A client with acute kidney injury (AKI) is admitted with an elevated heart rate and an elevated blood pressure. Which intervention should the practical nurse (PN) implement?
Monitor daily sodium intake.
Record usual eating patterns.
Document abdominal girth.
Measure and document urinary output.
The Correct Answer is D
A. Monitoring daily sodium intake is important for managing AKI, but it is not the immediate priority when addressing acute changes in heart rate and blood pressure.
B. Recording usual eating patterns is not relevant to the immediate concern of elevated heart rate and blood pressure in the context of AKI.
C. Documenting abdominal girth is relevant for assessing fluid status and potential complications like ascites, but it is not the first priority for addressing the acute symptoms of elevated heart rate and blood pressure.
D. Measuring and documenting urinary output is the most critical intervention because it provides essential information on kidney function and fluid balance, which directly impacts heart rate and blood pressure management in AKI.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"B"}}
Explanation
- "MRSA is not that big of a deal."
No Understanding: MRSA is a serious infection that can be difficult to treat and can spread. It is important for the client to understand the severity of MRSA. - "I should wash my hands and encourage others who are around me to wash their hands."
Understanding: Hand hygiene is critical in preventing the spread of MRSA. The client is aware of the importance of hand washing for infection control. - "I will no longer be able to transmit MRSA once my surgical site is completely healed."
No Understanding: MRSA can be a persistent infection, and healing of the surgical site does not guarantee that MRSA cannot be transmitted. Proper infection control measures must continue. - "My diet makes a difference in my ability to heal."
Understanding: Nutrition plays a role in the healing process and overall recovery. A balanced diet supports the immune system and aids in wound healing. - "I should only take antibiotics until I feel better."
No Understanding: It is crucial to complete the full course of antibiotics as prescribed to ensure the infection is fully treated and to prevent resistance
Correct Answer is ["C","D"]
Explanation
A. Teaching the client with fluid restrictions how to measure urine output requires specialized knowledge and skills. This task should be performed by a licensed nurse to ensure accurate instruction and patient understanding.
B. Irrigating an indwelling urinary catheter involves sterile technique and specialized knowledge, which should be performed by a licensed nurse. This task requires specific training to prevent complications.
C. Transporting a urine culture sample to the laboratory can be safely assigned to a UAP. It involves routine tasks that do not require advanced clinical skills and is essential for timely processing of specimens.
D. Emptying the bedside drainage unit for a client with an indwelling urinary catheter can be performed by a UAP. This task involves basic care procedures that support patient hygiene and comfort.
E. Obtaining a post-voided residual (PVR) volume requires a specific clinical skill and understanding of the procedure, which should be performed by a licensed nurse rather than a UAP.
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