Nokea
A patient’s vital signs are pulse 87, respirations 24, BP of 128/64 mm Hg, and cardiac output is 4.7 L/min. The patient’s stroke volume is ______ mL. (Round to the nearest whole number.)
- A. 54
- B. 64
- C. 74
- D. 84
Correct Answer: A
Rationale: The stroke volume is calculated by dividing the cardiac output by the heart rate. Given the cardiac output of 4.7 L/min and a heart rate of 87 bpm, the stroke volume is 54 mL (4700 mL/87 bpm ≈ 54 mL). Therefore, choice A (54) is the correct answer. Choices B, C, and D are incorrect as they do not match the calculated stroke volume based on the provided cardiac output and heart rate.
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The patient is admitted with acute kidney injury from a postrenal cause. Acceptable treatments for that diagnosis include: (Select all that apply.)
- A. bladder catheterization.
- B. increasing fluid volume intake.
- C. ureteral stenting.
- D. placement of nephrostomy tubes.
Correct Answer: A
Rationale: Step-by-step rationale:
1. Bladder catheterization helps relieve urinary obstruction, a common postrenal cause of acute kidney injury.
2. By draining urine from the bladder, it prevents further damage to the kidneys.
3. This intervention addresses the underlying cause of the kidney injury, leading to improvement.
Summary:
- Choice A is correct as it directly addresses the postrenal cause by relieving urinary obstruction.
- Choices B, C, and D are incorrect as they do not target the specific postrenal cause of acute kidney injury.
The family of a terminally ill patient is concerned about administering increasing doses of opioids for pain management. What is the nurse’s best response?
- A. Increasing opioids may hasten death, so alternative methods should be considered.
- B. Opioids are necessary to manage pain effectively and improve quality of life.
- C. We will reduce the opioid dose to avoid dependency.
- D. You should consult with a pain specialist about reducing the medication.
Correct Answer: B
Rationale: The correct answer is B because opioids are essential for effective pain management in terminally ill patients, improving their quality of life. Alternative methods may not provide sufficient pain relief. Choice A is incorrect as opioids do not necessarily hasten death when used appropriately for pain control. Choice C is incorrect because reducing opioid dose may lead to inadequate pain management. Choice D is incorrect as consulting a pain specialist to reduce medication may not be appropriate for terminally ill patients needing effective pain relief.
Acute kidney injury from postrenal etiology is caused by
- A. obstruction of the flow of urine.
- B. conditions that interfere with renal perfusion.
- C. hypovolemia or decreased cardiac output.
- D. conditions that act directly on functioning kidney tissue.
Correct Answer: A
Rationale: The correct answer is A because postrenal acute kidney injury is caused by obstruction of urine flow, leading to pressure build-up in the kidneys and subsequent damage. Obstructions can be due to conditions such as kidney stones, tumors, or enlarged prostate. Choices B, C, and D are incorrect as they relate to pre-renal and intrinsic renal causes of acute kidney injury, not specifically postrenal obstruction. B refers to decreased blood flow to the kidneys, C to low volume or poor heart function affecting kidney perfusion, and D to direct damage to kidney tissue, which do not characterize postrenal etiology.
The nurse obtains a heart rate of 92 and a blood pressure of 110/76 prior to administering a scheduled dose of verapamil (Calan) for a client with atrial flutter. Which action should the nurse implement?
- A. Give intravenous (IV) calcium gluconate.
- B. Withhold the drug and notify the healthcare provider.
- C. Administer the dose as prescribed.
- D. Recheck the vital signs in 30 minutes and then administer the dose.
Correct Answer: C
Rationale: The correct answer is C: Administer the dose as prescribed. Verapamil is a calcium channel blocker used to treat atrial flutter. The vital signs obtained are within normal range for this medication. A heart rate of 92 and blood pressure of 110/76 are not contraindications for administering verapamil. Option A is incorrect as calcium gluconate is not indicated in this situation. Option B is incorrect because the vital signs are stable and do not warrant withholding the medication. Option D is incorrect as there is no need to delay the administration of verapamil based on the vital signs provided.
The nurse notes that the patient’s arterial blood gas levels indicate hypoxemia. The patient is not intubated and has a respiratory rate of 22 breaths/min. what is the nurse’s first intervention to relieve hypoxemia?
- A. Call the physician for an emergency intubation proced ure.
- B. Obtain an order for bilevel positive airway pressure (BiPAP).
- C. Provide for oxygen administration.
- D. Suction secretions from the oropharynx.
Correct Answer: C
Rationale: The correct answer is C: Provide for oxygen administration. The first intervention for hypoxemia is to increase oxygen levels to improve oxygen saturation in the blood. Oxygen administration can be achieved through various devices such as nasal cannula, face mask, or non-rebreather mask. This intervention helps to increase the oxygen supply to the patient's tissues and organs, addressing the underlying cause of hypoxemia. Calling for emergency intubation (choice A) is not the first step unless the patient's condition deteriorates. Obtaining an order for BiPAP (choice B) may be beneficial in some cases but is not the initial intervention for hypoxemia. Suctioning secretions (choice D) may be necessary if airway obstruction is present but is not the first step in addressing hypoxemia.