MS4 EXAM QUESTIONS AND ANSWERS WITH
COMPLETE VERIFIED SOLUTIONS
What are important nursing care measures for a client with diabetes who is
admitted with end-stage renal failure?
Restrict sodium and potassium and restrict fluids as ordered.
Explanation:
In renal failure, there is retention of sodium and potassium, so these are restricted.
Important care measures will also include fluid restrictions. The client will require
permanent dialysis, not temporary as with acute renal failure. The diet will be restricted
in protein to decrease waste products. Hypertension is associated with chronic renal
failure.
A client is scheduled for a creatinine clearance test. The client needs further
instruction about preparing for the test after making which statement?
I will be sure to fast from midnight until the test begins at 8:00 am the following day."
Explanation:
The creatinine clearance test determines the kidneys' ability to remove a substance
from the plasma in 1 minute. High levels of protein in the diet, especially prior to the test
can lead to false abnormal test results. Similarly, staying hydrated is important, as fluid
deficit or overload can also skew test results. A client may engage in normal activity the
,days before the test but should not engage in overly vigorous exercise, as this may
cause muscle stress and alter the test results.
A nurse is caring for a client with chronic renal failure. The laboratory results
indicate hypocalcemia and hyperphosphatemia. When assessing the client, the
nurse would be alert for which signs and symptoms? Select all that apply.
Trousseau's sign
cardiac arrhythmias
fractures
Explanation:
Chronic renal failure is the slow process of losing kidney function over time. At some
point, the kidney will not be able to remove excess fluid and wastes from the body
causing fluid and electrolyte complications. Hypocalcemia is a calcium deficit that
causes nerve fiber irritability and repetitive muscle spasms. Signs and symptoms of
hypocalcemia include Trousseau's sign, cardiac arrhythmias, diarrhea, increased
clotting times, anxiety, and irritability. The calcium-phosphorus imbalance leads to brittle
bones and pathologic fractures. Drowsiness and lethargy are not typically associated
with hypocalcemia.
A client receiving peritoneal dialysis in the home is suspected of having
peritonitis. Which finding should the nurse expect to assess in this client? Select
all that apply.
, hypotension
abdominal pain
rebound tenderness
Explanation:
A client receiving peritoneal dialysis is at risk for developing peritonitis. Manifestations of
peritonitis include diffuse abdominal pain and rebound tenderness. Hypotension can
occur if the infection continues. Weight loss and extreme thirst are not signs of
peritonitis.
A client with chronic renal failure (CRF) is receiving a hemodialysis treatment.
After hemodialysis, the nurse knows that the client is most likely to experience:
weight loss.
Explanation:
Because CRF causes loss of renal function, the client with this disorder retains fluid.
Hemodialysis removes this fluid, causing weight loss. Hematuria is unlikely to follow
hemodialysis because the client with CRF usually forms little or no urine. Hemodialysis
doesn't increase urine output because it doesn't correct the loss of kidney function,
which severely decreases urine production in this disorder. By removing fluids,
hemodialysis decreases rather than increases the blood pressure.
COMPLETE VERIFIED SOLUTIONS
What are important nursing care measures for a client with diabetes who is
admitted with end-stage renal failure?
Restrict sodium and potassium and restrict fluids as ordered.
Explanation:
In renal failure, there is retention of sodium and potassium, so these are restricted.
Important care measures will also include fluid restrictions. The client will require
permanent dialysis, not temporary as with acute renal failure. The diet will be restricted
in protein to decrease waste products. Hypertension is associated with chronic renal
failure.
A client is scheduled for a creatinine clearance test. The client needs further
instruction about preparing for the test after making which statement?
I will be sure to fast from midnight until the test begins at 8:00 am the following day."
Explanation:
The creatinine clearance test determines the kidneys' ability to remove a substance
from the plasma in 1 minute. High levels of protein in the diet, especially prior to the test
can lead to false abnormal test results. Similarly, staying hydrated is important, as fluid
deficit or overload can also skew test results. A client may engage in normal activity the
,days before the test but should not engage in overly vigorous exercise, as this may
cause muscle stress and alter the test results.
A nurse is caring for a client with chronic renal failure. The laboratory results
indicate hypocalcemia and hyperphosphatemia. When assessing the client, the
nurse would be alert for which signs and symptoms? Select all that apply.
Trousseau's sign
cardiac arrhythmias
fractures
Explanation:
Chronic renal failure is the slow process of losing kidney function over time. At some
point, the kidney will not be able to remove excess fluid and wastes from the body
causing fluid and electrolyte complications. Hypocalcemia is a calcium deficit that
causes nerve fiber irritability and repetitive muscle spasms. Signs and symptoms of
hypocalcemia include Trousseau's sign, cardiac arrhythmias, diarrhea, increased
clotting times, anxiety, and irritability. The calcium-phosphorus imbalance leads to brittle
bones and pathologic fractures. Drowsiness and lethargy are not typically associated
with hypocalcemia.
A client receiving peritoneal dialysis in the home is suspected of having
peritonitis. Which finding should the nurse expect to assess in this client? Select
all that apply.
, hypotension
abdominal pain
rebound tenderness
Explanation:
A client receiving peritoneal dialysis is at risk for developing peritonitis. Manifestations of
peritonitis include diffuse abdominal pain and rebound tenderness. Hypotension can
occur if the infection continues. Weight loss and extreme thirst are not signs of
peritonitis.
A client with chronic renal failure (CRF) is receiving a hemodialysis treatment.
After hemodialysis, the nurse knows that the client is most likely to experience:
weight loss.
Explanation:
Because CRF causes loss of renal function, the client with this disorder retains fluid.
Hemodialysis removes this fluid, causing weight loss. Hematuria is unlikely to follow
hemodialysis because the client with CRF usually forms little or no urine. Hemodialysis
doesn't increase urine output because it doesn't correct the loss of kidney function,
which severely decreases urine production in this disorder. By removing fluids,
hemodialysis decreases rather than increases the blood pressure.
