A male client with acute kidney injury (AKI) is scheduled for his first hemodialysis treatment and asks the practical nurse (PN) how the treatments will be evaluated for effectiveness. The PN explains that blood samples will be collected for analysis. Which laboratory value should the PN explain as the best indicator of each hemodialysis?

Elevated potassium.

Decreased calcium.

Lowered hemoglobin.

Decreased creatinine.

Answer and Explanation

The Correct Answer is D

Hemodialysis is a procedure used to remove waste products and excess fluid from the blood when the kidneys are unable to function properly. One of the waste products that accumulate in the blood during kidney dysfunction is creatinine. Creatinine is a byproduct of muscle metabolism, and its levels in the blood are normally regulated and eliminated by the kidneys. In AKI, the kidneys are not able to effectively filter and eliminate creatinine, leading to elevated levels in the blood. Hemodialysis helps to remove excess creatinine from the blood, resulting in decreased creatinine levels.

A- Elevated potassium levels (hyperkalemia) are common in AKI and can be life-threatening. Hemodialysis helps to remove excess potassium from the blood, restoring normal levels.

However, the best indicator of the effectiveness of hemodialysis in managing hyperkalemia would be monitoring the potassium levels before and after the session rather than considering it as the "best" indicator.

B- Decreased calcium levels can occur in kidney dysfunction due to impaired activation of vitamin D and decreased absorption of calcium from the intestines. While hemodialysis can help restore calcium levels, it may not be the primary laboratory value used to evaluate the effectiveness of each session.

C- Lowered hemoglobin levels can be seen in AKI due to various factors, including decreased production of red blood cells and blood loss. Hemodialysis can help remove waste products and excess fluid, but it may not directly address the underlying causes of lowered hemoglobin levels.

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Correct Answer is D

Explanation

Gently blowing the nose helps to clear any mucus or debris from the nasal passages, allowing for better delivery and absorption of the medication. It also helps to ensure that the nasal passages are clear and open, allowing the medication to reach its intended target.
A. Deep breathing and coughing are unrelated to the administration of nasal spray and are not necessary before using the medication.
B. Checking glucose levels before and after administration is not relevant for fluticasone furoate nasal spray. Glucocorticoid nasal sprays are not typically associated with significant effects on blood glucose levels.
C. Exhaling through the mouth is not a specific action required before using the nasal spray. It may be a general instruction for some other respiratory therapies or procedures, but it is not directly related to the administration of the nasal spray.

A. "It's okay if you don't want to look or talk about the mastectomy. It will be available when you're ready." B. "Would you like me to call another nurse to be here while I show you the wound?" C. "Part of recovery is accepting your new body image, and you will need to look at your incision." D. "You will feel better when you see that the incision is not as bad as you may think."

Correct Answer is A

Explanation

When a client refuses to look at their mastectomy incision and refuses to talk about it, the best response by the practical nurse (PN) is to respect the client's autonomy and validate their feelings. Option a) acknowledges the client's discomfort and provides reassurance that it is okay for them to decline to look or talk about the incision at the moment. It also oﬀers support by letting the client know that the incision will be available for examination when they feel ready to do so.

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

At the first dressing change, the practical nurse (PN) tells the client that her mastectomy incision is healing well, but the client refuses to look at the incision and refuses to talk about it. Which response by the PN to the client's silence is best?

Correct Answer is A

Explanation

A client whose first child was delivered by cesarean section is 20 weeks pregnant with her second child and wishes to have a vaginal birth after cesarean (VBAC). What information is most important for the practical nurse (PN) to obtain?

The practical nurse (PN) is assisting with the plan of care for a client who is experiencing torticollis from a traumatic injury sustained during a football game. The client received a prescription for tramadol. Which intervention should the PN include in the client's plan of care?

A male client tells the practical nurse (PN) that he is afraid of getting cancer so he plans to quit smoking cigarettes by switching to a smokeless tobacco product. How should the PN respond?

Ancient is scheduled for a thoracentesis that will be done at the bedside. What should the practical nurse (PN) prepare before the healthcare provider arrives to perform the procedure?

A male preoperative client who has already signed the informed consent for a surgical procedure confides in the practical nurse (PN) that he is really frightened and unsure about undergoing the surgery. Which priority action should the PN take?

A client who had orthopedic surgery three days ago verbalizes difficulty in sleeping. Which initial intervention is best for the practical nurse (PN) to implement?

A female client with immune thrombocytopenic purpura (ITP) is transferred to a long-term care facility for physical rehabilitation. To prevent injury, which action is most important for the practical nurse to implement?

The practical nurse (PN) is assessing an older client with left-sided heart failure (HF). What intervention is most important for the PN to implement?