A client is preparing to have a fecal occult blood test (FOBT). What health teaching would the nurse include prior to the test?

"This test will determine whether you have colorectal cancer."

"This test can determine your genetic risk for developing colorectal cancer."

"You need to avoid red meat and NSAIDs for 48 hours before the test."

"You don't need to have this test because you can have a virtual colonoscopy."

Answer and Explanation

The Correct Answer is C

Choice A reason: The FOBT only detects the presence of blood in the stool; it is not diagnostic for cancer. While it is a screening tool for colorectal cancer, bleeding can be caused by many other conditions, such as hemorrhoids, ulcers, or inflammatory bowel disease. A positive result necessitates a follow-up colonoscopy for a definitive diagnosis.

Choice B reason: Fecal occult blood testing is a screening for active bleeding, not a genetic screen. Genetic risk for colorectal cancer is determined through blood tests that look for specific mutations, such as those found in Lynch syndrome or familial adenomatous polyposis (FAP), or through a thorough review of family history.

Choice C reason: Red meat contains animal hemoglobin, and NSAIDs (like aspirin or ibuprofen) can cause minor gastrointestinal irritation and bleeding. Both can lead to a false-positive result on a guaiac-based FOBT. Clients are instructed to avoid these for 48 to 72 hours before the test to ensure the accuracy of the screening.

Choice D reason: A virtual colonoscopy (CT colonography) is an alternative screening method, but it does not replace the need for routine non-invasive screening like the FOBT for many patients. Each screening modality has different indications and intervals. Suggesting the client forego the FOBT because of another test is inappropriate medical advice.

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Correct Answer is B

Explanation

Choice A reason: Hypernatremia refers to elevated serum sodium levels. Sodium polystyrene sulfonate is a cation-exchange resin that actually exchanges sodium ions for potassium ions in the intestine. Administering this medication would potentially increase sodium levels further, which would be contraindicated in a patient already suffering from hypernatremia.

Choice B reason: Hyperkalemia is a life-threatening complication of acute kidney injury due to the kidneys' inability to excrete excess potassium. Sodium polystyrene sulfonate works by binding potassium in the gastrointestinal tract in exchange for sodium, allowing the excess potassium to be excreted via the feces, thereby lowering serum potassium levels.

Choice C reason: Hypercalcemia is an elevation in serum calcium. This medication is not indicated for calcium imbalances. In the context of renal failure, patients are more likely to experience hypocalcemia due to impaired vitamin D activation and hyperphosphatemia, rather than hypercalcemia, which usually involves different pharmacological interventions like bisphosphonates.

Choice D reason: Hypomagnesemia is a low level of magnesium. Sodium polystyrene sulfonate is specifically designed to target potassium exchange. It does not provide a mechanism for increasing magnesium levels. Electrolyte replacement therapy, usually via magnesium sulfate, would be required to correct a magnesium deficiency in a clinical setting.

A. Hypocalcemia B. Dehydration C. Hypokalemia D. Hypernatremia

Correct Answer is A

Explanation

Choice A reason: Hypocalcemia is a classic finding in chronic kidney disease. As kidney function declines, the kidneys lose the ability to activate Vitamin D (calcitriol), which is necessary for intestinal calcium absorption. Additionally, the resulting hyperphosphatemia causes a reciprocal drop in serum calcium levels. This often leads to secondary hyperparathyroidism and renal osteodystrophy.

Choice B reason: While fluid status can fluctuate, CKD patients are more commonly prone to fluid volume excess rather than dehydration. The kidneys lose the ability to excrete water and sodium effectively, leading to edema, hypertension, and heart failure. Dehydration usually only occurs if the patient is over-diuresed or has excessive gastrointestinal losses that they cannot compensate for.

Choice C reason: Chronic kidney disease typically results in hyperkalemia, not hypokalemia. The kidneys are responsible for excreting 90% of the body's potassium. As the glomerular filtration rate (GFR) drops, potassium accumulates in the blood, posing a significant risk for cardiac dysrhythmias. Hypokalemia would be an unusual finding unless the patient is on specific wasting diuretics.

Choice D reason: While sodium levels can vary, "hypernatremia" is not the most definitive common finding. Often, sodium is retained, but water is retained proportionally or in excess, leading to dilutional hyponatremia or a normal serum sodium level despite an overall increase in total body sodium. Hypocalcemia remains a more consistent metabolic hallmark across the stages of CKD.

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A client is preparing to have a fecal occult blood test (FOBT). What health teaching would the nurse include prior to the test?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client in acute kidney injury (AKI). Which complication would most clearly warrant the administration of polystyrene sulfonate?

Correct Answer is B

Explanation

Which finding is common in a client who has chronic kidney disease (CKD)?

Correct Answer is A

Explanation

A client with chronic kidney disease (CKD) has an elevated serum phosphorus level. What drug would the nurse anticipate to be prescribed?

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