A client with decreased urine output refractory to fluid challenges is evaluated for renal failure. Which condition may cause the intrinsic (intrarenal) form of acute renal failure?

Damage to cells in the adrenal cortex

Nephrotoxic injury secondary to use of contrast media

Obstruction of the urinary collecting system

Poor perfusion to the kidneys

Answer and Explanation

The Correct Answer is B

A. Damage to the adrenal cortex affects hormone production (like aldosterone and cortisol), not directly the kidney tissue.
B. Nephrotoxic injury from contrast media directly damages kidney tissues, specifically the nephrons, making it an intrarenal cause of acute renal failure.
C. Urinary collecting system obstruction is a postrenal cause of renal failure.
D. Poor kidney perfusion is a prerenal cause of acute renal failure, not intrinsic.

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Correct Answer is B

Explanation

A. Administering an antiemetic can provide relief, but it is not the first priority in this case.
B. Administering pain medication is the priority because managing acute pain is essential for client comfort and can reduce stress responses.
C. Straining the urine is important for identifying possible kidney stones but is not the most immediate concern.
D. Monitoring intake and output helps assess kidney function but is secondary to relieving severe pain.

A. The client admitted to the hospital who has clinical findings of polyuria, nocturia, proteinuria, and a palpable kidney mass. B. The client admitted to the hospital who has clinical findings of periorbital edema, dark frothy urine, and elevated blood pressure. C. The client admitted to the hospital who has clinical findings of urinary urgency, weak urine stream, and dysuria D. The client admitted to the hospital who has clinical findings of severe flank pain, nausea, and vomiting.

Correct Answer is D

Explanation

A. These findings suggest a chronic kidney condition such as polycystic kidney disease, not acute kidney stones.
B. This presentation is consistent with glomerulonephritis, which is not directly related to kidney stones.
C. These symptoms are typical of a lower urinary tract issue such as benign prostatic hyperplasia (BPH) or urinary tract infection (UTI).
D. Severe flank pain, nausea, and vomiting are hallmark signs of a kidney stone. This client would benefit from education on kidney stone prevention to reduce recurrence risk.

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A client with decreased urine output refractory to fluid challenges is evaluated for renal failure. Which condition may cause the intrinsic (intrarenal) form of acute renal failure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

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