A client who has chronic renal failure and has been on dialysis for 2 years has been wondering why he is anemic. The nurse explains that anemia accompanies chronic renal failure because of:

Inadequate retention of serum sodium (Na).

Inadequate production of erythropoietin.

Blood loss in the urine.

Renal desensitization to Vitamin D.

Answer and Explanation

The Correct Answer is B

Choice A reason: Inadequate retention of serum sodium is not typically associated with anemia in chronic renal failure.

Choice B reason: Inadequate production of erythropoietin is the correct answer because the kidneys produce erythropoietin, which stimulates the bone marrow to produce red blood cells. In chronic renal failure, the kidneys cannot produce enough erythropoietin, leading to anemia.

Choice C reason: While blood loss in the urine can occur, it is not the primary cause of anemia in chronic renal failure.

Choice D reason: Renal desensitization to Vitamin D aﬀects bone health and calcium levels but is not the primary cause of anemia in chronic renal failure.

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Correct Answer is C

Explanation

Choice A reason: While it is important to address any questions the patient may have, it is not the highest priority before an IVP procedure.

Choice B reason: Asking the patient to void before the procedure is a standard practice, but it is not the highest priority. The bladder should be empty to allow for clear imaging, but this can be managed at the time of the procedure.

Choice C reason: Checking for an allergy to iodine or shellfish is the highest priority because the contrast medium used in an IVP can cause severe allergic reactions in patients with these allergies. This assessment must be done before administering the contrast to prevent potentially life-threatening complications.

Choice D reason: Assessing the client's ability to remain still is important for the quality of the images, but it is not as critical as ensuring the safety of the patient regarding potential allergic reactions.

A. "It is okay to take aspirin with GERD." B. "You should avoid possible mercury-containing foods such as some seafood because of their risk to GERD." C. "There is no causal link between lying down after eating and increased onset of GERD." D. "You should avoid or cut down on alcohol and caﬀeine which can aggravate GERD."

Correct Answer is D

Explanation

Choice A reason: Aspirin can irritate the stomach lining and increase acid reﬂux, worsening GERD symptoms. It is generally not recommended without consulting a healthcare provider.
Choice B reason : Mercury content in seafood is not directly linked to GERD. This statement is misleading and does not address known risk factors for GERD.
Choice C reason : Lying down after eating can indeed increase the onset of GERD as it allows stomach contents to ﬂow back into the esophagus more easily.
Choice D reason : Alcohol and caﬀeine can relax the lower esophageal sphincter, allowing stomach acid to rise into the esophagus and worsen GERD symptoms. Therefore, it is advisable to avoid or reduce their intake.

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A client who has chronic renal failure and has been on dialysis for 2 years has been wondering why he is anemic. The nurse explains that anemia accompanies chronic renal failure because of:

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who is going to have an intravenous pyelogram (IVP) using a contrast medium. Which of the following assessments by the nurse are of the highest priority?

Correct Answer is C

Explanation

A nurse is educating a client about the risk factors for GERD (gastroesophageal reﬂux disease). Which of the following statements should the nurse include?

Correct Answer is D

Explanation

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