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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What psychosocial factors may potentially contribute to the development of diabetic ketoacidosis? (Select all that apply.)
- A. Altered sleep/rest patterns
- B. Eating disorder
- C. Exposure to influenza
- D. High levels of stress
Correct Answer: A
Rationale: Rationale for correct answer A: Altered sleep/rest patterns can disrupt insulin regulation, leading to glucose imbalance and predisposing to diabetic ketoacidosis. Lack of sleep affects hormones that regulate blood sugar levels, increasing the risk of DKA.
Summary of why other choices are incorrect:
B: Eating disorder can affect blood sugar control but is not a direct cause of DKA.
C: Exposure to influenza may trigger stress on the body but is not a psychosocial factor contributing to DKA.
D: High levels of stress can impact blood sugar levels but are not specific psychosocial factors leading to DKA.
A patient is admitted to the oncology unit with a small-cell lung carcinoma. During the admission, the patient is noted to have a significant decrease in urine output accompanied by shortness of breath, edema, and mental status changes. The nurse is aware that this clinical presentation is consistent with
- A. adrenal crisis.
- B. diabetes insipidus.
- C. myxedema coma.
- D. syndrome of inappropriate secretion of antidiuretic hormone (SIADH).
Correct Answer: D
Rationale: The correct answer is D: syndrome of inappropriate secretion of antidiuretic hormone (SIADH). In this scenario, the patient's symptoms of decreased urine output, shortness of breath, edema, and mental status changes are indicative of fluid overload due to SIADH. SIADH causes excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. This results in edema, decreased urine output, and neurological symptoms.
A: Adrenal crisis presents with hypotension, shock, and electrolyte abnormalities, not consistent with the patient's symptoms.
B: Diabetes insipidus would present with excessive urine output and thirst, opposite of the patient's symptoms.
C: Myxedema coma results from severe hypothyroidism and presents with hypothermia, bradycardia, and altered mental status, not consistent with the patient's symptoms.
In summary, the patient's clinical presentation aligns
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.
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.
In calculating the glomerular filtration rate (GFR) results for women, the creatinine clearance is usually:
- A. the same as for men.
- B. greater than that for men.
- C. multiplied by 0.85.
- D. multiplied by 1.15.
Correct Answer: A
Rationale: The correct answer is A: the same as for men. GFR is calculated based on factors like age, weight, and serum creatinine levels, which are not directly influenced by gender. Therefore, the creatinine clearance for women is the same as for men. Choices B, C, and D are incorrect because there is no inherent biological difference between men and women that would cause a difference in creatinine clearance for GFR calculation.