A client with acute renal failure is at risk of developing hyperkalemia. What clinical manifestation is the most critical indicator of severe hyperkalemia in this client?

A. Correct. Encouraging the client to perform active range-of-motion exercises can help prevent complications of immobility, such as muscle wasting and joint contractures.

B. Incorrect. Elevating the head of the bed primarily benefits respiratory function and does not directly address the complications of immobility.

C. Incorrect. Limiting fluid intake would not prevent complications of immobility and may lead to dehydration.

D. Incorrect. Administering pain medication before passive range-of-motion exercises is not a standard practice and does not directly prevent complications of immobility.

A. Incorrect. While fluid restriction may be necessary in certain cases of acute renal failure, it should be prescribed and monitored by the healthcare provider based on the client's specific needs.

B. Incorrect. A high-protein diet can put additional strain on the kidneys, and it is not recommended for clients with acute renal failure.

C. Incorrect. Over-the-counter diuretics may not be safe for clients with acute renal failure and can lead to further electrolyte imbalances.

D. Correct. The nurse's best response is to encourage the client to follow their healthcare provider's instructions and avoid medications that may harm the kidneys. Compliance with prescribed treatment plans and avoiding nephrotoxic medications are essential to support kidney function and prevent further damage.