The nurse is instructing the client with chronic kidney disease (CKD) to maintain adequate nutritional intake. Which diet would be most appropriate?

Low-protein, high-potassium.

High-calcium, high-potassium, high-protein.

High-carbohydrate, high-protein.

Low-protein, low-sodium, low-potassium.

Answer and Explanation

The Correct Answer is D

Choice A reason: A low-protein diet can be beneficial in reducing the workload on the kidneys by decreasing the production of waste products that need to be excreted. However, high-potassium intake is not recommended for CKD patients because their kidneys may not efficiently excrete potassium, leading to hyperkalemia, which can be dangerous.

Choice B reason: A diet high in calcium, potassium, and protein is not suitable for CKD patients. Excessive protein can increase the production of waste products, calcium intake needs to be monitored to avoid complications like calcification, and high potassium levels can lead to hyperkalemia. This combination could potentially worsen the patient's condition.

Choice C reason: A high-carbohydrate, high-protein diet is not ideal for CKD patients. While carbohydrates can provide energy, high protein intake increases the load on the kidneys. The goal is to reduce the production of waste products that the kidneys need to filter, so a high-protein diet is counterproductive.

Choice D reason: A low-protein, low-sodium, low-potassium diet is most appropriate for CKD patients. Reducing protein intake decreases the production of waste products, low sodium helps control blood pressure and fluid balance, and low potassium prevents hyperkalemia. This diet helps manage the symptoms and progression of CKD more effectively.

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Correct Answer is B

Explanation

Choice A reason: Decreased cardiac arrhythmias are not the primary desired effect of dobutamine in heart failure patients. While dobutamine can have some effects on heart rhythm, its main action is to increase the strength of the heart's contractions.

Choice B reason: Increased myocardial contractility is the correct and desired effect of dobutamine. Dobutamine is a positive inotropic agent, meaning it increases the force of the heart's contractions. This is particularly beneficial in heart failure patients as it helps improve cardiac output and the effectiveness of the heart as a pump, thus alleviating symptoms of heart failure and improving organ perfusion.

Choice C reason: Decreased electrical conductivity in the heart is not an effect of dobutamine. In fact, dobutamine can increase the risk of arrhythmias due to its stimulating effects on the heart. The drug works by enhancing the contractility of the heart muscle rather than altering the electrical conduction system.

Choice D reason: Dilated coronary arteries are not a primary effect of dobutamine. While the drug may have some vasodilatory properties, especially at higher doses, its primary role is to enhance myocardial contractility rather than directly dilate the coronary arteries.

A. Regulation of water balance B. Regulation of acid-base balance C. Regulation of blood pressure D. Regulation of metabolic wastes

Correct Answer is A

Explanation

Choice A reason: The regulation of water balance by the kidneys involves maintaining the appropriate volume and concentration of body fluids. By taking daily weights, nurses can assess fluid retention or loss, while monitoring intake and output (I&O) helps track fluid balance. Specific gravity measures the concentration of urine, which provides information about the kidneys' ability to concentrate or dilute urine. These interventions directly relate to the kidneys' role in regulating water balance.

Choice B reason: Regulation of acid-base balance by the kidneys involves maintaining the proper pH levels in the blood through excretion or retention of hydrogen ions and bicarbonate. While important, this function is not the primary focus of interventions like daily weights, I&O, and specific gravity monitoring, which are more related to water balance.

Choice C reason: The regulation of blood pressure by the kidneys is achieved through the renin-angiotensin-aldosterone system, which controls blood volume and systemic vascular resistance. Although fluid balance can indirectly affect blood pressure, the specific interventions mentioned are more directly related to water balance than blood pressure regulation.

Choice D reason: Regulation of metabolic wastes involves the kidneys filtering and excreting waste products from the blood. This function is vital for overall health, but interventions like daily weights, I&O, and specific gravity monitoring are more focused on assessing fluid balance rather than directly measuring waste elimination.

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The nurse is instructing the client with chronic kidney disease (CKD) to maintain adequate nutritional intake. Which diet would be most appropriate?

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Naxlex Comprehensive Predictor Exams

A client with acute heart failure is receiving dobutamine. What is the desired effect of this drug in a patient with heart failure?

Correct Answer is B

Explanation

Nursing interventions such as taking daily weights, I&O, and monitoring specific gravity relate to which kidney function?

Correct Answer is A

Explanation

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