A nurse is assessing a client who has end-stage kidney disease. Which of the following findings should the nurse expect? (Select all that apply)

Anuria

Edema

Hyperkalemia

Hypocalcemia

Metabolic acidosis

Answer and Explanation

Correct Answer : A,B,C,D,E

Choice A reason: Anuria, minimal or no urine output, is expected in end-stage kidney disease (ESKD) due to nephron loss, reducing glomerular filtration rate. This causes fluid and toxin buildup, requiring dialysis to manage fluid balance and prevent complications like uremia in ESKD clients.
Choice B reason: Edema results from impaired sodium and water excretion in ESKD, causing fluid overload. Reduced filtration leads to volume retention, manifesting as peripheral or pulmonary edema, increasing cardiovascular strain and necessitating diuretics or dialysis to control fluid status effectively.
Choice C reason: Hyperkalemia occurs in ESKD, as failing kidneys cannot excrete potassium, elevating serum levels. This risks cardiac arrhythmias due to disrupted membrane potentials. Dietary restrictions or dialysis are needed to manage potassium, preventing life-threatening complications in end-stage renal failure.
Choice D reason: Hypocalcemia in ESKD stems from impaired vitamin D activation and phosphate retention, binding calcium. This disrupts bone mineralization and neuromuscular function, causing tetany or fractures. Calcium supplementation and dialysis correct this imbalance, addressing renal failure’s metabolic consequences.
Choice E reason: Metabolic acidosis in ESKD results from impaired hydrogen ion excretion and bicarbonate reabsorption. This lowers blood pH, causing fatigue and bone demineralization. Dialysis or bicarbonate therapy corrects acid-base imbalances, addressing the kidneys’ failure to maintain homeostasis in end-stage disease.

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Correct Answer is D

Explanation

Choice A reason: Maternal fever may cause fetal tachycardia, not bradycardia, as it increases metabolic demand. While fever can indicate infection, it does not directly lower FHR to 100/min, making it an incorrect cause for sustained fetal bradycardia in this scenario.
Choice B reason: Chorioamnionitis, an intrauterine infection, typically causes fetal tachycardia due to stress and inflammation, not bradycardia. While serious, it does not align with a sustained FHR of 100/min, making it incorrect for this fetal condition.
Choice C reason: Maternal hypoglycemia may cause fetal distress, but it is more likely to result in tachycardia or variable decelerations, not sustained bradycardia. Its impact on FHR is less direct, making it an incorrect primary cause for this finding.
Choice D reason: Fetal anemia reduces oxygen-carrying capacity, leading to sustained bradycardia (FHR <110/min) due to hypoxia. This condition, often from hemolytic disease or bleeding, directly causes low FHR, requiring urgent evaluation, making it the correct cause.

A. I cannot be a witness to your advance directives in writing. B. Your desire to have advance directives can be included in your medical record. C. Your name can be removed from your advance directives at any time. D. You must be at least 21 years old to complete advance directives.

Correct Answer is B

Explanation

Choice A reason: Nurses can witness advance directives in many settings, depending on state laws, so stating they cannot is inaccurate. This response dismisses the client’s request without providing guidance, making it incorrect and unhelpful for addressing their wishes.
Choice B reason: Including the client’s desire for advance directives in the medical record ensures their wishes are documented and respected. This aligns with the Patient Self-Determination Act, facilitating care planning, making it the correct and supportive response.
Choice C reason: Stating the client’s name can be removed from advance directives is confusing, as directives are personal and revocable, not about name removal. This response is inaccurate and irrelevant to the client’s request, making it incorrect.
Choice D reason: There is no universal age requirement of 21 for advance directives; competent adults (typically 18+) can create them. This statement is incorrect and restrictive, misinforming the client about their rights, making it inappropriate.

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A nurse is assessing a client who has end-stage kidney disease. Which of the following findings should the nurse expect? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is in active labor and notes the FHR baseline has been 100/min for the past 15 min. The nurse should identify which of the following conditions as a possible cause of fetal bradycardia?

Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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