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 B

Explanation

A. The erythrocyte sedimentation rate (ESR) is a nonspecific marker of inflammation and is not used to assess the therapeutic effect of epoetin alfa.
B. The hematocrit (Hct) measures the proportion of red blood cells in the blood. Epoetin alfa stimulates the production of red blood cells, leading to an increase in hematocrit levels, indicating a therapeutic effect of the medication.
C. The leukocyte count measures the number of white blood cells in the blood and is not relevant for assessing the therapeutic effect of epoetin alfa.
D. The platelet count measures the number of platelets in the blood and is not relevant for assessing the therapeutic effect of epoetin alfa.

A. Bicarbonate excess B. Muscle weakness C. Kussmaul's respirations D. Circumoral paresthesia E. Dizziness

Correct Answer is ["B","D","E"]

Explanation

A. Bicarbonate excess is not a clinical manifestation but rather the underlying cause of metabolic alkalosis.
B. Metabolic alkalosis can lead to potassium depletion, which may cause muscle weakness.
C. Kussmaul's respirations, characterized by deep and labored breathing, are more commonly associated with metabolic acidosis, not alkalosis, as the body tries to compensate for acidemia by expelling more carbon dioxide through deep breaths.
D. Alkalosis can cause peripheral vasodilation and decreased calcium ionization, leading to circumoral and digital paresthesia.
E. Alkalosis can cause cerebral vasoconstriction and decreased cerebral perfusion, leading to dizziness.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

Correct Answer is B

Explanation

A nurse is caring for a client who has metabolic alkalosis. For which of the following clinical manifestations should the nurse monitor? (Select all that apply.)

Correct Answer is ["B","D","E"]

Explanation

A nurse is caring for a client who has a postoperative ileus and an NG tube that has drained 2,500 mL in the past 6 hr. Which of the following electrolyte imbalances should the nurse monitor the client for?

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 caring for a client who has severe preeclampsia and is receiving magnesium sulfate IV at 2 g/hr. Which of the following findings indicates that it is safe for the nurse to continue the infusion?

A nurse is planning care for a client who has hypernatremia. Which of the following IV solutions should the nurse plan to initiate?

A nurse is assessing a client who has end-stage kidney disease and is receiving hemodialysis. Which of the following findings should the nurse identify as an indication the client is experiencing fluid overload?

A nurse is reviewing the arterial blood gas values for a client. The pH is 7.32, PaCO, 48 mm Hg and the HCO, is 23 mEq/L. The nurse should recognize that these findings indicate of which of the following acid base balances?

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?

A nurse is discussing laboratory values associated with the renal system with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the values?