A nurse is teaching a client diagnosed with acute renal failure about how the disease progresses. The nurse should recognize that the teaching is effective when the client can accurately identify which phases of renal disease progression? (Select all that apply.)

Recovery phase.

Diuretic phase.

Initiation phase.

Oliguric phase.

End phase.

Answer and Explanation

Correct Answer : A,B,C,D

A. Recovery phase: The recovery phase occurs after the oliguric phase and is characterized by the gradual improvement of renal function. During this phase, diuresis may occur as the kidneys begin to excrete waste and excess fluid more effectively.

B. Diuretic phase: The diuretic phase follows the oliguric phase and is characterized by increased urine output as the kidneys start to recover and regain their ability to concentrate urine. This phase can lead to electrolyte imbalances and dehydration if not managed properly.

C. Initiation phase: The initiation phase marks the onset of acute renal failure and is characterized by the initial insult or injury to the kidneys. This phase may be triggered by various factors such as hypotension, nephrotoxic medications, or sepsis.

D. Oliguric phase: The oliguric phase is the initial phase of acute renal failure and is characterized by decreased urine output (<400 mL/day). During this phase, waste products and electrolytes may accumulate in the body, leading to metabolic acidosis and fluid overload.

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Correct Answer is B

Explanation

A. Document how many inches the tube has been inserted: While documentation of the tube insertion depth is important, it is not the highest priority immediately after intubation. Ensuring proper placement and ventilation take precedence.

B. Auscultate both lungs for the presence of breath sounds: This is the priority action to confirm that the endotracheal tube is correctly placed in the trachea and that both lungs are being ventilated adequately. Absence of breath sounds on one side could indicate mainstem intubation or displacement of the tube.

C. Secure the endotracheal tube to prevent dislodgement: Securing the tube is important, but it should be done after confirming proper placement and ventilation.

D. Obtain a chest x-ray to ensure correct tube placement: While a chest x-ray is often performed after intubation to confirm tube placement, it is not the immediate priority. Auscultation provides more immediate feedback on the effectiveness of ventilation.

A. Irregular pulsations B. Bounding pulsations C. Tachycardia D. Bradycardia

Correct Answer is A

Explanation

A. Irregular pulsations: Premature ventricular contractions (PVCs) are abnormal heartbeats originating in the ventricles, causing irregularities in the heart rhythm. Auscultating the apical pulse during PVCs may reveal irregular pulsations due to the irregular timing of ventricular contractions.

B. Bounding pulsations: Bounding pulsations are typically associated with conditions such as hypertension or aortic valve regurgitation but are not specifically characteristic of PVCs.

C. Tachycardia: PVCs may occur in the setting of tachycardia, but the presence of PVCs themselves does not necessarily indicate a rapid heart rate. The rhythm may be irregular due to PVCs, but the overall heart rate may not be consistently elevated.

D. Bradycardia: PVCs are not typically associated with bradycardia. Bradycardia refers to a slow heart rate, while PVCs involve premature extra beats originating from the ventricles.

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A nurse is teaching a client diagnosed with acute renal failure about how the disease progresses. The nurse should recognize that the teaching is effective when the client can accurately identify which phases of renal disease progression? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who experienced sudden onset of dyspnea, tachycardia, oxygen saturation of 82%, and has been intubated with an endotracheal tube. The nurse should perform which priority action immediately after the tube is placed in the trachea?

Correct Answer is B

Explanation

Correct Answer is A

Explanation

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