The nurse is assessing a patient with acute renal failure.
Which of the following would be a priority nursing intervention?
Administering a potassium-sparing diuretic.
Encouraging the patient to consume a high-sodium diet.
Monitoring urine output and fluid balance.
Administering intravenous antibiotics.
The Correct Answer is C
This is because acute renal failure is a condition where the kidneys lose their ability to filter waste and excess fluid from the blood. This can lead to fluid overload, electrolyte imbalances, and metabolic acidosis. Therefore, the nurse should monitor the patient’s urine output and fluid balance to assess the severity of the renal impairment and prevent complications.
Choice A is wrong because administering a potassium-sparing diuretic would worsen the patient’s hyperkalemia, which is a common complication of acute renal failure.
Choice B is wrong because encouraging the patient to consume a high-sodium diet would increase the patient’s fluid retention and blood pressure, which can further damage the kidneys.
Choice D is wrong because administering intravenous antibiotics is not a priority intervention for acute renal failure unless there is a specific indication of infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Protein intake can increase the excretion of calcium and oxalate in the urine, which can promote the formation of calcium oxalate stones. The client should limit animal protein sources, such as meat, poultry, fish, eggs, and dairy products.
Choice A is wrong because purine-rich foods, such as organ meats, shellfish, and beer, can increase the production of uric acid, which can cause uric acid stones.
Choice B is wrong because a low-calcium diet can increase the absorption of oxalate in the intestine, which can increase the risk of calcium oxalate stones.
The client should consume a moderate amount of calcium from dietary sources, such as milk, cheese, yogurt, and green leafy vegetables.
Choice C is wrong because potassium-rich foods, such as bananas, oranges, potatoes, and tomatoes, can help prevent calcium oxalate stones by increasing the urinary pH and citrate levels.
The client should consume adequate amounts of potassium from dietary sources.
Correct Answer is ["A","B","C","E"]
Explanation
Choice A reason: This hypotonic saline solution is often used after initial resuscitation, especially when the patient’s serum sodium is normal or elevated. It helps replace intracellular fluid losses and provides ongoing hydration without excessively increasing sodium levels. It is typically administered once the initial intravascular volume is restored with isotonic fluids.
Choice B reason: This isotonic saline solution is the first-line intravenous fluid used in DKA. It helps expand intravascular volume quickly, restore tissue perfusion, and correct hypovolemia caused by osmotic diuresis. It is given initially as a bolus, followed by continuous infusion until the patient is stabilized.
Choice C reason: This dextrose-containing solution is introduced once blood glucose falls to approximately 200–250 mg/dL. At this point, insulin therapy must continue to clear ketones and correct acidosis, but dextrose is added to prevent hypoglycemia. It is usually combined with saline (e.g., D5 0.45% NS) to balance hydration and glucose support.
Choice D reason: This balanced electrolyte solution is not typically the preferred fluid in DKA management because the lactate component may complicate interpretation of acid–base status. Although it can expand volume, it is generally avoided in favor of saline solutions that more directly address dehydration and electrolyte imbalance in DKA.
Choice E reason: This form of insulin is the only type used intravenously in DKA. A continuous infusion of regular insulin is essential to reduce blood glucose, suppress ketone production, and correct metabolic acidosis. It is carefully titrated with close monitoring of electrolytes, especially potassium, since insulin drives potassium into cells and can cause hypokalemia.
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