The nurse preceptor is teaching the newly graduated nurse about the care and treatment of patients with Chronic Kidney Disease (CKD) who are on dialysis treatment. Which of the following statements is TRUE?

The CKD patient is likely to suffer from recurrent bouts of Diabetes Insipidus

The CKD patient's kidneys don't produce Erythropoietin, so they will receive shots to increase RBC production

The CKD patient is likely to be chronically hypokalemic

CKD patients will likely be chronically Hypercalcemic

Answer and Explanation

The Correct Answer is B

A.   Diabetes Insipidus is primarily related to issues with the production of vasopressin (ADH) or the body's response to it, which is not directly caused by CKD. CKD may lead to fluid retention and imbalances, but it does not typically cause recurrent bouts of diabetes insipidus.
B.   In CKD, the kidneys lose their ability to produce erythropoietin, a hormone that stimulates red blood cell production in the bone marrow. Patients often require erythropoiesis-stimulating agents (ESAs) like erythropoietin injections to manage anemia associated with CKD.
C.   CKD patients are often hyperkalemic (high potassium levels) rather than hypokalemic. As kidney function declines, the kidneys struggle to excrete potassium, leading to elevated levels, which can cause serious complications.
D.   CKD patients often experience hypocalcemia (low calcium levels) due to several factors, including decreased activation of vitamin D and imbalances in phosphate levels. While some patients may experience transient hypercalcemia due to treatments or dietary factors, chronic hypercalcemia is not typical in CKD.

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Correct Answer is ["A","C","D","E"]

Explanation

A. This term refers to the passage of fresh blood through the anus, usually indicating lower GI bleeding (such as from the colon or rectum). It is a common and significant sign of GI bleeding.
B. Hypertension (high blood pressure) is generally not a sign of GI bleeding. In fact, GI bleeding typically leads to hypotension (low blood pressure) due to volume loss, making this choice incorrect.
C. Tarry stool (melena) indicates the presence of digested blood in the stool, typically resulting from upper GI bleeding. It appears black and sticky and is a common sign of GI bleeding.
D. This refers to vomiting that looks like coffee grounds, which indicates that blood has been present in the stomach and has undergone digestion. This is a classic sign of upper GI bleeding and is a significant symptom.
E. Hematemesis is the vomiting of blood, which can be bright red or resemble coffee grounds, depending on the source and severity of the bleeding. It is a common and serious sign of GI bleeding, particularly from the upper GI tract.

A. The MTX will stop the pain but not the progression of your disease, so we also give you NSAIDS and steroids B. You have good insurance so we like to prescribe you a whole bunch of medications just in case C. The MTX helps treat the nausea associated with the other meds that actually treat your disease D. The MTX takes several weeks or months to reach full effect, so the other meds are started now to help your symptoms

Correct Answer is D

Explanation

A. Methotrexate (MTX) is a disease-modifying antirheumatic drug (DMARD) that helps slow disease progression but does not provide immediate pain relief. NSAIDs and steroids may be used for symptomatic relief, but MTX alone can manage both pain and disease progression over time.
B. This response is unprofessional and dismissive. It implies that the medication regimen is based solely on the patient's insurance coverage rather than their medical needs. It does not address the patient’s question and could undermine trust in the healthcare team.
C. Methotrexate does not primarily treat nausea; rather, it is used to manage rheumatoid arthritis. While some patients may experience nausea as a side effect of MTX or other medications, this is not its primary purpose.
D. Methotrexate is indeed a DMARD that can take weeks to months to show its full benefits in controlling inflammation and slowing disease progression. Meanwhile, NSAIDs or corticosteroids may be prescribed to provide quicker relief from symptoms such as pain and swelling.

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The nurse preceptor is teaching the newly graduated nurse about the care and treatment of patients with Chronic Kidney Disease (CKD) who are on dialysis treatment. Which of the following statements is TRUE?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following are common signs or symptoms of GI bleeding? (Select all that apply)

Correct Answer is ["A","C","D","E"]

Explanation

Your patient has just received a new diagnosis of Rheumatoid Arthritis. They are confused about their prescriptions, however. They ask you "Why am I receiving so many medications? I thought this 'MTX' drug was the one that would treat my arthritis?". What is your BEST response?

Correct Answer is D

Explanation

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