A client with chronic renal failure is asking the nurse why her hemoglobin and hematocrit counts are low. Which of the following is the nurse's best response?
Your counts are low because of all the heparin you are receiving during dialysis
Your counts are low because your kidneys are no longer producing erythropoietin
Your counts are low because you are losing blood with each dialysis treatment
Your counts are low because you are not eating a diet rich in protein
The Correct Answer is B
Choice A reason: Heparin prevents clotting during dialysis but doesn’t reduce hemoglobin or hematocrit directly. It’s not a primary cause of anemia in renal failure, unlike erythropoietin deficiency.
Choice B reason: Kidneys in chronic renal failure fail to produce erythropoietin, a hormone stimulating red blood cell production, leading to low hemoglobin and hematocrit, the key cause here.
Choice C reason: Minor blood loss occurs in dialysis, but it’s not the primary reason for chronic anemia. Erythropoietin deficiency from renal failure has a greater impact on counts.
Choice D reason: Poor protein intake affects overall health but isn’t the main driver of anemia in renal failure. Erythropoietin loss from kidney dysfunction is the dominant factor.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E"]
Explanation
Choice A reason: Barrel chest develops in emphysema from chronic air trapping, overexpanding lungs and flattening the diaphragm, altering thoracic shape over years.
Choice B reason: Edema relates to right heart failure from cor pulmonale, a late emphysema complication, not a direct or universal finding after five years.
Choice C reason: Productive cough is typical in chronic bronchitis, not emphysema, which features alveolar destruction and minimal mucus, leading to dry cough instead.
Choice D reason: Dyspnea in emphysema results from alveolar loss reducing oxygen exchange, forcing compensatory rapid breathing, a core symptom even after five years.
Choice E reason: Clubbed fingers occur in chronic hypoxia from emphysema, as poor oxygenation over years triggers nail bed angiogenesis, a common late finding.
Correct Answer is D
Explanation
Choice A reason: Steak, a solid, requires chewing and swallowing coordination, risking aspiration in dysphagia post-CVA due to impaired pharyngeal muscle control.
Choice B reason: Iced tea, a thin liquid, flows quickly, increasing aspiration risk in CVA patients with weakened swallow reflexes, unable to manage thin consistencies safely.
Choice C reason: Grapes, small and round, pose choking and aspiration hazards in dysphagia, as they require intact bolus control, often compromised post-stroke.
Choice D reason: Mashed potatoes, soft and thick, are easier to swallow, reducing aspiration risk in dysphagia post-CVA, aligning with thickened consistency recommendations.
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