A nurse assesses a client with renal insufficiency and a low red blood cell count. The client asks, "is my anemia related to my kidney problem?" How would the nurse respond?
"Kidney insufficiency inhibits active transportation of red blood cells throughout the blood."
"Red blood cells produce erythropoietin, which increases blood flow to the kidneys."
"Your anemia and kidney problem are related to inadequate vitamin D and a loss of bone density."
"Erythropoietin is usually released from the kidneys and stimulates red blood cell production in the bone marrow.
The Correct Answer is D
Rationale:
A. The kidneys do not transport red blood cells; the circulatory system does. This option confuses renal function with circulatory processes.
B. Red blood cells do not produce erythropoietin; rather, the kidneys produce erythropoietin to stimulate red blood cell formation in the bone marrow.
C. While vitamin D metabolism and bone density are affected by kidney disease, these are not the primary cause of anemia in renal insufficiency.
D. The kidneys produce erythropoietin, a hormone that stimulates red blood cell production in the bone marrow. In renal insufficiency, reduced erythropoietin secretion leads to anemia due to decreased red blood cell formation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Pruritus is a common symptom of CKD due to the buildup of uremic toxins and calcium-phosphate crystals under the skin. While uncomfortable, it is not immediately life-threatening and does not require urgent assessment.
B. Hypertension is common in CKD as a result of fluid retention and activation of the renin-angiotensin system. Although this blood pressure needs monitoring and management, it is not an emergency requiring first assessment.
C. These are uremic manifestations due to the accumulation of ammonia and toxins in the body. They indicate progression of CKD but are not urgent or immediately life-threatening findings.
D. Kussmaul respirations are deep, rapid breathing that occur as a compensatory mechanism for metabolic acidosis, a serious and potentially life-threatening complication of CKD. This client should be assessed first to evaluate acid-base balance, respiratory effort, and potential need for urgent intervention such as dialysis or bicarbonate therapy.
Correct Answer is C
Explanation
Rationale:
A. This is typically seen in acute glomerulonephritis, due to hematuria (blood in the urine). In nephrotic syndrome, urine is usually frothy because of high protein content, not bloody.
B. Mild or normal blood pressure is more common in nephrotic syndrome. Severe hypertension is more characteristic of acute glomerulonephritis.
C. Periorbital (facial) edema is a classic early sign of nephrotic syndrome. It is due to massive protein loss in urine (proteinuria), leading to low serum albumin and fluid shifting into interstitial tissues. The edema may later progress to generalized (anasarca).
D. Children with nephrotic syndrome often have decreased urine output (oliguria) due to fluid retention, not increased urine production.
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