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?
Breast cancer survivor for 8 years.
65 years of age.
Alcohol use disorder.
Pacemaker.
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 D
Explanation
Choice A rationale
Decreased serum lipase is not expected in acute pancreatitis; rather, lipase levels are typically elevated due to pancreatic enzyme leakage into the bloodstream.
Choice B rationale
Increased serum calcium is not a typical finding in acute pancreatitis; instead, hypocalcemia can occur due to fat necrosis and soap formation.
Choice C rationale
Decreased WBC is not expected; an elevated WBC count is common due to the inflammatory response associated with pancreatitis.
Choice D rationale
Increased serum amylase is a hallmark of acute pancreatitis as the damaged pancreas releases more amylase into the blood.
Correct Answer is C
Explanation
Choice A rationale
Acetaminophen can be hepatotoxic in clients with liver damage, so it should be avoided. This is especially critical for clients with cirrhosis, where liver function is already compromised.
Choice B rationale
Eating three large meals can be overwhelming for someone with cirrhosis, as the liver is less able to process nutrients efficiently. Smaller, more frequent meals are advised.
Choice C rationale
Avoiding high-sodium foods is crucial because cirrhosis often leads to fluid retention and ascites, which can be exacerbated by a high-sodium diet.
Choice D rationale
Increasing activity as much as possible may not be safe for someone with cirrhosis, who often experiences fatigue and muscle wasting. Activity should be balanced with rest and tolerance levels.