A nurse is assessing a client who has end-stage kidney disease. Which of the following findings should the nurse expect? (Select all that apply)

Anuria

Edema

Hyperkalemia

Hypocalcemia

Metabolic acidosis

Answer and Explanation

Correct Answer : A,B,C,D,E

Choice A reason: Anuria, minimal or no urine output, is expected in end-stage kidney disease (ESKD) due to nephron loss, reducing glomerular filtration rate. This causes fluid and toxin buildup, requiring dialysis to manage fluid balance and prevent complications like uremia in ESKD clients.
Choice B reason: Edema results from impaired sodium and water excretion in ESKD, causing fluid overload. Reduced filtration leads to volume retention, manifesting as peripheral or pulmonary edema, increasing cardiovascular strain and necessitating diuretics or dialysis to control fluid status effectively.
Choice C reason: Hyperkalemia occurs in ESKD, as failing kidneys cannot excrete potassium, elevating serum levels. This risks cardiac arrhythmias due to disrupted membrane potentials. Dietary restrictions or dialysis are needed to manage potassium, preventing life-threatening complications in end-stage renal failure.
Choice D reason: Hypocalcemia in ESKD stems from impaired vitamin D activation and phosphate retention, binding calcium. This disrupts bone mineralization and neuromuscular function, causing tetany or fractures. Calcium supplementation and dialysis correct this imbalance, addressing renal failure’s metabolic consequences.
Choice E reason: Metabolic acidosis in ESKD results from impaired hydrogen ion excretion and bicarbonate reabsorption. This lowers blood pH, causing fatigue and bone demineralization. Dialysis or bicarbonate therapy corrects acid-base imbalances, addressing the kidneys’ failure to maintain homeostasis in end-stage disease.

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Correct Answer is B

Explanation

Choice A reason: The lactation amenorrhea method is effective only up to 6 months postpartum, and only if exclusive breastfeeding and amenorrhea are maintained. It is not reliable for 12 months, so this statement is inaccurate, making it incorrect for contraception teaching.
Choice B reason: Placing the transdermal contraceptive patch on the upper arm or back ensures proper adhesion and absorption. This aligns with manufacturer guidelines for effective contraception, making it a correct and appropriate instruction for postpartum clients seeking reliable methods.
Choice C reason: A diaphragm used before pregnancy may no longer fit due to pelvic changes post-delivery. It requires refitting 6 weeks postpartum, so continuing use without adjustment is ineffective and risky, making this incorrect.
Choice D reason: Starting oral contraceptives immediately after delivery is not recommended, especially for breastfeeding mothers, due to risks like reduced milk supply or thromboembolism. Initiation typically begins 3-6 weeks postpartum, making this incorrect and unsafe.

A. Clients exhibit a stable sense of self and consistent relationships. B. Clients often engage in self-harming behaviors. C. Clients respond well to group therapy as the primary treatment. D. Clients rarely experience mood swings or emotional instability.

Correct Answer is B

Explanation

Choice A reason: Clients with borderline personality disorder (BPD) typically exhibit an unstable sense of self and tumultuous relationships, not stability. Their identity disturbances and fear of abandonment lead to chaotic interpersonal dynamics, making this statement incorrect as it misrepresents core BPD characteristics.
Choice B reason: Self-harming behaviors, such as cutting or suicidal gestures, are common in BPD due to emotional dysregulation and impulsivity. These actions serve as maladaptive coping mechanisms for intense emotions, aligning with DSM-5 criteria for BPD, making this the correct information to include.
Choice C reason: While group therapy can be beneficial, dialectical behavior therapy (DBT), an individual and skills-based approach, is the primary evidence-based treatment for BPD. Group therapy alone is not the standard, as it may not address individual emotional regulation needs, making this statement inaccurate.
Choice D reason: Clients with BPD frequently experience mood swings and emotional instability, a hallmark of the disorder due to affective dysregulation. This contradicts the statement, as BPD involves rapid mood shifts, not stability, making this information incorrect for describing BPD characteristics.

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A nurse is assessing a client who has end-stage kidney disease. Which of the following findings should the nurse expect? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who is postpartum and interested in information about contraception. Which of the following instructions should the nurse include?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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