A nurse is caring for a client who has end-stage kidney disease (ESKD) and reports having shortness of breath and swelling in his lower extremities. Upon assessment, the nurse notes the client has crackles in his lungs and an elevated blood pressure. The nurse should suspect which of the following based on the client's manifestations?
Hyponatremia
Hyperkalemia
Hypovolemia
Hypervolemia
The Correct Answer is D
A. Hyponatremia is characterized by low sodium levels in the blood and is not typically associated with crackles in the lungs or elevated blood pressure.
B. While hyperkalemia is a concern in end-stage kidney disease, it is not typically associated with crackles in the lungs or elevated blood pressure.
C. Hypovolemia, or low blood volume, is not consistent with the client's reported symptoms of swelling in the lower extremities and crackles in the lungs.
D. Hypervolemia, or fluid overload, is common in end-stage kidney disease and can manifest with symptoms such as shortness of breath, lower extremity edema, crackles in the lungs (due to pulmonary congestion), and elevated blood pressure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Creatinine levels rise in acute kidney injury due to impaired kidney function, as the kidneys are unable to effectively filter creatinine from the blood.
B. BUN (blood urea nitrogen) levels typically increase in dehydration due to reduced kidney perfusion, leading to decreased urine output and increased concentration of waste products in the blood.
C. Specific gravity increases in hypovolemia because urine becomes more concentrated as the body tries to conserve water.
D. Potassium levels may vary depending on the cause of polyuria, but polyuria itself does not necessarily cause hyperkalemia. It can be caused by various factors including diabetes insipidus or diabetes mellitus.
Correct Answer is D
Explanation
A. In primary hypothyroidism, the thyroid gland fails to produce sufficient thyroid hormone.
Consequently, free T4 levels are typically decreased.
B. Although serum T3 levels may also decrease in primary hypothyroidism due to impaired thyroid function, TSH is the primary marker used for diagnosis and monitoring.
C. Similarly, serum T4 levels may decrease in primary hypothyroidism due to decreased synthesis by the thyroid gland.
D. In primary hypothyroidism, the anterior pituitary gland releases more TSH to stimulate the thyroid gland to produce thyroid hormones. Therefore, elevated TSH levels are characteristic of primary hypothyroidism.
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