A client with a 16-year history of diabetes mellitus is having renal function tests because of recent fatigue, weakness, elevated blood urea nitrogen, and serum creatinine levels. Which finding should the nurse conclude as an early symptom of renal insufficiency?
Stomatitis and Diarrhea
Dyspnea and Anuria
Confusion and Vomiting
Nocturia and Oliguria
The Correct Answer is D
Choice A rationale: These are symptoms of advance renal failure. Stomatitis and diarrhea are signs of uremia, which is the accumulation of waste products in the blood.
Choice B rationale: Dyspnea and anuria are signs of fluid overload and kidney shutdown and indicate advanced renal failure.
Choice C rationale: Confusion and vomiting are signs of acidosis and electrolyte disturbances and occur in advanced stages of renal failure.
Choice D rationale: One of the early symptoms of renal insufficiency is nocturia, which is the need to urinate frequently at night. This occurs because the kidneys are unable to concentrate urine during the day and produce more urine at night. Another early symptom is oliguria, which is the production of less than 400 mL of urine per day. This occurs because the kidneys are unable to excrete enough urine to maintain fluid balance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale: A breast lump that increases in size before the menstrual period might be related to hormonal changes and is not necessarily indicative of a concerning issue.
Choice B rationale: Bilateral breast nodules that are tender with palpation might be related to benign conditions or hormonal changes.
Choice C rationale: A small, mobile, rubbery breast lump could suggest a benign condition like a fibroadenoma, which might not be as concerning.
Choice D rationale: A breast nodule that is 1 cm in size, nontender, and fixed could potentially raise concerns about malignancy and requires further evaluation.
Correct Answer is D
Explanation
Choice A rationale: Furosemide is a loop diuretic used to increase urine output by blocking the reabsorption of sodium and water. It's not typically associated with hyperkalemia. In fact, it's more common for loop diuretics like furosemide to cause hypokalemia (low potassium) due to increased urinary excretion of potassium.
Choice B rationale: Lovastatin is a statin used to lower cholesterol levels. It is not related to increased cholesterol. Additionally, there is no known direct interaction between lovastatin and furosemide. Furosemide is a diuretic, while selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants, and they do not typically interact in a way that requires discontinuation.
Choice C rationale: Duloxetine is an antidepressant (SNRI), and glipizide is an oral diabetes medication. There's no direct interaction between duloxetine and glipizide that would necessitate discontinuation.
Choice D rationale: Trimethoprim/sulfamethoxazole (Bactrim) is a sulfonamide antibiotic, and glipizide belongs to the sulfonylurea class of medications. Both drugs contain sulfur groups in their chemical structures, and there is a possibility of cross-reactivity or drug interaction. This interaction can potentially reduce the effectiveness of glipizide, leading to compromised blood sugar control. Additionally, sulfonamide antibiotics like trimethoprim/sulfamethoxazole can cause adverse reactions, including skin rashes or hypersensitivity reactions, particularly in individuals sensitive to sulfa medications.
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