Nokea
In determining the glomerular filtration rate (GFR) or creatinine clearance, a 24-hour urine is obtained. If a reliable 24-hour urine collection is not possible,
- A. it is not possible to determine the GFR.
- B. the BUN may be used to determine renal function.
- C. an elevated BUN/creatinine ratio can be used.
- D. a standardized formula may be used to calculate GFR.
Correct Answer: D
Rationale: The correct answer is D because if a reliable 24-hour urine collection is not possible, a standardized formula can be used to estimate the GFR. This is typically done using the patient's serum creatinine level, age, sex, and race. It is a validated method when direct measurement is not feasible.
A: Incorrect. It is still possible to estimate GFR using formulas when 24-hour urine collection is not possible.
B: Incorrect. BUN alone is not sufficient to accurately determine renal function.
C: Incorrect. BUN/Creatinine ratio is not a direct measure of GFR and may be influenced by other factors.
You may also like to solve these questions
Which of the following is a high-priority nursing diagnosis for both diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome?
- A. Activity intolerance
- B. Fluid volume deficient
- C. Hyperthermia
- D. Impaired nutrition, more than body requirements
Correct Answer: B
Rationale: The correct answer is B: Fluid volume deficient. Both diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome can lead to severe dehydration and electrolyte imbalances. Addressing fluid volume deficiency is crucial to stabilize the patient's condition. Choice A is not the priority as the main concern is the fluid imbalance, not activity intolerance. Hyperthermia (choice C) may be present but is not the primary concern compared to fluid volume deficit. Impaired nutrition (choice D) is not the immediate priority in these emergency situations. In summary, maintaining fluid balance is essential to manage both conditions effectively.
The patient has a temporary percutaneous catheter in place for treatment of acute kidney injury. The catheter has been in place for 5 days. The nurse should
- A. prepare to assist with a routine dialysis catheter change.
- B. evaluate the patient for signs and symptoms of infection.
- C. teach the patient that the catheter is designed for long-term use.
- D. use one of the three lumens for fluid administration.
Correct Answer: B
Rationale: The correct answer is B: evaluate the patient for signs and symptoms of infection. After 5 days, infection risk increases. Signs of infection include fever, redness, swelling, and tenderness at the catheter site. Monitoring for these signs is crucial to prevent complications. A: Routine dialysis catheter change is not indicated after 5 days. C: Teaching long-term use is incorrect as temporary catheters are not meant for extended use. D: Using lumens for fluid administration can increase infection risk and is not recommended.
The patient is admitted to the unit with the diagnosis of rhabdomyolysis. The patient is started on intravenous (IV) fluids and IV mannitol. What action by the nurse is best?
- A. Assess the patient’s hearing.
- B. Assess the patient’s lungs.
- C. Decrease IV fluids once the diuretic has been administered.
- D. Give extra doses before giving radiological contrast agents.
Correct Answer: B
Rationale: The correct answer is B: Assess the patient's lungs. In rhabdomyolysis, muscle breakdown releases myoglobin which can cause kidney damage. Mannitol is given to prevent kidney damage by promoting diuresis. However, mannitol can also cause fluid overload and pulmonary edema. Therefore, assessing the patient's lungs is crucial to monitor for signs of fluid overload and prevent complications.
A: Assessing the patient's hearing is not directly related to the management of rhabdomyolysis and mannitol administration.
C: Decreasing IV fluids after administering a diuretic like mannitol can lead to inadequate fluid resuscitation and worsening kidney injury.
D: Giving extra doses before radiological contrast agents is not necessary in the context of rhabdomyolysis and mannitol administration.
A patient with newly diagnosed type 1 diabetes is being transitioned from an infusion of intravenous (IV) regular insulin to an intensive insulin therapy regimen of insulin glargine and insulin aspart. How should the nurse manage this transition in insulin delivery?
- A. Administer the insulin glargine and continue the IV insulin infusion for 24 hours.
- B. Administer the insulin glargine and discontinue the IV infusion in several hours.
- C. Discontinue the IV infusion and administer the insulin aspart with the next meal.
- D. Discontinue the IV infusion and administer the Lantus insulin at bedtime.
Correct Answer: D
Rationale: The correct answer is D: Discontinue the IV infusion and administer the Lantus insulin at bedtime. This is the correct approach because insulin glargine (Lantus) is a long-acting basal insulin that provides a steady level of insulin throughout the day and night. By administering it at bedtime, it mimics the basal insulin secretion in a person without diabetes. This helps maintain stable blood sugar levels overnight.
Choice A is incorrect because continuing the IV insulin infusion for 24 hours alongside insulin glargine is unnecessary and may lead to insulin overdose. Choice B is incorrect because discontinuing the IV infusion in several hours without administering the long-acting insulin can lead to inadequate insulin coverage. Choice C is incorrect because insulin aspart is a rapid-acting insulin that should be given with meals, not as a basal insulin replacement at bedtime.
The nurse is caring for a patient who underwent pituitary surgery 12 hours ago. The nurse will give priority to monitoring the patient carefully for which of the following?
- A. Congestive heart failure
- B. Hypovolemic shock
- C. Infection
- D. Volume overload
Correct Answer: B
Rationale: The correct answer is B: Hypovolemic shock. After pituitary surgery, patients are at risk for hypovolemic shock due to potential intraoperative blood loss and fluid shifts. Monitoring for signs of shock, such as hypotension and tachycardia, is crucial for early intervention. A: Congestive heart failure is less likely immediately post-surgery. C: Infection is a concern but not the highest priority in the immediate postoperative period. D: Volume overload is not a common immediate complication of pituitary surgery.