A nurse is planning care for a client who has chronic kidney disease. The nurse should identify which of the following laboratory values as an indication for hemodialysis?

Correct Answer: A

Rationale: In the context of chronic kidney disease (CKD), a glomerular filtration rate (GFR) of 14 mL/minute indicates severe kidney dysfunction. GFR measures how well the kidneys are filtering waste from the blood. When GFR drops below 15 mL/minute, it indicates end-stage renal disease (ESRD) where dialysis is required to remove waste and excess fluid from the body. This critical level of kidney function necessitates the initiation of hemodialysis to maintain the client's health and prevent complications of uremia. Option B, a blood urea nitrogen (BUN) level of 16 mg/dL, is within the normal range (7-20 mg/dL) and does not directly indicate the need for hemodialysis. Similarly, options C and D, serum magnesium and phosphorus levels within normal ranges, do not serve as indicators for the initiation of hemodialysis in CKD. Educationally, understanding the significance of GFR levels in CKD management is crucial for nurses caring for clients with kidney disease. Recognizing the appropriate indications for hemodialysis helps nurses intervene in a timely manner, ensuring optimal patient outcomes and quality of life. This rationale underscores the importance of clinical judgment based on laboratory values in the comprehensive care of clients with chronic conditions like CKD.

Correct Answer: D

Rationale: The correct answer is D: Weight. Weight monitoring is essential to assess the effectiveness of desmopressin therapy, as fluid retention is a common side effect. Monitoring fasting blood glucose (choice A) is not directly related to desmopressin therapy for diabetes insipidus. Monitoring carbohydrate intake (choice B) may be important in diabetes management but is not specific to desmopressin therapy. Hematocrit (choice C) monitoring is not a primary concern when managing diabetes insipidus with desmopressin.

Correct Answer: C

Rationale: The correct answer is C. Doxazosin can cause orthostatic hypotension, leading to dizziness and falls if the client rises quickly from a seated position. Instructing the client to rise slowly when sitting up from bed helps prevent these adverse effects. Choices A, B, and D are incorrect because doxazosin does not directly relate to caloric intake, dietary fiber, or a specific time of day for administration.

Correct Answer: C

Rationale: The correct answer is C: Fever. When a client is taking clozapine, fever can indicate serious conditions such as infection or severe reactions, which need immediate medical attention. Constipation (choice A), blurred vision (choice B), and dry mouth (choice D) are common side effects of clozapine but are not as urgent as fever. Constipation can be managed with dietary changes or medications, blurred vision can improve over time, and dry mouth can be relieved with frequent sips of water.

Correct Answer: D

Rationale: A glomerular filtration rate of 14 mL/min indicates severe kidney impairment and the need for hemodialysis. The other choices, such as BUN 16 mg/dL, serum magnesium 1.8 mg/dL, and serum phosphorus 4.0 mg/dL, are within normal ranges and do not directly indicate the need for hemodialysis in chronic kidney disease.