A nurse is caring for a patient with chronic kidney disease (CKD). Which of the following lab results would the nurse expect to be elevated in this patient?

Correct Answer: A

Rationale: The correct answer is A: Blood urea nitrogen (BUN). In CKD, the kidneys are unable to effectively filter waste products, leading to an increase in BUN levels. Elevated BUN indicates impaired kidney function. Calcium, potassium, and sodium levels may also be affected in CKD, but they are more likely to be imbalanced rather than consistently elevated. Calcium levels may be low due to impaired vitamin D activation, potassium levels may be high due to decreased excretion, and sodium levels can fluctuate based on fluid status. Therefore, while these lab values may be abnormal in CKD, BUN is the most consistently elevated marker of kidney dysfunction.

Correct Answer: A

Rationale: The correct technique to determine the presence of crepitus during a physical examination is palpation. Crepitus is a crackling or grating sensation that is felt when there is air trapped in the subcutaneous tissue. Palpation involves using the hands to feel for abnormalities such as crepitus. Percussion involves tapping on the body to produce sounds that can help assess underlying structures, not to determine the presence of crepitus. Auscultation is listening to sounds within the body using a stethoscope, which is not relevant for detecting crepitus.

Correct Answer: B

Rationale: The correct answer is B: Specific client issues. A focused assessment is a targeted examination that addresses specific client concerns or issues. By focusing on a particular aspect of the client's health, healthcare providers can gather relevant information efficiently and effectively. This approach allows for a more in-depth evaluation of the specific problem at hand, leading to better treatment outcomes. Choice A (Comprehensive physical findings) is incorrect because a focused assessment does not aim to gather information on all physical findings, but rather on specific issues. Choice C (Multiple body systems) is incorrect because a focused assessment is more narrow in scope and typically focuses on one area or system of the body. Choice D (Long-term wellness goals) is incorrect as a focused assessment is more immediate and targeted towards addressing current issues rather than long-term goals.

Correct Answer: A

Rationale: The correct answer is A: Administer albuterol. Albuterol is a bronchodilator that helps open the airways, relieving wheezing in asthma patients. It is the first-line treatment for acute asthma exacerbations. Antihistamines (B) do not treat asthma symptoms. Monitoring for infection (C) is important but not the immediate action for wheezing. Epinephrine (D) is used for severe allergic reactions, not routine asthma management.

Correct Answer: B

Rationale: The correct answer is B: strain. A strain refers to excessive stretching or tearing of a muscle or tendon, not a ligament. A sprain (choice A) is the correct term for excessive stretching of a ligament. Subluxation (choice C) refers to partial dislocation of a joint, not a ligament injury. Distortion (choice D) is a general term that does not specifically describe ligament stretching. Therefore, the correct term for excessive stretching of a ligament is a sprain, making choice A the correct answer.

Correct Answer: B

Rationale: The correct answer is B because increasing physical activity and reducing stress are important lifestyle changes for managing chronic hypertension. Exercise helps lower blood pressure and stress reduction techniques can help control hypertension. Option A is incorrect as reducing sodium intake, not increasing it, is recommended. Option C is incorrect as medications for hypertension should be taken as prescribed, not only when blood pressure increases. Option D is incorrect as monitoring blood pressure should be done regularly, but not necessarily every week.

Correct Answer: A

Rationale: The correct answer is A: Administer epinephrine. This is the first step in the care of a client with a severe allergic reaction because epinephrine is the primary medication used to reverse the life-threatening symptoms of anaphylaxis. Epinephrine acts quickly to constrict blood vessels, relax smooth muscles in the lungs to improve breathing, and increase heart rate. Administering epinephrine promptly can prevent progression to severe outcomes like respiratory failure or shock. Corticosteroids (B and C) are used as adjunct therapy and do not provide immediate relief. Applying a cold compress (D) does not address the systemic effects of anaphylaxis and can delay potentially life-saving treatment.

Correct Answer: B

Rationale: The correct answer is B: Deep vein thrombosis (DVT). Patients with a history of stroke are at increased risk for DVT due to immobility and potential damage to blood vessels. Monitoring for DVT is crucial to prevent life-threatening complications like pulmonary embolism. Pulmonary embolism (A) is a potential complication of DVT but not the most direct concern. Hypertension (C) is a common condition but not directly linked to a history of stroke. Hyperglycemia (D) is more commonly associated with diabetes rather than stroke history. Monitoring for DVT in stroke patients is essential for early detection and intervention.

Correct Answer: A

Rationale: The correct answer is A: Administer IV fluids. In acute renal failure, the priority is to maintain adequate hydration to support kidney function. IV fluids help improve renal perfusion and urine output. Monitoring vital signs is important but not the priority. Performing a kidney function test can provide valuable information but does not address the immediate need for fluid resuscitation. Administering IV antibiotics may be necessary if there is an infection contributing to renal failure, but hydration takes precedence. In summary, administering IV fluids is crucial to support kidney function in acute renal failure, making it the top priority among the choices given.