The nurse is developing a plan of care for a client diagnosed with acute renal failure (ARF). Which statement would be an appropriate outcome for the client?

Electrolytes are within normal limits.

Blood pressure is decreased to 120/80

Decrease of pain by 3 points on a 1-10 scale.

The client will understand how to care for the AV fistula

Answer and Explanation

The Correct Answer is A

A. Electrolytes are within normal limits: Acute Renal Failure (ARF) leads to electrolyte imbalances (↑ K+, ↑ BUN/creatinine, metabolic acidosis). A successful treatment goal is restoring normal electrolyte balance.

B. Blood pressure is decreased to 120/80. BP control is important but not the primary goal in ARF.

C. Decrease of pain by 3 points on a 1-10 scale. Pain control is important, but not the main indicator of ARF improvement.

D. The client will understand how to care for the AV fistula. This applies to chronic kidney disease clients on hemodialysis, not ARF management.

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Correct Answer is C

Explanation

A. "I can’t wait to start back to work next week, I really need the money." Returning to work too soon increases the risk of infection and complications. Clients should follow their provider's recommendations.

B. "I will follow my 1,500 mL fluid restriction." After a kidney transplant, patients typically need increased fluid intake to maintain kidney perfusion, not restriction.

C. "I will take my temperature and if it is above 101°F, I will call my doctor." Fever >101°F (38.3°C) is an early sign of infection or organ rejection. Prompt medical attention is required.

D. "I am glad I won't have to keep track of how much I urinate in the day." Clients must monitor urine output to detect signs of kidney rejection or dysfunction.

A. Stable blood pressure, normal urine output, and flat neck veins. B. Nausea, vomiting, diarrhea and normal blood pressure. C. Tachycardia, decreased blood pressure, and decreased urine output. D. Tachycardia, increased blood pressure, and poor skin turgor

Correct Answer is C

Explanation

A. Stable blood pressure, normal urine output, and flat neck veins. BP and urine output are not stable in hypovolemia.

B. Nausea, vomiting, diarrhea, and normal blood pressure. These can contribute to hypovolemia, but BP is not normal in severe cases.

C. Tachycardia, decreased blood pressure, and decreased urine output. Hypovolemia (low blood volume) causes compensatory tachycardia to maintain perfusion. BP drops due to decreased circulatory volume. Urine output decreases (<30 mL/hr) due to reduced renal perfusion.

D. Tachycardia, increased blood pressure, and poor skin turgor. BP is decreased, not increased in hypovolemia.

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The nurse is developing a plan of care for a client diagnosed with acute renal failure (ARF). Which statement would be an appropriate outcome for the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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