A nurse is caring for a client immediately following a hemodialysis treatment. For which of the following manifestations will the nurse administer a PRN dose of phenytoin?

Headache, restlessness

Decreased blood pressure, rapid pulse

Muscle cramps, chest heaviness

Pain and tingling at the access site

Answer and Explanation

The Correct Answer is A

The correct answer is Choice A

Choice A rationale: Headache and restlessness can be signs of a seizure or neurological disturbance, which phenytoin is used to treat. Phenytoin is an anticonvulsant medication that helps control seizures by stabilizing neuronal membranes and reducing excitability.

Choice B rationale: Decreased blood pressure and rapid pulse are not indications for phenytoin administration. These symptoms may suggest hypotension or cardiovascular issues, which require different interventions such as fluid resuscitation or vasopressors.

Choice C rationale: Muscle cramps and chest heaviness are not treated with phenytoin. These symptoms could indicate electrolyte imbalances or cardiac issues, which need specific treatments like electrolyte replacement or cardiac monitoring.

Choice D rationale: Pain and tingling at the access site are not indications for phenytoin administration. These symptoms may suggest local irritation or infection at the dialysis access site, requiring appropriate wound care or antibiotics.

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Correct Answer is D

Explanation

Choice A reason: A pH of 7.26 indicates acidosis, but an HCO3 of 24 and PaCO2 of 46 suggest a respiratory cause rather than metabolic, which is not typical for AKI.

Choice B reason: A pH of 7.49 indicates alkalosis, and with an HCO3 of 30 and PaCO2 of 40, this suggests metabolic alkalosis, which is not expected in AKI.

Choice C reason: A pH of 7.49 indicates alkalosis. An HCO3 of 24 is normal, and a PaCO2 of 30 would suggest respiratory alkalosis, not typically associated with AKI.

Choice D reason: A pH of 7.26 indicates acidosis, and with an HCO3 of 14, this suggests metabolic acidosis, which is consistent with AKI. The PaCO2 of 30 indicates a compensatory respiratory response to the metabolic acidosis. This ABG result aligns with the expected findings in a patient with AKI, where there is an accumulation of acids and a decrease in bicarbonate due to the kidneys' inability to filter and excrete hydrogen ions effectively.

A. The client states that they consume a high calcium diet and have had high calcium in their blood. B. The client reports that they had two urinary tract infections (UTI) in the past 10 months. C. The client reports that they took a lot of ibuprofen for arthritis for many years. D. The client states that they remember their mother saying their grandmother had this same genetic disease.

Correct Answer is B

Explanation

Choice A reason: A high calcium diet and high blood calcium levels are not directly related to pyelonephritis.

Choice B reason: Recurrent UTIs can lead to pyelonephritis, especially if the infections ascend to the kidneys.

Choice C reason: Long-term use of ibuprofen can affect kidney function but is not a direct cause of pyelonephritis.

Choice D reason: Genetic diseases can affect kidney health, but there is no common genetic disease that directly causes pyelonephritis.

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A nurse is caring for a client immediately following a hemodialysis treatment. For which of the following manifestations will the nurse administer a PRN dose of phenytoin?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has acute kidney injury (AKI). Which of the following arterial blood gas (ABG) values would the nurse expect this client to have?

Correct Answer is D

Explanation

A nurse is gathering medical history from a client admited for pyelonephritis. Which of the following should the nurse expect the client to report when asked about their medical history?

Correct Answer is B

Explanation

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