Question

A client with chronic kidney disease (CKD) has a serum potassium level of 6.5 mEq/L. Which of the following medications removes excess potassium from the body?

Answer 1

Correct Answers:

Lisinopril

Rationale :

🧪Patiromer is a potassium-binding medication that works in the gastrointestinal tract to remove excess potassium from the body, making it suitable for managing hyperkalemia in clients with chronic kidney disease (CKD).

💊Insulin and sodium bicarbonate shift potassium into the cells temporarily but do not eliminate it from the body.

⚠️Calcium gluconate helps stabilize cardiac membranes in hyperkalemia but also does not remove potassium.

🚫Lisinopril, an ACE inhibitor, may worsen hyperkalemia by reducing potassium excretion.

📌Core Message

Patiromer removes excess potassium through gastrointestinal excretion, making it ideal for CKD-related hyperkalemia.

Answer 2

Correct Answers:

You may end up needing dialysis as the disease progresses.

Rationale :

🧬Polycystic kidney disease (PKD) is a progressive genetic disorder that causes fluid-filled cysts in the kidneys, which can gradually impair renal function.

📉As the disease advances, glomerular filtration may decline, potentially leading to end-stage renal disease requiring dialysis or transplant.

🚼Vasectomy is not routinely required for clients with PKD; reproductive choices are personal and require genetic counseling.

🚫Clients with PKD are not excluded from kidney transplantation; many are candidates when the disease reaches ESRD.

📌Core Message

Polycystic kidney disease may lead to renal failure, and clients often eventually require dialysis.

Answer 3

Correct Answers:

Place the client on a low-protein diet.

Rationale :

🦠The client’s presentation is consistent with acute glomerulonephritis following a streptococcal infection, indicated by flank pain, edema, and proteinuria.

🍖A low-protein diet helps reduce nitrogenous waste production, minimizing the renal workload when glomerular filtration is impaired.

🚱Increasing fluid intake can worsen fluid overload, especially with oliguria (250 mL/24 hr output).

⚖️Weekly weight monitoring is insufficient for detecting rapid changes in fluid balance; daily monitoring would be more appropriate.

📌Core Message

A low-protein diet helps reduce renal workload in clients with glomerular inflammation and renal impairment.

Answer 4

Correct Answers:

Comparing the client's current weight to the last post-dialysis weight.

Rationale :

⚖️Daily weight comparison—especially against the last post-dialysis weight—is the most accurate indicator of fluid retention in clients on dialysis.

🧴One liter of fluid equals approximately 1 kilogram, so weight gain directly correlates with fluid accumulation.

🩺Other methods like assessing edema or lung sounds are useful but less precise in quantifying retained volume.

🧪BUN and creatinine levels may fluctuate but are not reliable for detecting fluid volume changes specifically.

📌Core Message

Comparing to the last post-dialysis weight is the most accurate method for evaluating fluid retention in hemodialysis clients.

Answer 5

Correct Answers:

Antibiotics

Rationale :

🦠Struvite stones are commonly caused by urinary tract infections involving urease-producing bacteria, such as Proteus.

💊Antibiotic therapy targets the underlying infection, helping to prevent recurrence of these infection-related stones.

🧬Other medications like calcium gluconate or phosphate binders are unrelated to the typical pathophysiology of struvite stones.

🌀Tamsulosin helps relax urinary tract muscles for stone passage, but does not prevent infection-based stone formation.

📌Core Message

Antibiotics prevent recurrence of struvite stones by treating the causative urinary tract infection.

Answer 6

Correct Answers:

A client with multiple sclerosis who has a flaccid bladder

Rationale :

🚽Post-renal acute kidney injury (AKI) occurs due to obstruction of urine outflow, leading to backpressure on the kidneys.

🧠A flaccid bladder in clients with neurologic conditions like multiple sclerosis results in urinary retention, a classic post-renal cause.

💉Contrast-induced nephropathy causes intrarenal AKI, not post-renal.

💔Heart failure results in prerenal AKI due to reduced renal perfusion, and TTP causes intrarenal damage via microthrombi.

📌Core Message

A flaccid bladder in neurologic disease causes urinary retention, leading to post-renal AKI.

Answer 7

Correct Answers:

This medication slows the growth of renal cysts.

Rationale :

🧫Tolvaptan is a vasopressin V2-receptor antagonist that has been shown to slow cyst progression in autosomal dominant polycystic kidney disease (ADPKD).

💧It promotes aquaresis, helping reduce kidney size and cyst growth, thus delaying progression of renal impairment.

🚫It does not increase GFR, nor does it prevent eventual transplant in advanced disease stages.

⚠️A common side effect is actually hypernatremia, not hyponatremia, due to increased free water loss.

📌Core Message

Tolvaptan helps slow renal cyst growth, delaying progression of ADPKD.

Answer 8

Correct Answers:

Liver

Rationale :

🥩Purines are metabolized into uric acid, and high-purine foods like organ meats (e.g., liver) increase the risk of uric acid stones.

🥛Milk is low in purines and often encouraged to increase calcium excretion and reduce stone risk.

🥬Spinach contains oxalates, which contribute to calcium oxalate stones, not purine-related stones.

🍫Chocolate may contain oxalates but is not high in purines.

📌Core Message

Liver is a high-purine food that can contribute to uric acid stone formation.

Answer 9

Correct Answers:

Peritonitis

Rationale :

🤢Peritonitis is a common and serious complication of peritoneal dialysis, especially when GI symptoms and cloudy dialysate are present.

🦠Signs like nausea, vomiting, diarrhea, and elevated WBC count strongly indicate infection of the peritoneal cavity.

💉Pericarditis and pleuritis involve inflammation of the heart and lungs, respectively, and don’t typically present with abdominal catheter drainage or GI symptoms.

💧Intraperitoneal bleeding may cause fluid at the catheter site but would not be associated with systemic signs of infection.

📌Core Message

Peritonitis is a common infectious complication of peritoneal dialysis with GI and systemic signs.

Answer 10

Correct Answers:

Potassium 5.4 mEq/L. hemoglobin 9.8 g/dL7 creatinine 4.6 mg/dl.

Rationale :

⚠️This profile shows hyperkalemia, anemia, and elevated creatinine, all consistent with untreated chronic kidney disease (CKD).

🧪Creatinine of 4.6 mg/dL suggests significant loss of renal function.

💉Low hemoglobin reflects reduced erythropoietin production, common in CKD.

🔢Potassium elevation indicates impaired renal excretion, another hallmark of CKD.

📌Core Message

Hyperkalemia, anemia, and elevated creatinine are hallmark signs of untreated chronic kidney disease.

1 :
A client with chronic kidney disease (CKD) has a serum potassium level of 6.5 mEq/L. Which of the following medications removes excess potassium from the body?

2 :
The nurse is providing education to a male client who is newly- diagnosed with polycystic kidney disease. Which of the following statements should be included in the client teaching?

4 :
A nurse is assessing a client who has chronic kidney disease (CKD) for fluid volume overload prior to scheduled hemodialysis. Which of the following methods provides a reliable measurement of the amount of fluid the client has retained since the last dialysis treatment?

5 :
A female client has undergone surgery to remove a large struvite kidney stone. Based on the cause of struvite stones, which medication therapy should the nurse anticipate will be ordered to prevent recurrence of the stones?

6 :
Which of the following clients is at risk of developing acute kidney injury from a post-renal cause?

7 :
A client with polycystic kidney disease is prescribed the medication Tolvaptan. What should the nurse include when educating the client about this medication.

8 :
A client has had recurrent kidney stones. Upon lab analysis of the client's urine, it is found that excessive purine intake is the underlying cause. Which of the following high-purine foods should the nurse instruct the client to avoid?

10 :
A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of untreated chronic kidney disease?

1 : A client with chronic kidney disease (CKD) has a serum potassium level of 6.5 mEq/L. Which of the following medications removes excess potassium from the body?

2 : The nurse is providing education to a male client who is newly- diagnosed with polycystic kidney disease. Which of the following statements should be included in the client teaching?

4 : A nurse is assessing a client who has chronic kidney disease (CKD) for fluid volume overload prior to scheduled hemodialysis. Which of the following methods provides a reliable measurement of the amount of fluid the client has retained since the last dialysis treatment?

5 : A female client has undergone surgery to remove a large struvite kidney stone. Based on the cause of struvite stones, which medication therapy should the nurse anticipate will be ordered to prevent recurrence of the stones?

6 : Which of the following clients is at risk of developing acute kidney injury from a post-renal cause?

7 : A client with polycystic kidney disease is prescribed the medication Tolvaptan. What should the nurse include when educating the client about this medication.

8 : A client has had recurrent kidney stones. Upon lab analysis of the client's urine, it is found that excessive purine intake is the underlying cause. Which of the following high-purine foods should the nurse instruct the client to avoid?

10 : A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of untreated chronic kidney disease?

1 :
A client with chronic kidney disease (CKD) has a serum potassium level of 6.5 mEq/L. Which of the following medications removes excess potassium from the body?

2 :
The nurse is providing education to a male client who is newly- diagnosed with polycystic kidney disease. Which of the following statements should be included in the client teaching?

4 :
A nurse is assessing a client who has chronic kidney disease (CKD) for fluid volume overload prior to scheduled hemodialysis. Which of the following methods provides a reliable measurement of the amount of fluid the client has retained since the last dialysis treatment?

5 :
A female client has undergone surgery to remove a large struvite kidney stone. Based on the cause of struvite stones, which medication therapy should the nurse anticipate will be ordered to prevent recurrence of the stones?

6 :
Which of the following clients is at risk of developing acute kidney injury from a post-renal cause?

7 :
A client with polycystic kidney disease is prescribed the medication Tolvaptan. What should the nurse include when educating the client about this medication.

8 :
A client has had recurrent kidney stones. Upon lab analysis of the client's urine, it is found that excessive purine intake is the underlying cause. Which of the following high-purine foods should the nurse instruct the client to avoid?

10 :
A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of untreated chronic kidney disease?