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 ["500"]

Explanation

1 liter is equal to 1000 milliliters. Therefore, to calculate the fluid intake in mL, we can multiply 1/2 liter by 1000 mL/liter:

1/2 liter * 1000 mL/liter = 500 mL

So, the practical nurse should document 500 mL as the client's fluid intake.

A. Reassure the client that the drops will not be needed often since eye pain in glaucoma is not common. B. Reteach the client about the action of the eye drops to decrease pressure in the eyes. C. Document in the chart that the client understands the action and use of the eye drops. D. Explain to the client that the eye drops do provide pain relief, but do not anesthetize the eyes.

Correct Answer is D

Explanation

Pilocarpine ophthalmic drops are used to treat glaucoma by reducing intraocular pressure. They do not have an anesthetic effect and are not used for the purpose of numbing or anesthetizing the eyes. It is important for the client to have a correct understanding of the medication and its intended use.
Here's why the other options are incorrect:

A. Reassure the client that the drops will not be needed often since eye pain in glaucoma is not common: This statement is not accurate. While eye pain may not be a common symptom of glaucoma, pilocarpine drops are primarily used to reduce intraocular pressure, not to address eye pain.
B. Reteach the client about the action of the eye drops to decrease pressure in the eyes: This option may be considered if the client misunderstood the information initially, but it is not the most appropriate response in this scenario. The client's statement indicates a specific belief about the drops providing anesthetic effects, so clarifying the purpose of the drops is more appropriate.
C. Document in the chart that the client understands the action and use of the eye drops: Documentation is important, but in this case, it is necessary to address the client's misconception about the anesthetic effect of the drops and provide accurate information.

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Naxlex Comprehensive Predictor Exams

A client reports that she ingested 1/2 of a liter of a prep solution for a colonoscopy. How many mL of fluid intake should the practical nurse (PN) document? (Enter numeric value only. If rounding is required, round to the nearest whole number.)

Correct Answer is ["500"]

Explanation

The practical nurse (PN) is reviewing instructions for the use of pilocarpine ophthalmic drops with a client who has glaucoma. The client replies that the drops should be used to anesthetize the eye if eye pain is experienced. What action should the PN implement?

Correct Answer is D

Explanation

The practical nurse (PN) is assisting with the preparation of a client for fecal diversion surgery. While inserting an indwelling urinary catheter, the client asks if the surgical opening will be visible. Which action should the PN implement?

The practical nurse (PN) selects the ventrolateral site to administer an intramuscular (IM) injection to an adult. Identify the Injection site.

Two weeks after cast application, a client with a fractured right arm returns to the clinic for evaluation. The client seems upset and tells the practical nurse (PN) that the healthcare provider said a callus has formed on the bone. Which action should the PN take?

The practical nurse (PN) determines that a client's pupils constrict as they change focus from a far object to a near object. How should the PN document this finding?

The practical nurse (PN) is assisting the recreational director of a long-term care facility in planning outdoor activities for wheelchair-bound older residents who are mentally alert. Which activity should the PN suggest that meets the physical and social needs of these residents?

Which statement by an older female client who lost her spouse two years ago should indicate to the practical nurse (PN) that the client may need bereavement counseling?

A male client attends a community support program for mentally impaired and chemical-abusing clients. The client tells the practical nurse (PN) that his drugs of choice are cocaine and heroin. What is the greatest health risk for this client?

A client is being treated for chronic kidney disease (CKD). On examination, the client has elevated blood pressure (BP) and is exhibiting changes in mental status. Which intervention in the plan of care should the practical nurse (PN) implement?