A 78-year-old male client presents to the emergency department complaining of a history of urinary frequency and a weak urinary stream. Today he complains of extreme pain in the pelvic area. The client urinates 50 mL, and an immediate bladder scan shows a post-void residual urine measurement of 600 mL. The nurse recognizes these symptoms are most likely related to which condition?

Benign prostatic hyperplasia (BPH)

End stage renal disease (ESRD)

Pre-renal acute kidney injury (AKI)

Polycystic kidney disease (PKD)

Answer and Explanation

The Correct Answer is A

A.   BPH is a common condition in older men that causes the prostate gland to enlarge, obstructing the urethra and leading to difficulty urinating, urinary retention, and pelvic pain. The symptoms described, including urinary frequency, weak urinary stream, severe pelvic pain, and a significantly elevated post- void residual urine volume, are consistent with BPH.
B.   ESRD can cause urinary symptoms. However, the presentation in this case is more consistent with a urinary obstruction, not a kidney failure issue. ESRD typically involves more systemic symptoms like fatigue, edema, and electrolyte imbalances.
C.   This is unlikely given the patient's age and lack of significant comorbidities. Additionally, the primary issue appears to be urinary obstruction, not a decrease in renal perfusion.
D.   This is a chronic condition that typically presents with flank pain, and it does not usually cause acute urinary retention.

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Correct Answer is B

Explanation

A. Calcium gluconate does not directly affect the elimination of potassium from the body or its excretion in the stool. It does not act on the kidneys or gastrointestinal tract to remove potassium. Its primary role is to stabilize the cardiac membrane.
B. Calcium gluconate stabilizes the cardiac membrane and reduces the risk of dysrhythmias associated with elevated serum potassium levels. Hyperkalemia can increase the risk of cardiac arrhythmias, and calcium gluconate helps to counteract these effects by protecting the heart muscle.
C. Calcium gluconate does not cause potassium to shift from the blood into the cells. The shift of potassium into cells is typically induced by other treatments such as insulin and glucose or beta- agonists. Calcium gluconate does not have this effect.
D. Calcium gluconate does not increase serum potassium levels. It primarily serves to protect the heart from the effects of high potassium levels. It does not have a direct effect on the potassium level itself but helps manage the consequences of hyperkalemia.

A. Hyperkalemia and hypernatremia B. Hypokalemia and hypernatremia C. Hyperkalemia and hyponatremia D. Hypokalemia and hyponatremia

Correct Answer is D

Explanation

A. Hyperkalemia and hypernatremia are generally not associated with the diuretic phase of AKI. In the diuretic phase, the primary issue is excessive loss of electrolytes and fluid, rather than their accumulation.
B. Hypokalemia can occur during the diuretic phase because diuretics increase the excretion of potassium along with water. Hypernatremia is not typical of the diuretic phase. Instead, sodium levels might decrease or remain normal due to the loss of fluid and electrolytes.
C. Hyperkalemia is unlikely during the diuretic phase as diuretics often lead to increased potassium loss. Hyponatremia is a more likely outcome during the diuretic phase due to the loss of sodium and fluid through increased urine output.

D. During the diuretic phase of AKI, there is significant loss of electrolytes, including potassium and sodium. Diuretics increase urine output, leading to the loss of potassium and sodium, which can occur as a result of excessive fluid and electrolyte loss.

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Naxlex Comprehensive Predictor Exams

A client with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L. The nurse recognizes that administering IV calcium gluconate to this client will result in which of the following effects?

Correct Answer is B

Explanation

During the diuretic phase of acute kidney injury, the nurse understands that the client is at risk for which of the following electrolyte imbalances?

Correct Answer is D

Explanation

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

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?

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?

A client with rapidly progressing end-stage renal disease (ESRD) asks about the possibility of a kidney transplant. In responding to the client, the nurse understands that which of the following is a contraindication for receiving a kidney transplant?

A nurse is admitting a client who has been diagnosed with acute glomerulonephritis. Considering the most common cause of this condition, which test should the nurse anticipate will be performed?