A patient admitted with acute kidney injury due to dehydration has oliguria, anemia, and hyperkalemia. Which prescribed action should the nurse take first?

Place the patient on a cardiac monitor.

Insert a urinary retention catheter.

Give the prescribed spironolactone.

Administer epoetin alfa (Epogen).

Answer and Explanation

The Correct Answer is A

Choice A rationale
In the case of hyperkalemia, which can cause fatal cardiac arrhythmias, the most immediate nursing action is to place the patient on a cardiac monitor. This allows for continuous monitoring of the heart's rhythm and immediate detection of any life-threatening changes, which is crucial for timely intervention.

Choice B rationale
Inserting a urinary retention catheter may be necessary for managing oliguria, but it is not the most urgent action when compared to the potential cardiac risks associated with hyperkalemia.

Choice C rationale
Administering spironolactone, a potassium-sparing diuretic, could be part of the treatment for hyperkalemia, but it is not the first action to take. Spironolactone works more slowly and does not address the immediate risk of cardiac arrhythmias.

Choice D rationale
Epoetin alfa (Epogen) is used to treat anemia, particularly in chronic kidney disease, to increase red blood cell production. However, it does not have an immediate effect and is not the priority in the presence of hyperkalemia and potential cardiac complications.

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Correct Answer is ["A","C","D","F"]

Explanation

Choice A rationale
Chocolate is known to have moderate levels of potassium and should be limited in a diet for chronic kidney disease to prevent hyperkalemia¹.

Choice B rationale

Green beans are considered a lower potassium vegetable and can be included in a kidney-friendly diet in appropriate portions².

Choice C rationale

Tomatoes are high in potassium and should be avoided by individuals with chronic kidney disease to maintain safe potassium levels¹.

Choice D rationale

Bananas are very high in potassium and are one of the most well-known foods that individuals with chronic kidney disease are advised to avoid¹.

Choice E rationale

Asparagus is lower in potassium compared to other vegetables and can be consumed in moderation by people with chronic kidney disease².

Choice F rationale
Salt substitutes often contain potassium chloride and should be avoided as they can significantly increase potassium intake, which is harmful for those with chronic kidney disease¹.

A. Inflammatory cells invade the already damaged kidneys. B. There is a reduction of blood flow to the kidneys. C. There is injury to the renal tubular cells. D. There is obstruction leading to the filtration system backing up and eventually shutting the kidneys down.

Correct Answer is C

Explanation

Choice A rationale
While inflammation can affect the kidneys, the presence of inflammatory cells alone does not typically cause a decrease in GFR. Inflammatory cells invading the kidneys is more associated with conditions like glomerulonephritis rather than acute tubular necrosis.

Choice B rationale
A reduction in blood flow to the kidneys, known as prerenal azotemia, can indeed lead to a decreased GFR. However, in the context of acute tubular necrosis, the primary issue is damage to the renal tubules rather than blood flow.

Choice C rationale
Acute tubular necrosis is characterized by damage to the renal tubular cells, which can lead to a decrease in GFR. This damage impairs the kidney's ability to filter waste products from the blood, resulting in a lower GFR.

Choice D rationale
Obstruction of the urinary tract can lead to postrenal azotemia, which may decrease GFR if severe enough. However, this is not the typical pathophysiological change seen in acute tubular necrosis, which primarily involves tubular cell injury.

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A patient admitted with acute kidney injury due to dehydration has oliguria, anemia, and hyperkalemia. Which prescribed action should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has chronic kidney disease about limiting foods that are high in potassium. Which of the following foods should the nurse instruct the client to avoid? (Select all that apply.)

Correct Answer is ["A","C","D","F"]

Explanation

Correct Answer is C

Explanation

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A patient admitted with acute kidney injury due to dehydration has oliguria, anemia, and hyperkalemia. Which prescribed action should the nurse take first?

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