Recognizing the role of the kidney in the production of erythropoietin, the nurse assesses a client with chronic kidney disease (CKD) for which clinical manifestation?

Pallor.

Petechiae.

Jaundice.

Pruritus.

Answer and Explanation

The Correct Answer is A

Choice A reason: In CKD, impaired kidneys produce less erythropoietin, reducing red blood cell production and causing anemia. Pallor results from decreased hemoglobin, a hallmark of CKD-related anemia. This manifestation aligns with the kidney’s role in erythropoiesis, making it the primary clinical sign the nurse should assess in this client.

Choice B reason: Petechiae, small skin hemorrhages, result from platelet dysfunction or vascular issues, not directly from reduced erythropoietin in CKD. While CKD may cause uremic bleeding tendencies, petechiae are less specific than pallor, which directly reflects anemia due to impaired erythropoietin production, a core pathophysiological feature.

Choice C reason: Jaundice, caused by bilirubin accumulation, indicates liver dysfunction or hemolysis, not erythropoietin deficiency. CKD does not typically cause jaundice unless complicated by unrelated conditions. Pallor from anemia is a more direct consequence of reduced erythropoietin, making it the priority manifestation for assessment in CKD.

Choice D reason: Pruritus in CKD results from uremic toxin accumulation or calcium-phosphate imbalances, not erythropoietin deficiency. While common, it is unrelated to the kidney’s erythropoiesis role. Pallor, linked to anemia from low erythropoietin, is the most relevant clinical sign for the nurse to assess in this context.

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Correct Answer is D

Explanation

Choice A reason: Polyuria, excessive urination, is not caused by renal calculi movement. Stones obstruct the ureter, reducing urine flow and causing pain, not increased output. Polyuria is associated with conditions like diabetes, making this incorrect for the pathophysiological change linked to calculi movement in the urinary tract.

Choice B reason: Uric acid increases may contribute to stone formation but are not a change caused by calculi movement. Movement triggers pain and obstruction, not serum uric acid changes. Renal colic is the direct result of stones moving, making this choice incorrect for the pathophysiological effect.

Choice C reason: Cystitis, bladder inflammation, may occur secondary to stones but is not the primary change from calculi movement. Stones moving through the ureter cause renal colic due to obstruction and spasm. Cystitis is a complication, not the direct pathophysiological change, making this incorrect.

Choice D reason: Renal colic, severe pain from ureteral obstruction and smooth muscle spasm, occurs as renal calculi move through the urinary tract. Stones irritate and block the ureter, triggering intense, colicky pain. This is the primary pathophysiological change, aligning with urological evidence for stone movement effects.

A. Maintain a normal amount of circulating antidiuretic hormone. B. Increase the client’s serum osmolarity. C. Increase the excretion of acetone in the client’s urine. D. Control the client’s blood glucose levels.

Correct Answer is D

Explanation

Choice A reason: Normal antidiuretic hormone levels regulate water balance but do not address thirst in diabetes mellitus, which is caused by hyperglycemia-induced osmotic diuresis. Controlling blood glucose corrects the osmotic imbalance driving thirst, making ADH maintenance less relevant and incorrect for this manifestation’s control.

Choice B reason: Increasing serum osmolarity would worsen thirst, as high osmolarity from hyperglycemia causes dehydration and polydipsia. The goal is to reduce osmolarity by controlling blood glucose, which mitigates osmotic diuresis. This choice is incorrect, as it exacerbates the mechanism driving the client’s symptom.

Choice C reason: Increased acetone excretion occurs in diabetic ketoacidosis, not directly related to thirst in new diabetes mellitus. Thirst results from hyperglycemia causing osmotic diuresis. Controlling glucose levels addresses the root cause, making acetone excretion irrelevant and incorrect for managing polydipsia in this client.

Choice D reason: Increased thirst in diabetes mellitus results from hyperglycemia causing osmotic diuresis, leading to dehydration. Controlling blood glucose levels reduces serum osmolarity, preventing fluid loss and alleviating thirst. This is the primary physiologic mechanism, supported by endocrinology evidence for managing diabetes-related polydipsia effectively.

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Recognizing the role of the kidney in the production of erythropoietin, the nurse assesses a client with chronic kidney disease (CKD) for which clinical manifestation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who has been diagnosed with renal calculi. Which pathophysiologic change occurs as renal calculi move through the urinary tract?

Correct Answer is D

Explanation

A client newly diagnosed with diabetes mellitus is experiencing increased thirst. Which physiologic mechanism must take place to control this manifestation?

Correct Answer is D

Explanation

Recognizing the role of the kidney in the production of erythropoietin, the nurse assesses a client with chronic kidney disease (CKD) for which clinical manifestation?

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