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.

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice A rationale
The left extrapyramidal tract is involved in motor control, but lesions here would not cause right homonymous hemianopia or inability to move the right arm. These symptoms are more indicative of a lesion in the cerebral hemisphere.
Choice B rationale
A lesion in the right cerebral hemisphere would cause left-sided symptoms, not right-sided. The patient’s symptoms are indicative of a lesion in the left cerebral hemisphere.
Choice C rationale
The cerebellum is involved in coordination and balance, not in causing right homonymous hemianopia or inability to move the right arm. These symptoms are more indicative of a lesion in the cerebral hemisphere.
Choice D rationale
A lesion in the left cerebral hemisphere can cause right homonymous hemianopia and inability to move the right arm. This is because the left hemisphere controls the right side of the body and processes visual information from the right visual field.

A. Meningitis. B. Myocardial infarction. C. Appendicitis. D. Pneumonia.

Correct Answer is A

Explanation

Choice A rationale
A temperature of 38°C (100.4°F) and a stiff neck are classic signs of meningitis, indicating inflammation of the meninges.
Choice B rationale
Myocardial infarction typically presents with chest pain, not a stiff neck.
Choice C rationale
Appendicitis presents with abdominal pain, not a stiff neck.
Choice D rationale
Pneumonia presents with respiratory symptoms, not a stiff neck.

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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:

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Naxlex Comprehensive Predictor Exams

A patient with cerebral ischemia has signs and symptoms of right homonymous hemianopia and inability to move the right arm. This is indicative of increased intracranial pressure that is most probably due to a lesion in the:

Correct Answer is D

Explanation

A client presents with a temperature of 38°C (100.4°F) and a stiff neck. Which condition should the nurse suspect?

Correct Answer is A

Explanation

A patient has been told that the recent changes in her facial features are due to a hormonal pathology called myxedema. Her nurse’s explanation will be based on understanding that myxedema is:

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A goiter is often associated with:

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