A nurse is caring for a client admitted with a diagnosis of acute kidney injury. The client asks the nurse, "Are my kidneys failing and will I need a kidney transplant?" The nurse should respond to the client with which of the following statements?

"When the doctor comes to see you, we can talk about whether you will need a transplant."

"Kidney transplantation is likely, and it would be a good idea to start talking to family members."

"No, don't think that. You're going to be fine in a few weeks."

"Your condition can be reversed with prompt treatment and usually will not destroy the kidney."

Answer and Explanation

The Correct Answer is A

A. "When the doctor comes to see you, we can talk about whether you will need a transplant." This response acknowledges the client's concerns and opens the door for further discussion with the healthcare provider about the client's prognosis and potential need for a kidney transplant. It provides an opportunity for the client to receive accurate information from the appropriate healthcare professional.

B. "Kidney transplantation is likely, and it would be a good idea to start talking to family members." This response may cause unnecessary anxiety and speculation for the client without

confirmation from the healthcare provider. It is important to provide information based on the client's specific situation and medical assessment.

C. "No, don't think that. You're going to be fine in a few weeks." This response provides false reassurance and does not address the client's concerns or the potential seriousness of acute kidney injury. It is essential to provide honest and accurate information to the client.

D. "Your condition can be reversed with prompt treatment and usually will not destroy the kidney." While acute kidney injury can sometimes be reversible with prompt and appropriate treatment, it is not always the case. Additionally, it does not address the potential need for a kidney transplant, which depends on the severity and underlying cause of the kidney injury.

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Correct Answer is B

Explanation

A. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain: This prescription is appropriate for managing pain associated with acute heart failure and MI.

B. Bumetanide 1 mg IV bolus every 12 hr: Bumetanide is a loop diuretic commonly used in heart failure to reduce fluid overload. However, the frequency of administration (every 12 hours) may not be sufficient for managing acute heart failure, where more frequent dosing may be necessary initially.

C. Laboratory testing of serum potassium upon admission: This is a routine and appropriate order to monitor electrolyte balance, especially with the use of diuretics.

D. 0.9% normal saline IV at 75 mL/hr: This is a maintenance IV fluid rate that may be appropriate depending on the client's fluid status. However, it does not directly address acute heart failure.

A. pH 7.42, PaCO2 48 mm HG, HCO3 25 mEq/L B. pH 7.28, PaCO2 63 mm HG, HCO3 22 mEq/L C. pH 7.49, PaCO2 30 mm Hg, HCO3 35 mEq/L D. pH 7.36; PaCO2 42 mm Hg, HCO3 26 mEq/L

Correct Answer is B

Explanation

A. This result shows a slightly elevated PaCO2, which could suggest respiratory compensation for a metabolic alkalosis, not acidosis, as the pH is within the normal range.
B. This result indicates both a low pH and an elevated PaCO2, which are consistent with respiratory acidosis. The low HCO3 also suggests a metabolic acidosis component, making it the best match for a client with acidosis.

C. The elevated pH indicates alkalosis. The low PaCO2 and high HCO3 further suggest a primary respiratory alkalosis with metabolic compensation.
D. These values are within normal limits, indicating neither acidosis nor alkalosis.

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A nurse is caring for a client admitted with a diagnosis of acute kidney injury. The client asks the nurse, "Are my kidneys failing and will I need a kidney transplant?" The nurse should respond to the client with which of the following statements?

Nursing Test Bank

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