Which of the following would the nurse expect to find when reviewing the laboratory test results of a client with renal failure?
Increased red blood cell count
Decreased serum potassium level
Increased serum creatinine level
Increased serum calcium level
The Correct Answer is C
Choice A reason: Renal failure impairs erythropoietin production, a hormone stimulating red blood cell synthesis, leading to anemia, not an increased red blood cell count. Reduced glomerular filtration exacerbates toxin accumulation, further suppressing bone marrow activity, making an elevated red blood cell count unlikely in this condition.
Choice B reason: In renal failure, kidneys fail to excrete potassium, leading to hyperkalemia, not decreased serum potassium. Hyperkalemia can cause cardiac arrhythmias due to altered membrane potentials. A decreased potassium level is more associated with conditions like diuretic use or vomiting, not renal failure.
Choice C reason: Increased serum creatinine is a hallmark of renal failure, as kidneys cannot filter creatinine, a muscle metabolism byproduct. Elevated levels reflect reduced glomerular filtration rate, indicating kidney dysfunction. This is a reliable marker for assessing renal failure severity and progression, making it an expected finding.
Choice D reason: Renal failure typically causes hypocalcemia, not increased serum calcium, due to impaired vitamin D activation and phosphate retention, which binds calcium. Hypercalcemia is rare and may occur in other conditions like hyperparathyroidism, not renal failure, where calcium homeostasis is disrupted by kidney dysfunction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Saying “I am not sure I follow you” seeks clarification, encouraging the patient to elaborate without dismissing their feelings. It fosters open communication, allowing the nurse to understand the patient’s concerns better, which supports therapeutic interaction and validates the patient’s emotional expression in a clinical setting.
Choice B reason: Noticing lip-biting acknowledges nonverbal cues, signaling the nurse’s attentiveness to the patient’s emotional state. This observation invites further discussion without judgment, promoting trust and validating the patient’s feelings, which is therapeutic and does not undermine or belittle their concerns in a mental health context.
Choice C reason: Stating “You appear tense” reflects observation of the patient’s emotional state, prompting exploration of underlying issues. It validates the patient’s feelings without dismissal, encouraging dialogue. This therapeutic approach supports emotional expression and does not belittle concerns, making it appropriate in a nurse-patient interaction.
Choice D reason: Saying “Everything will be alright” dismisses the patient’s concerns by offering false reassurance without addressing specific issues. This minimizes their emotional experience, potentially invalidating feelings and discouraging open communication, which can undermine trust and hinder therapeutic progress in managing mental health concerns.
Correct Answer is ["A","B","C"]
Explanation
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.
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