A client is in a motor vehicle accident with a severe kidney injury and develops acute renal failure. Which acid-base imbalance is most likely to develop?

Respiratory Acidosis

Metabolic Alkalosis

Respiratory Alkalosis

Metabolic acidosis

Answer and Explanation

The Correct Answer is D

A. Respiratory Acidosis: Respiratory acidosis results from inadequate ventilation leading to CO₂ retention, which is unrelated to kidney failure.

B. Metabolic Alkalosis: Metabolic alkalosis occurs due to excessive loss of acids (e.g., vomiting) or excess bicarbonate intake. Acute renal failure causes acid retention, not loss.

C. Respiratory Alkalosis: Respiratory alkalosis is caused by hyperventilation and excessive CO₂ loss, not renal dysfunction.

D. Metabolic acidosis: The kidneys play a vital role in acid-base balance by excreting hydrogen ions and reabsorbing bicarbonate. Acute renal failure impairs these functions, leading to acid retention and metabolic acidosis.

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Correct Answer is A

Explanation

A. Obtain vital signs: Dizziness and lightheadedness during dialysis suggest hypotension, a common complication. The nurse should first assess vital signs to determine the severity before taking further action.

B. Bolus the client with 1000 mL of normal saline: If the client is hypotensive, a smaller fluid bolus (e.g., 250–500 mL) would be more appropriate.

C. Turn off the dialysis machine immediately: Stopping dialysis abruptly may cause fluid overload and other complications. The rate may need adjustment but not immediate cessation.

D. Notify the health care provider as soon as possible: While important, assessing the client’s current status is the priority before contacting the provider.

A. Fluid will be pushed in the interstitial spaces B. Fluid will be pulled out of the cells and into the blood stream. C. Fluid will be pushed out of the blood stream into the extravascular spaces. D. Fluid will be pulled out of the bloodstream into the cells

Correct Answer is B

Explanation

A. Fluid will be pushed into the interstitial spaces. Hypertonic solutions draw water into the bloodstream, not into tissues.

B. Fluid will be pulled out of the cells and into the bloodstream: Hypertonic solutions (e.g., 3% NaCl, D10W) have a higher osmolarity than blood plasma. This pulls fluid from cells into the intravascular space, causing cell shrinkage and increasing blood volume.

C. Fluid will be pushed out of the bloodstream into extravascular spaces. This describes a hypotonic solution’s effect.

D. Fluid will be pulled out of the bloodstream into the cells. This describes an isotonic or hypotonic effect.

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A client is in a motor vehicle accident with a severe kidney injury and develops acute renal failure. Which acid-base imbalance is most likely to develop?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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