The nurse is caring for a client with a history of chronic kidney disease. Which dietary restriction should the nurse emphasize?

Limit potassium-rich foods

Increase protein intake

Restrict carbohydrate consumption

Encourage high-sodium foods

Answer and Explanation

The Correct Answer is A

Choice A reason: Limiting potassium-rich foods is critical in chronic kidney disease, as impaired renal excretion causes hyperkalemia, risking cardiac arrhythmias. Foods like bananas and oranges are restricted to maintain safe potassium levels, making this the priority dietary teaching to prevent life-threatening complications.

Choice B reason: Increasing protein intake is inappropriate, as chronic kidney disease requires protein restriction to reduce uremic toxins and kidney workload. Potassium restriction is prioritized, as hyperkalemia poses an immediate cardiac risk, making it the essential dietary focus over protein adjustments.

Choice C reason: Restricting carbohydrates is not standard in chronic kidney disease unless diabetes is present. Potassium restriction is critical, as elevated potassium levels from impaired renal clearance cause arrhythmias, making it the priority dietary intervention to ensure cardiac safety.

Choice D reason: Encouraging high-sodium foods is incorrect, as sodium restriction prevents fluid retention and hypertension in chronic kidney disease. Potassium restriction is the priority, as hyperkalemia directly threatens cardiac function, making it the essential dietary focus over sodium concerns.

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Correct Answer is B

Explanation

Choice A reason: Transparent dressings are semi-permeable, suitable for superficial wounds with minimal exudate. Stage 3 pressure injuries, with deeper tissue damage and granulation, require moisture-retentive dressings to support healing. Transparent dressings may not provide the moist environment needed for optimal granulation tissue formation and epithelialization in deeper wounds.

Choice B reason: Hydrocolloid gel dressings maintain a moist wound environment, ideal for stage 3 pressure injuries with granulation tissue. They promote autolytic debridement, support epithelialization, and protect the wound. This is the best choice, as gauze may adhere to granulation tissue, causing trauma during removal, unlike hydrocolloids, which foster healing.

Choice C reason: Leaving the dressing off exposes the wound to infection and drying, which impairs granulation tissue and delays healing. Stage 3 pressure injuries require a moist, protected environment. Consulting the provider may be appropriate for complex cases, but immediate dressing application is standard to maintain optimal wound conditions.

Choice D reason: Increasing dressing change frequency may disrupt granulation tissue and delay healing, especially with gauze, which can adhere to the wound bed. Stage 3 pressure injuries benefit from stable, moist environments provided by advanced dressings like hydrocolloids, not frequent changes that risk trauma and infection.

A. Monitor for respiratory depression B. Assess for constipation C. Check for skin rash D. Evaluate for nausea

Correct Answer is A

Explanation

Choice A reason: Hydromorphone, an opioid, poses a significant risk of respiratory depression by suppressing the brainstem’s respiratory centers. After four days, cumulative effects increase this risk, especially in opioid-naïve patients. Monitoring respiratory rate and depth is critical to prevent life-threatening hypoxia, making it the priority assessment.

Choice B reason: Constipation is a common hydromorphone side effect due to opioid-induced reduced gastrointestinal motility. While important, it is not life-threatening like respiratory depression. Monitoring bowel function is secondary, as respiratory compromise poses an immediate risk requiring urgent intervention in opioid therapy.

Choice C reason: Skin rash is a rare allergic reaction to hydromorphone, not a primary concern after four days of use. Respiratory depression is far more critical, as opioids directly depress respiratory drive, risking hypoxia, making rash assessment secondary to monitoring respiratory function.

Choice D reason: Nausea is a frequent hydromorphone side effect, often diminishing with continued use. While bothersome, it is not life-threatening compared to respiratory depression, which can cause rapid hypoxia. Monitoring respiratory status is the priority to ensure patient safety during opioid administration.

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The nurse is caring for a client with a history of chronic kidney disease. Which dietary restriction should the nurse emphasize?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is performing a routine dressing change for a client with a stage 3 pressure injury that is red with significant granulation. The wound has a gauze dressing covering the area. Which action should the nurse implement?

Correct Answer is B

Explanation

The nurse notes that a client has been receiving hydromorphone every six hours for four days. Which assessment is most important for the nurse to complete?

Correct Answer is A

Explanation

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