A patient with chronic kidney disease (CKD) develops anemia. The nurse explains to the patient that anemia in CKD is primarily due to which cause?

Escape of red blood cells through damaged glomeruli

Minimal production of erythropoietin by the kidney

Decrease absorption of Vitamin B12 and folic acid

Interference with transportation of iron to bone marrow

Answer and Explanation

The Correct Answer is B

A. Escape of red blood cells through damaged glomeruli: Hematuria can occur in some kidney diseases, but the loss of red blood cells through glomerular damage is usually minimal and does not account for the chronic anemia seen in CKD. This mechanism is not the primary cause of anemia in these patients.

B. Minimal production of erythropoietin by the kidney: The kidneys produce erythropoietin, a hormone that stimulates bone marrow to produce red blood cells. In CKD, damaged renal tissue reduces erythropoietin synthesis, leading to decreased red blood cell production and anemia. This is the most common and primary cause of anemia in CKD patients.

C. Decrease absorption of Vitamin B12 and folic acid: Vitamin B12 and folate deficiencies can contribute to megaloblastic anemia, but absorption is usually unaffected by CKD. Nutritional deficiencies are secondary contributors and not the main cause of anemia in chronic kidney disease.

D. Interference with transportation of iron to bone marrow: While CKD may cause functional iron deficiency due to inflammation and hepcidin elevation, iron transport interference is a contributing factor, not the primary cause. The key driver of anemia in CKD remains low erythropoietin production.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. Alteplase: Alteplase is a thrombolytic used to dissolve existing clots in conditions such as acute myocardial infarction, ischemic stroke, or massive pulmonary embolism. It is not used routinely for DVT prophylaxis because it carries a high risk of bleeding and is not preventive.

B. Clopidogrel: Clopidogrel is an antiplatelet agent used primarily for arterial thrombotic conditions, such as prevention of stroke or myocardial infarction. It does not provide adequate prophylaxis against venous thromboembolism, which is more platelet-independent and coagulation-factor dependent.

C. Warfarin: Warfarin is an oral anticoagulant that inhibits vitamin K–dependent clotting factors. While it can prevent DVT, it is not typically used immediately postoperatively due to delayed onset of action and the need for close INR monitoring.

D. Enoxaparin: Enoxaparin is a low-molecular-weight heparin commonly prescribed postoperatively to prevent DVT, especially after orthopedic surgeries like total knee replacement. It acts quickly, inhibits factor Xa, and effectively reduces venous thromboembolism risk in high-risk surgical patients.

A. Measure hourly urine output. B. Monitor daily weight. C. Check skin turgor. D. Assess mucous membranes.

Correct Answer is A

Explanation

A. Measure hourly urine output: In the emergent phase of burn injury, massive fluid shifts occur due to increased capillary permeability and third spacing. Hourly urine output is the most reliable and immediate indicator of adequate renal perfusion and effective fluid resuscitation. Maintaining urine output at approximately 0.5 mL/kg/hr in adults reflects sufficient circulating volume and organ perfusion.

B. Monitor daily weight: Daily weight is useful for evaluating overall fluid balance trends but is not sensitive enough for rapid assessment during the emergent phase. Fluid shifts in major burns occur quickly, requiring more immediate indicators than once-daily measurements.

C. Check skin turgor: Skin turgor is not a reliable indicator of fluid status in burn patients because skin integrity is compromised and edema is common. Burn injury alters the elasticity and appearance of the skin, limiting the usefulness of this assessment.

D. Assess mucous membranes: Mucous membrane moisture may provide general information about hydration status, but it does not accurately reflect intravascular volume in patients with significant burn injuries. Rapid capillary leak and fluid shifts require more precise monitoring parameters such as urine output.

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A patient with chronic kidney disease (CKD) develops anemia. The nurse explains to the patient that anemia in CKD is primarily due to which cause?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Explanation

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