Nursing Elites

1. A nurse is caring for a client who has chronic kidney disease and reports nausea. The nurse should identify that this client is at risk for which of the following imbalances?

• A. Metabolic alkalosis
• B. Metabolic acidosis
• C. Respiratory alkalosis
• D. Respiratory acidosis

Correct answer: B

Rationale: The correct answer is B: Metabolic acidosis. Clients with chronic kidney disease are at risk for metabolic acidosis because the kidneys are unable to effectively excrete acids, leading to an accumulation of acid in the body. This metabolic imbalance can result in symptoms like nausea. Choices A, C, and D are incorrect. Metabolic alkalosis is not typically associated with chronic kidney disease. Respiratory alkalosis is more commonly seen in conditions such as hyperventilation. Respiratory acidosis, on the other hand, is often linked to conditions affecting the lungs or respiratory system, not primarily kidney disease.

2. A nurse is caring for a client who has schizophrenia. Which of the following findings should the nurse expect?

• A. Decreased level of consciousness
• B. Inability to identify common objects
• C. Preoccupation with somatic disturbances
• D. Poor problem-solving ability

Correct answer: B

Rationale: The correct answer is B: Inability to identify common objects. Clients with schizophrenia often experience cognitive deficits, such as difficulty in identifying common objects. This can be attributed to impairments in perception and cognition. Choices A, C, and D are not typically associated with schizophrenia. Decreased level of consciousness is more indicative of conditions like head injuries or metabolic disturbances. Preoccupation with somatic disturbances is commonly seen in somatic symptom disorders, not schizophrenia. Poor problem-solving ability is a characteristic of conditions affecting executive functioning like dementia, rather than schizophrenia.

3. A nurse is teaching a client who has chronic kidney disease about managing protein intake. Which of the following statements should the nurse include in the teaching?

• A. You should consume more plant-based protein.
• B. You should increase your intake of animal protein.
• C. You should increase your intake of high-protein foods.
• D. You should limit your intake of high-protein foods.

Correct answer: D

Rationale: The correct answer is D: "You should limit your intake of high-protein foods." Clients with chronic kidney disease should reduce their intake of high-protein foods to lessen the workload on the kidneys and prevent further kidney damage. Choices A, B, and C are incorrect because increasing intake of either plant-based or animal protein or high-protein foods can exacerbate kidney issues in individuals with chronic kidney disease.

4. A nurse is caring for a client who has chronic kidney disease. The nurse should identify which of the following laboratory values as an indication for hemodialysis?

• A. Glomerular filtration rate of 14 mL/min
• B. BUN 16 mg/dL
• C. Serum magnesium 1.8 mg/dL
• D. Serum phosphorus 4.0 mg/dL

Correct answer: A

Rationale: A glomerular filtration rate (GFR) of 14 mL/min is significantly low, indicating poor kidney function and the need for hemodialysis to remove waste products effectively. BUN, serum magnesium, and serum phosphorus levels are important in assessing kidney function and electrolyte balance but are not direct indicators for the initiation of hemodialysis. BUN (blood urea nitrogen) reflects the kidney's ability to filter waste products, serum magnesium levels are important for muscle and nerve function, and serum phosphorus levels are vital for bone health.

5. A nurse is caring for a client who is at 32 weeks of gestation and has preeclampsia. Which of the following findings should the nurse report to the provider?

• A. Blood pressure of 120/80 mm Hg
• B. Respiratory rate of 16/min
• C. 1+ protein in the urine
• D. Heart rate of 88/min

Correct answer: C

Rationale: The correct answer is C. 1+ protein in the urine is indicative of worsening preeclampsia and should be reported to the provider immediately. Elevated blood pressure (choice A) is expected in preeclampsia, but a reading of 120/80 mm Hg is within the normal range. A respiratory rate of 16/min (choice B) and a heart rate of 88/min (choice D) are also within normal limits and not indicative of worsening preeclampsia.

Similar Questions