A nurse is assessing a client who has acute kidney failure and is in a state of metabolic acidosis. The nurse should monitor for which of the following manifestations?

Bounding peripheral pulses

Hyperreflexia

Cool skin

Hypotension

Answer and Explanation

The Correct Answer is D

A) Bounding peripheral pulses: Metabolic acidosis typically does not cause bounding peripheral pulses. In metabolic acidosis, vasodilation might occur, but it usually leads to weaker, not bounding, pulses due to decreased cardiac output and blood pressure.

B) Hyperreflexia: Hyperreflexia is not commonly associated with metabolic acidosis. Instead, metabolic acidosis may cause symptoms like muscle weakness or fatigue due to the effect of acid-base imbalance on neuromuscular function.

C) Cool skin: While cool skin can sometimes be associated with poor perfusion in severe cases, it is not a direct manifestation of metabolic acidosis. Metabolic acidosis more commonly affects internal physiology rather than peripheral skin temperature directly.

D) Hypotension: Hypotension is a common manifestation of metabolic acidosis. The acidosis leads to vasodilation and decreased cardiac contractility, resulting in a drop in blood pressure. This is a critical sign for the nurse to monitor as it indicates the severity of the acid-base imbalance and its effect on the cardiovascular system.

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Correct Answer is A

Explanation

A) "I'll use pursed-lip breathing when I feel short of breath.": Pursed-lip breathing is a beneficial technique for clients with COPD as it helps keep the airways open longer, reduces the work of breathing, and improves ventilation. This statement indicates the client understands a key management strategy for COPD.

B) "I'll skip my exercises for the week if I feel short of breath.": Regular exercise is important for managing COPD, and while adjustments may be necessary when symptoms are severe, completely skipping exercise can lead to deconditioning and worsening of symptoms. This statement does not reflect appropriate management of COPD.

C) "I will use my inhaler 30 minutes after each meal.": Inhalers should be used as prescribed, usually before activities that might trigger symptoms, such as eating, rather than on a fixed schedule unrelated to symptoms or physician's guidance. This statement indicates a misunderstanding of inhaler use.

D) "I will limit myself to drinking only 1 quart of water each day.": Staying hydrated is important for thinning mucus in COPD. Unless there are specific medical reasons to restrict fluids, such as heart failure, limiting water intake could lead to dehydration and thickened mucus, making breathing more difficult. This statement is not appropriate for managing COPD.

A. Potatoes B. Mushrooms C. Eggs D. Spinach

Correct Answer is D

Explanation

A) Potatoes: Potatoes are not particularly high in oxalates and can be included in the diet for individuals who have had calcium oxalate renal calculi. They do not significantly contribute to oxalate levels and are generally considered safe for those managing this type of kidney stone.

B) Mushrooms: While mushrooms are a nutritious food, they do not have a high oxalate content compared to other foods. Therefore, they are not a primary concern for individuals managing calcium oxalate stones.

C) Eggs: Eggs are low in oxalates and do not contribute significantly to the formation of calcium oxalate renal stones. They are a good source of protein and can be included in the diet.

D) Spinach: Spinach is high in oxalates and should be limited in the diet of individuals who have experienced calcium oxalate renal calculi. High oxalate foods can contribute to the formation of calcium oxalate stones, so limiting spinach can help reduce the risk of recurrence.

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A nurse is assessing a client who has acute kidney failure and is in a state of metabolic acidosis. The nurse should monitor for which of the following manifestations?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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