A nurse is talking with a patient, and 5 minutes remain in the session. The patient has been silent for most of the session. Another patient comes to the door of the room, interrupts, and says, “I really need to talk to you right now.” The nurse should:

Say to the interrupting patient, “I am not available to talk with you at the present time”

End the unproductive session with the current patient and spend time with the patient who has just interrupted

Invite the interrupting patient to join in the session with the current patient

Tell the patient who interrupted, “This session will be 5 more minutes; then, I will talk with you”

Answer and Explanation

The Correct Answer is D

Choice A reason: Bluntly stating unavailability dismisses the interrupting patient’s needs without offering a solution, potentially escalating distress. This approach lacks therapeutic communication, as it fails to acknowledge the patient’s urgency or provide a clear plan, which is critical in maintaining trust in a mental health setting.

Choice B reason: Ending the current session prematurely disrespects the silent patient’s therapeutic process. Silence may reflect processing or discomfort, requiring time to build trust. Abruptly shifting focus undermines the current patient’s care, potentially worsening their mental health and disrupting the therapeutic relationship.

Choice C reason: Inviting the interrupting patient to join violates confidentiality and disrupts the current patient’s safe space. Combining sessions without consent breaches ethical principles, potentially causing discomfort or mistrust, which hinders therapeutic progress for both patients in a mental health context.

Choice D reason: Acknowledging the interruption and scheduling a follow-up in 5 minutes respects both patients’ needs. It maintains the current patient’s therapeutic time while addressing the interrupting patient’s urgency, ensuring fairness and trust. This approach upholds ethical care and supports a therapeutic environment for mental health treatment.

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Correct Answer is C

Explanation

Choice A reason: Renal failure impairs erythropoietin production, a hormone stimulating red blood cell synthesis, leading to anemia, not an increased red blood cell count. Reduced glomerular filtration exacerbates toxin accumulation, further suppressing bone marrow activity, making an elevated red blood cell count unlikely in this condition.

Choice B reason: In renal failure, kidneys fail to excrete potassium, leading to hyperkalemia, not decreased serum potassium. Hyperkalemia can cause cardiac arrhythmias due to altered membrane potentials. A decreased potassium level is more associated with conditions like diuretic use or vomiting, not renal failure.

Choice C reason: Increased serum creatinine is a hallmark of renal failure, as kidneys cannot filter creatinine, a muscle metabolism byproduct. Elevated levels reflect reduced glomerular filtration rate, indicating kidney dysfunction. This is a reliable marker for assessing renal failure severity and progression, making it an expected finding.

Choice D reason: Renal failure typically causes hypocalcemia, not increased serum calcium, due to impaired vitamin D activation and phosphate retention, which binds calcium. Hypercalcemia is rare and may occur in other conditions like hyperparathyroidism, not renal failure, where calcium homeostasis is disrupted by kidney dysfunction.

A. Increased potassium intake B. Increased protein intake C. Decreased phosphorus intake D. Decreased calcium intake/supplementation

Correct Answer is C

Explanation

Choice A reason: Increased potassium intake is dangerous in ESRD, as impaired kidneys cannot excrete potassium, leading to hyperkalemia. This can disrupt cardiac membrane potentials, causing arrhythmias or cardiac arrest. ESRD diets require strict potassium restriction to prevent life-threatening electrolyte imbalances, making this modification inappropriate.

Choice B reason: Increased protein intake is often recommended in ESRD patients on hemodialysis to replace protein lost during dialysis and prevent malnutrition. However, it must be balanced to avoid excess urea production, which can worsen uremia. This is not the primary focus compared to phosphorus management in this context.

Choice C reason: Decreased phosphorus intake is critical in ESRD, as kidneys cannot excrete phosphate, leading to hyperphosphatemia. This causes vascular calcification and secondary hyperparathyroidism, increasing cardiovascular risk. Dietary phosphorus restriction, often with phosphate binders, prevents these complications, making it a key dietary modification for hemodialysis patients.

Choice D reason: Decreased calcium intake is not recommended in ESRD, as patients often have hypocalcemia due to impaired vitamin D activation and phosphate retention. Calcium supplementation or adequate intake is needed to prevent bone disease and secondary hyperparathyroidism, making this modification incorrect for ESRD management.

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A nurse is talking with a patient, and 5 minutes remain in the session. The patient has been silent for most of the session. Another patient comes to the door of the room, interrupts, and says, “I really need to talk to you right now.” The nurse should:

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Naxlex Comprehensive Predictor Exams

Which of the following would the nurse expect to find when reviewing the laboratory test results of a client with renal failure?

Correct Answer is C

Explanation

A client with end-stage kidney disease is scheduled to begin hemodialysis. The nurse is working with the client to adapt the client’s diet to maximize the therapeutic effect and minimize the risks of complications. The client’s diet should include which of the following modifications?

Correct Answer is C

Explanation

A nurse is talking with a patient, and 5 minutes remain in the session. The patient has been silent for most of the session. Another patient comes to the door of the room, interrupts, and says, “I really need to talk to you right now.” The nurse should:

The nurse is sitting down with a client to begin a conversation. Which position will the nurse take to convey acceptance of the client?

The nurse is caring for a client who is in the oliguric phase of acute kidney injury (AKI). During this phase of AKI, the nurse might anticipate which of the following findings?

The physician orders mefoxin (Cefoxitin) 800 mg IV Q 8 hours. To reconstitute the medications the instructions state to add 7.5 mL of NSS for a total of 8 mL with each mL containing 250 mg. How many millilitres will be given?

When is a nurse legally obligated to breach confidentiality?

The nurse is receiving the morning report on four clients on a medical-surgical unit. Based on the information provided, which clients are at greatest risk for developing end-stage renal disease (ESRD)? (Select all that apply)

A nurse is reviewing an electronic medical record to determine if a client’s rights have been violated by another member of the healthcare team. Which finding will the nurse identify that would indicate a violation of the client’s rights?