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 70-year-old client with a BMI of 30 and a history of hypertension

A 64-year-old client with a history of vascular disorders

A 50-year-old client with poorly controlled diabetes mellitus

A 60-year-old client with chronic obstructive pulmonary disease

A 60-year-old client with a recent episode of dehydration due to gastroenteritis

Answer and Explanation

Correct Answer : A,B,C

Choice A reason: Hypertension and obesity (BMI 30) are major risk factors for ESRD. Chronic hypertension damages renal vasculature, reducing glomerular filtration over time. Obesity exacerbates hypertension and promotes glomerulosclerosis, leading to progressive kidney damage. This combination significantly increases the risk of developing ESRD through sustained renal injury.

Choice B reason: Vascular disorders, such as atherosclerosis, impair renal blood flow, causing ischemic nephropathy. Chronic reduced perfusion damages nephrons, leading to progressive renal failure. Vascular diseases also contribute to hypertension, further stressing kidneys. This client’s history indicates a high risk for ESRD due to ongoing vascular compromise affecting renal function.

Choice C reason: Poorly controlled diabetes mellitus causes diabetic nephropathy, a leading cause of ESRD. Chronic hyperglycemia damages glomerular capillaries, leading to proteinuria and declining kidney function. Sustained high glucose levels accelerate nephron loss, making this client at high risk for ESRD due to irreversible renal damage from diabetes.

Choice D reason: Chronic obstructive pulmonary disease (COPD) primarily affects the lungs, not the kidneys. While hypoxia or medications like corticosteroids may indirectly stress kidneys, COPD is not a direct risk factor for ESRD. Renal damage requires specific insults like hypertension or diabetes, making this client less likely to develop ESRD.

Choice E reason: A recent dehydration episode from gastroenteritis can cause acute kidney injury but is reversible with treatment. It is not a chronic condition leading to ESRD unless recurrent or combined with other risk factors like diabetes or hypertension. This isolated event poses a lower risk for ESRD development.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A reason: Allowing a client with suicidal comments to leave against medical advice is unsafe, as it risks self-harm without immediate intervention. Providing resources does not address acute suicide risk, which requires inpatient stabilization to ensure safety, making this action inappropriate in the context of expressed suicidal ideation.

Choice B reason: Contacting family to persuade the client to stay does not address immediate suicide risk. While family support may be helpful, it lacks legal authority to prevent discharge and does not ensure safety, making it less effective than initiating a commitment for a client with suicidal intent.

Choice C reason: A 302 involuntary commitment is appropriate for a client expressing suicidal ideation, indicating imminent danger to self. This legal action ensures safety through inpatient evaluation and treatment, preventing self-harm. Mental health laws prioritize protection in such cases, making this the most appropriate nursing action.

Choice D reason: Calling security to detain the client is coercive and lacks legal basis without a formal commitment process. It may escalate agitation and violate autonomy. A 302 commitment is the proper legal mechanism to ensure safety for a suicidal client, making detention by security inappropriate.

A. Supporting neighborhood watch programs B. Taking meals at the food bank C. Participation in treatment D. Safe living environment

Correct Answer is C

Explanation

Choice A reason: Neighborhood watch programs enhance community safety but do not directly address mental health needs. They lack therapeutic components to manage symptoms or prevent decompensation, which are critical for preventing readmission in clients with mental health disorders, making this factor less relevant to sustained community stability.

Choice B reason: Taking meals at a food bank addresses nutritional needs but does not directly support mental health stability. While nutrition is important, it does not provide the therapeutic interventions or coping strategies needed to manage mental health disorders and prevent relapse or hospital readmission.

Choice C reason: Participation in treatment, such as therapy or medication adherence, directly addresses mental health symptoms, improving coping skills and emotional regulation. Consistent treatment reduces relapse risk, enhances stability, and supports community integration, making it the most effective factor for preventing readmission in clients with mental health disorders.

Choice D reason: A safe living environment reduces stress and safety risks but is secondary to active treatment. Without ongoing therapy or medication, environmental safety alone cannot manage symptoms or prevent decompensation, making it less critical than treatment participation for maintaining community stability and avoiding readmission.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

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)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A nurse is planning the discharge of a client with a mental health disorder. Which factor does the nurse identify as the best chance for the client to remain in the community without readmission?

Correct Answer is C

Explanation

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 client has used defensive communicating with the nurse today. Which can be a positive outcome from the use of defense mechanisms?

A novice nurse is beginning work on a behavioral health unit and states to the preceptor, “What if I encounter a client who is sexually aggressive?” Which is the appropriate response by the preceptor?

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 client states, “I understand that in order to leave, I must sign a request to withdraw from treatment.” What is the client’s legal status?

A nurse and client are engaged in a discussion. The client says, “I feel really close to you. You are my only true friend.” Which response by the nurse would be most therapeutic?