Nokea
An advantage of peritoneal dialysis is that
- A. peritoneal dialysis is time intensive.
- B. a decreased risk of peritonitis exists.
- C. biochemical disturbances are corrected rapidly.
- D. the danger of hemorrhage is minimal.
Correct Answer: B
Rationale: The correct answer is B: a decreased risk of peritonitis exists. Peritoneal dialysis involves using the peritoneum as a membrane for fluid exchange, reducing the risk of infections like peritonitis compared to hemodialysis. Option A is incorrect as peritoneal dialysis can be done at home and is less time-consuming than hemodialysis. Option C is incorrect as biochemical disturbances are corrected more gradually with peritoneal dialysis. Option D is incorrect as there is a risk of bleeding complications with peritoneal dialysis.
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Renin plays a role in blood pressure regulation by
- A. activating the renin-angiotensin-aldosterone cascade.
- B. suppressing angiotensin production.
- C. decreasing sodium reabsorption.
- D. inhibiting aldosterone release.
Correct Answer: A
Rationale: The correct answer is A because renin activates the renin-angiotensin-aldosterone cascade. Renin is released by the kidneys in response to low blood pressure or low sodium levels. It acts on angiotensinogen to form angiotensin I, which is then converted to angiotensin II by angiotensin-converting enzyme. Angiotensin II causes vasoconstriction, leading to increased blood pressure, and stimulates aldosterone release, promoting sodium and water retention.
Choice B is incorrect because renin does not suppress angiotensin production; it actually initiates the process. Choice C is incorrect because renin's action leads to increased sodium reabsorption by stimulating aldosterone release. Choice D is incorrect because renin does not inhibit aldosterone release; it promotes it as part of the renin-angiotensin-aldosterone cascade.
Which of the following patients is at the greatest risk of developing acute kidney injury? A patient who
- A. has been on aminoglycosides for the past 6 days
- B. has a history of controlled hypertension with a blood pressure of 138/88 mm Hg
- C. was discharged 2 weeks earlier after aminoglycoside therapy of 2 weeks
- D. has a history of fluid overload as a result of heart failure
Correct Answer: C
Rationale: The correct answer is C because the patient was recently discharged after a prolonged course of aminoglycoside therapy, which is a known risk factor for acute kidney injury due to its nephrotoxic effects. Choice A is incorrect because although aminoglycosides can cause kidney injury, the duration of therapy is shorter in this case. Choice B is incorrect because controlled hypertension is not a significant risk factor for acute kidney injury. Choice D is incorrect because fluid overload from heart failure may lead to other complications but is not directly associated with acute kidney injury.
Noninvasive diagnostic procedures used to determine kidney function include which of the following? (Select all that apply.)
- A. Kidney, ureter, bladder (KUB) x-ray
- B. Renal ultrasound
- C. Magnetic resonance imaging (MRI)
- D. Intravenous pyelography (IVP)
Correct Answer: A
Rationale: The correct answer is A: Kidney, ureter, bladder (KUB) x-ray. KUB x-ray is a noninvasive diagnostic procedure that provides information about the size, shape, and position of the kidneys, ureters, and bladder. It can help detect abnormalities such as kidney stones or structural issues.
Rationale:
1. KUB x-ray is noninvasive, meaning it does not require any incisions or insertion of instruments into the body.
2. It is commonly used as an initial screening tool to assess kidney function.
3. Renal ultrasound (Choice B) is also noninvasive but primarily used for imaging the kidneys and not the entire urinary system.
4. MRI (Choice C) and IVP (Choice D) are more invasive procedures that involve injecting contrast agents and may not be routinely used for initial kidney function assessment.
In summary, the KUB x-ray is the correct choice as it is a noninvasive procedure specifically designed to evaluate kidney
A patient with type 1 diabetes who is receiving a continuous subcutaneous insulin infusion via an insulin pump contacts the clinic to report mechanical failure of the infusion pump. The nurse instructs the patient to begin monitoring for signs of:
- A. adrenal insufficiency.
- B. diabetic ketoacidosis.
- C. hyperosmolar, hyperglycemic state.
- D. hypoglycemia.
Correct Answer: B
Rationale: The correct answer is B: diabetic ketoacidosis. When an insulin pump fails, the patient may experience a sudden decrease in insulin delivery, leading to a potential rise in blood glucose levels. This can trigger diabetic ketoacidosis, characterized by hyperglycemia, ketosis, and acidosis. Monitoring for signs such as increased thirst, frequent urination, fruity breath odor, and rapid breathing is crucial.
Incorrect choices:
A: Adrenal insufficiency is not directly related to insulin pump failure.
C: Hyperosmolar, hyperglycemic state is more common in type 2 diabetes and typically occurs with extreme hyperglycemia, not sudden pump failure.
D: Hypoglycemia is less likely with pump failure due to decreased insulin delivery.
The patient is in the critical care unit and will receive dialysis this morning. The nurse will (Select all that apply.)
- A. evaluate morning laboratory results and report abnormal results.
- B. administer the patient’s antihypertensive medications.
- C. assess the dialysis access site and report abnormalities.
- D. weigh the patient to monitor fluid status.
Correct Answer: A
Rationale: The correct answer is A. By evaluating the morning laboratory results and reporting abnormal results, the nurse can ensure the patient's safety during dialysis by addressing any concerning findings promptly. This step is crucial in monitoring the patient's condition and adjusting the treatment plan as needed.
Incorrect choices:
B: Administering antihypertensive medications is not directly related to the patient's dialysis procedure and does not address the immediate needs of the patient in the critical care unit.
C: While assessing the dialysis access site is important, reporting abnormalities alone may not be sufficient without a comprehensive evaluation of the patient's laboratory results.
D: Weighing the patient to monitor fluid status is important in the context of dialysis, but it is not as critical as evaluating laboratory results for immediate intervention.