A nurse is assessing a client who has acute kidney failure and is in a state of metabolic acidosis. The nurse should monitor for which of the following manifestations?

Bounding peripheral pulses

Hyperreflexia

Cool skin

Hypotension

Answer and Explanation

The Correct Answer is D

A) Bounding peripheral pulses: Metabolic acidosis typically does not cause bounding peripheral pulses. In metabolic acidosis, vasodilation might occur, but it usually leads to weaker, not bounding, pulses due to decreased cardiac output and blood pressure.

B) Hyperreflexia: Hyperreflexia is not commonly associated with metabolic acidosis. Instead, metabolic acidosis may cause symptoms like muscle weakness or fatigue due to the effect of acid-base imbalance on neuromuscular function.

C) Cool skin: While cool skin can sometimes be associated with poor perfusion in severe cases, it is not a direct manifestation of metabolic acidosis. Metabolic acidosis more commonly affects internal physiology rather than peripheral skin temperature directly.

D) Hypotension: Hypotension is a common manifestation of metabolic acidosis. The acidosis leads to vasodilation and decreased cardiac contractility, resulting in a drop in blood pressure. This is a critical sign for the nurse to monitor as it indicates the severity of the acid-base imbalance and its effect on the cardiovascular system.

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Correct Answer is C

Explanation

A) Hispanic ethnicity: While ethnicity can influence the prevalence and risk of hypertension, Hispanic ethnicity alone is not a direct risk factor for hypertension. Other factors such as lifestyle, diet, and genetic predispositions play more significant roles in the development of hypertension.

B) Cholesterol 190 mg/dL: Although elevated cholesterol levels can contribute to cardiovascular disease, a cholesterol level of 190 mg/dL is considered borderline high but not a primary risk factor for hypertension. The risk for hypertension is more directly related to factors like blood pressure levels and weight.

C) BMI of 28: A Body Mass Index (BMI) of 28 falls into the overweight category, which is a known risk factor for developing hypertension. Excess body weight can increase blood pressure by increasing the workload on the heart and contributing to insulin resistance, which can further elevate blood pressure.

D) History of atrial fibrillation: While atrial fibrillation is a significant cardiac condition and can be associated with other cardiovascular risks, it is not a direct risk factor for the development of hypertension. The primary risk factors for hypertension include factors like obesity, diet, and physical inactivity.

A. "Switch from breastfeeding to formula feeding when your baby is 2 months old." B. "Avoid exposing your baby to secondhand smoke." C. "Ensure your baby receives the Hepatitis B vaccine." D. "Place your baby in a supine position during feeding."

Correct Answer is B

Explanation

A) "Switch from breastfeeding to formula feeding when your baby is 2 months old": Breastfeeding is associated with a reduced risk of otitis media, as breast milk contains antibodies and other factors that help protect against infections. Switching to formula feeding may not reduce the incidence of otitis media and can potentially increase the risk.

B) "Avoid exposing your baby to secondhand smoke": Exposure to secondhand smoke is a significant risk factor for otitis media. Smoke irritates the respiratory tract and can lead to inflammation and fluid accumulation in the middle ear, increasing the likelihood of ear infections. Avoiding secondhand smoke can help reduce the incidence of otitis media.

C) "Ensure your baby receives the Hepatitis B vaccine": While the Hepatitis B vaccine is important for preventing Hepatitis B infection, it does not have a direct impact on the incidence of otitis media. The vaccine’s primary role is in preventing liver disease rather than ear infections.

D) "Place your baby in a supine position during feeding": Placing a baby in a supine position (lying on their back) during feeding does not reduce the risk of otitis media. In fact, feeding a baby while lying flat can increase the risk of ear infections as it may cause milk to flow into the middle ear. It is generally recommended to hold the baby in an upright or semi-upright position during feeding.

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A nurse is assessing a client who has acute kidney failure and is in a state of metabolic acidosis. The nurse should monitor for which of the following manifestations?

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Naxlex Comprehensive Predictor Exams

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