A nurse is assessing a client who is experiencing acute kidney injury. The client is found to have a significant change in mental status, is lethargic, and confused. The nurse auscultates crackles in the client's lungs. Upon reviewing labs, it is noted that the client's BUN is 140 mg/dL and the potassium is 6.7 mEq/L. Which treatment will the nurse anticipate to be ordered for a client with these findings?

Sodium polystyrene sulfonate (Kayexalate)

Bolus with 1 liter of lactated ringer's (LR)

Renal replacement therapy (RRT)

Patiromer (Veltassa)

Answer and Explanation

The Correct Answer is C

A.   While this medication is used to treat hyperkalemia, it is a slower acting treatment. Given the patient's critical condition with altered mental status, hyperkalemia, and elevated BUN, a more rapid intervention is needed.
B.   Fluid resuscitation is important in some cases of AKI but it is not the priority in this patient. The patient is already showing signs of fluid overload (crackles in the lungs) and the primary issue is the inability of the kidneys to remove waste products and excess fluids.
C.   This is the most appropriate treatment for this patient. RRT, such as hemodialysis or continuous renal replacement therapy (CRRT), can rapidly remove waste products, excess fluid, and electrolytes from the blood, correcting the imbalances and improving the patient's condition.
D.   This medication is used for long-term management of hyperkalemia, but it is not effective in an acute setting like this.

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Correct Answer is C

Explanation

A. While this medication is used to treat hyperkalemia, it is a slower acting treatment. Given the patient's critical condition with altered mental status, hyperkalemia, and elevated BUN, a more rapid intervention is needed.
B. Fluid resuscitation is important in some cases of AKI but it is not the priority in this patient. The patient is already showing signs of fluid overload (crackles in the lungs) and the primary issue is the inability of the kidneys to remove waste products and excess fluids.
C. This is the most appropriate treatment for this patient. RRT, such as hemodialysis or continuous renal replacement therapy (CRRT), can rapidly remove waste products, excess fluid, and electrolytes from the blood, correcting the imbalances and improving the patient's condition.
D. This medication is used for long-term management of hyperkalemia, but it is not effective in an acute setting like this.

A. A client who is having an exacerbation of left-sided heart failure B. A client with multiple sclerosis who has a flaccid bladder C. A client who will receive contrast media for an MRI D. A client who has thrombotic thrombocytopenic purpura

Correct Answer is B

Explanation

A. This is a pre-renal cause of acute kidney injury, related to decreased blood flow to the kidneys.
B. This is a post-renal cause of acute kidney injury, as it obstructs the outflow of urine.
C. This is an intrarenal cause of acute kidney injury, directly affecting the kidney tissue.
D. This is an intrarenal cause of acute kidney injury, related to damage to the small blood vessels in the kidneys.

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

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

Correct Answer is B

Explanation

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

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?

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?

A nurse is teaching a client who has chronic kidney disease about limiting foods that are high in potassium. Which of the following are high-potassium foods which the client should avoid? (Select all that apply.)

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?

A client who received a kidney transplant last month is in the nephrology clinic for a follow-up visit. Which education should the nurse provide to the client regarding complications which can arise after a kidney transplant?

A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication?