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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
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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.
The nurse is caring for a patient who has sustained blunt trauma to the left flank area, and is evaluating the patient’s urinalysis results. The nurse should become concerned when
- A. creatinine levels in the urine are similar to blood levels of creatinine.
- B. sodium and chloride are found in the urine.
- C. urine uric acid levels have the same values as serum levels.
- D. red blood cells and albumin are found in the urine.
Correct Answer: D
Rationale: The correct answer is D because the presence of red blood cells and albumin in the urine indicates kidney damage, as these are not normally found in urine. A: Creatinine levels should be similar in blood and urine for proper kidney function. B: Sodium and chloride are normal components of urine. C: Uric acid levels can vary in urine and serum. Therefore, D is the correct answer as it signals potential kidney injury.
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 nurse has been assigned the following patients. Which patients require assessment of blood glucose control as a nursing priority? (Select all that apply.)
- A. 18-year-old male who has undergone surgical correction of a fractured femur
- B. 29-year-old female who is undergoing evaluation for pheochromocytoma
- C. 43-year-old male with acute pancreatitis who is receiving total parenteral nutrition (TPN)
- D. 62-year-old morbidly obese female who underwent a hysterectomy for ovarian cancer
Correct Answer: C
Rationale: The correct answer is C because the patient with acute pancreatitis receiving TPN is at risk for hyperglycemia due to the high glucose content in TPN. Monitoring blood glucose levels is crucial to prevent complications.
Explanation for why other choices are incorrect:
A: The 18-year-old male post-surgery for a fractured femur does not have a direct correlation to blood glucose control assessment.
B: The 29-year-old female undergoing evaluation for pheochromocytoma is not directly related to blood glucose control assessment.
D: The 62-year-old morbidly obese female post-hysterectomy for ovarian cancer does not specifically require immediate blood glucose control assessment.
The nurse is caring for a patient with a diagnosis of head trauma. The nurse notes that the patient’s urine output has increased tremendously over the past 18 hours. The nurse suspects that the patient may be developing
- A. diabetes insipidus.
- B. diabetic ketoacidosis.
- C. hyperosmolar hyperglycemic syndrome.
- D. syndrome of inappropriate secretion of antidiuretic hormone.
Correct Answer: A
Rationale: Rationale: A patient with head trauma may develop diabetes insipidus due to damage to the hypothalamus or pituitary gland, leading to decreased secretion of antidiuretic hormone (ADH). This results in excessive urine output and thirst. Other options are incorrect because:
B: Diabetic ketoacidosis is associated with high blood sugar and ketones, not increased urine output.
C: Hyperosmolar hyperglycemic syndrome is characterized by extreme hyperglycemia, not increased urine output.
D: Syndrome of inappropriate secretion of antidiuretic hormone results in decreased urine output due to excess ADH.