A nurse is assessing a client who has chronic kidney disease and notes that the client has small crystals on his forehead. The nurse understands that this manifestation is a result of an excess of which substance in the body?

Potassium

Sodium

Urea

Creatinine

Answer and Explanation

The Correct Answer is C

A.   Elevated potassium levels (hyperkalemia) can occur in chronic kidney disease, as the kidneys struggle to excrete potassium. However, hyperkalemia does not typically cause visible crystals on the skin. It is more associated with cardiac arrhythmias and muscle weakness rather than skin manifestations.
B.   Sodium imbalance is common in chronic kidney disease, often leading to fluid retention and hypertension. However, excess sodium does not result in crystal formation on the skin. Sodium issues are more related to fluid balance and blood pressure, not external crystalline deposits.
C.   Urea is a waste product formed from the breakdown of proteins and is normally excreted by the kidneys. In chronic kidney disease, urea accumulates in the blood (uremia) because the kidneys cannot effectively filter it out. Urea can be deposited on the skin and form crystals, leading to a condition known as "uremic frost." This is often observed on the forehead or other areas of the skin and is a direct result of excess urea in the body.

D.   Creatinine is another waste product filtered by the kidneys. Elevated levels indicate impaired kidney function, but creatinine itself does not form visible crystals on the skin. Elevated creatinine levels are primarily used as an indicator of kidney function rather than a cause of external skin manifestations.

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Correct Answer is D

Explanation

A. Cushing syndrome is characterized by excessive levels of cortisol in the body, often due to an adrenal gland tumor or prolonged use of corticosteroid medications. The primary symptoms include weight gain, hypertension, and changes in skin appearance. Exophthalmos is not typically associated with Cushing syndrome.
B. Hashimoto's disease is an autoimmune thyroid disorder that leads to hypothyroidism (underactive thyroid). The condition is characterized by symptoms such as fatigue, weight gain, cold intolerance, and dry skin. Exophthalmos is not a feature of Hashimoto's disease. Instead, it is more commonly associated with hyperthyroidism.
C. Addison's disease is a condition caused by inadequate production of cortisol and aldosterone by the adrenal glands. Symptoms include fatigue, weight loss, hyperpigmentation of the skin, and low blood pressure. Exophthalmos is not related to Addison's disease.
D. Graves' disease is an autoimmune hyperthyroid condition that leads to an overproduction of thyroid hormones. One of the hallmark symptoms of Graves' disease is exophthalmos or protruding eyes, caused by inflammation and swelling of the tissues around the eyes. This condition is directly associated with exophthalmos.

A. Methylprednisolone B. Enoxaparin C. Pantoprazole D. Ibuprofen

Correct Answer is C

Explanation

A. Methylprednisolone is a corticosteroid used to reduce inflammation and suppress the immune system. While corticosteroids are sometimes used in critical care settings, they are not specifically used to prevent stress ulcers. In fact, corticosteroids can increase the risk of gastrointestinal bleeding and may require additional measures to protect the stomach lining.
B. Enoxaparin is a low molecular weight heparin (LMWH) used primarily for the prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE). It works as an anticoagulant, preventing blood clots. While enoxaparin is important for preventing thromboembolic events in critically ill patients, it does not specifically address the prevention of stress ulcers.
C. Pantoprazole is a proton pump inhibitor (PPI) that reduces gastric acid production by inhibiting the proton pumps in the stomach lining. PPIs are commonly used to prevent and treat stress ulcers because they help decrease gastric acid secretion, thereby reducing the risk of ulcer formation and bleeding. This makes pantoprazole the appropriate medication to administer to prevent physiologic stress ulcers in a patient with sepsis on a ventilator.
D. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used for pain relief and inflammation. NSAIDs can actually increase the risk of gastrointestinal bleeding and ulceration, especially in critically ill patients.

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A nurse is assessing a client who has chronic kidney disease and notes that the client has small crystals on his forehead. The nurse understands that this manifestation is a result of an excess of which substance in the body?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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