A client is in a motor vehicle accident with a severe kidney injury and develops acute renal failure. Which acid-base imbalance is most likely to develop?

Respiratory Acidosis

Metabolic Alkalosis

Respiratory Alkalosis

Metabolic acidosis

Answer and Explanation

The Correct Answer is D

A. Respiratory Acidosis: Respiratory acidosis results from inadequate ventilation leading to CO₂ retention, which is unrelated to kidney failure.

B. Metabolic Alkalosis: Metabolic alkalosis occurs due to excessive loss of acids (e.g., vomiting) or excess bicarbonate intake. Acute renal failure causes acid retention, not loss.

C. Respiratory Alkalosis: Respiratory alkalosis is caused by hyperventilation and excessive CO₂ loss, not renal dysfunction.

D. Metabolic acidosis: The kidneys play a vital role in acid-base balance by excreting hydrogen ions and reabsorbing bicarbonate. Acute renal failure impairs these functions, leading to acid retention and metabolic acidosis.

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Correct Answer is D

Explanation

A. Hypotension: Fluid overload typically causes hypertension, not hypotension.

B. Polyuria: ESRD patients typically have oliguria or anuria, not excessive urine output.

C. Weight loss: Fluid overload leads to weight gain due to fluid retention.

D. Edema: Fluid overload causes peripheral and pulmonary edema due to impaired kidney function. Clients may also experience hypertension, dyspnea, and crackles.

A. Serum potassium 4.8 mmol/l B. Serum glucose 58 mg/d C. Serum sodium 138 mEq/L D. Calcium level of 100 mg

Correct Answer is B

Explanation

A. Serum potassium 4.8 mmol/L: This is a normal potassium level (3.5–5.0 mmol/L) and indicates successful treatment.

B. Serum glucose 58 mg/dL: IV insulin drives potassium into cells, lowering serum potassium. However, insulin also lowers blood glucose, which can lead to hypoglycemia (glucose <70 mg/dL). Hypoglycemia is the primary adverse effect of IV insulin therapy.

C. Serum sodium 138 mEq/L: This is a normal sodium level (135–145 mEq/L) and not an adverse effect.

D. Calcium level of 100 mg: Calcium is not directly affected by IV insulin therapy.

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A client is in a motor vehicle accident with a severe kidney injury and develops acute renal failure. Which acid-base imbalance is most likely to develop?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following manifestations are commonly seen in an end stage renal disease patient with fluid overload?

Correct Answer is D

Explanation

A nurse is caring for a client who has hyperkalemia and is to receive intravenous insulin. Which of the following should the nurse recognize as an adverse outcome?

Correct Answer is B

Explanation

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