Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
The nurse identifies that a patient with chronic kidney disease is at risk for which electrolyte disturbance?
A. Hypokalemia
B. Hyponatremia
C. Hypercalcemia
D. Hyperphosphatemia
A patient with chronic kidney disease is at risk for hyperphosphatemia. In chronic kidney disease, the kidneys' ability to excrete phosphate is impaired, leading to elevated levels of phosphate in the blood. This can further lead to calcium-phosphate imbalances, bone problems, and other complications associated with kidney disease. Managing phosphate levels is an essential aspect of the treatment plan for patients with chronic kidney disease.
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Full Explanation
A patient with chronic kidney disease is at risk for hyperphosphatemia. In chronic kidney disease, the kidneys' ability to excrete phosphate is impaired, leading to elevated levels of phosphate in the blood. This can further lead to calcium-phosphate imbalances, bone problems, and other complications associated with kidney disease. Managing phosphate levels is an essential aspect of the treatment plan for patients with chronic kidney disease.
Similar Questions
A female client with chronic kidney disease (CKD) is receiving peritoneal dialysis with 2-L inflows. Which information should the nurse report promptly to the health care provider?
A. The client's peritoneal effluent appears cloudy.
Cloudy peritoneal effluent may indicate infection or peritonitis, which is a severe complication of peritoneal dialysis. Peritonitis can be life-threatening and requires immediate medical attention. The nurse should report this finding promptly to the health care provider for further evaluation and intervention.
B. The client has an outflow volume of 1800 mL.
C. The client has abdominal pain during the inflow phase.
D. The client's abdomen appears bloated after the inflow.
Full Explanation
Cloudy peritoneal effluent may indicate infection or peritonitis, which is a severe complication of peritoneal dialysis. Peritonitis can be life-threatening and requires immediate medical attention. The nurse should report this finding promptly to the health care provider for further evaluation and intervention.
A nurse is assessing a client who has end-stage kidney disease and is receiving hemodialysis. Which of the following findings should the nurse identify as an indication the client is experiencing fluid overload?
A. The client has had a 3 lb weight gain since yesterday.
A 3 lb weight gain in a short period, especially overnight, is indicative of fluid overload in a client with end-stage kidney disease receiving hemodialysis. Hemodialysis is performed to remove excess fluid and waste products from the body. If the client is experiencing fluid overload, it means that their body is retaining more fluid than it should, and this can lead to complications such as pulmonary edema, heart failure, and other cardiovascular problems. The nurse should identify this finding as an indication of potential fluid overload and report it to the healthcare provider for further evaluation and intervention.
B. Flattened neck veins
C. Oxygen saturation 93%
D. Return of skin to previous position when the client's shin is palpated
Full Explanation
A 3 lb weight gain in a short period, especially overnight, is indicative of fluid overload in a client with end-stage kidney disease receiving hemodialysis. Hemodialysis is performed to remove excess fluid and waste products from the body. If the client is experiencing fluid overload, it means that their body is retaining more fluid than it should, and this can lead to complications such as pulmonary edema, heart failure, and other cardiovascular problems. The nurse should identify this finding as an indication of potential fluid overload and report it to the healthcare provider for further evaluation and intervention.
A nurse in the emergency department is caring for a client who is experiencing chest pain.
Physical Examination
0900:
Client admitted with a report of chest pain radiating to the left arm, sweating, shortness of breath, and epigastric discomfort.
Client awake. alert, and oriented x3.
Lung sounds clear bilaterally. $152 heart sounds noted.
All pulses palpable.
Skin cool and diaphoretic to touch.
tachycardia with ST elevation. Provider notified.
Medication Administration Record
Sildenafil 50 mg PO once daily
Simvastatin 40 mg PO once daily
Metoprolol 100 mg PO once daily
Multivitamin once daily
The nurse is reviewing the client's assessment data to prepare the plan of care. What two (2) things should you monitor based on their condition? Select two (2) answers.
A. WBC Count
B. Platelet Count
C. Electrocardiogram (ECG) Rhythm
Electrocardiogram (ECG) Rhythm: The client is experiencing chest pain with ST elevation, which indicates a possible myocardial infarction (MI). Continuous monitoring of the ECG rhythm is essential to identify any changes or dysrhythmias that may occur during the course of the client's care.
D. Serum glucose level
E. Vital signs
Vital signs: The client's tachycardia with ST elevation suggests cardiac involvement. Monitoring vital signs, including heart rate, blood pressure, respiratory rate, and oxygen saturation, is crucial to assess the client's hemodynamic status and detect any signs of deterioration or improvement.
Full Explanation
Based on the client's condition, the nurse should monitor the following:
C. Electrocardiogram (ECG) Rhythm: The client is experiencing chest pain with ST elevation, which indicates a possible myocardial infarction (MI). Continuous monitoring of the ECG rhythm is essential to identify any changes or dysrhythmias that may occur during the course of the client's care.
E. Vital signs: The client's tachycardia with ST elevation suggests cardiac involvement. Monitoring vital signs, including heart rate, blood pressure, respiratory rate, and oxygen saturation, is crucial to assess the client's hemodynamic status and detect any signs of deterioration or improvement.
The other options (A. WBC Count, B. Platelet Count, and D. Serum glucose level) are not directly related to the client's acute chest pain and the possible MI. While these tests may be ordered for other reasons or as part of the overall assessment, they are not the immediate priorities in this situation. Monitoring the ECG rhythm and vital signs are more relevant to the client's acute cardiac condition.