine ratio of 30:1. 
B)  hematuria. 
C)  proteinuria. 
D)  a urine specific gravity of 1.001.

Question 6

For a client with chronic renal failure who is experiencing insomnia, the least helpful strategy would be

Accepted Answer

A)  establishing a pre-sleep quiet time. 
B)  planning on a standard time to go to bed. 
C)  setting up a bedtime routine. 
D)  taking an over-the-counter sedative drug.

Question 7

A client had a kidney transplant and is doing well, except for being concerned that the spouse does not seem happy about it. The assessment by the nurse that would yield the most helpful information is to ask the

Accepted Answer

A)  client what hobbies and activities they enjoy together. 
B)  client why he/she thinks the spouse is acting that way. 
C)  spouse how he/she feels about the client's progress. 
D)  spouse what his/her role was while the client was ill.

Question 8

A client is complaining about the decrease in quality of life experienced since the client started dialysis. Using recent research to guide suggestions, the nurse counsels the client to

Accepted Answer

A)  become more active in care planning. 
B)  engage in regular exercise. 
C)  start attending church if not already going. 
D)  try to stay active in the community.

Question 9

The nurse explains to a client's family that the most common overall manifestation of ARF is that

Accepted Answer

A)  expected urine output is altered. 
B)  the client's breath develops a fruity odor. 
C)  urine specific gravity is greater than 1.040. 
D)  urine develops a "root beer" color.

Question 10

While caring for a client in the oliguric phase of ARF, the nurse's plan of care should include

Accepted Answer

A)  encouraging fluid intake to prevent dehydration. 
B)  increasing the client's protein intake to prevent muscle wasting. 
C)  maintaining reverse isolation to prevent infection. 
D)  meticulous skin care to prevent skin breakdown.

Exam 36: Management of Clients with Renal Failure