Nokea
When the client asks about the source of donated kidneys, the nurse correctly identifies which of the following as the preferred donor?
- A. A additional peritoneal human
- B. A sibling or living relative
- C. An unrelated living human
- D. A chimpanzee or other primate
Correct Answer: B
Rationale: A sibling or living relative is preferred due to better histocompatibility, reducing the risk of rejection.
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The nurse is caring for the client diagnosed with chronic kidney disease (CKD) who is experiencing metabolic acidosis. Which statement best describes the scientific rationale for metabolic acidosis in this client?
- A. There is an increased excretion of phosphates and organic acids, which leads to an increase in arterial blood pH.
- B. A shortened life span of red blood cells because of damage secondary to dialysis treatments in turn leads to metabolic acidosis.
- C. The kidney cannot excrete increased levels of acid because they cannot excrete ammonia or cannot reabsorb sodium bicarbonate.
- D. An increase in nausea and vomiting causes a loss of hydrochloric acid and the respiratory system cannot compensate adequately.
Correct Answer: C
Rationale: In CKD, the kidneys fail to excrete acids (via ammonia) and reabsorb bicarbonate, leading to metabolic acidosis. Increased acid excretion would raise pH, RBC lifespan affects anemia, and vomiting causes alkalosis, not acidosis.
Which statement by the client provides the best evidence that he understands the potential side effects associated with hormonal therapy? Select all that apply.
- A. My breasts may enlarge.
- B. I may have spontaneous erections.
- C. My sperm count will be higher.
- D. I'll have strong sexual urges.
- E. My voice may become higher.
- F. I may have a rapid weight gain.
Correct Answer: A,F
Rationale: Estradiol can cause gynecomastia (breast enlargement) and weight gain, which are expected side effects.
The client is admitted with a serum sodium level of 110 mEq/L. Which nursing intervention should be implemented?
- A. Encourage fluids orally.
- B. Administer 10% saline solution IVPB.
- C. Administer antidiuretic hormone intranasally.
- D. Place on seizure precautions.
Correct Answer: D
Rationale: Severe hyponatremia (110 mEq/L) increases seizure risk due to cerebral edema. Seizure precautions are the priority to ensure safety. Oral fluids or ADH may worsen hyponatremia, and 10% saline is not standard.
The client diagnosed with a fluid and electrolyte disturbance in the emergency department is exhibiting peaked T waves on the STAT electrocardiogram. Which interventions should the nurse implement? List in order of priority.
- A. Assess the client for leg and muscle cramps.
- B. Check the serum potassium level.
- C. Notify the health-care provider.
- D. Arrange for a transfer to the telemetry floor.
- E. Administer Kayexalate, a cation resin.
Correct Answer: B,C,E,D,A
Rationale: Peaked T waves indicate hyperkalemia. Priority: 1) Check potassium level to confirm; 2) Notify HCP for orders; 3) Administer Kayexalate to lower potassium; 4) Transfer to telemetry for monitoring; 5) Assess cramps, a less urgent symptom.
The client who is postoperative TURP asks the nurse, 'When will I know if I will be able to have sex after my TURP?' Which response is most appropriate by the nurse?
- A. You seem anxious about your surgery.'
- B. Tell me about your fears of impotency.'
- C. Potency can return in six (6) to eight (8) weeks.'
- D. Did you ask your doctor about your concern?'
Correct Answer: C
Rationale: Sexual function typically resumes 6–8 weeks post-TURP, providing a direct and reassuring answer. Other responses avoid the question or assume anxiety without addressing the concern.