A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication?

Increasing hematocrit

Decreasing serum potassium

Decreasing platelets

Increasing white blood cells

Answer and Explanation

The Correct Answer is A

A.   Hematocrit measures the proportion of blood volume that is occupied by red blood cells. Epoetin alfa stimulates red blood cell production, so a therapeutic effect would be indicated by an increase in hematocrit levels. This is a key laboratory result to monitor when assessing the effectiveness of epoetin alfa in treating anemia in CKD patients.
B.   Serum potassium levels are important to monitor in CKD patients due to the risk of hyperkalemia, but they are not directly affected by epoetin alfa. Decreasing serum potassium is not a primary indicator of the therapeutic effect of epoetin alfa.
C.   Platelet count measures the number of platelets in the blood, which are crucial for blood clotting. Epoetin alfa is not designed to affect platelet counts; thus, a change in platelet count is not an indicator of the medication's therapeutic effect.
D.   White blood cell count reflects the immune system's status and is not directly influenced by epoetin alfa. This medication specifically targets red blood cell production and does not impact white blood cell counts.

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Correct Answer is C

Explanation

A. While this medication is used to treat hyperkalemia, it is a slower acting treatment. Given the patient's critical condition with altered mental status, hyperkalemia, and elevated BUN, a more rapid intervention is needed.
B. Fluid resuscitation is important in some cases of AKI but it is not the priority in this patient. The patient is already showing signs of fluid overload (crackles in the lungs) and the primary issue is the inability of the kidneys to remove waste products and excess fluids.
C. This is the most appropriate treatment for this patient. RRT, such as hemodialysis or continuous renal replacement therapy (CRRT), can rapidly remove waste products, excess fluid, and electrolytes from the blood, correcting the imbalances and improving the patient's condition.
D. This medication is used for long-term management of hyperkalemia, but it is not effective in an acute setting like this.

A. "If you experience chronic rejection, you will not be eligible to go back onto the transplant list." B. "You are at an increased risk of developing benign prostatic hyperplasia after a transplant." C. "You should limit your fluid intake to 1,500 mL per day so your new kidney will not have to work as hard." D. "Immunosuppressants can make hypertension worse, so you may need to go on blood pressure medication."

Correct Answer is D

Explanation

A. This is incorrect. While chronic rejection is a serious complication, patients who experience it can often receive another transplant.
B. This is incorrect and unrelated to kidney transplant.
C. This is incorrect. Adequate hydration is essential for proper kidney function.
D. This is correct. Immunosuppressants can contribute to hypertension, a common complication after kidney transplant.

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A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A client who received a kidney transplant last month is in the nephrology clinic for a follow-up visit. Which education should the nurse provide to the client regarding complications which can arise after a kidney transplant?

Correct Answer is D

Explanation

A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication?

A client with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L. The nurse recognizes that administering IV calcium gluconate to this client will result in which of the following effects?

A client with polycystic kidney disease is prescribed the medication Tolvaptan. What should the nurse include when educating the client about this medication.

During the diuretic phase of acute kidney injury, the nurse understands that the client is at risk for which of the following electrolyte imbalances?

Which of the following clients is at risk of developing acute kidney injury from a post-renal cause?

A client has had recurrent kidney stones. Upon lab analysis of the client's urine, it is found that excessive purine intake is the underlying cause. Which of the following high-purine foods should the nurse instruct the client to avoid?

A nurse is teaching a client who has chronic kidney disease about limiting foods that are high in potassium. Which of the following are high-potassium foods which the client should avoid? (Select all that apply.)

A female client has undergone surgery to remove a large struvite kidney stone. Based on the cause of struvite stones, which medication therapy should the nurse anticipate will be ordered to prevent recurrence of the stones?