A client who received a kidney transplant 3 months ago is in the nephrologists office for a follow up appointment. Which finding would indicate that the client is experiencing a complication which is common after a kidney transplant?

Creatinine 1.2 mg/dL

24-hour urine output 1,800 mL

White blood cell count (WBC) 13,500/mm3

Blood urea nitrogen (BUN) 18 mg/dL

Answer and Explanation

The Correct Answer is C

A creatinine level of 1.2 mg/dL is within the upper range of normal but may be slightly elevated depending on the baseline level pre-transplant and individual patient factors. For a client 3 months post- transplant, this level could indicate stable kidney function or a mild increase but is not necessarily indicative of a significant complication.
B.A 24-hour urine output of 1,800 mL is within the normal range for adults (about 1,000 to 2,000 mL per day). This level of urine output suggests that the transplanted kidney is functioning adequately in terms of urine production.
C. An elevated white blood cell count of 13,500/mm³ could indicate an infection or inflammation. This finding is relevant in the context of post-transplant care because patients are at increased risk for infections due to immunosuppressive therapy and the surgical procedure. An elevated WBC count could also suggest an acute rejection episode, as rejection can cause inflammation and an immune response.
D. A BUN level of 18 mg/dL is within the normal range but on the higher end. It might suggest some level of kidney impairment, but it is not necessarily indicative of a severe complication on its own.

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Correct Answer is D

Explanation

A. Phacoemulsification is a procedure used to remove cataracts from the eye. It involves using ultrasound waves to break up the cloudy lens (cataract) into small fragments, which are then suctioned out. While this procedure is relevant for cataract treatment, it does not address the acute management of angle-closure glaucoma.
B. Extracapsular cataract extraction is a surgical procedure to remove a cataract from the eye by making an incision and extracting the lens in one piece or in large segments. Like phacoemulsification, this procedure is focused on cataract removal and does not directly treat the underlying issue of acute angle-closure glaucoma.
C. A cochlear implant is a device used to provide a sense of sound to individuals with severe hearing loss or deafness. This procedure is unrelated to the treatment of eye conditions or intraocular pressure and therefore is not appropriate for managing primary angle-closure glaucoma.
D. Surgical iridectomy is a procedure specifically aimed at treating angle-closure glaucoma. It involves creating a small hole (iridectomy) in the peripheral iris to allow aqueous humor to flow from the posterior chamber of the eye to the anterior chamber, bypassing the obstructed drainage angle.

A. Begin broad spectrum IV antibiotics. B. Transfuse 1 unit of packed red blood cells. C. Prepare client for endoscopic retrograde cholangiopancreatography. D. Administer morphine sulfate IV push for pain.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"B"}}

Explanation

1. Begin Broad Spectrum IV Antibiotics Anticipated
The client's symptoms, including right upper quadrant pain, nausea, vomiting, jaundice, fever, and elevated white blood cell count, suggest a potential infection or inflammation in the abdominal area, possibly related to the biliary system (e.g., cholecystitis or cholangitis). Broad-spectrum antibiotics are commonly used to treat infections that could be causing these symptoms, especially if the exact pathogen is not yet identified. The elevated white blood cell count further supports the likelihood of an infection.
2. Transfuse 1 Unit of Packed Red Blood Cells Contraindicated
There is no indication from the provided information that the client has anemia or a significant drop in hemoglobin that would necessitate a blood transfusion. The hemoglobin level is 15.1 g/dL, which is within normal limits. Blood transfusion would typically be considered if there was evidence of significant blood loss or anemia, neither of which is indicated by the client’s current lab results.
3. Prepare Client for Endoscopic Retrograde Cholangiopancreatography (ERCP) Anticipated
The symptoms described, including right upper quadrant pain radiating to the right shoulder, jaundice, and the dark amber urine, are suggestive of biliary tract involvement, such as gallstones causing obstruction or infection. ERCP is a diagnostic and therapeutic procedure used to visualize and treat conditions of the bile ducts and pancreatic ducts. Given the symptoms and clinical presentation, preparing the client for an ERCP to assess and potentially address issues in the biliary system is appropriate.

4. Administer Morphine Sulfate IV Push for Pain Contraindicated
The client has a documented allergy to morphine. Administering morphine could lead to an allergic reaction and is therefore contraindicated. Alternative pain management options should be considered, such as non-opioid analgesics or other opioid medications that the client is not allergic to.

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A client who received a kidney transplant 3 months ago is in the nephrologists office for a follow up appointment. Which finding would indicate that the client is experiencing a complication which is common after a kidney transplant?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse is caring for a 43-year-old female client who reports abdominal pain. Exhibits For each potential provider's order, click to specify if the potential order is anticipated or contraindicated for this client.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"B"}}

Explanation

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