Nokea
A normal urine output is considered to be
- A. 80 to 125 mL/min.
- B. 180 L/day.
- C. 80 mL/min.
- D. 1 to 2 L/day.
Correct Answer: D
Rationale: The correct answer is D: 1 to 2 L/day. Normal urine output typically ranges from 1 to 2 liters per day, which is considered adequate for maintaining proper hydration and eliminating waste products. A: 80 to 125 mL/min is too low for daily output. B: 180 L/day is excessively high and unrealistic. C: 80 mL/min is also too low for daily urine output. Therefore, D is the most appropriate choice based on standard guidelines for urine excretion.
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Mechanisms for development of diabetes insipidus include which of the following? (Select all that apply.)
- A. ADH deficiency
- B. ADH excess
- C. ADH insensitivity
- D. ADH replacement therapy
Correct Answer: A
Rationale: The correct answer is A: ADH deficiency. Diabetes insipidus is caused by a deficiency of antidiuretic hormone (ADH), leading to excessive urine production and thirst. ADH is responsible for regulating water reabsorption in the kidneys. When ADH levels are low or absent, the kidneys cannot concentrate urine effectively, resulting in excessive urine output.
Explanation for why other choices are incorrect:
B: ADH excess would not lead to diabetes insipidus, as it would result in increased water reabsorption and concentrated urine.
C: ADH insensitivity refers to a condition where the body does not respond to ADH, but it does not cause diabetes insipidus.
D: ADH replacement therapy is actually a treatment for diabetes insipidus, not a mechanism for its development.
The patient is on intake and output (I&O), as well as daily weights. The nurse notes that output is considerably less than intake over the last shift, and daily weight is 1 kg more than yesterday. The nurse should
- A. draw a trough level after the next dose of antibiotic.
- B. obtain an order to place the patient on fluid restriction.
- C. assess the patient’s lungs.
- D. insert an indwelling catheter.
Correct Answer: C
Rationale: The correct answer is C: assess the patient's lungs. The discrepancy between intake, output, and weight gain indicates a potential fluid imbalance. By assessing the patient's lungs, the nurse can identify signs of fluid overload, such as crackles or difficulty breathing, which could explain the weight gain and imbalance. This step is crucial in determining the underlying cause and guiding further interventions. Drawing a trough level (A) or inserting an indwelling catheter (D) are not necessary at this point and may not address the immediate issue. Placing the patient on fluid restriction (B) should only be considered after a thorough assessment to determine the cause of the imbalance.
Which of the following laboratory values would be found in a patient with syndrome of inappropriate secretion of antidiuretic hormone?
- A. Fasting blood glucose 156 mg/dL
- B. Serum potassium 5.8 mEq/L
- C. Serum sodium 115 mEq/L
- D. Serum sodium 152 mEq/L
Correct Answer: C
Rationale: The correct answer is C, Serum sodium 115 mEq/L. In syndrome of inappropriate secretion of antidiuretic hormone (SIADH), there is excess release of ADH leading to water retention and dilutional hyponatremia. Low serum sodium levels (hyponatremia) are characteristic of SIADH due to water retention without proportional sodium retention. Choices A and B are not indicative of SIADH. Choice D, high serum sodium, is more likely in conditions causing dehydration or excessive sodium intake.
Acute kidney injury from postrenal etiology is caused by
- A. obstruction of the flow of urine.
- B. conditions that interfere with renal perfusion.
- C. hypovolemia or decreased cardiac output.
- D. conditions that act directly on functioning kidney tissue
Correct Answer: A
Rationale: The correct answer is A because acute kidney injury from postrenal etiology is caused by obstruction of the flow of urine, leading to back pressure and damage to the kidneys. Choices B and C relate to prerenal causes, affecting renal perfusion and volume status. Choice D refers to intrinsic renal causes, directly affecting kidney tissue function, not postrenal obstruction. Therefore, A is correct due to the nature of postrenal etiology.
The term used to describe an increase in blood urea nitrogen (BUN) and serum creatinine is
- A. oliguria.
- B. azotemia.
- C. acute kidney injury.
- D. prerenal disease.
Correct Answer: B
Rationale: The correct answer is B: azotemia. Azotemia refers to elevated levels of nitrogenous waste products like BUN and creatinine in the blood. This occurs when the kidneys are not functioning properly, leading to decreased filtration and excretion of waste products. Oliguria (A) is reduced urine output, not specific to elevated BUN and creatinine levels. Acute kidney injury (C) is a broader term for sudden loss of kidney function. Prerenal disease (D) typically refers to conditions affecting blood flow to the kidneys, leading to decreased kidney function, but it does not specifically describe the increase in BUN and creatinine levels.