NACC PSW Practice Exam

Renal failure significantly affects the balance of multiple electrolytes, leading to potential imbalances that can have serious health implications. In renal failure, the kidneys are less able to filter and excrete waste and excess electrolytes from the bloodstream.

Calcium balance is influenced because the kidneys play a crucial role in converting vitamin D into its active form, which is necessary for calcium absorption in the intestines. Additionally, renal failure may lead to decreased calcium reabsorption in the renal tubules.

Sodium balance is also impacted as kidneys are primarily responsible for regulating sodium levels through filtration and reabsorption processes. In renal failure, the ability to excrete excess sodium is compromised, potentially leading to sodium retention and fluid overload.

Potassium balance is particularly critical as kidneys are responsible for maintaining normal potassium levels. In renal failure, potassium can accumulate in the body since the kidneys are unable to effectively remove it, leading to hyperkalemia, which can be life-threatening.

Given the role of the kidneys in managing these electrolytes, it becomes clear that all three—calcium, sodium, and potassium—are often affected in renal failure. This makes the option that encompasses all of these imbalances correct, as each electrolyte balance can be disturbed by this condition.