A client is admitted for hemodialysis. Which abnormal lab value would the nurse anticipate not being improved by hemodialysis?

Correct Answer: A

Rationale: In the context of a client undergoing hemodialysis, the nurse would anticipate that low hemoglobin (Option A) would not be improved by this procedure. Hemodialysis primarily focuses on removing waste products and excess fluids from the blood, such as urea and creatinine, which are water-soluble substances. Hemoglobin, on the other hand, is a component of red blood cells responsible for oxygen transport and is not directly affected by the process of hemodialysis. Hypernatremia (Option B), high serum creatinine (Option C), and hyperkalemia (Option D) are all conditions that can be effectively managed through hemodialysis. Hypernatremia can be corrected by adjusting the sodium concentration in the dialysate, high serum creatinine levels can be reduced by clearing the blood of waste products, and hyperkalemia can be normalized by removing excess potassium during hemodialysis. From an educational perspective, understanding the rationale behind the impact of hemodialysis on different lab values is crucial for nurses caring for clients undergoing this procedure. It reinforces the importance of monitoring lab values, understanding the principles of hemodialysis, and providing safe and effective care to clients with renal insufficiency.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Crashing. The term "crashing" in the context of drug use refers to the period following the high when the user experiences a range of unpleasant symptoms. This can include fatigue, depression, anxiety, irritability, and intense drug cravings. It is a physiological response to the stimulant effects of cocaine wearing off and the body's attempt to regain balance. Option A) Craving is incorrect because while it is a common experience after drug use, it specifically refers to the intense desire or urge to use the drug again, rather than the overall unpleasant feeling after the high. Option C) Outward bound is unrelated to the physiological effects of cocaine use and does not describe the specific state discussed in the question. Option D) Nodding out is a term more commonly associated with opioid use, describing the drowsy, semi-conscious state that users may experience, which is not typically associated with the effects of cocaine. In an educational context, understanding the physiological and psychological effects of drug use, such as the concept of crashing after a cocaine high, is crucial for healthcare professionals, especially nurses, who may encounter patients with substance use disorders. Recognizing these symptoms and understanding their implications can help in providing appropriate care and support to individuals struggling with substance abuse.

Correct Answer: C

Rationale: The correct answer is C) Palpate for a thrill over the fistula. This action is important because a thrill is a vibrating sensation that can be felt over a functioning fistula, indicating proper blood flow. Assessing for a thrill is a key nursing intervention to ensure the patency of the fistula and the success of hemodialysis treatments. This assessment technique allows the nurse to detect any potential issues with blood flow promptly. Option A) Observe for edema proximal to the site is incorrect because edema may not always be present even if there is an issue with the fistula. Option B) Irrigate with 5 mls of 0.9% Normal Saline is incorrect as it is not a standard practice to irrigate a fistula without a specific medical order. Option D) Check color and warmth in the extremity is also incorrect because while changes in color and warmth can indicate issues, they may not always be reliable indicators of fistula patency. In an educational context, it is crucial for nursing students to understand the importance of proper fistula assessment in clients with end-stage renal disease. By mastering this skill, students can ensure the safety and effectiveness of hemodialysis treatments for their patients, promoting positive outcomes and quality care.

Correct Answer: C

Rationale: The correct answer is C) Decreased cardiac output. In a post myocardial infarction client, a drop in urinary output can be attributed to decreased cardiac output. This is because a compromised heart function can lead to reduced perfusion to the kidneys, resulting in decreased urine production. Option A) Dehydration is less likely in this scenario as the client is in an intensive care unit where fluid balance is closely monitored. Option B) Diminished blood volume could be a consequence of decreased cardiac output, but it is not the primary reason for the drop in urinary output in this case. Option D) Renal failure would typically present with other signs and symptoms such as changes in electrolyte levels and increased creatinine levels, which are not mentioned in the question stem. Educationally, understanding the relationship between cardiac output and renal perfusion is crucial in managing post myocardial infarction clients. Nurses need to recognize the signs of inadequate tissue perfusion and understand the impact it can have on organ function, particularly the kidneys. Monitoring urinary output is a key component of assessing a client's hemodynamic status and response to treatment in critical care settings.

Correct Answer: C

Rationale: Idiosyncratic response means it occurs because of an unknown reason. This response to something the body has been exposed to before is not unknown. Autoimmune disorders are ones in which the body attacks self-cells. This example is an outside antigen. Type I hypersensitivities are those that occur when the body, previously sensitized to a substance, is then exposed a second time and reacts. Immunossuppression occurs when the immune system is not working. Mr. Rowe's immune system responded to the antigen, so it is not suppressed.