A patient with chronic kidney disease usually has a decrease in the ability to activate vitamin D, likely resulting in signs and symptoms (S&S) such as:
Hypercalcemia: increased absorption of calcium from the gut into the blood.
A positive Chvostek’s sign: hypocalcemia.
Tetany: hyperpolarization.
Hyperphosphatemia: inability to absorb phosphate from the gut into the blood.
The Correct Answer is B
Choice A rationale
Hypercalcemia is characterized by increased calcium levels in the blood, often due to increased absorption of calcium from the gut. However, in chronic kidney disease (CKD), the kidneys’ ability to activate vitamin D is impaired, leading to decreased calcium absorption from the gut, not increased. Therefore, hypercalcemia is not a typical sign of CKD1.
Choice B rationale
A positive Chvostek’s sign is indicative of hypocalcemia, which is a common symptom in CKD. The kidneys’ reduced ability to activate vitamin D leads to decreased calcium absorption from the gut, resulting in low calcium levels in the blood. This hypocalcemia can cause neuromuscular irritability, leading to a positive Chvostek’s sign.
Choice C rationale
Tetany is a condition characterized by muscle cramps and spasms, often due to hypocalcemia. In CKD, hypocalcemia occurs due to the kidneys’ inability to activate vitamin D, leading to decreased calcium absorption from the gut. This hypocalcemia can cause hyperexcitability of nerves and muscles, resulting in tetany.
Choice D rationale
Hyperphosphatemia is characterized by high phosphate levels in the blood. In CKD, the kidneys’ ability to excrete phosphate is impaired, leading to its accumulation in the blood. However, this is not directly related to the inability to absorb phosphate from the gut but rather the kidneys’ reduced excretion capacity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
A temperature of 38°C (100.4°F) and a stiff neck are classic signs of meningitis, indicating inflammation of the meninges.
Choice B rationale
Myocardial infarction typically presents with chest pain, not a stiff neck.
Choice C rationale
Appendicitis presents with abdominal pain, not a stiff neck.
Choice D rationale
Pneumonia presents with respiratory symptoms, not a stiff neck.
Correct Answer is A
Explanation
Choice A rationale
Serum amylase is typically elevated in acute pancreatitis. It is one of the key diagnostic markers for this condition.
Choice B rationale
Serum potassium levels are not typically elevated in acute pancreatitis. Potassium levels are more commonly associated with kidney function and electrolyte balance.
Choice C rationale
Serum calcium levels are usually decreased, not elevated, in acute pancreatitis. Hypocalcemia can occur due to fat saponification in the pancreas.
Choice D rationale
Serum sodium levels are not typically elevated in acute pancreatitis. Sodium levels are more related to overall fluid balance and kidney function.
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