A nurse is assessing a client who is experiencing acute kidney injury. The client is found to have a significant change in mental status, is lethargic, and confused. The nurse auscultates crackles in the client's lungs. Upon reviewing labs, it is noted that the client's BUN is 140 mg/dL and the potassium is 6.7 mEq/L. Which treatment will the nurse anticipate to be ordered for a client with these findings?

Sodium polystyrene sulfonate (Kayexalate)

Bolus with 1 liter of lactated ringer's (LR)

Renal replacement therapy (RRT)

Patiromer (Veltassa)

Answer and Explanation

The Correct Answer is C

A.   While this medication is used to treat hyperkalemia, it is a slower acting treatment. Given the patient's critical condition with altered mental status, hyperkalemia, and elevated BUN, a more rapid intervention is needed.
B.   Fluid resuscitation is important in some cases of AKI but it is not the priority in this patient. The patient is already showing signs of fluid overload (crackles in the lungs) and the primary issue is the inability of the kidneys to remove waste products and excess fluids.
C.   This is the most appropriate treatment for this patient. RRT, such as hemodialysis or continuous renal replacement therapy (CRRT), can rapidly remove waste products, excess fluid, and electrolytes from the blood, correcting the imbalances and improving the patient's condition.
D.   This medication is used for long-term management of hyperkalemia, but it is not effective in an acute setting like this.

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Correct Answer is B

Explanation

A. Patients with PKD may have issues with kidney function over time, which can affect potassium levels. Typically, a high-potassium diet is not recommended for those with kidney problems because it can exacerbate hyperkalemia.
B. Polycystic kidney disease can lead to progressive loss of kidney function, and many patients eventually require dialysis or a kidney transplant as the disease advances and kidney function declines.

C. There is no general recommendation for a vasectomy solely based on having PKD. While PKD is a genetic condition, and individuals with PKD can pass the condition on to their children, there is no requirement for men with PKD to undergo sterilization.
D. People with PKD are potential candidates for kidney transplantation if their kidney function deteriorates to the point where dialysis is required. PKD itself does not disqualify individuals from receiving a kidney transplant.

A. Potassium 3.3 mEq/L. hemoglobin 14.1 g/dL, creatinine 0.8 mg/dL B. BUN 5 mg/dL, potassium 4.8 mEq/L, creatinine 0.9 mg/dL C. Potassium 5.4 mEq/L. hemoglobin 9.8 g/dL, creatinine 4.6 mg/dl. D. Potassium 4.5 mEq/L, BUN 18 mg/dL, creatinine 1.1 mg/dL

Correct Answer is C

Explanation

A. These values are within normal ranges.
B. BUN is low, but potassium and creatinine are within normal ranges.
C. Elevated potassium (hyperkalemia), low hemoglobin (anemia), and elevated creatinine are all classic signs of chronic kidney disease.
D. BUN and creatinine are slightly elevated, but not to a level indicative of chronic kidney disease. Potassium is within normal range.

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Naxlex Comprehensive Predictor Exams

The nurse is providing education to a male client who is newly-diagnosed with polycystic kidney disease. Which of the following statements should be included in the client teaching?

Correct Answer is B

Explanation

A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of untreated chronic kidney disease?

Correct Answer is C

Explanation

Which of the following clients is at risk of developing acute kidney injury from a post-renal cause?

A client with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L. The nurse recognizes that administering IV calcium gluconate to this client will result in which of the following effects?

During the diuretic phase of acute kidney injury, the nurse understands that the client is at risk for which of the following electrolyte imbalances?

A client who received a kidney transplant last month is in the nephrology clinic for a follow-up visit. Which education should the nurse provide to the client regarding complications which can arise after a kidney transplant?

A nurse is admitting a client who has been diagnosed with acute glomerulonephritis. Considering the most common cause of this condition, which test should the nurse anticipate will be performed?

A nurse is assessing a client's arteriovenous fistula prior to hemodialysis, but does not hear a bruit or feel a thrill. Pulses distal to the fistula are not palpable, and the capillary refill is slow. Which of the following actions is the nurse's priority?