A client with end-stage renal disease (ESRD) has been on hemodialysis for 3 years. The client chooses to discontinue dialysis, and to begin receiving hospice services at home with day-to-day care provided by family members. The hospice nurse performs an assessment on the client 7 days after the client last received a dialysis treatment. Which assessment finding would not be expected for this client?

Pruritis

Lethargy

Polyuria

Uremic frost

Answer and Explanation

The Correct Answer is C

A.   This is a common symptom of uremia, which is the buildup of waste products in the blood due to kidney failure. It is expected in a patient with ESRD who has discontinued dialysis.
B.   As the body accumulates waste products, fatigue and lethargy are common symptoms of uremia. This is expected in a patient with ESRD who has discontinued dialysis.

C.   Polyuria is excessive urination. With kidney failure, the kidneys are unable to concentrate urine, leading to oliguria or anuria, not polyuria. Therefore, polyuria would not be expected in this patient.
D.   This is a white, crystalline deposit on the skin caused by the accumulation of urea and uric acid. It is a sign of severe uremia and would be expected in a patient with ESRD who has discontinued dialysis.

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Correct Answer is ["C","D"]

Explanation

A. Green beans are relatively low in potassium compared to other foods. While they do contain potassium, it is not in particularly high amounts. Therefore, they are generally considered safe in moderate amounts for individuals with CKD, but should still be monitored as part of a potassium- restricted diet.
B. Apples are low in potassium compared to many other fruits. They can be a good option for those needing to restrict potassium intake.
C. A typical serving of orange juice can contain a significant amount of potassium, which can contribute to elevated potassium levels in CKD patients. It should be limited or avoided to manage potassium intake effectively.
D. Avocados are high in potassium. A single avocado contains a substantial amount of potassium, making it a food that should be limited or avoided in a potassium-restricted diet for individuals with CKD.
E. Onions are relatively low in potassium and can be used in moderation by individuals with CKD. They are not typically a major concern for potassium restriction.

A. Milk B. Liver C. Spinach D. Chocolate

Correct Answer is B

Explanation

A. Milk is low in purines and is not associated with an increase in uric acid levels or the formation of uric acid stones. In fact, dairy products like milk can be beneficial in a diet for managing kidney stones because they are low in purines and provide calcium, which may help prevent stone formation.

B. Liver is very high in purines. High-purine foods increase the levels of uric acid in the body, which can lead to the formation of uric acid stones in the kidneys. Therefore, clients with recurrent kidney stones due to excessive purine intake should avoid liver and other organ meats.
C. Spinach is considered to have a moderate level of purines. While it is not as high in purines as organ meats, it still contains a notable amount. However, in comparison to foods like liver, it is less of a concern for individuals who need to strictly limit purine intake.
D. Chocolate contains a moderate amount of purines, but it is not as high in purines as organ meats like liver. While it’s not completely free from purines, its purine content is generally lower compared to foods such as liver.

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Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has chronic kidney disease about limiting foods that are high in potassium. Which of the following are high-potassium foods which the client should avoid? (Select all that apply.)

Correct Answer is ["C","D"]

Explanation

A client has had recurrent kidney stones. Upon lab analysis of the client's urine, it is found that excessive purine intake is the underlying cause. Which of the following high-purine foods should the nurse instruct the client to avoid?

Correct Answer is B

Explanation

Which of the following clients is at risk of developing acute kidney injury from a post-renal cause?

A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of untreated chronic kidney disease?

A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication?

A client with polycystic kidney disease is prescribed the medication Tolvaptan. What should the nurse include when educating the client about this medication.

A nurse is assessing a client who has chronic kidney disease (CKD) for fluid volume overload prior to scheduled hemodialysis. Which of the following methods provides a reliable measurement of the amount of fluid the client has retained since the last dialysis treatment?

The nurse is providing education to a male client who is newly-diagnosed with polycystic kidney disease. Which of the following statements should be included in the client teaching?