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

Answer and Explanation

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.

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Correct Answer is B

Explanation

Choice A reason: Violating a nurse’s boundaries, such as inappropriate behavior, does not legally mandate breaching confidentiality. Ethical responses involve setting boundaries or reporting within the care team, but confidentiality is protected unless harm to others is threatened, making this situation insufficient for a legal breach.

Choice B reason: Nurses are legally obligated to breach confidentiality when a client makes credible threats to harm an identifiable third party (Tarasoff duty). This protects potential victims by ensuring warnings or interventions occur, balancing patient confidentiality with public safety, as harm prevention takes precedence in mental health law.

Choice C reason: Client aggression does not automatically warrant breaching confidentiality unless it involves specific threats to identifiable individuals. Aggression is managed within the care setting, and confidentiality is maintained unless legal criteria, like imminent harm to others, are met, making this option incorrect.

Choice D reason: Disagreement with the nurse does not justify breaching confidentiality. Ethical care respects client autonomy, and confidentiality is protected unless legal exceptions, like threats or court orders, apply. Disagreement is managed through therapeutic communication, not by disclosing private information, making this an invalid reason for breach.

A. Be coerced to accept treatment B. Have the client’s family petition for a 302 as they recently witnessed the client’s behavior C. Continue to refuse treatment D. Be committed by their doctor involuntarily to receive needed treatment

Correct Answer is C

Explanation

Choice A reason: Coercing treatment violates the voluntary client’s autonomy. Legally, voluntary patients can refuse medication unless they pose imminent danger, requiring involuntary commitment. Manipulation or disruption does not meet legal criteria for forced treatment, as mental health laws prioritize patient rights absent clear harm risks.

Choice B reason: A 302 (involuntary commitment) requires evidence of imminent danger to self or others, not just disruptive behavior. Family petitions cannot override this legal threshold without clinical justification, and manipulation alone does not qualify, making this option incorrect for enforcing treatment in a voluntary client.

Choice C reason: As a voluntary client, the individual retains the right to refuse treatment unless deemed a danger to self or others. Mental health laws protect autonomy, and manipulation or lack of progress does not justify forced medication, making refusal a legal right in this scenario.

Choice D reason: Involuntary commitment by a doctor requires evidence of imminent danger or inability to care for oneself, not just disruptive behavior or nonadherence. Without such criteria, the client’s voluntary status protects their right to refuse, making involuntary commitment legally inappropriate in this situation.

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Which of the following would the nurse expect to find when reviewing the laboratory test results of a client with renal failure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When is a nurse legally obligated to breach confidentiality?

Correct Answer is B

Explanation

Correct Answer is C

Explanation

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