A nurse is caring for a client who has chronic kidney disease (CKD) and states she has heartburn.

The provider prescribes aluminum hydroxide. The client asks, "Why can't I just take the antacid magaldrate my husband has at home?" The nurse explains to the client that aluminum hydroxide is the preferred antacid because it lowers which of the following?

Serum magnesium levels

Serum phosphorus levels

Serum potassium levels

Serum calcium levels

Answer and Explanation

The Correct Answer is B

A.   Aluminum hydroxide can lead to increased serum magnesium levels, but this is not the reason for its preference in chronic kidney disease.
B.   Aluminum hydroxide is preferred because it binds to dietary phosphate, reducing serum phosphorus levels in patients with chronic kidney disease who are prone to hyperphosphatemia.
C.   Aluminum hydroxide does not significantly affect serum potassium levels.
D.   Aluminum hydroxide can lead to decreased serum calcium levels due to binding, but this is not the primary reason for its preference in chronic kidney disease.

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Correct Answer is A

Explanation

A. 0.45% sodium chloride, also known as half-normal saline, is a hypotonic solution with a lower concentration of sodium than normal serum levels. It can help to lower the sodium levels in a client with hypernatremia by diluting the excess sodium in the body.
B. Dextrose 10% in water is hypertonic and not appropriate for a client with hypernatremia, as it could exacerbate the imbalance.
C. Lactated Ringer's is isotonic and contains sodium in a similar concentration to serum levels, hence it could further increase the sodium levels.
D. Dextrose 5% in 0.9% sodium chloride (also known as D5NS) is a hypertonic solution that contains both dextrose and sodium. It would not be appropriate for a client with hypernatremia, as it could exacerbate the condition.

A. "It is caused by the lack of production of insulin by the pancreas.." B. "It is caused by the overproduction of growth hormone by the pituitary gland." C. "It is caused by the overproduction of parathormone by the parathyroid gland." D. "It is caused by the lack of production of aldosterone by the adrenal gland."

Correct Answer is D

Explanation

A. This statement describes the cause of diabetes mellitus, not Addison's disease.

B. This statement describes the cause of acromegaly, not Addison's disease.

C. This statement describes the cause of hyperparathyroidism, not Addison's disease.

D. This is the correct explanation of the cause of Addison's disease, which involves adrenal insufficiency.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has hypernatremia and requires IV fluid therapy due to his NPO status. Which of the following solutions should the nurse prepare to infuse for this client?

Correct Answer is A

Explanation

A staff nurse is teaching a client who has Addison's disease about the disease process. The client asks the nurse what causes Addison's disease. Which of the following responses should the nurse make?

Correct Answer is D

Explanation

A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis?

A nurse is caring for a client who has the following arterial blood gas results: HCO3-, 18 mEq, PaCO, 28 mm Hg and pH 7.30. The nurse recognizes the client is experiencing which of the following acid base imbalances?

A nurse is caring for a female client who has recurrent kidney stones and is scheduled for an intravenous pyelogram. Which of the following statements by the client should the nurse report to the provider?

A nurse is assessing a client who has end-stage kidney disease and is receiving hemodialysis. Which of the following findings should the nurse identify as an indication the client is experiencing fluid overload?

A nurse is reviewing the laboratory values of a client who has respiratory acidosis. Which of the following findings should the nurse expect?

A nurse is assisting with the care of a client who has metabolic alkalosis. Which of the following actions should the nurse take?

A nurse is discussing laboratory values associated with the renal system with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the values?