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In calculating the glomerular filtration rate (GFR) results for women, the creatinine clearance is usually:
- A. the same as for men.
- B. greater than that for men.
- C. multiplied by 0.85.
- D. multiplied by 1.15.
Correct Answer: A
Rationale: The correct answer is A: the same as for men. GFR is calculated based on factors like age, weight, and serum creatinine levels, which are not directly influenced by gender. Therefore, the creatinine clearance for women is the same as for men. Choices B, C, and D are incorrect because there is no inherent biological difference between men and women that would cause a difference in creatinine clearance for GFR calculation.
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A patient presents to the emergency department with the following clinical signs: Pulse: 132 beats/min Blood pressure: 88/50 mm Hg Respiratory rate: 32 breaths/min Temperature: 8°F Chest x-ray: Findings consistent with congestive heart failure Cardiac rhythm: Atrial fibrillation with rapid ventricular response These signs are consistent with which disorder?
- A. Adrenal crisis
- B. Myxedema coma
- C. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
- D. Thyroid storm
Correct Answer: D
Rationale: Rationale: The clinical signs indicate a hypermetabolic state with tachycardia, hypotension, tachypnea, and potential fever, typical of a thyroid storm. The presence of congestive heart failure and atrial fibrillation further support this diagnosis due to the hyperthyroid state exacerbating cardiovascular symptoms. Adrenal crisis (A) would present with hypotension and shock, but not with the hypermetabolic state seen here. Myxedema coma (B) would present with hypothermia, bradycardia, and altered mental status, which are not present in this case. SIADH (C) would typically present with hyponatremia and concentrated urine, which are not seen here.
Identify which substances in the glomerular filtrate would indicate a problem with renal function. (Select all that apply.)
- A. Protein
- B. Sodium
- C. Creatinine
- D. Red blood cells
Correct Answer: A
Rationale: The presence of protein in the glomerular filtrate indicates a problem with renal function as healthy kidneys should not allow large molecules like proteins to pass through the filtration barrier. This could be a sign of kidney damage or dysfunction. Sodium, creatinine, and red blood cells are normally present in the filtrate and are not specific indicators of renal function issues. Sodium is actively reabsorbed in the renal tubules, creatinine is a waste product filtered by the kidneys, and a small number of red blood cells may pass through the filtration barrier under normal circumstances.
The removal of plasma water and some low–molecular weight particles by using a pressure or osmotic gradient is known as
- A. dialysis.
- B. diffusion.
- C. clearance.
- D. ultrafiltration.
Correct Answer: D
Rationale: The correct answer is D: ultrafiltration. Ultrafiltration involves the removal of plasma water and low-molecular weight particles using a pressure or osmotic gradient. This process allows small molecules to pass through a semipermeable membrane while retaining larger molecules. Dialysis (A) involves the removal of waste products and excess fluids from the blood, while diffusion (B) is the movement of molecules from an area of high concentration to low concentration. Clearance (C) refers to the rate at which a substance is removed from the blood by a specific organ or process. Ultrafiltration specifically targets the removal of plasma water and low-molecular weight particles through a pressure or osmotic gradient, making it the correct choice in this context.
The patient has elevated blood urea nitrogen (BUN) and serum creatinine levels with a normal BUN/creatinine ratio. These levels most likely indicate
- A. increased nitrogen intake.
- B. acute kidney injury, such as acute tubular necrosis (ATN).
- C. hypovolemia.
- D. fluid resuscitation.
Correct Answer: B
Rationale: The elevated BUN and serum creatinine levels with a normal BUN/creatinine ratio suggest kidney dysfunction. This pattern is commonly seen in acute kidney injury, like acute tubular necrosis (ATN), where the kidneys are unable to properly filter waste products. Other choices (A) increased nitrogen intake and (C) hypovolemia would not cause the specific pattern of elevated BUN and creatinine levels with a normal ratio. (D) Fluid resuscitation would actually aim to correct hypovolemia and would not directly affect the BUN and creatinine levels.
The nurse is caring for a patient who has a temporary percutaneous dialysis catheter in place. In caring for this patient, the nurse should
- A. apply a sterile gauze dressing to maintain sterility.
- B. replace the transparent dressing every 10 days to prevent manipulation.
- C. assess the catheter site for redness and/or swelling.
- D. use the catheter for drawing blood samples to reduce patient discomfort.
Correct Answer: C
Rationale: The correct answer is C because assessing the catheter site for redness and/or swelling is essential in monitoring for signs of infection or complications. Redness and swelling can indicate infection, which requires prompt intervention.
A: Applying a sterile gauze dressing is not necessary for a temporary percutaneous dialysis catheter unless specified by the healthcare provider.
B: Transparent dressings are typically left in place for several days unless there is a specific reason to change them more frequently.
D: Using the catheter for drawing blood samples is not recommended as it can increase the risk of infection and may interfere with the dialysis process.