Nokea
The most common reasons for initiating dialysis in acute kidney injury include which of the following? (Select all that apply.)
- A. Acidosis
- B. Hypokalemia
- C. Volume overload
- D. Hyperkalemia
Correct Answer: A
Rationale: Explanation:
A: Acidosis is a common reason to initiate dialysis in acute kidney injury due to impaired acid-base balance.
B: Hypokalemia is not a common reason for initiating dialysis in acute kidney injury.
C: Volume overload may require dialysis but is not as common as acidosis.
D: Hyperkalemia is a valid reason for dialysis but not as common as acidosis in acute kidney injury.
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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).
A patient is receiving hydrocortisone sodium succinate for adrenal crisis. What other medication does the nurse prepare to administer?
- A. Regular insulin
- B. A proton pump inhibitor
- C. Canagliflozin
- D. Propranolol
Correct Answer: B
Rationale: The correct answer is B: A proton pump inhibitor. When a patient is receiving hydrocortisone for adrenal crisis, it can lead to increased gastric acid secretion. A proton pump inhibitor helps reduce acid production and prevents gastric ulcers. Regular insulin (A) is not typically indicated in this scenario. Canagliflozin (C) is a medication used for diabetes management and is not relevant here. Propranolol (D) is a beta-blocker and may mask signs of hypoglycemia when used with insulin, which is not suitable in this case.
A normal glomerular filtration rate is
- A. less than 80 mL/min.
- B. 80 to 125 mL/min.
- C. 125 to 180 mL/min.
- D. more than 189 mL/min.
Correct Answer: B
Rationale: The correct answer is B (80 to 125 mL/min) because this range represents the normal glomerular filtration rate (GFR) for a healthy adult. GFR indicates the rate at which blood is filtered by the kidneys, with 125 mL/min being the average value. Values below 80 mL/min (Choice A) suggest impaired kidney function, while values above 189 mL/min (Choice D) may indicate hyperfiltration or underlying conditions. Choice C (125 to 180 mL/min) falls within the normal range, but the typical average is around 125 mL/min. Thus, choice B is the correct answer as it reflects the standard GFR range for adults.
The nurse is caring for an elderly patient who was admitted with renal insufficiency. An expected laboratory finding for this patient may be
- A. an increased glomerular filtration rate (GFR).
- B. a normal serum creatinine level.
- C. increased ability to excrete drugs.
- D. hypokalemia.
Correct Answer: C
Rationale: Correct Answer: C - Increased ability to excrete drugs.
Rationale:
1. Renal insufficiency impairs kidney function, leading to decreased excretion of drugs.
2. In elderly patients with renal insufficiency, there may be compensatory mechanisms to enhance drug excretion.
3. This increased ability to excrete drugs helps prevent drug accumulation and potential toxicity.
Summary:
A: Increased GFR is not expected in renal insufficiency; it typically decreases.
B: Serum creatinine level would likely be elevated in renal insufficiency, not normal.
D: Hypokalemia is not a typical lab finding in renal insufficiency; hyperkalemia is more common.
What is a minimally acceptable urine output for a patient weighing 75 kg?
- A. Less than 30 mL/hour
- B. 37 mL/hour
- C. 80 mL/hour
- D. 150 mL/hour
Correct Answer: C
Rationale: The correct answer is C (80 mL/hour) as it is considered a minimally acceptable urine output for a patient weighing 75 kg. Adequate urine output is crucial for kidney function and fluid balance. The general rule is to maintain a urine output of at least 0.5 mL/kg/hour, which in this case would be 37.5 mL/hour for a 75 kg patient. Option C (80 mL/hour) exceeds this minimum requirement, ensuring proper kidney perfusion and waste elimination. Options A (Less than 30 mL/hour) and D (150 mL/hour) are incorrect as they fall below or exceed the recommended urine output range, potentially indicating renal impairment or fluid overload, respectively. Option B (37 mL/hour) is close to the minimum requirement but does not provide a sufficient margin for variations in fluid status or kidney function.