The Client with Chronic

Renal Failure

74.

The nurse assesses the client who has

chronic renal failure and notes the following: crackles
in the lung bases, elevated blood pressure, and
weight gain of 2 lb in 1 day. Based on these data,
which of the following nursing diagnoses is appropriate?
1. Excess fl uid volume related to the kidneys
inability to maintain fl uid balance.
2. Ineffective breathing pattern related to fl uid
in the lungs.
3. Ineffective tissue perfusion related to interrupted
arterial blood fl ow.
4. Ineffective therapeutic regimen management
related to lack of knowledge about
therapy.

75.

What is the primary disadvantage of using

peritoneal dialysis for long-term management of
chronic renal failure?
1. The danger of hemorrhage is high.
2. It cannot correct severe imbalances.
3. It is a time-consuming method of treatment.
4. The risk of contracting hepatitis is high.

76.

A client with chronic renal failure who

receives hemodialysis three times a week is experiencing
severe nausea. What should the nurse advise
the client to do to manage the nausea? Select all that
apply.
1. Drink fl uids before eating solid foods.
2. Have limited amounts of fl uids only when
thirsty.
3. Limit activity.
4. Keep all dialysis appointments.
5. Eat smaller, more frequent meals.

77.

The dialysis solution is warmed before use in

peritoneal dialysis primarily to:
1. Encourage the removal of serum urea.
2. Force potassium back into the cells.
3. Add extra warmth to the body.
4. Promote abdominal muscle relaxation.

78.

Which of the following assessments would

be most appropriate for the nurse to make while
the dialysis solution is dwelling within the clients
abdomen?
1. Assess for urticaria.
2. Observe respiratory status.
3. Check capillary refi ll time.
4. Monitor electrolyte status.

79.

During the clients dialysis, the nurse

observes that the solution draining from the abdomen
is consistently blood-tinged. The client has

a permanent peritoneal catheter in place. Which

interpretation of this observation would be correct?
1. Bleeding is expected with a permanent peritoneal
catheter.
2. Bleeding indicates abdominal blood vessel
damage.
3. Bleeding can indicate kidney damage.
4. Bleeding is caused by too-rapid infusion of
the dialysate.

80.

During dialysis, the nurse observes that the

fl ow of dialysate stops before all the solution has
drained out. The nurse should:
1. Have the client sit in a chair.
2. Turn the client from side to side.
3. Reposition the peritoneal catheter.
4. Have the client walk.

81.

Which of the following nursing interventions

should be included in the clients plan of care during
dialysis therapy?
1. Limit the clients visitors.
2. Monitor the clients blood pressure.
3. Pad the side rails of the bed.
4. Keep the client on nothing-by-mouth (NPO)
status.

82.

The client performs his own peritoneal dialysis.

What should the nurse teach the client about
preventing peritonitis? Select all that apply.
1. Broad-spectrum antibiotics may be administered
to prevent infection.
2. Antibiotics may be added to the dialysate to
treat peritonitis.
3. Clean technique is permissible for prevention
of peritonitis.
4. Peritonitis is characterized by cloudy
dialysate drainage and abdominal discomfort.
5. Peritonitis is the most common and serious
complication of peritoneal dialysis.

83.

After completion of peritoneal dialysis, the

nurse should expect the client to exhibit which of
the following characteristics?
1. Hematuria.
2. Weight loss.
3. Hypertension.
4. Increased urine output.

84.

Aluminum hydroxide gel (Amphojel) is

prescribed for the client with chronic renal failure
to take at home. What is the expected outcome of
giving this drug?
1. Relieving the pain of gastric hyperacidity.
2. Preventimg Curlings stress ulcers.
3. Binding phosphate in the intestine.
4. Reversing metabolic acidosis.

85.

The nurse teaches the client with chronic

renal failure when to take aluminum hydroxide gel

(Amphojel). Which of the following statements would
indicate that the client understands the teaching?
1. Ill take it every 4 hours around the clock.
2. Ill take it between meals and at bedtime.
3. Ill take it when I have a sour stomach.
4. Ill take it with meals and bedtime snacks.

86.

The client with chronic renal failure tells

the nurse he takes magnesium hydroxide (milk of
magnesia) at home for constipation. The nurse suggests
that the client switch to psyllium hydrophilic
mucilloid (Metamucil) because:
1. Milk of magnesia can cause magnesium
intoxication.
2. Milk of magnesia is too harsh on the bowel.
3. Metamucil is more palatable.
4. Milk of magnesia is high in sodium.

87.

The nurse is determining which teaching

approaches for the client with chronic renal failure
and uremia would be most appropriate. The nurse
should:
1. Provide all needed teaching in one extended
session.
2. Validate the clients understanding of the
material frequently.
3. Conduct a one-on-one session with the client.
4. Use videotapes to reinforce the material as
needed.

88.

The nurse is instructing the client with

chronic renal failure to maintain adequate nutritional
intake. Which of the following diets would be
most appropriate?
1. High-carbohydrate, high-protein.
2. High-calcium, high-potassium, high-protein.
3. Low-protein, low-sodium, low-potassium.
4. Low-protein, high-potassium.

89.

The nurse is discussing concerns about sexual

activity with a client with chronic renal failure.
Which one of the following strategies would be most
useful?
1. Help the client to accept that sexual activity
will be decreased.
2. Suggest using alternative forms of sexual
expression and intimacy.
3. Tell the client to plan rest periods after sexual
activity.
4. Suggest that the client avoid sexual activity to
prevent embarrassment.

90.

A client with chronic renal failure has asked

to be evaluated for a home continuous ambulatory
peritoneal dialysis (CAPD) program. The nurse
should explain that the major advantage of this
approach is that it:

1. Is relatively low in cost.

2. Allows the client to be more independent.
3. Is faster and more effi cient than standard
peritoneal dialysis.
4. Has fewer potential complications than standard
peritoneal dialysis.

91.

The client asks about diet changes when

using continuous ambulatory peritoneal dialysis
(CAPD). Which of the following would be the
nurses best response?
1. Diet restrictions are more rigid with CAPD
because standard peritoneal dialysis is a more
effective technique.
2. Diet restrictions are the same for both CAPD
and standard peritoneal dialysis.
3. Diet restrictions with CAPD are fewer than
with standard peritoneal dialysis because
dialysis is constant.
4. Diet restrictions with CAPD are fewer than
with standard peritoneal dialysis because
CAPD works more quickly.

92.

A client is receiving continous ambulatory

peritoneal dialysis (CAPD). The nurse should assess
the client for which of the following signs of peritoneal
infection?
1. Cloudy dialysate fl uid.
2. Swelling in the legs.
3. Poor drainage of the dialysate fl uid.
4. Redness at the catheter insertion site.