Nokea
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.
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Complications common to patients receiving hemodialysis for acute kidney injury include which of the following? (Select all that apply.)
- A. Hypotension
- B. Dysrhythmias
- C. Muscle cramps
- D. Hemolysis
Correct Answer: A
Rationale: The correct answer is A: Hypotension. Hemodialysis can lead to hypotension due to rapid fluid removal, causing a drop in blood pressure. This occurs as the dialysis machine removes excess fluid, affecting plasma volume. Hypotension can result in complications like dizziness, nausea, and potential cardiac issues. Dysrhythmias (B) are less common during hemodialysis for acute kidney injury. Muscle cramps (C) may occur due to electrolyte imbalances but are not as common as hypotension. Hemolysis (D) is not a common complication of hemodialysis but can occur if there are issues with the dialysis machine or blood tubing.
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.
Which of the following would be seen in a patient with myxedema coma?
- A. Decreased reflexes
- B. Hyperthermia
- C. Hyperventilation
- D. Tachycardia
Correct Answer: A
Rationale: The correct answer is A: Decreased reflexes. In myxedema coma, a severe form of hypothyroidism, patients often present with decreased mental status, hypothermia, and bradycardia. Decreased reflexes are a common neurological manifestation due to the slowing of metabolic processes and the central nervous system depression associated with this condition. Hyperthermia (B) is not typically seen in myxedema coma, as patients usually have low body temperature. Hyperventilation (C) is also unlikely, as respiratory depression is more common. Tachycardia (D) is incorrect because bradycardia is more characteristic of myxedema coma.
The patient is in a progressive care unit following arteriovenous fistula implantation in his left upper arm, and is due to have blood drawn with his next set of vital signs and assessment. When the nurse assesses the patient, the nurse should
- A. draw blood from the left arm.
- B. take blood pressures from the left arm.
- C. start a new intravenous line in the left lower arm.
- D. auscultate the left arm for a bruit and palpate for a thrill.
Correct Answer: D
Rationale: The correct answer is D. Auscultating the left arm for a bruit and palpating for a thrill post arteriovenous fistula implantation is crucial to assess the patency and functionality of the fistula. A bruit indicates turbulent blood flow, while a thrill signifies the presence of a strong pulse through the fistula. These assessments help identify any complications like stenosis or thrombosis. Drawing blood or taking blood pressures from the arm with the fistula can lead to inaccurate results or damage the fistula. Starting a new IV line in the left lower arm is unnecessary and not relevant to monitoring the arteriovenous fistula.
Factors associated with the development of nephrogenic diabetes insipidus include which of the following? (Select all that apply.)
- A. Heredity
- B. Medications
- C. Meningitis
- D. Pituitary tumors
Correct Answer: A
Rationale: The correct answer is A: Heredity. Nephrogenic diabetes insipidus can be inherited as a genetic condition. The mutation in genes responsible for regulating water balance in the kidneys can lead to this disorder. Other choices are incorrect: B: Medications like lithium can cause acquired nephrogenic diabetes insipidus, not its development. C: Meningitis is an inflammatory condition that does not directly relate to nephrogenic diabetes insipidus. D: Pituitary tumors are associated with central diabetes insipidus, not nephrogenic.