Renal NCLEX Questions (66-70)

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66. A nurse has administered a dose of epoetin alfa (Epogen) to a client with chronic renal failure. The nurse interprets that which of the following hemodynamic effects experienced by the client is a side effect of this medication?

a) bradycardia
b) tachycardia
c) hypotension
d) hypertension

67. A client with chronic renal failure who has just undergone repair of an umbilical hernia is complaining of postoperative pain. The nurse should call the physician if which of the following opioid analgesics is prescribed for this client?

a) meperidine hydrochloride (Demerol)
b) morphine sulfate
c) codeine sulfate
d) oxycodone (OxyContin, Roxicodone)

68. Renal NCLEX Questions about a client with chronic renal failure who did not receive any juice on the breakfast meal tray. The nurse asks the nursing assistant to give the client a cup of which of the following juices from the unit kitchen?

a) grape
b) grapefruit
c) orange
d) prune

69. A nurse is caring for a client with chronic renal failure whose daily fluid allotment is determined by calculating the previous day's output plus insensible losses through the lungs. If the client's urine output for the previous day was 300 ml, the nurse anticipates how many milliliters of fluid will be allotted for today?

a) 400 ml
b) 700 ml
c) 1000 ml
d) 1200 ml

70. A nurse has instructed a client about the procedure for continuous ambulatory peritoneal dialysis (CAPD). The nurse determines that the client needs further instruction if the client:

a) states that dwell times will vary depending on whether it is a daytime or nighttime
b) allows air to get into the dialysis tubing
c) warms the dialysate solution before infusion
d) plans on doing four exchanges per day

Renal NCLEX Questions
Answers and Rationale

66) D
- The client taking exogenous erythropoietin may develop or have an increase in the degree of hypertension. This probably results from increased blood viscosity and the hemodynamic changes that accompany it. The nurse monitors the client's blood pressure carefully and regularly. Options A, B, and C are not associated with the use of epoetin alfa.

67) A
- Although all of the medications listed in the options are metabolized by the liver, meperidine hydrochloride is metabolized partially to normeperidine, which must be excreted by the kidneys. Seizure activity can occur in the client with chronic renal failure from accumulation of normeperidine in the client's system. It is also generally true that dosages for all opioid analgesics will be reduced for the client with chronic renal failure.

68) A
- Apple juice and grape juice are lower in potassium and are the better choices of juice for the client with chronic renal failure. Prune, orange, and grapefruit juices are higher in potassium and should be used cautiously or avoided in these clients.

69) B
- The lungs expire about 400 mL of water per day. Therefore, if the client's urine output for the previous day was 300 mL, then 700 mL of fluid is to be allotted (400 mL from the lungs and 300 mL urine output).

70) B
- Peritoneal dialysis tubing is flushed to avoid introducing air into the peritoneal cavity. With CAPD, there are usually four exchanges planned per day, with dwell times varying, depending on whether it is a daytime or nighttime exchange. The dialysate solution should be slightly warmed (37° C) prior to use.

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Renal NCLEX Questions (1-7)

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Renal NCLEX Questions (71-75)