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A nurse is discussing kidney transplant with a client who has end-stage renal disease (ESRD). Which of the following should the nurse identify as a contraindication for this treatment?

A.

Breast cancer survivor for 8 years.

B.

65 years of age.

C.

Alcohol use disorder.

D.

Pacemaker.

Answer and Explanation

The Correct Answer is C

Choice A rationale

A breast cancer survivor for 8 years without recurrence is generally considered for transplantation if otherwise healthy.

 

Choice B rationale

Age 65 is not an absolute contraindication for kidney transplantation. Many factors such as overall health status are considered.

 

Choice C rationale

Alcohol use disorder is a contraindication due to the potential for poor adherence to post-transplant care and medication, as well as the increased risk of liver damage.

 

Choice D rationale

Having a pacemaker is not an absolute contraindication for a kidney transplant; individuals with pacemakers can still be eligible for transplantation if otherwise healthy.


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Correct Answer is A

Explanation

Choice A rationale

Withholding oral fluids and food is the priority because it reduces pancreatic stimulation and decreases the secretion of pancreatic enzymes, preventing further autodigestion and inflammation of the pancreas.

Choice B rationale

Auscultating the client's lungs is important to check for complications such as pleural effusion or atelectasis, but it is not the immediate priority after pain management.

Choice C rationale

Assisting the client to a side-lying position can help with comfort and may ease breathing, but it does not directly address the underlying issue of pancreatic inflammation.

Choice D rationale

Providing oral hygiene is essential for overall care but does not impact the acute management of pancreatitis.

Correct Answer is D

Explanation

Choice A rationale

An HbA1c level of 5.7% or below indicates normal glucose tolerance, not impaired glucose tolerance.

Choice B rationale

In type 1 diabetes mellitus, the beta cells are destroyed, and dietary changes alone cannot restore insulin production.

Choice C rationale

Type 1 diabetes mellitus is a chronic condition and is not considered reversible.

Choice D rationale

Type 1 diabetes mellitus is characterized by the autoimmune destruction of beta cells in the pancreas, leading to an absolute lack of insulin production.

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