which lab result would be most indicative of renal failure

HESI RN

HESI Medical Surgical Test Bank

1. Which lab result would be most indicative of renal failure?

A. Elevated creatinine levels.
B. Low potassium levels.
C. Low calcium levels.
D. High sodium levels.

Correct answer: A

Rationale: The correct answer is A: Elevated creatinine levels. Creatinine is a waste product that is normally filtered by the kidneys. Elevated creatinine levels indicate impaired kidney function, which is commonly seen in renal failure. Choice B, low potassium levels, is not typically associated with renal failure. In fact, renal failure is more likely to cause high potassium levels due to the kidneys' inability to excrete potassium effectively. Choice C, low calcium levels, are not directly indicative of renal failure. Renal failure can lead to disturbances in calcium levels, but low calcium levels alone are not a specific marker for renal failure. Choice D, high sodium levels, are also not typically associated with renal failure. In renal failure, there may be disturbances in sodium levels, but high sodium levels alone are not a direct indicator of renal failure.

2. A client with stress incontinence is being taught about pelvic muscle exercises. Which statements should be included by the nurse? (Select all that apply.)

A. Starting and stopping the urine stream involves using pelvic muscles.
B. Tighten pelvic muscles for a slow count of 10 and then relax for a slow count of 10.
C. Pelvic muscle exercises can be performed in various positions: lying down, sitting up, and standing.
D. A & B

Correct answer: D

Rationale: The correct statements to include when teaching a client with stress incontinence about pelvic muscle exercises are that starting and stopping the urine stream involve using pelvic muscles and that tightening pelvic muscles for a slow count of 10 and then relaxing for a slow count of 10 can help strengthen them. It is essential to highlight that pelvic muscle exercises can be performed in various positions, including lying down, sitting up, and standing. This variety in positions helps engage the muscles effectively. Performing these exercises 15 times in each position can aid in strengthening the pelvic floor muscles. Consistent exercise over several weeks typically leads to improved control over urine leakage. Choice C is incorrect because pelvic muscle exercises can be performed in different positions and are not limited to sitting upright with feet on the floor.

3. When planning activities for a socialization group for older residents of a long-term facility, what information would be most useful for the nurse?

A. The length of time each resident has resided at the facility.
B. A brief description of each resident's family life.
C. The age of each resident.
D. The usual activity patterns of each resident.

Correct answer: D

Rationale: The most useful information for the nurse when planning activities for a socialization group for older residents of a long-term facility would be the usual activity patterns of each resident. An older person's level of activity is a determining factor in adjustment to aging, as described by the Activity Theory of Aging. By understanding the usual activity patterns of each resident, the nurse can tailor activities that cater to their interests and abilities, promoting social engagement and overall well-being. The other options, such as the length of time residing at the facility, a brief description of family life, or the age of each resident, may provide some insights but do not directly relate to planning activities that support adjustment to aging and socialization within the group.

4. Which client is at greatest risk for coronary artery disease?

A. A 32-year-old female with mitral valve prolapse who quit smoking 10 years ago.
B. A 43-year-old male with a family history of CAD and a cholesterol level of 158 (8.8 mmol/L).
C. A 56-year-old male with an HDL of 60 (3.3 mmol/L) who takes atorvastatin.
D. A 65-year-old female who is obese with an LDL of 188 (10.4 mmol/L).

Correct answer: D

Rationale: The 65-year-old female who is obese with a high LDL level of 188 (10.4 mmol/L) is at the greatest risk for coronary artery disease. Obesity and high LDL cholesterol levels are significant risk factors for developing coronary artery disease. While factors like mitral valve prolapse (choice A) and a family history of CAD (choice B) can contribute to the risk, they are not as significant as obesity and high LDL levels. Choice C, a 56-year-old male with high HDL and taking atorvastatin, is actually at lower risk due to the high HDL levels and being on statin therapy, which helps reduce cholesterol levels and lower the risk of coronary artery disease.

5. The healthcare provider is assessing a client with chronic renal failure who is receiving hemodialysis. Which of the following findings would indicate that the client is experiencing a complication of the treatment?

A. Clear dialysate outflow.
B. Blood pressure of 150/90 mm Hg.
C. Increased heart rate.
D. Fatigue.

Correct answer: B

Rationale: A blood pressure of 150/90 mm Hg during hemodialysis may indicate fluid overload or an ineffective dialysis session, which can lead to complications such as heart failure or pulmonary edema. This finding should be reported promptly for further evaluation and intervention. Clear dialysate outflow is a normal and expected finding during hemodialysis, indicating proper filtration of waste products. Increased heart rate can be a normal compensatory response to hemodialysis due to fluid shifts and should be monitored but does not necessarily indicate a complication. Fatigue is a common symptom in clients with chronic renal failure undergoing hemodialysis and is not specific to complications of the treatment.