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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Maintaining oxygen saturation helps symptoms but doesn’t diagnose the cause (e.g., MI), delaying critical evaluation of atypical pain and dyspnea.
Choice B reason: Ibuprofen relieves pain but risks bleeding in potential MI, not addressing cardiac etiology of jaw, back pain, and shortness of breath urgently.
Choice C reason: Acetaminophen eases pain but doesn’t assess or treat potential cardiac ischemia, missing the diagnostic priority for these MI-like symptoms.
Choice D reason: An EKG identifies cardiac ischemia (e.g., MI) in atypical pain (jaw, back), dyspnea, and nausea, guiding urgent treatment, the priority action here.
Correct Answer is ["B"]
Explanation
Choice A reason: Calcium carbonate supplements increase serum calcium by providing exogenous calcium, worsening hyperparathyroidism’s already elevated levels from excessive PTH-driven bone resorption and gut absorption.
Choice B reason: A low calcium diet reduces intake, limiting absorption, while high fiber binds calcium in the gut, enhancing fecal excretion, countering PTH’s hypercalcemic effect in hyperparathyroidism.
Choice C reason: Parathyroidectomy removes overactive glands, directly stopping excessive PTH production, which drives calcium release from bones and reabsorption in kidneys, effectively normalizing calcium levels.
Choice D reason: Furosemide, a loop diuretic, increases renal calcium excretion by inhibiting reabsorption in the loop of Henle, reducing serum calcium elevated by PTH in hyperparathyroidism.
Choice E reason: Fluid restriction raises calcium concentration by reducing dilution, worsening hypercalcemia in hyperparathyroidism, where PTH already increases calcium reabsorption, making this counterproductive.
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