A client with chronic kidney disease (CKD) arrives at the emergency department reporting shortness of breath upon exertion. What should the nurse assess first?

Correct Answer: A

Rationale: In a client with chronic kidney disease (CKD) experiencing shortness of breath upon exertion, the nurse should first assess blood pressure. CKD often leads to fluid overload and hypertension due to impaired kidney function, which can exacerbate pulmonary edema and cause dyspnea. Elevated blood pressure can directly contribute to cardiac workload and respiratory distress, making it a critical initial assessment. While respiratory rate, oxygen saturation, and heart rate are also important, blood pressure provides immediate insight into the underlying cause and guides subsequent interventions, such as administering antihypertensive or diuretic therapy.

Correct Answer: B

Rationale: Eliminating whole milk and daily ice cream indicates successful teaching for cholecystitis. This condition involves gallbladder inflammation, often from gallstones, worsened by high-fat foods like whole milk and ice cream, which trigger bile release and pain. Low-fat diets are recommended. Pasta with herbal butter is lower fat, canned vegetables with salt affect sodium not fat, and citrus/melon are neutral, making dairy elimination the key sign of understanding dietary management.

Correct Answer: B

Rationale: Podocytes are specialized, branching epithelial cells located in the visceral layer of the glomerular (Bowman's) capsule, surrounding the glomerular capillaries. Their foot processes form filtration slits, allowing small molecules like water and ions to pass into the capsule while retaining larger proteins. This role in filtration distinguishes them from cells in the proximal tubule (reabsorption), distal tubule (macula densa), or collecting duct (water regulation), making B the correct answer.

Correct Answer: C

Rationale: The filtration membrane consists of three layers: fenestrated endothelium, basement membrane, and visceral layer of the glomerular capsule (podocytes with filtration slits), filtering blood into the capsule. The capsular space (Bowman's space) is where filtrate collects, not part of the membrane itself, distinguishing it from the structural components, making C correct.

Correct Answer: A

Rationale: The proximal convoluted tubule (PCT) is the primary site for secreting organic ions like urate and creatinine. Specialized transporters in the PCT move these substances from peritubular capillaries into the tubular lumen, aiding waste elimination. The distal tubule secretes H⁺ and K⁺, while the Loop and collecting duct have different roles, making A correct.