Correct Answer: D

Rationale: In the scenario described, with the patient having an acute exacerbation of chronic kidney disease (CKD) leading to hyperkalemia and metabolic acidosis, the priority intervention to manage the metabolic derangements is to perform emergent hemodialysis for potassium removal. Hemodialysis is the most effective and rapid method to lower dangerously high potassium levels in the blood. It is crucial in cases of severe hyperkalemia where other measures such as medications or dietary modifications may not be sufficient or fast enough to correct the elevated potassium levels. Additionally, hemodialysis can also help in improving metabolic acidosis by removing waste products and excess electrolytes from the blood. Overall, emergent hemodialysis is the most appropriate intervention for managing the acute metabolic abnormalities in this critically ill patient.

Correct Answer: C

Rationale: The most appropriate nursing action for managing a patient with dependent edema in the lower extremities is to administer diuretics as prescribed. Diuretics help the body remove excess fluid, reducing swelling and edema in the extremities. It is important to follow the healthcare provider's orders for administering diuretics to ensure the patient's fluid balance is managed effectively. While elevating the legs above heart level and applying compression stockings may provide temporary relief, addressing the underlying cause of fluid retention with diuretics is essential for long-term management of the edema in a patient with heart failure. Encouraging increased fluid intake would not be appropriate in this case, as the focus should be on reducing fluid overload rather than increasing fluid intake.

Correct Answer: B

Rationale: Ella's statement "I will hang myself" directly indicates a desire and intent to commit suicide. This is classified as a suicidal intent, which is a serious concern that requires immediate attention and intervention. It is crucial to take any mention or indication of suicide seriously and seek help from mental health professionals or crisis intervention services.

Correct Answer: A

Rationale: The presentation of flank pain, hematuria, and a palpable mass in the abdomen is characteristic of renal cell carcinoma. Renal cell carcinoma is a common type of kidney cancer that often presents with these symptoms. The presence of a solid renal mass with calcifications on imaging further supports this diagnosis, as renal cell carcinoma is known to have this appearance on imaging studies. It is important to promptly evaluate and manage patients with suspected renal cell carcinoma to optimize outcomes.

Correct Answer: A

Rationale: Administering a stool softener as ordered is the most appropriate nursing intervention for a postpartum client experiencing severe perineal pain and difficulty passing stools following a vaginal delivery. Stool softeners help to soften the stool, making it easier for the client to pass without straining, which can exacerbate perineal pain. It is important to follow the healthcare provider's orders when administering medications to ensure proper dosing and effectiveness. Encouraging the client to refrain from defecation may lead to constipation and worsen the situation. Applying ice packs to the perineum can provide temporary pain relief, but addressing the underlying issue of constipation with a stool softener is more effective in the long term. Providing education on proper perineal hygiene is important for overall postpartum care, but addressing the immediate issue of constipation with a stool softener takes precedence in this scenario.