A nurse reviews labs for a client with end-stage renal disease. Which finding is expected?
Hypophosphatemia
Hypokalemia
Metabolic acidosis
Hypernatremia
The Correct Answer is C
Rationale:
A. In end-stage renal disease (ESRD), the kidneys lose the ability to excrete phosphate efficiently, leading to hyperphosphatemia, not low phosphate levels. Elevated phosphate can contribute to secondary hyperparathyroidism and bone mineral disorders.
B. ESRD impairs potassium excretion, making hyperkalemia more common. Low potassium levels are not typical unless there are other contributing factors such as excessive diuretic use or gastrointestinal losses. Hyperkalemia in ESRD can be life-threatening due to its potential to cause cardiac arrhythmias.
C. In ESRD, the kidneys are unable to excrete hydrogen ions or reabsorb bicarbonate adequately. This leads to acid retention and a decrease in blood pH, resulting in metabolic acidosis. This condition is chronic and contributes to complications such as bone demineralization and muscle wasting.
D. Sodium levels in ESRD are usually normal or low. While fluid balance is disrupted, hypernatremia is not a primary lab finding associated with renal failure. Sodium abnormalities are often secondary to fluid retention, diuretic therapy, or dietary intake rather than intrinsic renal dysfunction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Veins are incorrect. Veins have thinner walls and less smooth muscle compared with arteries because they operate under lower pressure. Their structure includes valves to prevent backflow, but they do not require thick muscular walls to maintain blood pressure.
B. Venules are incorrect. Venules are small vessels that collect blood from capillaries and transport it to veins. Their walls are very thin, primarily composed of endothelium and a small amount of smooth muscle, insufficient for significant pressure regulation.
C. Capillaries are incorrect. Capillaries consist of a single layer of endothelial cells and a basement membrane to facilitate exchange of gases, nutrients, and waste between blood and tissues. They have no smooth muscle layer.
D. Arteries is correct. Arteries have the thickest walls and the most smooth muscle and elastic tissue of all blood vessels. This structure allows arteries to withstand and regulate high-pressure blood flow from the heart, maintain blood pressure through vasoconstriction and vasodilation, and distribute blood efficiently to organs and tissues. The thick smooth muscle layer is essential for maintaining vascular tone and responding to changes in physiological demand.
Correct Answer is D
Explanation
Rationale:
A. Thrombocytosis refers to an elevated platelet count, which can increase the risk of clot formation. It is unrelated to white blood cells and does not indicate infection or inflammation.
B. Neutropenia is a decreased number of neutrophils, a type of white blood cell, which can increase susceptibility to infections. This term represents a deficiency rather than an increase in white blood cells.
C. Anemia refers to a reduced number of red blood cells or decreased hemoglobin, leading to impaired oxygen delivery. It is unrelated to white blood cell counts or immune response.
D. Leukocytosis is defined as an increase in the total number of white blood cells (leukocytes), often in response to infection, inflammation, stress, or certain hematologic disorders. This increase is part of the body’s immune response, helping to fight pathogens and promote healing.
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