A nurse is reviewing the medication list of a patient with end-stage renal disease (ESRD) who is receiving hemodialysis. The nurse knows that certain medications are used to prevent complications of this disease. Which of the following medications would the nurse question as part of routine therapy for preventing complications of ESRD?
Antihypertensive medications
Antidiuretic hormone (ADH)
Erythrocyte-stimulating agents
Phosphate binders
The Correct Answer is B
Choice A reason: Antihypertensives are routinely used in ESRD to manage hypertension caused by fluid overload and renin-angiotensin system dysregulation. Controlling blood pressure prevents cardiovascular complications like heart failure or stroke, which are common in ESRD due to chronic volume and pressure overload, making this medication appropriate.
Choice B reason: ADH is not used in ESRD, as it promotes water reabsorption, worsening fluid overload in anuric patients. ESRD patients rely on dialysis for fluid balance, and ADH could exacerbate hypertension or pulmonary edema. Its use is more relevant in conditions like diabetes insipidus, not renal failure.
Choice C reason: Erythrocyte-stimulating agents, like erythropoietin, are standard in ESRD to treat anemia caused by reduced erythropoietin production by failing kidneys. These agents stimulate red blood cell production, improving oxygen delivery and reducing fatigue, making them essential for managing ESRD-related anemia and improving quality of life.
Choice D reason: Phosphate binders are used in ESRD to manage hyperphosphatemia by binding dietary phosphate in the gut, preventing its absorption. This reduces the risk of vascular calcification and secondary hyperparathyroidism, common complications in ESRD due to impaired phosphate excretion, making these medications a standard part of therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: A 201 status indicates voluntary admission to a mental health facility, where the client can request discharge by signing a withdrawal form, typically with a 72-hour notice period. This matches the client’s statement, as voluntary patients retain control over their discharge, consistent with mental health laws.
Choice B reason: A 303 status involves extended involuntary commitment for ongoing treatment, typically after a court hearing. It does not allow self-initiated discharge by signing a form, as the client’s statement suggests, making this status incompatible with the described ability to request withdrawal.
Choice C reason: A 302 status is an involuntary commitment for imminent danger, requiring medical or legal approval for discharge, not a simple request form. The client’s ability to sign for withdrawal indicates voluntary status, making 302 incorrect for this scenario.
Choice D reason: A 301 status is not a standard term in mental health commitment laws (e.g., Pennsylvania’s Mental Health Procedures Act). The client’s ability to request discharge aligns with voluntary (201) status, not an undefined or involuntary category, making this option incorrect.
Correct Answer is D
Explanation
Choice A reason: Assault involves threatening harm, not applicable here, as the issue is failure to document assessments, not intentional threats by staff. The client’s self-harm resulted from inadequate monitoring, not a staff-initiated threat, making assault an incorrect legal issue in this scenario.
Choice B reason: Battery involves unauthorized physical contact, not relevant to failure to document assessments. The client’s self-harm stemmed from inadequate observation, not staff-inflicted harm, making battery an inappropriate legal claim compared to negligence in monitoring and documentation.
Choice C reason: Suicide risk is a clinical concern, not a legal issue to defend against. While the client’s self-harm indicates risk, the hospital’s liability arises from failure to follow monitoring protocols, not the risk itself, making this option incorrect for the legal defense context.
Choice D reason: Malpractice involves negligence, such as failing to document hourly assessments for a high-risk client, leading to harm. This breach of standard care (1:1 observation) allowed self-harm, making the hospital liable for not adhering to protocols, requiring defense against malpractice for inadequate monitoring and documentation.
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