A client with chronic renal failure is asking the nurse why her hemoglobin and hematocrit counts are low. Which of the following is the nurse's best response?
Your counts are low because of all the heparin you are receiving during dialysis
Your counts are low because your kidneys are no longer producing erythropoietin
Your counts are low because you are losing blood with each dialysis treatment
Your counts are low because you are not eating a diet rich in protein
The Correct Answer is B
Choice A reason: Heparin prevents clotting during dialysis but doesn’t reduce hemoglobin or hematocrit directly. It’s not a primary cause of anemia in renal failure, unlike erythropoietin deficiency.
Choice B reason: Kidneys in chronic renal failure fail to produce erythropoietin, a hormone stimulating red blood cell production, leading to low hemoglobin and hematocrit, the key cause here.
Choice C reason: Minor blood loss occurs in dialysis, but it’s not the primary reason for chronic anemia. Erythropoietin deficiency from renal failure has a greater impact on counts.
Choice D reason: Poor protein intake affects overall health but isn’t the main driver of anemia in renal failure. Erythropoietin loss from kidney dysfunction is the dominant factor.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: NSTEMI causes chest pain at rest due to reduced blood flow from partial occlusion, unlike stable angina, reflecting demand-supply mismatch without full blockage.
Choice B reason: Complete occlusion causes ST-elevation MI (STEMI), not NSTEMI, which involves partial blockage, leading to subendocardial ischemia without full transmural infarction.
Choice C reason: Chest pain on exertion resolving with rest describes stable angina, not NSTEMI, which occurs unpredictably, often at rest, due to unstable plaque rupture.
Choice D reason: NSTEMI results from partial coronary occlusion, causing ischemia without ST elevation, detectable by troponin rise, distinguishing it from STEMI’s complete blockage.
Correct Answer is D
Explanation
Choice A reason: Soft foods like applesauce aid swallowing in Parkinson’s dysphagia, reducing aspiration risk from rigidity, a correct self-management strategy.
Choice B reason: Prune juice relieves constipation, common in Parkinson’s from slowed gut motility due to dopamine loss, so this is an accurate statement.
Choice C reason: Carbidopa-levodopa boosts dopamine, easing Parkinson’s motor symptoms (tremors, rigidity), a standard treatment, making this statement correct.
Choice D reason: Parkinson’s stems from dopamine deficiency, not acetylcholine; excess acetylcholine worsens symptoms, so this is incorrect and needs teaching.
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