The nurse is caring for a client with chronic kidney disease (CKD). Which meal selection should the nurse recommend to the client?
Chicken, yams, pinto beans and pecans.
Steak and baked potato with butter and cheese topping.
Canned ham and green beans.
Pasta with fish and an orange.
The Correct Answer is D
A. Chicken, yams, pinto beans, and pecans: This meal is not ideal for a client with CKD because pinto beans and pecans are high in potassium and phosphorus, which can be problematic for clients with CKD. Yams are also high in potassium.
B. Steak and baked potato with butter and cheese topping: Steak is high in protein and phosphorus, which can overload the kidneys. Baked potato, especially with cheese, can be high in potassium, which should be monitored in CKD.
C. Canned ham and green beans: Canned ham is often high in sodium, which is not recommended for clients with CKD, as it can exacerbate fluid retention and high blood pressure. Green beans are a good choice, but the sodium content in the ham is a concern.
D. Pasta with fish and an orange: Pasta is low in potassium and phosphorus, and fish provides a good source of protein that is generally easier on the kidneys compared to red meat. This meal is lower in sodium, phosphorus, and potassium, making it a better choice for CKD.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Morphine: Morphine is used to relieve chest pain and anxiety in acute coronary syndromes. It acts as a vasodilator and analgesic, and there are no direct contraindications with recent sildenafil use, although blood pressure should still be monitored.
B. Nitroglycerin: Nitroglycerin is absolutely contraindicated in clients who have taken sildenafil within the past 24–48 hours. Both drugs are vasodilators, and their combination can lead to severe, life-threatening hypotension due to additive effects on vascular smooth muscle relaxation.
C. Aspirin: Aspirin is recommended in acute chest pain cases as it reduces platelet aggregation and helps prevent clot extension. It has no interaction with sildenafil and should not be withheld when myocardial ischemia is suspected.
D. Heparin: Heparin is an anticoagulant used in suspected myocardial infarction to prevent further clot formation. It does not have any adverse interactions with sildenafil and remains safe and beneficial in this context.
Correct Answer is B
Explanation
A. Recommend substituting opioids with other pain medication: Simply switching to another pain medication without addressing underlying misuse behaviors may reinforce dependency. This overlooks the denial and psychological aspects of addiction.
B. Explore other coping strategies aside from using medications: This client-centered approach gently addresses the issue without direct confrontation. It encourages self-reflection, promotes healthy alternatives, and meets the client where they are in terms of readiness for change, which is essential in early recovery.
C. Provide a list of local Narcotics Anonymous meetings: Although this is useful, offering it during the first interaction with a client in denial may lead to resistance. Engagement and trust-building through conversation about alternatives are more effective initially.
D. Explain that opioid abuse poses a great risk to life: Providing factual information about risk can be helpful, but directly labeling it as abuse when the client is in denial may trigger defensiveness. It is more therapeutic to explore behaviors and build insight before confrontation.
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