The nurse is caring for four clients with chronic kidney disease (CKD). Which client would the nurse assess first upon initial rounding?

Client with skin Itching from head to toe

Client with a blood pressure of 158/90 mm Hg

Client with halitosis and stomatitis

Client with Kussmaul respirations

Answer and Explanation

The Correct Answer is D

Rationale:
A. Pruritus is a common symptom of CKD due to the buildup of uremic toxins and calcium-phosphate crystals under the skin. While uncomfortable, it is not immediately life-threatening and does not require urgent assessment.

B. Hypertension is common in CKD as a result of fluid retention and activation of the renin-angiotensin system. Although this blood pressure needs monitoring and management, it is not an emergency requiring first assessment.

C. These are uremic manifestations due to the accumulation of ammonia and toxins in the body. They indicate progression of CKD but are not urgent or immediately life-threatening findings.

D. Kussmaul respirations are deep, rapid breathing that occur as a compensatory mechanism for metabolic acidosis, a serious and potentially life-threatening complication of CKD. This client should be assessed first to evaluate acid-base balance, respiratory effort, and potential need for urgent intervention such as dialysis or bicarbonate therapy.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is D

Explanation

Rationale:
A. Antihypertensives may be prescribed as supportive therapy to control elevated blood pressure, which is common in glomerulonephritis. However, they do not address the underlying cause, which is the streptococcal infection.

B. Anti-lipids (lipid-lowering agents) are not a standard treatment for acute glomerulonephritis. While hyperlipidemia can occur in chronic kidney disease, it is not the priority in the acute phase caused by infection.

C. Antidepressants may be used for patients experiencing long-term chronic illness–related depression, but they have no therapeutic role in treating acute glomerulonephritis.

D. Antibiotics are the expected and priority therapy for acute glomerulonephritis caused by beta-hemolytic Streptococcus infection. Treating the infection with appropriate antibiotics (e.g., penicillin) helps eliminate the organism, prevent further immune response, and reduce the risk of additional kidney damage.

A. Maintain a mean arterial pressure of 65 mm Hg. B. Prevent kidney infections by administering antibiotics. C. Give antihistamines to prevent allergic response. D. Correct fluid volume by administering IV normal saline.

Correct Answer is D

Explanation

Rationale:
A. Maintaining a mean arterial pressure (MAP) of 65 mm Hg is important for ensuring adequate renal perfusion in general, but in the initial phase of acute kidney injury (AKI) following an anaphylactic reaction, the immediate priority is to restore intravascular volume. Hypotension from anaphylaxis causes decreased renal perfusion, which must be corrected first to prevent ischemic injury.
B. Antibiotics are not indicated unless there is a documented or suspected infection. In this scenario, the AKI is due to hemodynamic instability, not infection.
C. Antihistamines help manage the allergic response during the acute phase of anaphylaxis but do not directly prevent kidney damage once perfusion has already decreased.
D. The primary treatment goal during the initial phase of AKI secondary to anaphylaxis is to restore circulating blood volume and renal perfusion by administering IV isotonic fluids (normal saline). This helps maintain glomerular filtration rate (GFR), prevents tubular ischemia, and reduces the risk of permanent kidney damage. Fluid resuscitation is critical before considering vasopressors or other supportive measures.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The nurse is caring for four clients with chronic kidney disease (CKD). Which client would the nurse assess first upon initial rounding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is admitting a client who has acute glomerulonephritis caused by beta streptococcus. What drug therapy would the nurse expect to be prescribed for this client?

Correct Answer is D

Explanation

The nurse is caring for a patient with acute kidney injury that developed after a severe anaphylactic reaction. What is a primary treatment goal of the initial phase that will help to prevent permanent kidney damage for this patient?

Correct Answer is D

Explanation

The nurse is caring for four clients with chronic kidney disease (CKD). Which client would the nurse assess first upon initial rounding?

A nurse is caring for a client who has end-stage kidney disease who will soon begin hemodialysis treatments. Which of the following restrictions should the nurse discuss with the client that may impact quality of life? (Select All that Apply.)

A client with acute kidney injury (AKI) has a blood pressure of 76/55 mm Hg. The primary health care provider prescribed 1000 mL of normal saline to be infused over 1 hour to maintain perfusion. The client starts to develop shortness of breath. What is the nurse's priority action?

A nurse evaluates a client with acute glomerulonephritis (GN). Which assessment finding would the nurse recognize as a positive response to the prescribed treatment?

The charge nurse is orienting a new nurse about care for an assigned client with an arteriovenous (AV) fistula for hemodialysis in her left arm. Which action by the float nurse would be considered unsafe?

The nurse is caring for four clients with chronic kidney disease (CKD). Which client would the nurse assess first upon initial rounding?

A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of acute kidney injury?