A nurse is evaluating a client who has chronic kidney disease (CKD) and is receiving hemodialysis.
Which finding indicates that the client's nutritional status is improving?
The client's serum albumin level is 4.0 g/dL.
The client's blood urea nitrogen (BUN) level is 60 mg/dL.
The client's body weight is 2 kg higher than the dry weight.
The client's serum creatinine level is 3.0 mg/dL.
The Correct Answer is A
The client's serum albumin level is 4.0 g/dL.
Rationale: A serum albumin level of 4.0 g/dL indicates that the client's nutritional status is improving, as albumin is a protein that reflects the client's protein intake and nutritional status. The normal range for serum albumin levels is 3.5 to 5.0 g/dL.
Incorrect options:
B) The client's blood urea nitrogen (BUN) level is 60 mg/dL. - This finding indicates that the client's nutritional status is worsening, as BUN is a waste product of protein metabolism that accumulates in the blood due to impaired renal function. A high BUN level can indicate excessive protein intake or inadequate dialysis. The normal range for BUN levels is 10 to 20 mg/dL.
C) The client's body weight is 2 kg higher than the dry weight. - This finding indicates that the client has fluid retention, not improved nutritional status. Dry weight is the weight of the client after dialysis, when all excess fluid has been removed. A weight gain of more than 1 kg above the dry weight can indicate inadequate fluid restriction or dialysis.
D) The client's serum creatinine level is 3.0 mg/dL. - This finding indicates that the client has impaired renal function, not improved nutritional status. Creatinine is a waste product of muscle metabolism that accumulates in the blood due to reduced glomerular filtration rate (GFR). A high creatinine level can indicate decreased muscle mass or inadequate dialysis. The normal range for serum creatinine levels is 0.6 to 1.2 mg/dL.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
"I will quit smoking as soon as possible."
Rationale: Quitting smoking is a lifestyle modification that can lower blood pressure, as smoking causes vasoconstriction and increases cardiac workload and oxygen demand.
Incorrect options:
A) "I will limit my sodium intake to 4 grams per day." - This statement indicates a need for further teaching, as limiting sodium intake to 4 grams per day is not sufficient for someone with hypertension. The recommended daily sodium intake for individuals with hypertension is generally lower, around 1,500-2,300 milligrams (mg).
B) "I will drink no more than two cups of coffee per day." - While limiting caffeine intake is generally recommended for individuals with hypertension, this statement does not address other lifestyle modifications specifically related to blood pressure.
C) "I will exercise for at least 30 minutes three times per week." - Regular exercise is beneficial for overall health, but the frequency and duration mentioned in this statement may not be sufficient for effectively lowering blood pressure. The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity exercise per week for individuals with hypertension.
Correct Answer is B
Explanation
Serum potassium level of 6.5 mEq/L
Rationale: A serum potassium level of 6.5 mEq/L indicates hyperkalemia, which is a potential complication of DKA due to insulin deficiency, acidosis, and dehydration. Hyperkalemia can cause cardiac dysrhythmias, muscle weakness, and paresthesia.
Incorrect options:
A) Blood glucose level of 350 mg/dL - This is an expected finding for a client who has DKA, as insulin deficiency leads to hyperglycemia and glycosuria. The goal of treatment for DKA is to lower blood glucose levels gradually to prevent cerebral edema.
C) Arterial blood pH of 7.25 - This is an expected finding for a client who has DKA, as insulin deficiency leads to increased breakdown of fatty acids and production of ketones, resulting in metabolic acidosis. The normal range for arterial blood pH is 7.35 to 7.45.
D) Serum bicarbonate level of 18 mEq/L - This is an expected finding for a client who has DKA, as metabolic acidosis causes a decrease in serum bicarbonate levels due to buffering mechanisms. The normal range for serum bicarbonate levels is 22 to 26 mEq/L.
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