A nurse is reinforcing teaching about renal transplant with a newly licensed nurse. Which of the following clients should the nurse identify as having a contraindication for this procedure?

A client who has a pacemaker

A client who has a history of IV drug abuse

A client who has a body mass index (BMI) of 25

A client who is 65 years old

Answer and Explanation

The Correct Answer is B

A. A client who has a pacemaker: Having a pacemaker is not a contraindication for renal transplantation. As long as the patient is otherwise healthy and able to tolerate surgery, a pacemaker does not preclude the procedure.

B. A client who has a history of IV drug abuse: IV drug abuse is a contraindication for renal transplant due to the potential for poor compliance with post-transplant care and higher risk for recurrent infections and complications.

C. A client who has a body mass index (BMI) of 25: A BMI of 25 is within the normal to slightly overweight range. A BMI of 30 or higher may be a concern due to increased risks during surgery, but a BMI of 25 is not a contraindication.

D. A client who is 65 years old: Age alone is not a contraindication for a renal transplant. While younger patients may have better outcomes, transplants are performed on older patients if they are otherwise good candidates and able to tolerate the surgery and long-term immunosuppressive therapy.

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Correct Answer is C

Explanation

A. Elevate the head of the bed to 90 degrees: While elevating the head of the bed may help ease breathing, it does not address the potential issue of NG tube misplacement.

B. Administer a bronchodilator as prescribed: This would only be appropriate if the patient’s respiratory distress were related to bronchospasm or asthma, not NG tube displacement.

C. Check the placement of the NG tube to ensure it has not dislodged into the lungs. When a patient with an NG tube experiences respiratory distress, the tube may have dislodged and entered the respiratory tract, which could obstruct breathing. Verifying the placement of the NG tube is critical to preventing aspiration or further complications.

D. Increase the flow rate of the patient’s oxygen therapy: This may provide temporary relief but does not resolve the underlying cause of the distress if the NG tube has entered the respiratory tract.

A. Wear sleeveless or short-sleeved shirts and shorts to better visualize any skin issues. B. Use a floss pick instead of the floss string to floss in between the teeth. C. Apply an ice pack over a bleeding wound. D. Only use a soft-bristle toothbrush.

Correct Answer is D

Explanation

A. Wear sleeveless or short-sleeved shirts and shorts to better visualize any skin issues: While wearing loose or visible clothing may allow skin issues to be seen, it does not directly prevent bleeding complications, and there are more effective measures to focus on.

B. Use a floss pick instead of the floss string to floss in between the teeth: Flossing in any form, especially using a floss pick, can still increase the risk of gum bleeding in thrombocytopenic clients. It is safer to avoid flossing altogether or consult a dentist.

C. Apply an ice pack over a bleeding wound: While applying an ice pack may reduce bleeding once it occurs, it does not prevent bleeding. The focus should be on avoiding activities that increase the risk of bleeding.

D. Only use a soft-bristle toothbrush: Using a soft-bristle toothbrush helps reduce the risk of bleeding from the gums, which is a common issue for clients with thrombocytopenia due to the reduced platelet count.

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A nurse is reinforcing teaching about renal transplant with a newly licensed nurse. Which of the following clients should the nurse identify as having a contraindication for this procedure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with a nasogastric (NG) tube in place is experiencing respiratory distress. What is the most appropriate initial nursing intervention?

Correct Answer is C

Explanation

A nurse is reinforcing teaching with a client who has end-stage liver disease and a recent diagnosis of thrombocytopenia. Which of the following statements provides the best recommendation to prevent complications of bleeding?

Correct Answer is D

Explanation

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