A client on hemodialysis is complaining of muscle weakness and numbness in his legs. His lab results are: Na 136 mEq/L, K 5.9 mEq/L, Cl 100 mEq/L, ca 8.5 mg/dl. Which electrolyte imbalance is the client suffering from?

Correct Answer: A

Rationale: The correct answer is A: Hyperkalemia. In hemodialysis, potassium levels can be elevated due to impaired renal excretion. High potassium can lead to muscle weakness and numbness. The client's K level of 5.9 mEq/L is above the normal range (3.5-5.0 mEq/L), confirming hyperkalemia. Na, Cl, and Ca levels are within normal limits, ruling out hypernatremia, hypochloremia, and hypocalcemia as the client's primary electrolyte imbalance. Monitoring and managing hyperkalemia are crucial to prevent life-threatening complications like cardiac arrhythmias.

Correct Answer: B

Rationale: The correct answer is B: Keep extremities at neutral position. This intervention promotes proper blood flow and reduces the risk of thrombophlebitis by preventing compression or restriction of blood vessels. Removing and reapplying elastic stockings (choice A) can disrupt circulation and increase the risk of thrombophlebitis. Changing the client's position (choice C) may not directly address hemostasis or thrombophlebitis. Using a flotation mattress (choice D) is not specifically focused on maintaining proper positioning of the extremities to promote circulation.

Correct Answer: B

Rationale: Rationale: The correct answer is B because the kidneys do not reabsorb carbon dioxide to regulate acid-base balance. Carbon dioxide is mainly regulated by the lungs through respiration. The kidneys regulate acid-base balance by excreting hydrogen ions, reabsorbing or excreting bicarbonate (HCO3-) into the blood, and retaining or excreting hydrogen ions. Reabsorbing carbon dioxide is not a mechanism utilized by the kidneys for acid-base balance. Choices A, C, and D are correct mechanisms involved in acid-base balance regulation by the kidneys.

Correct Answer: A

Rationale: The correct answer is A: Failing to involve the client in the planning process. This is because involving the client in the planning process is crucial for promoting client-centered care and ensuring that the outcomes are realistic and aligned with the client's goals. By engaging the client, the nurse can better understand their preferences and values, leading to more effective planning and goal setting. Choice B is incorrect as collecting data to establish a database is related to assessment, not outcome identification and planning. Choice C is incorrect as stating specific and measurable outcomes based on nursing diagnoses is actually a key component of effective outcome identification and planning. Choice D is incorrect as writing clear nursing orders, although important, is more related to implementation rather than outcome identification and planning.

Correct Answer: A

Rationale: The correct answer is A: Pregnancy. During pregnancy, the need for iron increases significantly to support the growth of the fetus and to prevent maternal anemia. Iron is essential for the production of hemoglobin and for oxygen transport in the blood. In contrast, infants require iron for rapid growth and development, making choice B partially correct. Choice C (Old age) and choice D (Male reproductive years) are incorrect as the need for iron typically decreases in old age and remains relatively stable during male reproductive years.

Correct Answer: A

Rationale: The correct answer is A: 7.35-7.45. Plasma pH typically falls within this range for normal clients. A pH of 7.35-7.45 indicates a slightly alkaline to neutral environment, which is essential for various physiological processes to function optimally. Choices B, C, and D have pH values outside the normal range, indicating either acidic (B and C) or highly alkaline (D) conditions, which would be abnormal and potentially harmful to the body's functioning. Therefore, the normal range for plasma pH is crucial to maintain homeostasis and support overall health.

Correct Answer: D

Rationale: The correct answer is D: Hyperparathyroidism. This disorder is characterized by excessive secretion of parathyroid hormone, leading to increased calcium levels in the blood. The symptoms described in the question - bone pain, weakness, irritability, and depression - are all associated with hypercalcemia, a common manifestation of hyperparathyroidism. Additionally, the client's anorexia and increased urination can be attributed to the effects of hypercalcemia on the gastrointestinal and renal systems. Diabetes mellitus (choice A) involves high blood sugar levels and is not associated with the symptoms described. Hypoparathyroidism (choice B) is characterized by low levels of parathyroid hormone and calcium, leading to different symptoms such as muscle cramps and seizures. Diabetes insipidus (choice C) is a disorder of water balance characterized by excessive thirst and urination, not the symptoms presented in the question.

Correct Answer: B

Rationale: The correct answer is B: ELISA and Western Blot. The rationale is as follows: ELISA (enzyme-linked immunosorbent assay) and Western Blot are specific tests used to confirm HIV infection by detecting antibodies or antigens related to the virus. ELISA is the initial screening test, while Western Blot is the confirmatory test. These tests are highly sensitive and specific for HIV detection. Choice A is incorrect because CD4+ cell count and thymus function are not tests used to confirm HIV infection. They are used to monitor disease progression and immune function in HIV-positive individuals. Choice C is incorrect because B-cell and T-cell count are also not tests used to confirm HIV infection. They are indicators of immune system health but not specific for HIV diagnosis. Choice D is incorrect because while CD4+ and viral load tests are used in monitoring HIV progression, ELISA is the main confirmatory test for HIV diagnosis, and viral load is not typically used for initial

Correct Answer: B

Rationale: The correct answer is B: canned tomato juice. Canned tomato juice is high in sodium content, which would not be suitable for a patient on a 2 gm sodium diet for heart failure. Sodium restriction is crucial in managing heart failure to reduce fluid retention and strain on the heart. Whole wheat bread, beef tenderloin strips, and apples are lower in sodium content compared to canned tomato juice, making them more appropriate choices for someone on a low-sodium diet.