Nokea
In a patient with AKI, which laboratory urinalysis result indicates tubular damage?
- A. Hematuria
- B. Specific gravity fixed at 1.010
- C. Urine sodium of 12 mEq/L (12 mmol/L)
- D. Osmolality of 1000 mOsm/kg (1000 mmol/kg)
Correct Answer: C
Rationale: The correct answer is C: Urine sodium of 12 mEq/L (12 mmol/L). In a patient with AKI, tubular damage results in the inability of the kidneys to reabsorb sodium effectively, leading to a low urine sodium concentration. This is because damaged tubules cannot properly regulate sodium reabsorption. Choices A, B, and D do not directly indicate tubular damage. Hematuria (choice A) can be seen in various renal conditions, fixed specific gravity at 1.010 (choice B) may indicate dilute urine, and osmolality of 1000 mOsm/kg (choice D) could be within normal range depending on the clinical context.
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Patients with nephrolithiasis or kidney stones need to increase fluid intake. This is to:
- A. Concentrate the urine.
- B. Help flush the stones through the urinary tract.
- C. Crystallize the struvite from the renal tubules.
- D. Break down the stones into smaller pieces that will more easily pass through the urinary tract.
Correct Answer: B
Rationale: The correct answer is B: Help flush the stones through the urinary tract. Increasing fluid intake can help dilute the urine, preventing stone formation and aiding in the passage of existing stones. Adequate hydration promotes frequent urination, which can help flush out the stones and reduce the risk of complications. Choices A, C, and D are incorrect. A: Concentrating the urine can actually exacerbate stone formation. C: Struvite crystals are not typically formed in nephrolithiasis. D: Breaking down stones requires medical intervention, not just increased fluid intake.
A patient with psychologic disorder is being treated with a drug. Few months he is worried that he is constantly thirsty and urinates copiously frequently throughout the day and night. Which of the following drugs most likely cause inappropriate secretion of ADH?
- A. Diazepam
- B. Lithium
- C. Haloperidol
- D. Phenytoin
Correct Answer: B
Rationale: The correct answer is B: Lithium. Lithium is known to cause nephrogenic diabetes insipidus, leading to inappropriate secretion of ADH. This results in excessive thirst and copious urination. Diazepam (A) does not affect ADH secretion. Haloperidol (C) and Phenytoin (D) are not associated with ADH dysregulation.
Which of the following methods should the nurse use to assess the kidneys for tenderness or pain?
- A. By auscultating the abdomen for bruits.
- B. By lightly striking the fist at the costovertebral angle.
- C. By observing for signs of bleeding.
- D. Monitor pressure dressing to note any frank bleeding.
Correct Answer: B
Rationale: The correct answer is B: By lightly striking the fist at the costovertebral angle. This method is known as percussion and is used to assess for kidney tenderness or pain. Percussion helps to identify any abnormalities in the kidneys or surrounding structures. Auscultation (choice A) is used to listen for sounds, not assess for tenderness. Observing for signs of bleeding (choice C) and monitoring pressure dressing (choice D) are not appropriate methods for assessing kidney tenderness or pain.
Which antibiotics should be avoided in patients of liver disease?:
- A. Tetracycline
- B. Cotrimoxazole
- C. Cephalexin
- D. Ethanbutol
Correct Answer: A
Rationale: The correct answer is A: Tetracycline. Tetracycline should be avoided in patients with liver disease due to its potential hepatotoxicity. Tetracycline is primarily metabolized in the liver and can exacerbate liver damage in patients with pre-existing liver conditions. Cotrimoxazole, Cephalexin, and Ethambutol are generally considered safe for use in patients with liver disease as they are not known to cause significant liver toxicity.
A 50-year-old woman reports that she has been experiencing hot flashes, night sweats, and vaginal dryness. The nurse suspects that she is in the peri-menopausal stage. What is the primary reason for these symptoms?
- A. Decreased estrogen levels.
- B. Increased estrogen levels.
- C. Hormonal fluctuations.
- D. Psychological stress.
Correct Answer: D
Rationale: I must clarify that the correct answer should be A: Decreased estrogen levels. In the peri-menopausal stage, a woman's ovaries produce less estrogen, leading to symptoms like hot flashes, night sweats, and vaginal dryness. Option B is incorrect because increased estrogen levels are not typical during peri-menopause. Option C is vague and does not specifically address the primary reason for the symptoms. Option D, psychological stress, may exacerbate symptoms but is not the primary cause in this scenario.