A week after kidney transplantation, a client develops a temperature of 101°F (38.3°C), the blood pressure is elevated, and there is tenderness over the transplanted kidney. The serum creatinine is rising, and urine output is decreased. The x-ray indicates that the transplanted kidney is enlarged. Based on these assessment findings, the nurse anticipates which treatment?

Antibiotic therapy.

Peritoneal dialysis.

Removal of the transplanted kidney.

Increased immunosuppression therapy.

Answer and Explanation

The Correct Answer is D

Choice A reason: Antibiotics treat infection, but fever, tenderness, and rising creatinine suggest rejection, not infection. Immunosuppression addresses rejection, making this incorrect, as it’s less likely than the nurse’s anticipation of therapy to manage transplant rejection in the client.

Choice B reason: Peritoneal dialysis is used for kidney failure, not acute transplant rejection, which causes fever and creatinine rise. Immunosuppression is needed, making this incorrect, as it’s irrelevant to the nurse’s expected treatment for the client’s post-transplant symptoms.

Choice C reason: Removing the kidney is a last resort, not the first response to rejection signs like fever and tenderness. Increased immunosuppression is standard, making this incorrect, as it’s premature compared to the nurse’s anticipation of rejection management.

Choice D reason: Increased immunosuppression treats acute transplant rejection, indicated by fever, tenderness, rising creatinine, and kidney enlargement. This aligns with post-transplant care, making it the correct treatment the nurse would anticipate for the client’s symptoms one week after transplantation.

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Correct Answer is D

Explanation

Choice A reason: Referring to the ethics committee is premature without discussing the patient’s wishes with the family. Asking about the patient’s preferences respects autonomy, making this incorrect, as it bypasses the family’s role in decision-making for the unresponsive patient.

Choice B reason: Asking what the family wants is vague and may pressure them without context. Inquiring about the patient’s wishes guides ethical decisions, making this incorrect, as it’s less focused than the nurse’s approach to honor the patient’s likely preferences.

Choice C reason: Stating the doctor’s recommendation may bias the family and doesn’t explore the patient’s wishes. Asking what the patient would want is more patient-centered, making this incorrect, as it’s less collaborative in discussing ongoing care options.

Choice D reason: Asking what the patient would want respects autonomy and guides family decision-making in the absence of an advance directive. This aligns with ethical principles, making it the correct approach for the nurse to discuss ongoing care with the family.

A. Nonmaleficence. B. Fidelity. C. Beneficence. D. Veracity.

Correct Answer is D

Explanation

Choice A reason: Nonmaleficence ensures no harm but is less central than veracity, which ensures truthful disclosure for informed consent. Truthfulness enables autonomous decisions, making this incorrect, as it’s secondary to the ethical priority of honesty in the consent process for femur surgery.

Choice B reason: Fidelity involves keeping promises but doesn’t directly address the truthful disclosure required for informed consent. Veracity ensures the patient understands risks, making this incorrect, as it’s less relevant than honesty in the nurse’s role during the consent process for surgery.

Choice C reason: Beneficence promotes well-being but is secondary to veracity, which provides accurate information for the patient’s decision. Truthfulness is critical for consent, making this incorrect, as it’s not the primary ethical principle when soliciting informed consent for the femur procedure.

Choice D reason: Veracity, or truthfulness, is the most important ethical principle, ensuring the patient receives accurate information about risks and benefits for informed consent. This aligns with surgical ethical standards, making it the correct principle for the nurse to prioritize during the consent process.

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

The nurse is taking care of a 60-year-old client who is scheduled for open reduction internal fixation of the left femur. Which ethical principle is most important when soliciting informed consent from the patient?

Correct Answer is D

Explanation

A client returns to the unit immediately following a cardiac catheterization. Which action by the nurse is MOST important?

A nurse teaches a client with a new permanent pacemaker. Which instructions would the nurse include in this client’s teaching? (Select all that apply)

A client with severe ulcer disease in the distal stomach undergoes a gastrojejunostomy (Billroth II procedure). Which postoperative prescription would the nurse question and verify?

Which actions are considered best practices for the nurse to use during the administration of parenteral potassium to a client with a serum potassium level of 1.9 mEq/L (mmol/L)? (Select all that apply)

A patient’s blood pressure is 90/72 mm Hg. What is the patient’s pulse pressure?

A client with acute kidney injury has a serum potassium level of 7.0 mEq/L (7.0 mmol/L). The nurse would plan which actions as a priority? (Select all that apply)

The nurse is assessing the patency of a client’s left arm arteriovenous fistula prior to initiating hemodialysis. Which finding indicates that the fistula is patent?