Nokea
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.
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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.
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.
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 critical care nurse knows that in critically ill patients, renal dysfunction
- A. is a very rare problem.
- B. affects nearly two thirds of patients.
- C. has a low mortality rate once renal replacement therapy has been initiated.
- D. has little effect on morbidity, mortality, or quality of life.
Correct Answer: B
Rationale: The correct answer is B because renal dysfunction is a common issue in critically ill patients due to factors like sepsis or hypoperfusion. This affects nearly two thirds of patients, leading to potential complications. Choice A is incorrect as renal dysfunction is common, not rare. Choice C is incorrect as mortality rates can still be high even with renal replacement therapy. Choice D is incorrect as renal dysfunction can significantly impact morbidity, mortality, and quality of life in critically ill patients.
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.