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 A

Explanation

A. Lethargy is a common symptom of hypothyroidism due to decreased metabolic rate and energy levels.
B. Photophobia is not typically associated with hypothyroidism.
C. Weight gain is more common in hypothyroidism due to slowed metabolism, rather than weight loss.
D. Exophthalmos is a characteristic feature of hyperthyroidism, not hypothyroidism.

A. Place the child on a low-sodium diet. B. Monitor the child for fluid volume excess. C. Discuss the manifestations of hyperglycemia with the parents. D. Teach the parents about cortical replacement therapy.

Correct Answer is D

Explanation

A. Placing the child on a low-sodium diet is not a priority action for managing Addison's disease. Sodium restriction may be necessary in some cases, but it's not the primary intervention.
B. Monitoring the child for fluid volume excess is not directly related to managing Addison's disease. Addison's disease often leads to hypovolemia due to decreased aldosterone secretion.
C. Discussing manifestations of hyperglycemia may not be directly relevant to Addison's disease, which primarily affects cortisol and aldosterone levels, not glucose metabolism.
D. Teaching the parents about cortical replacement therapy is crucial. Addison's disease results from adrenal insufficiency, and cortical replacement therapy, typically with glucocorticoids and mineralocorticoids, is the mainstay of treatment.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has hypothyroidism. Which of the following findings should the nurse expect?

Correct Answer is A

Explanation

A nurse is caring for a child who has Addison's disease. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123 mEq/L. Which of the following prescriptions should the nurse anticipate?

A nurse is reviewing the laboratory results for four clients. The nurse should recognize which of the following clients has a manifestation of hypoparathyroidism?

A nurse is caring for a client who has nephrotic syndrome and is receiving high-dose corticosteroid therapy. For which of the following electrolyte imbalances should the nurse monitor?

A nurse is assessing a client who is admitted for elective surgery and has a history of Addison's disease. Which of the following findings should the nurse expect?

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.)

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?