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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.
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When assessing an individual with peripheral vascular disease, which clinical manifestation would indicate complete arterial obstruction in the lower left leg?
- A. Aching pain in the left calf.
- B. Burning pain in the left calf.
- C. Numbness and tingling in the left leg.
- D. Coldness of the left foot and ankle.
Correct Answer: D
Rationale: Coldness of the left foot and ankle is the correct clinical manifestation indicating complete arterial obstruction in the lower left leg. Complete arterial obstruction results in reduced blood flow, leading to decreased temperature in the affected area. Aching pain (Choice A) and burning pain (Choice B) are more commonly associated with partial obstructions or ischemia, while numbness and tingling (Choice C) can be indicative of nerve involvement or compromised circulation, but not specifically complete arterial obstruction. The coldness in the foot and ankle is a result of severely reduced blood flow, which impairs the delivery of oxygen and nutrients to the tissues in that area, leading to a lower temperature. This symptom is a critical indicator of a more severe blockage compared to the other options provided.
Which of the following is a common cause of acute kidney injury?
- A. Hypertension
- B. Dehydration
- C. Infection
- D. Hypotension
Correct Answer: C
Rationale: Infection is a common cause of acute kidney injury because when the body fights an infection, it activates the immune response, leading to inflammation. This inflammatory response can affect the kidneys and impair their function. While hypertension (choice A) is a risk factor for chronic kidney disease, it is not a direct cause of acute kidney injury. Dehydration (choice B) can lead to prerenal acute kidney injury due to decreased blood flow to the kidneys, but infection is a more common cause of acute kidney injury. Hypotension (choice D) can contribute to prerenal acute kidney injury, but it is not a direct cause like infection.
A client is scheduled for an arteriogram. The nurse should explain to the client that the arteriogram will confirm the diagnosis of occlusive arterial disease by:
- A. Showing the location of the obstruction and the collateral circulation.
- B. Scanning the affected extremity and identifying the areas of volume changes.
- C. Using ultrasound to estimate the velocity changes in the blood vessels.
- D. Determining how long the client can walk.
Correct Answer: A
Rationale: The correct answer is A: Showing the location of the obstruction and the collateral circulation. An arteriogram is a diagnostic procedure that involves injecting a contrast agent to visualize the blood vessels and identify the location of any obstructions. This helps confirm the diagnosis of occlusive arterial disease by showing where the blockage is located and how collateral circulation is compensating for the reduced blood flow. Choices B, C, and D are incorrect because scanning the extremity, estimating velocity changes with ultrasound, or determining walking distance are not the primary purposes of an arteriogram in diagnosing occlusive arterial disease.
The nurse is providing discharge instructions to a client who is receiving prednisone 5 mg PO daily for a rash due to contact with poison ivy. Which symptoms should the nurse tell the client to report to the healthcare provider?
- A. Rapid weight gain
- B. Abdominal striae
- C. Moon faces
- D. Gastric irritation
Correct Answer: A
Rationale: Rapid weight gain can indicate fluid retention, which is a serious side effect of prednisone and should be reported.
The client with chronic renal failure is being taught about dietary restrictions by the nurse. Which of the following food items should the client avoid?
- A. Apples
- B. Bananas
- C. Chicken
- D. Rice
Correct Answer: B
Rationale: The correct answer is B: Bananas. Bananas are high in potassium, which should be limited in clients with chronic renal failure to prevent hyperkalemia. Apples (choice A), chicken (choice C), and rice (choice D) are not typically restricted in clients with chronic renal failure. Apples and rice are lower in potassium, while chicken is a good source of lean protein, which is usually encouraged in these clients to meet their protein needs without excess potassium intake.