OMSB_OEN Exam - Topic 3 Question 30 Discussion

Actual exam question for OMSB's OMSB_OEN exam

Question #: 30
Topic #: 3

The nurse assesses a patient with Chronic Renal Failure notes crackles in the lung bases, elevated blood pressure, and weight gain of 1 kg in one day.

Based on these finding, which of the following nursing diagnoses is the MOST appropriate for this patient?

AIncreased cardiac output related to fluid overload

BIneffective tissue perfusion related to interrupted arterial blood flow

CImbalance nutrition more than body requirements related to dietary excess

DExcess fluid volume related to the kidney's inability to maintain fluid balance

Show Suggested Answer

Suggested Answer: D

The patient's symptoms---crackles in the lung bases, elevated blood pressure, and rapid weight gain---are indicative of fluid overload, which is a common issue in chronic renal failure due to the kidneys' inability to excrete excess fluid.

Increased Cardiac Output Related to Fluid Overload: Increased cardiac output would not typically result from fluid overload; rather, fluid overload can lead to decreased cardiac output due to strain on the heart.

Ineffective Tissue Perfusion Related to Interrupted Arterial Blood Flow: This diagnosis does not directly correlate with the symptoms of fluid overload observed in this patient.

Imbalanced Nutrition More Than Body Requirements Related to Dietary Excess: This diagnosis is not relevant to the observed symptoms, which are more clearly related to fluid retention rather than dietary intake.

Excess Fluid Volume Related to the Kidney's Inability to Maintain Fluid Balance: This is the most appropriate nursing diagnosis as it directly addresses the kidney's failure to regulate fluid balance, leading to the observed clinical signs.

National Kidney Foundation: Clinical Practice Guidelines for Chronic Kidney Disease

Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care

by Delbert at Jul 13, 2025, 02:19 PM

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Mary

2 months ago

Crackles and weight gain usually point to excess fluid volume.

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Lottie

2 months ago

Agreed, D is the best choice based on the symptoms.

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Meaghan

3 months ago

I think A could be a possibility too, but D seems more fitting.

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Lonna

3 months ago

Wait, 1 kg in a day? That seems like a lot, are we sure?

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Shonda

3 months ago

Definitely D, fluid overload is a big issue here.

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Lashon

3 months ago

I keep second-guessing myself, but "Ineffective tissue perfusion" doesn't seem relevant here since the symptoms point more towards fluid overload.

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Dominga

4 months ago

I practiced a similar question where lung crackles were a key indicator. I think "Excess fluid volume" fits best based on those findings.

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Lai

4 months ago

I'm not entirely sure, but "Increased cardiac output" seems off since the patient has crackles, which usually indicate fluid in the lungs.

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Glory

4 months ago

I remember studying fluid overload in patients with renal failure, so I think "Excess fluid volume" might be the right choice here.

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Krystal

4 months ago

This is a tricky one. The symptoms could fit a few different nursing diagnoses. I'm leaning towards option A, increased cardiac output due to fluid overload, but I'm not 100% sure. I'll have to review my notes on fluid and electrolyte imbalances in renal failure to make sure I'm choosing the most appropriate answer.

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Annamae

4 months ago

Okay, let me break this down. Chronic Renal Failure means the kidneys can't maintain fluid balance, so that's the most likely cause of the fluid overload. The crackles and weight gain support that. I'm going to go with option D as the best answer.

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Aliza

4 months ago

Hmm, I'm a little unsure about this one. The weight gain and lung crackles could indicate fluid overload, but the elevated blood pressure makes me wonder if it's more of a perfusion issue. I'll have to think this through carefully before answering.

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Raina

5 months ago

This seems like a pretty straightforward question. The key symptoms here are the crackles in the lung bases, elevated blood pressure, and rapid weight gain, which all point to fluid overload. I'm going to go with option D.

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Shaun

6 months ago

I don't think so. The crackles in the lung bases and weight gain suggest excess fluid volume is the main issue here.

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Cherelle

6 months ago

But what about option A) Increased cardiac output related to fluid overload? Could that be a possibility as well?

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Raina

7 months ago

I'm going with D, and I'm feeling as confident as a cat with nine lives about it. Fluid overload is the culprit, and this patient needs to get their kidneys back on track.

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Angelo

7 months ago

If this patient was a fish, I'd say they're just swimming in their own pool of problems! But seriously, option D is the way to go. Gotta keep that fluid balance in check.

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Lauran

7 months ago

Hmm, this is a tricky one. I'm torn between A and D, but I think D is the best fit. Fluid overload is the root cause, and the weight gain is a dead giveaway.

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Franchesca

6 months ago

User 1: I think D is the best fit. The weight gain is a sign of fluid overload.

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Eladia

7 months ago

I'm going with B. The elevated blood pressure and interrupted arterial blood flow seem like the biggest issues here. Tissue perfusion is the way to go.

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Ceola

5 months ago

User1: I think A is the best option. Increased cardiac output due to fluid overload makes sense.

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Colene

7 months ago

I agree with Kimbery. The patient's symptoms point towards fluid overload.

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Nickolas

7 months ago

Option D, definitely. The weight gain and crackles in the lungs are clear signs of fluid overload due to the kidney's inability to maintain fluid balance. This is the most appropriate nursing diagnosis.

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Nell

6 months ago

Yes, excess fluid volume related to the kidney's inability to maintain fluid balance seems like the best fit here.

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Trina

6 months ago

I agree, option D makes the most sense given the patient's symptoms.

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Kimbery

7 months ago

I think the answer is D) Excess fluid volume related to the kidney's inability to maintain fluid balance.

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