Nokea
Slow continuous ultrafiltration is also known as isolated ultrafiltration and is used to
- A. remove plasma water in cases of volume overload.
- B. remove fluids and solutes through the process of convection.
- C. remove plasma water and solutes by adding dialysate.
- D. combine ultrafiltration, convection, and dialysis.
Correct Answer: A
Rationale: Rationale:
Slow continuous ultrafiltration is a method used to remove excess plasma water in cases of volume overload, making choice A the correct answer. This process does not involve adding dialysate (choice C) or combining ultrafiltration, convection, and dialysis (choice D). While ultrafiltration does involve the removal of fluids and solutes, it is primarily achieved through ultrafiltration rather than convection (choice B).
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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.
An individual with type 2 diabetes who takes glipizide has begun a formal exercise program at a local gym. While exercising on the treadmill, the individual becomes pale, diaphoretic, shaky, and has a headache. The individual feels as though she is going to pass out. What is the individual’s priority action?
- A. Drink additional water to prevent dehydration.
- B. Eat something with 15 g of simple carbohydrates.
- C. Go to the first-aid station to have glucose checked.
- D. Take another dose of the oral agent.
Correct Answer: B
Rationale: The correct answer is B: Eat something with 15 g of simple carbohydrates. In this scenario, the individual is exhibiting signs of hypoglycemia due to the combination of glipizide (which can lower blood sugar) and exercise. The priority action is to raise blood sugar levels quickly to prevent further complications. Consuming simple carbohydrates, like glucose tablets or juice, will rapidly increase blood sugar levels. This is crucial to prevent the individual from passing out or experiencing more serious consequences.
Choice A is incorrect because while hydration is important, it is not the immediate priority in this situation. Choice C is incorrect as going to the first-aid station may waste valuable time when immediate action is needed. Choice D is incorrect as taking another dose of the oral agent can further lower blood sugar levels and worsen the hypoglycemia.
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 assigned to care for a patient who presented to the emergency department with diabetic ketoacidosis. A continuous insulin intravenous infusion is started, and hourly bedside glucose monitoring is ordered. The targeted blood glucose value after the first hour of therapy is
- A. 70 to 120 mg/dL.
- B. a decrease of 25 to 50 mg/dL compared with admitting values.
- C. a decrease of 35 to 90 mg/dL compared with admitting values.
- D. less than 200 mg/dL.
Correct Answer: C
Rationale: The correct answer is C: a decrease of 35 to 90 mg/dL compared with admitting values. In diabetic ketoacidosis, there is severe hyperglycemia which needs to be corrected gradually to prevent complications like cerebral edema. A rapid decrease in glucose levels can lead to osmotic shifts and neurological issues. The targeted decrease of 35 to 90 mg/dL is considered safe and effective in managing hyperglycemia in these patients. This range ensures a controlled reduction in blood glucose levels without causing harm.
Choice A (70 to 120 mg/dL) is too broad and may lead to overly aggressive treatment. Choice B (a decrease of 25 to 50 mg/dL) is too conservative and may not adequately address the high glucose levels seen in diabetic ketoacidosis. Choice D (less than 200 mg/dL) does not provide a specific target range for glucose reduction, which is essential in managing diabetic ketoacidosis effectively.
The most significant clinical finding of acute adrenal crisis associated with fluid and electrolyte imbalance is
- A. fluid volume excess.
- B. hyperglycemia.
- C. hyperkalemia
- D. hypernatremia
Correct Answer: C
Rationale: Step-by-step rationale for the correct answer (C: hyperkalemia):
1. Adrenal crisis leads to adrenal insufficiency, causing decreased cortisol levels.
2. Cortisol plays a crucial role in regulating potassium levels.
3. With decreased cortisol, potassium levels can rise, leading to hyperkalemia.
4. Hyperkalemia can result in life-threatening cardiac arrhythmias.
Summary:
A: Fluid volume excess is not typical in adrenal crisis.
B: Hyperglycemia can be present but is not the most significant finding.
D: Hypernatremia is not a typical feature of adrenal crisis.