During acidosis, ammonia plays a key role in allowing for continued renal H+ secretion.

Correct Answer: A

Rationale: During acidosis, ammonia (NH3) can combine with H+ ions in the renal tubules to form ammonium (NH4+), which can be excreted in the urine to help buffer excess H+ ions and maintain acid-base balance. This process allows for continued renal H+ secretion, making choice A true. Choices C and D are not applicable as they do not provide any relevant information. Choice B is incorrect because ammonia does indeed play a key role in facilitating renal H+ secretion during acidosis.

Correct Answer: D

Rationale: The correct answer is D: Monitor for Trousseau's and Chvostek's signs. A calcium level of 12.1 mg/dL indicates hypercalcemia, which can lead to neuromuscular irritability. Trousseau's and Chvostek's signs are manifestations of hypocalcemia, but in the context of hypercalcemia, they may also present due to the calcium imbalance affecting neuromuscular function. Therefore, monitoring for these signs is crucial for early detection of potential complications. Choice A is incorrect because bed rest is not specifically indicated for hypercalcemia unless there are other medical reasons necessitating it. Choice B is incorrect because auscultating lung sounds every 4 hours is not directly related to managing hypercalcemia. Choice C is incorrect because encouraging fluid intake up to 4000 mL daily may not be appropriate without considering the patient's renal function and the potential risk of fluid overload in the context of hypercalcemia.

Correct Answer: D

Rationale: The correct answer is D. Teaching the patient to take slow, deep breaths when anxious is the first action the nurse should take. The patient is experiencing respiratory alkalosis, likely due to hyperventilation from anxiety. Teaching the patient relaxation techniques can help normalize the respiratory rate and improve oxygenation. Checking the nasogastric tube (A) can be done later as it is not the priority. Giving morphine (B) may further depress respiratory drive and worsen the alkalosis. Notifying the health care provider (C) is not necessary at this moment as the nurse can address the situation effectively.

Correct Answer: D

Rationale: The correct answer is D because the presence of coarse, muddy brown granular casts in the urinalysis indicates intrarenal disease, specifically acute tubular necrosis. This condition is characterized by damage to the renal tubules, leading to the presence of casts in the urine. The patient's symptoms of malaise, fatigue, and decreased urinary output are consistent with acute tubular necrosis. Choice A is incorrect because it does not specify the underlying cause of the kidney injury. Choice B is incorrect as prerenal conditions would typically present with different urinalysis findings. Choice C is incorrect as postrenal obstruction would not typically lead to the presence of granular casts in the urine.

Correct Answer: D

Rationale: The correct answer is D because assessing the catheter site for redness and swelling is crucial in monitoring for signs of infection, which is a common complication with percutaneous dialysis catheters. This step helps in early detection and prompt intervention to prevent further complications. Incorrect choices: A: This choice is too vague and does not provide specific guidance on catheter care. B: Applying a sterile gauze dressing is important, but it is not the most critical step in caring for a percutaneous dialysis catheter. C: Replacing the transparent dressing every 10 days is not recommended as it may increase the risk of infection due to unnecessary manipulation of the catheter site.