A nurse is caring for a client who has chronic kidney disease (CKD) and states she has heartburn.

The provider prescribes aluminum hydroxide. The client asks, "Why can't I just take the antacid magaldrate my husband has at home?" The nurse explains to the client that aluminum hydroxide is the preferred antacid because it lowers which of the following?

Serum magnesium levels

Serum phosphorus levels

Serum potassium levels

Serum calcium levels

Answer and Explanation

The Correct Answer is B

A.   Aluminum hydroxide can lead to increased serum magnesium levels, but this is not the reason for its preference in chronic kidney disease.
B.   Aluminum hydroxide is preferred because it binds to dietary phosphate, reducing serum phosphorus levels in patients with chronic kidney disease who are prone to hyperphosphatemia.
C.   Aluminum hydroxide does not significantly affect serum potassium levels.
D.   Aluminum hydroxide can lead to decreased serum calcium levels due to binding, but this is not the primary reason for its preference in chronic kidney disease.

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Correct Answer is D

Explanation

A. Furosemide use is more commonly associated with hyponatremia rather than hypernatremia due to its diuretic effect.
B. Furosemide does not typically cause hypercalcemia; instead, it may lead to hypocalcemia.
C. Hyperchloremia is not a primary concern with furosemide, as the drug can cause a loss of chloride ions alongside sodium.
D. Furosemide can cause an increase in uric acid levels by reducing its excretion through the kidneys.

A. Obtain a prescription for insulin for the client. B. Have the client breath into a paper bag. C. Place the client on continuous cardiac monitoring, D. Plan to administer sodium bicarbonate to the client.

Correct Answer is C

Explanation

A. Insulin administration is not indicated for metabolic alkalosis.
B. Breathing into a paper bag is a treatment for respiratory alkalosis, not metabolic alkalosis.
C. Metabolic alkalosis can lead to cardiac dysrhythmias due to electrolyte imbalances, particularly hypokalemia. Continuous cardiac monitoring is essential to promptly identify and manage any dysrhythmias that may occur.
D. Administering sodium bicarbonate would exacerbate metabolic alkalosis and is not indicated.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has heart failure and is receiving IV furosemide. The nurse should monitor the client for which of the following electrolyte imbalances?

Correct Answer is D

Explanation

A nurse is caring for a client who has metabolic alkalosis. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?

A nurse is caring for a client who has polycystic kidney disease (PKD). Which of the following findings should the nurse expect?

A nurse is caring for a client who has respiratory alkalosis and is hyperventilating Which of the following actions should the nurse take?

A nurse is reviewing the BUN and creatinine levels of an older adult client who has chronic kidney disease. The nurse should expect which of the following findings?

A nurse is teaching a client who has acute kidney injury about the oliguric phase. Which of the following information should the nurse include in the teaching?

A nurse is caring for a client who had total thyroidectomy and a serum calcium level of 7.6 mg/dL. Which of the following findings should the nurse expect?

A nurse is discussing kidney transplant with a client who has end-stage renal disease (ESRD). Which of the following should the nurse identify as a contraindication for this treatment?