A patient with chronic kidney disease usually has a decrease in the ability to activate vitamin D, likely resulting in signs and symptoms (S&S) such as:
Hypercalcemia: increased absorption of calcium from the gut into the blood.
A positive Chvostek’s sign: hypocalcemia.
Tetany: hyperpolarization.
Hyperphosphatemia: inability to absorb phosphate from the gut into the blood.
The Correct Answer is B
Choice A rationale
Hypercalcemia is characterized by increased calcium levels in the blood, often due to increased absorption of calcium from the gut. However, in chronic kidney disease (CKD), the kidneys’ ability to activate vitamin D is impaired, leading to decreased calcium absorption from the gut, not increased. Therefore, hypercalcemia is not a typical sign of CKD1.
Choice B rationale
A positive Chvostek’s sign is indicative of hypocalcemia, which is a common symptom in CKD. The kidneys’ reduced ability to activate vitamin D leads to decreased calcium absorption from the gut, resulting in low calcium levels in the blood. This hypocalcemia can cause neuromuscular irritability, leading to a positive Chvostek’s sign.
Choice C rationale
Tetany is a condition characterized by muscle cramps and spasms, often due to hypocalcemia. In CKD, hypocalcemia occurs due to the kidneys’ inability to activate vitamin D, leading to decreased calcium absorption from the gut. This hypocalcemia can cause hyperexcitability of nerves and muscles, resulting in tetany.
Choice D rationale
Hyperphosphatemia is characterized by high phosphate levels in the blood. In CKD, the kidneys’ ability to excrete phosphate is impaired, leading to its accumulation in the blood. However, this is not directly related to the inability to absorb phosphate from the gut but rather the kidneys’ reduced excretion capacity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Autonomic neuropathy is a common complication of diabetes and can affect various autonomic functions, including heart rate, blood pressure, and digestion. It is caused by damage to the autonomic nerves due to prolonged high blood sugar levels.
Choice B rationale
Diabetic-induced leukocyte depletion is not a recognized complication of diabetes. Diabetes primarily affects blood vessels and nerves rather than causing leukocyte depletion.
Choice C rationale
Diabetic-induced angiopathy refers to damage to blood vessels caused by diabetes. While it is a recognized complication, autonomic neuropathy is more directly related to diabetic-induced complications.
Choice D rationale
Overdrive of the RAAS (renin-angiotensin-aldosterone system) is not a specific complication of diabetes. While diabetes can affect the RAAS, it is not the most likely condition related to diabetic-induced complications.
Correct Answer is B
Explanation
Choice A rationale
Deep vein thrombosis (DVT) can lead to pulmonary embolism but does not directly cause chest pain and shortness of breath.
Choice B rationale
Pulmonary embolus (PE) is characterized by chest pain, shortness of breath, and hemoptysis (coughing up blood), especially in patients on bed rest.
Choice C rationale
Anemia can cause fatigue and shortness of breath but not typically chest pain and hemoptysis.
Choice D rationale
Right heart failure can cause shortness of breath and edema but not typically chest pain and hemoptysis.
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