A client who received a kidney transplant 3 months ago is in the nephrologists office for a follow up appointment. Which finding would indicate that the client is experiencing a complication which is common after a kidney transplant?

Creatinine 1.2 mg/dL

24-hour urine output 1,800 mL

White blood cell count (WBC) 13,500/mm3

Blood urea nitrogen (BUN) 18 mg/dL

Answer and Explanation

The Correct Answer is C

A creatinine level of 1.2 mg/dL is within the upper range of normal but may be slightly elevated depending on the baseline level pre-transplant and individual patient factors. For a client 3 months post- transplant, this level could indicate stable kidney function or a mild increase but is not necessarily indicative of a significant complication.
B.A 24-hour urine output of 1,800 mL is within the normal range for adults (about 1,000 to 2,000 mL per day). This level of urine output suggests that the transplanted kidney is functioning adequately in terms of urine production.
C. An elevated white blood cell count of 13,500/mm³ could indicate an infection or inflammation. This finding is relevant in the context of post-transplant care because patients are at increased risk for infections due to immunosuppressive therapy and the surgical procedure. An elevated WBC count could also suggest an acute rejection episode, as rejection can cause inflammation and an immune response.
D. A BUN level of 18 mg/dL is within the normal range but on the higher end. It might suggest some level of kidney impairment, but it is not necessarily indicative of a severe complication on its own.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

A. Gum bleeding can be a sign of thrombocytopenia (low platelet count) and is concerning because it indicates a potential for bleeding complications. However, while it's significant, it might not be the most urgent symptom in the context of HIT compared to symptoms indicating acute thrombosis.

B. A hemoglobin level of 14 g/dL is generally within the normal range for most adults. In the context of HIT, this level does not indicate any immediate abnormality or severe issue related to anemia or bleeding, making it less concerning compared to other symptoms that might indicate acute complications.
C. Tachycardia (increased heart rate) and shortness of breath are concerning symptoms in the context of HIT. These symptoms can be indicative of a thrombotic event such as a pulmonary embolism (PE) or deep vein thrombosis (DVT), which are serious complications of HIT. The presence of these symptoms requires urgent evaluation as they suggest possible life-threatening complications.
D. Petechiae are small, pinpoint red or purple spots that appear due to bleeding under the skin, often associated with low platelet counts. While petechiae are a concerning sign and indicate bleeding issues, the presence of tachycardia and shortness of breath generally represents a more immediate threat to the patient's life due to potential thromboembolic events.

A. Thirty seconds after administration, the facial weakness and ptosis will be relieved for approximately 5 minutes. B. After administration, the client will experience worsening facial weakness and ptosis. C. After administration of the medication, there will be no change in the status of the ptosis or facial weakness. D. The client will have elimination of symptoms lasting at least 24 hours after the administration of the medication.

Correct Answer is A

Explanation

This is the correct expected outcome if the test is positive for myasthenia gravis. Edrophonium works quickly to increase acetylcholine levels, leading to temporary improvement in muscle strength. In a patient with myasthenia gravis, administration of edrophonium typically results in a rapid improvement in symptoms like facial weakness and ptosis within 30 to 60 seconds, with the effects lasting for a few minutes. This brief improvement is indicative of a positive result for myasthenia gravis.
B.A Worsening symptoms after administration of edrophonium are not expected and could indicate an adverse reaction or incorrect diagnosis. In myasthenia gravis, edrophonium typically improves symptoms rather than worsening them.
C. No change in symptoms would be unexpected in the case of myasthenia gravis. If edrophonium is effective, there should be a noticeable improvement in symptoms. If there is no change, it might suggest a diagnosis other than myasthenia gravis or that the test is inconclusive.
D. This outcome is not expected. Edrophonium has a very short duration of action, typically relieving symptoms for only a few minutes. The effects do not last for 24 hours. A longer-lasting improvement might be observed with other treatments for myasthenia gravis, such as anticholinesterase medications like pyridostigmine, but not with edrophonium.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A client who received a kidney transplant 3 months ago is in the nephrologists office for a follow up appointment. Which finding would indicate that the client is experiencing a complication which is common after a kidney transplant?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has been diagnosed with heparin-induced thrombocytopenia (HIT). Which of the following clinical manifestations should the nurse recognize as the most concerning for a client with this condition?

Correct Answer is C

Explanation

The nurse is assisting while a neurologist administers an edrophonium (Tensilon) test to a client with facial weakness and ptosis. If the test is positive for myasthenia gravis, which outcome would the nurse observe?

Correct Answer is A

Explanation

A client with age-related macular degeneration (AMD) is undergoing photodynamic therapy with the medication Verteporfin. What should the nurse include in the discharge teaching for this client?

A client experiencing exophthalmos is seen in a primary care provider's clinic. The nurse understands that the most likely endocrine disorder which would cause this symptom is which of the following?

A client with chronic obstructive pulmonary disease (COPD) is experiencing tachypnea and dyspnea. The nurse should plan to implement which of the following interventions to reduce bronchiolar collapse and air-trapping?

A client who is receiving chemotherapy for breast cancer is experiencing myelosuppression as a side effect of the treatment. Which of the following is a manifestation directly related to myelosuppression?

A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication?

A nurse is assessing a client who has osteoarthritis of the right hand. Which of the following would be the preferred treatment for this client?

A client with multiple complaints has been referred to a neurologist for further evaluation. Which of the following complaints are common manifestations of amyotrophic lateral sclerosis? (Select all that apply.)