Nokea
The client is diagnosed with acute kidney failure. Which of the following is an appropriate psychosocial problem for the nurse to include in the care plan?
- A. Imbalanced nutrition: less than body requirements related to altered metabolic state and dietary restrictions.
- B. Anxiety related to the disease process and uncertainty of prognosis.
- C. Excess fluid volume related to compromised regulatory mechanisms secondary to acute renal failure.
- D. Risk for infection related to invasive procedures and an altered immune response secondary to renal failure.
Correct Answer: B
Rationale: Anxiety is a psychosocial issue related to the uncertainty and stress of acute kidney failure, unlike the other physiological options.
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A newly hired nurse is caring for a client who is receiving prescribed total parenteral nutrition (TPN) therapy. The nurse preceptor should intervene if the newly hired nurse?
- A. wears a surgical mask while changing the client's central vascular access dressing.
- B. obtains the client's capillary blood glucose every four to six hours.
- C. spikes and primes a new bag of TPN without an inline filter.
- D. continues the infusion via an infusion pump while the client is receiving a computed tomography scan.
Correct Answer: C
Rationale: TPN requires an inline filter to prevent infusion of particulate matter or air emboli. Not using a filter (C) is unsafe and requires intervention. Wearing a mask (A), checking glucose (B), and continuing infusion during a CT scan (D) are appropriate or not inherently unsafe.
The nurse is reviewing the assessment data for a client with acute glomerulonephritis (AGN). Which of the following would be an expected finding?
- A. Ketonuria
- B. Hematuria
- C. Polyuria
- D. Glycosuria
Correct Answer: B
Rationale: Hematuria is a hallmark of acute glomerulonephritis due to glomerular inflammation.
The nurse is placing a client with chronic kidney disease on a cardiac monitor. What is the reason for this action?
- A. Clients with chronic kidney disease are prone to hypertension
- B. Hyperkalemia may result in dysrhythmias
- C. Cardiac monitoring is necessary to evaluate the need for hemodialysis
- D. Clients with chronic kidney disease may experience false episodes of asystole
Correct Answer: B
Rationale: Hyperkalemia, common in CKD, can cause dysrhythmias, necessitating cardiac monitoring.
A client experiencing an acute exacerbation of ulcerative colitis underwent diagnostic testing and was found to have elevated serum osmolality and urine specific gravity. Which of the following is related to these findings?
- A. Renal insufficiency
- B. Diabetes insipidus
- C. Hypoaldosteronism
- D. Deficient fluid volume
Correct Answer: D
Rationale: Elevated serum osmolality and urine specific gravity indicate deficient fluid volume due to dehydration from colitis.
The nurse reviews the lab values of a client and notes a serum sodium level of 125 mEq/L (mmol/L) [Reference range: 135-145 mEq/L (mmol/L)]. Which conditions does the nurse recognize as potential causes of this laboratory abnormality? Select all that apply.
- A. syndrome of inappropriate antidiuretic hormone (SIADH)
- B. diabetes Insipidus
- C. addison's disease (adrenal insufficiency)
- D. psychogenic polydipsia
- E. salt water drowning
Correct Answer: A,C,D
Rationale: SIADH causes water retention, diluting sodium. Addison's disease reduces aldosterone, leading to sodium loss. Psychogenic polydipsia causes excessive water intake, diluting sodium.