The laboratory findings for a client with chronic kidney disease (CKD) include elevated blood urea nitrogen (BUN) and serum creatinine levels. The client reports feeling fatigued and is unable to concentrate during the morning assessments. Based on these findings, which action should the nurse implement?

Provide high protein snacks.

Administer PRN oxygen.

Monitor glucose levels every 4 hours.

Schedule frequent rest periods.

Answer and Explanation

The Correct Answer is D

A.   Provide high protein snacks. High protein snacks may exacerbate the symptoms of CKD by increasing urea and creatinine levels further. It is not recommended.
B.   Administer PRN oxygen. Oxygen therapy is not indicated based on the symptoms described and the laboratory findings of elevated BUN and serum creatinine.
C.   Monitor glucose levels every 4 hours. Monitoring glucose levels is not directly related to the symptoms described or the laboratory findings associated with CKD.
D.   Schedule frequent rest periods. Fatigue and difficulty concentrating are common symptoms of CKD due to the buildup of waste products in the blood. Scheduling frequent rest periods can
help alleviate these symptoms and improve the client's overall well-being.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Test the fluid on the dressing for glucose.
This is the correct action. Clear fluid on a dressing after lumbar spinal surgery could indicate a cerebrospinal fluid (CSF) leak. Testing the fluid for glucose is essential because CSF contains glucose, whereas normal wound drainage does not. A positive glucose test would confirm the presence of CSF, indicating a potential complication that requires immediate medical attention.

B. Mark the drainage area with a pen and continue to monitor.
While monitoring the size of the drainage area can be useful, it is not the immediate priority. The nurse should first determine whether the clear fluid is CSF.

C. Change the dressing using a compression bandage.
Changing the dressing might be necessary, but using a compression bandage without first identifying the nature of the fluid could be inappropriate and potentially harmful if the fluid is CSF.

D. Document the findings in the electronic medical record.
Documentation is important, but it is not the immediate action. The nurse needs to identify the nature of the fluid first.

A. For the next 24 hours, notify the nurse when the bladder is full, and the nurse will collect catheterized specimens. B. Urinate immediately into a urinal, and the lab will collect the specimen every 6 hours for the next 24 hours. C. Urinate at a specified time, discard this urine, and collect all subsequent urine during the next 24 hours. D. Cleanse and meatus, discard the first portion of voiding, and collect the rest in a sterile bottle.

Correct Answer is C

Explanation

A. This instruction is incorrect because it suggests collecting catheterized specimens, which is not necessary for a creatinine clearance test. Catheterization may increase the risk of contamination and is not typically performed for this test.
B. This instruction is incorrect because it does not involve the collection of a complete 24-hour urine specimen. Collecting specimens every 6 hours would not provide an accurate measurement of creatinine clearance over a 24-hour period.
C. This instruction is correct. For a 24-hour urine collection, the client should urinate at a specified time to start the collection period, discard this urine, and then collect all subsequent urine produced over the next 24 hours. This ensures that the entire 24-hour period is captured for analysis.
D. This instruction is incorrect because it does not involve the collection of all urine produced over a 24-hour period. Additionally, discarding the first portion of voiding is not necessary for a creatinine clearance test and may lead to inaccurate results.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse identifies the presence of clear fluid on the surgical dressing of a client who just returned to the unit following lumbar spinal surgery. Which action should the nurse implement immediately?

Correct Answer is A

Explanation

The nurse plans to collect a 24-hour urine specimen for a creatinine clearance test. Which instruction should the nurse provide to the CLIENT?

Correct Answer is C

Explanation

The nurse is providing teaching to a client admitted with a blood glucose level of 580 mg/dL about preventing complications related to diabetes mellitus. Which information reported by the client indicates understanding?

The nurse is assigned to care for a client diagnosed with psoriasis. Which behavior by the nurse addresses this client's psychosocial need for acceptance?

To auscultate for a carotid bruit, the nurse places the stethoscope at what location (Select the correct location on the image. To change, click on a new location.)

A client who weighs 176 pounds receives a prescription for enoxaparin sodium 1.5mg/kg/day subcutaneously. The medication is available in 120 mg/0.8 mL prefilled syringe. How many mL should the nurse administer? (Enter numerical value only.)

The nurse is teaching a group of women about osteoporosis and exercise. The nurse should emphasize the need for which type of regular activity?

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