A nurse is caring for a client who has end-stage kidney disease (ESKD) and reports having shortness of breath and swelling in his lower extremities. Upon assessment, the nurse notes the client has crackles in his lungs and an elevated blood pressure. The nurse should suspect which of the following based on the client's manifestations?

Hyponatremia

Hyperkalemia

Hypovolemia

Hypervolemia

Answer and Explanation

The Correct Answer is D

A.   Hyponatremia is characterized by low sodium levels in the blood and is not typically associated with crackles in the lungs or elevated blood pressure.
B.   While hyperkalemia is a concern in end-stage kidney disease, it is not typically associated with crackles in the lungs or elevated blood pressure.
C.   Hypovolemia, or low blood volume, is not consistent with the client's reported symptoms of swelling in the lower extremities and crackles in the lungs.
D.   Hypervolemia, or fluid overload, is common in end-stage kidney disease and can manifest with symptoms such as shortness of breath, lower extremity edema, crackles in the lungs (due to pulmonary congestion), and elevated blood pressure.

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Correct Answer is B

Explanation

A. Increasing sodium intake is generally not recommended in chronic kidney disease, as it can exacerbate hypertension and fluid retention.
B. Epoetin alfa is a medication used to treat anemia associated with chronic kidney disease, and iron supplementation is often necessary to support erythropoiesis.
C. Potassium intake may need to be restricted in chronic kidney disease, especially in later stages when kidney function declines.
D. Protein intake may need to be adjusted in chronic kidney disease, but it's not directly related to the prescription of epoetin alfa.

A. Ondansetron B. Diphenhydramine C. Vancomycin D. Omeprazole

Correct Answer is C

Explanation

A. Ondansetron is an antiemetic commonly used to prevent nausea and vomiting, and it is not typically associated with nephrotoxicity.
B. Diphenhydramine is an antihistamine used for allergy symptoms and as a sleep aid. It is not known to cause nephrotoxicity.
C. Vancomycin is an antibiotic that can cause nephrotoxicity, especially when administered in high doses or in individuals with impaired renal function. Monitoring renal function is crucial when using vancomycin.
D. Omeprazole is a proton pump inhibitor used to reduce gastric acid secretion and treat conditions such as gastroesophageal reflux disease (GERD) and peptic ulcers. It is not associated with nephrotoxicity.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has chronic kidney disease and a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances?

Correct Answer is B

Explanation

A nurse is reviewing the medication record for a client who has chronic kidney disease. Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?

Correct Answer is C

Explanation

A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. Which of the following laboratory values should the nurse anticipate an elevation of?

A nurse is caring for a female client who has recurrent kidney stones and is scheduled for an intravenous pyelogram. Which of the following statements by the client should the nurse report to the provider?

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?

A nurse is assessing a client in the oliguric phase of acute kidney injury. Which of the following findings should the nurse expect?

A nurse is caring for a client who has end-stage renal disease (ESRD). Which of the following are expected findings? (Select all that apply).

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 a new diagnosis of hyperparathyroidism. The nurse should include in the teaching that the client is at risk for which of the following complications?