Which laboratory results should the nurse closely monitor in a client who has end-stage renal disease (ESRD.?
Blood pressure, heart rate, and temperature.
Leukocytes, neutrophils, and thyroxine.
Serum potassium, calcium, and phosphorus.
Erythrocytes, hemoglobin, and hematocrit.
The Correct Answer is C
Choice C is correct because serum potassium, calcium, and phosphorus are electrolytes that can be affected by ESRD. ESRD is a condition in which the kidneys lose their ability to filter waste products and excess fluids from the blood. This can cause electrolyte imbalances that can lead to serious complications, such as cardiac arrhythmias, bone disorders, or metabolic acidosis. The nurse should closely monitor these electrolytes and report any abnormal values.
Choice A is incorrect because blood pressure, heart rate, and temperature are vital signs that are not specific to ESRD. Vital signs can be influenced by many factors and may not reflect the severity of kidney damage. The nurse should monitor vital signs regularly, but not as closely as electrolytes.
Choice B is incorrect because leukocytes, neutrophils, and thyroxine are not laboratory results that are directly related to ESRD. Leukocytes and neutrophils are types of white blood cells that are involved in immune response and inflammation. Thyroxine is a hormone that regulates metabolism and growth. These laboratory results may be altered by other conditions or medications, but not by ESRD.
Choice D is incorrect because erythrocytes, hemoglobin, and hematocrit are laboratory results that measure the red blood cell count and oxygen-carrying capacity of the blood. These laboratory results may be decreased in ESRD due to anemia, which is a common complication of chronic kidney disease. However, anemia is not as life-threatening as electrolyte imbalances and can be treated with erythropoietin injections or iron supplements.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A is correct because a quiet, non-stimulating environment can help reduce the agitation, confusion, and hallucinations that are common in alcohol withdrawal delirium. The nurse should also provide reassurance, orientation, and safety measures to the client.
Choice B is incorrect because forcing oral fluids and providing frequent small meals are not the most important interventions for a client with alcohol withdrawal delirium. The client may have difficulty swallowing, nausea, vomiting, or diarrhea that can interfere with oral intake. The nurse should monitor the client's hydration and nutrition status and provide intravenous fluids or supplements as needed.
Choice C is incorrect because confronting the client's denial of substance abuse is not the most important intervention for a client with alcohol withdrawal delirium. The client may not be able to comprehend or accept the reality of their situation due to their altered mental state. The nurse should avoid arguing or challenging the client and focus on providing supportive care.
Choice D is incorrect because encouraging attendance and group participation are not the most important interventions for a client with alcohol withdrawal delirium. The client may not be able to participate in group activities due to their severe withdrawal symptoms and may need individualized care. The nurse should facilitate referrals to appropriate resources for substance abuse treatment when the client is stable and ready.
Correct Answer is A
Explanation
Choice A: This hernia is a normal variation that resolves without treatment is a correct explanation for the nurse to provide, as this refers to an umbilical hernia, which is a common and harmless condition in infants that usually disappears by age 2. Therefore, this is the correct choice.
Choice B: An abdominal binder can be worn daily to reduce the protrusion is not an appropriate explanation for the nurse to provide, as this is not an effective or recommended method to treat a hernia. This is a distractor choice.
Choice C: Restrictive clothing will be adequate to help the hernia go away is not a relevant explanation for the nurse to provide, as this does not affect the hernia or its resolution. This is another distractor choice.
Choice D: The quarter should be secured with an elastic bandage wrap is not a sensible explanation for the nurse to provide, as this is a folk remedy that has no scientific basis and can cause skin irritation and infection. This is another distractor choice.
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