A 58-yr-old male patient who is diagnosed with nephrotic syndrome has ascites and 4+ leg edema. Which patient problem is present, based on these findings?
inadequate nutrition
Poor perfusion
Activity intolerance
Excess fluid volume
The Correct Answer is D
A. Inadequate nutrition: Clients with nephrotic syndrome can experience protein loss in the urine leading to malnutrition, but the presence of ascites and 4+ leg edema directly indicates fluid retention rather than poor nutrition alone.
B. Poor perfusion: Poor perfusion is associated with signs such as hypotension, weak pulses, or cool extremities. While edema can impair tissue oxygenation to some extent, the primary problem here is not circulatory perfusion but excessive fluid accumulation.
C. Activity intolerance: Activity intolerance may develop secondarily due to discomfort from edema and ascites, but it is not the central issue reflected in the assessment findings. The immediate problem is fluid overload causing the visible physical changes.
D. Excess fluid volume: The hallmark signs of nephrotic syndrome include severe edema and ascites caused by low serum albumin and fluid shifting into interstitial spaces. These findings clearly demonstrate fluid retention, making excess fluid volume the primary patient problem.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Breast cancer survivor for 8 years: A history of cancer may be a concern, but most transplant programs require 2–5 years of remission before eligibility. Being cancer-free for 8 years would not be a contraindication.
B. Alcohol use disorder: Active substance abuse is a contraindication because it increases the risk of poor medication adherence, post-transplant complications, and graft failure. Patients must demonstrate sobriety before being considered.
C. 65-years of age: Older age alone is not a contraindication. Many transplant centers accept patients in their 60s and even 70s, as long as they are otherwise healthy and suitable candidates for surgery.
D. Pacemaker: The presence of a pacemaker is not a contraindication to transplantation. It is compatible with surgery and long-term management, provided cardiac function is stable.
Correct Answer is D
Explanation
A. Blood pressure 98/56 mm Hg: A slightly low blood pressure is not a contraindication to epoetin alfa administration. The major concern with this medication is hypertension, not hypotension, so this finding would not prevent giving the dose.
B. Creatinine 1.6 mg/dL: Elevated creatinine is expected in end-stage kidney disease and does not affect the decision to administer epoetin alfa. This medication is used specifically to manage anemia related to chronic kidney disease.
C. Oxygen saturation 89%: A low oxygen saturation reflects hypoxemia, but epoetin alfa does not treat oxygenation problems directly. Supplemental oxygen and pulmonary assessment would be the priority, but this finding is not a contraindication to giving the drug.
D. Hemoglobin level 13 g/dL: Epoetin alfa stimulates red blood cell production, and giving it when hemoglobin is already elevated increases the risk of serious adverse effects such as thrombosis, stroke, and hypertension. Reporting this value is essential drug administration.
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