A client with end-stage kidney disease is scheduled to begin hemodialysis. The nurse is working with the client to adapt the client’s diet to maximize the therapeutic effect and minimize the risks of complications. The client’s diet should include which of the following modifications?

Increased potassium intake

Increased protein intake

Decreased phosphorus intake

Decreased calcium intake/supplementation

Answer and Explanation

The Correct Answer is C

Choice A reason: Increased potassium intake is dangerous in ESRD, as impaired kidneys cannot excrete potassium, leading to hyperkalemia. This can disrupt cardiac membrane potentials, causing arrhythmias or cardiac arrest. ESRD diets require strict potassium restriction to prevent life-threatening electrolyte imbalances, making this modification inappropriate.

Choice B reason: Increased protein intake is often recommended in ESRD patients on hemodialysis to replace protein lost during dialysis and prevent malnutrition. However, it must be balanced to avoid excess urea production, which can worsen uremia. This is not the primary focus compared to phosphorus management in this context.

Choice C reason: Decreased phosphorus intake is critical in ESRD, as kidneys cannot excrete phosphate, leading to hyperphosphatemia. This causes vascular calcification and secondary hyperparathyroidism, increasing cardiovascular risk. Dietary phosphorus restriction, often with phosphate binders, prevents these complications, making it a key dietary modification for hemodialysis patients.

Choice D reason: Decreased calcium intake is not recommended in ESRD, as patients often have hypocalcemia due to impaired vitamin D activation and phosphate retention. Calcium supplementation or adequate intake is needed to prevent bone disease and secondary hyperparathyroidism, making this modification incorrect for ESRD management.

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Correct Answer is D

Explanation

Choice A reason: One-to-one observation for aggressive behavior is a standard safety measure to prevent harm, aligning with the right to safe care. It does not violate client rights when justified by clinical need, as it prioritizes protection without restricting autonomy unnecessarily, making it an appropriate intervention.

Choice B reason: Using physical restraints to prevent self-harm is permissible when less restrictive measures fail, aligning with the right to safety. If properly documented and justified, it does not violate rights, as mental health laws allow restraints for imminent danger, making this action compliant with client rights.

Choice C reason: Searching belongings at admission is standard in psychiatric settings to ensure safety (e.g., removing contraband). This practice, when conducted respectfully and per policy, does not violate client rights, as it prioritizes a safe therapeutic environment for all patients and staff on the unit.

Choice D reason: Lack of documentation of treatment benefits and options violates the right to informed consent. Clients must be informed about treatment rationale and alternatives to make autonomous decisions. Failure to document this breaches legal and ethical standards, undermining the client’s ability to participate in their care, making it a rights violation.

Correct Answer is ["50"]

Explanation

The correct answer is 50 drops per minute
Explanation:
Step 1 is identify the total volume to be infused
50 mL

Step 2 is identify the time in minutes
1 hour = 60 minutes

Step 3 is identify the drop factor for a microdrip set
Microdrip = 60 drops per mL

Step 4 is multiply the volume by the drop factor
50 × 60 = 3000 drops

Step 5 is divide total drops by time in minutes
(3000 ÷ 60) = 50

Result = 50 drops per minute

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A client with end-stage kidney disease is scheduled to begin hemodialysis. The nurse is working with the client to adapt the client’s diet to maximize the therapeutic effect and minimize the risks of complications. The client’s diet should include which of the following modifications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing an electronic medical record to determine if a client’s rights have been violated by another member of the healthcare team. Which finding will the nurse identify that would indicate a violation of the client’s rights?

Correct Answer is D

Explanation

The order is to infuse 50ml of piggyback antibiotic over 1 hour. The set calibration has a microdrip drop factor. What the flow rate in drops per minute?

Correct Answer is ["50"]

Explanation

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