A client with chronic kidney disease (CKD) is prescribed a low-potassium diet. Which food choice indicates to the nurse that the client understands the dietary restrictions?

Baked potato with skin.

Orange juice.

White rice.

Banana smoothie.

Answer and Explanation

The Correct Answer is C

Choice A reason: Baked potato with skin is high in potassium (about 900 mg), unsuitable for CKD, where impaired renal excretion risks hyperkalemia, causing cardiac arrhythmias. White rice is low-potassium, aligning with dietary restrictions, demonstrating understanding of the need to limit potassium intake in renal disease.

Choice B reason: Orange juice contains high potassium (about 500 mg per cup), dangerous in CKD, as reduced glomerular filtration increases hyperkalemia risk, affecting cardiac conduction. White rice, with minimal potassium, complies with restrictions, indicating the client’s understanding of safe dietary choices for kidney function.

Choice C reason: White rice is low in potassium (about 50 mg per cup), appropriate for CKD, where the kidneys cannot excrete excess potassium, risking hyperkalemia and arrhythmias. Choosing white rice shows the client understands the low-potassium diet, supporting safe management of renal disease and electrolyte balance.

Choice D reason: Banana smoothie is high in potassium (about 400 mg per banana), contraindicated in CKD, where hyperkalemia risks cardiac instability due to poor renal clearance. White rice, low in potassium, reflects dietary compliance, demonstrating the client’s understanding of restrictions to prevent electrolyte imbalances.

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Correct Answer is C

Explanation

Choice A reason: Showing the client how to clean assumes cognitive capacity impaired in schizophrenia, where psychosis or disorganized thinking drives behaviors like fecal smearing. This may reflect delusions, not a lack of cleaning knowledge. Escorting the client out prioritizes hygiene and safety, allowing psychiatric assessment over teaching in an acute situation.

Choice B reason: Assisting with cleaning risks reinforcing the behavior and exposes both to pathogens like E. coli in feces. Schizophrenia may impair compliance or understanding. Escorting the client out ensures safety and hygiene, enabling evaluation of psychotic triggers, making this less appropriate than removing the client from the situation.

Choice C reason: Escorting the client out prevents further pathogen exposure, as feces carry infection risks (e.g., gastroenteritis). In schizophrenia, smearing may stem from psychosis, requiring psychiatric evaluation. This action ensures hygiene and safety, allowing assessment of underlying mental health issues, addressing the behavior’s root cause effectively.

Choice D reason: Explaining that feces belong in the toilet assumes rational understanding, impaired in schizophrenia due to disorganized thought or delusions. This behavior likely reflects psychosis. Escorting the client out prioritizes hygiene and safety, followed by psychiatric intervention, making explanation less effective than immediate removal from the contaminated area.

A. Monitor the client’s metabolic panel results during antibiotic therapy. B. Schedule prescribed nebulizer treatments with respiratory therapy. C. Collect blood specimens for culture prior to starting antibiotic therapy. D. Review medical record for results of a chest x-ray taken on admission.

Correct Answer is C

Explanation

Choice A reason: Monitoring the metabolic panel detects antibiotic side effects like renal toxicity, but this is ongoing. Collecting blood cultures first identifies the HAP pathogen, ensuring targeted therapy. Premature antibiotics may obscure results, leading to resistance, making cultures more urgent for effective treatment of this nosocomial infection.

Choice B reason: Nebulizer treatments aid airway clearance in HAP, but identifying the pathogen via cultures is critical before antibiotics. Ineffective therapy delays recovery, as bacteria proliferate in mucus. Cultures guide precise antibiotic selection, reducing resistance risk, making this less immediate than obtaining microbiological data.

Choice C reason: Collecting blood cultures before antibiotics identifies the HAP pathogen (e.g., MRSA) and its sensitivity, critical for tailoring therapy. Broad-spectrum antibiotics can yield false-negative cultures, complicating treatment. This ensures accurate diagnosis, optimizing outcomes in severe infections, addressing the microbiological basis of HAP management.

Choice D reason: Reviewing chest x-ray confirms HAP with infiltrates but does not guide immediate antibiotic therapy. Cultures are urgent to identify the pathogen before antibiotics, as x-rays are non-specific and already documented. Cultures ensure pathogen-specific treatment, critical for combating hospital-acquired infections effectively.

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A client with chronic kidney disease (CKD) is prescribed a low-potassium diet. Which food choice indicates to the nurse that the client understands the dietary restrictions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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