Nokea
The patient’s potassium level is 7.0 mEq/L. Besides dialysis, which of the following actually reduces plasma potassium levels and total body potassium content safely in a patient with renal dysfunction?
- A. Sodium polystyrene sulfonate
- B. Sodium polystyrene sulfonate with sorbitol
- C. Regular insulin
- D. Calcium gluconate
Correct Answer: C
Rationale: Correct Answer: C - Regular insulin
Rationale:
1. Insulin promotes cellular uptake of potassium.
2. When insulin is administered, it moves potassium from extracellular to intracellular space.
3. This decreases plasma potassium levels safely.
4. Other options do not directly lower potassium levels in the same manner.
Summary of Other Choices:
A: Sodium polystyrene sulfonate - exchanges sodium for potassium in the intestines, not reducing total body potassium.
B: Sodium polystyrene sulfonate with sorbitol - similar to A, does not reduce total body potassium.
D: Calcium gluconate - does not directly lower potassium levels, used for treating hyperkalemia-induced cardiac toxicity.
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The nurse is preparing to obtain a right atrial pressure (RA P/CVP) reading. What are the most appropriate nursing actions? (Select all that apply.)
- A. Compare measured pressures with other physiological parameters.
- B. Flush the central venous catheter with 20 mL of sterile saline.
- C. Inflate the balloon with 3 mL of air and record the pres sure tracing.
- D. Obtain the right atrial pressure measurement during en d exhalation.
Correct Answer: A
Rationale: The correct answer is A because comparing measured pressures with other physiological parameters ensures accuracy and consistency. This step helps in interpreting the RA P/CVP reading correctly. Choice B is incorrect as flushing the catheter with saline is not necessary for obtaining the pressure reading. Choice C is incorrect as inflating the balloon with air is not part of the correct procedure. Choice D is incorrect because obtaining the measurement during exhalation can affect the accuracy of the reading.
The term used to describe an increase in blood urea nitrogen (BUN) and serum creatinine is
- A. oliguria.
- B. azotemia.
- C. acute kidney injury.
- D. prerenal disease.
Correct Answer: B
Rationale: The correct answer is B: azotemia. Azotemia refers to an increase in BUN and serum creatinine levels, indicating impaired kidney function. Oliguria (A) is a decrease in urine output, not specific to BUN and creatinine levels. Acute kidney injury (C) is a broader term encompassing various causes of kidney dysfunction, not specific to elevated BUN and creatinine. Prerenal disease (D) refers to conditions affecting blood flow to the kidneys, not directly related to elevated BUN and creatinine levels.
The critical care nurse knows that in critically ill patients, renal dysfunction
- A. is a very rare problem.
- B. affects nearly two thirds of patients.
- C. has a low mortality rate once renal replacement therapy has been initiated.
- D. has little effect on morbidity, mortality, or quality of life.
Correct Answer: B
Rationale: The correct answer is B. Renal dysfunction is common in critically ill patients due to various factors like sepsis, hypotension, and nephrotoxic medications. This affects nearly two thirds of patients, making it a significant issue in critical care. Choices A, C, and D are incorrect. A is wrong because renal dysfunction is not rare in critically ill patients. C is incorrect as renal replacement therapy does not guarantee low mortality rates. D is inaccurate as renal dysfunction can have a significant impact on morbidity, mortality, and quality of life in critically ill patients.
A patient who has been diagnosed with inoperable lung cancer and has a poor prognosis plans a trip across the country to settle some issues with their siblings. The nurse recognizes that the patient is manifesting which psychosocial response to death?
- A. Restlessness.
- B. Yearning and protest.
- C. Anxiety about unfinished business.
- D. Fear of the meaninglessness of one’s life.
Correct Answer: C
Rationale: The correct answer is C: Anxiety about unfinished business. The patient's desire to settle issues with their siblings before death indicates a concern about unresolved matters. This response aligns with the concept of psychosocial responses to death, specifically the need for closure and resolution. Restlessness (choice A) may not necessarily indicate a specific focus on unfinished business. Yearning and protest (choice B) typically refer to the initial stages of grief, not specifically related to settling unresolved issues. Fear of the meaninglessness of one's life (choice D) is more existential and philosophical, whereas the patient's focus here is on addressing specific issues with their siblings.
What nursing delivery of care provides the nurse to plan and direct care of a group of clients over a 24-hour period?
- A. Case management.
- B. Team nursing.
- C. Primary nursing.
- D. Functional nursing.
Correct Answer: C
Rationale: The correct answer is C: Primary nursing. Primary nursing is a care delivery model where one nurse is responsible for the total care of a group of clients over a 24-hour period. This promotes continuity of care, individualized attention, and better nurse-client relationships. In primary nursing, the nurse plans and directs care, coordinates with other healthcare team members, and serves as the main point of contact for the clients.
A: Case management involves coordinating care across different healthcare providers and services, not necessarily focusing on a specific group of clients over a 24-hour period.
B: Team nursing involves a team of healthcare providers working together to deliver care, rather than one nurse being responsible for a specific group of clients over a 24-hour period.
D: Functional nursing divides tasks among different healthcare team members based on their specific skills, which may not provide the same level of continuity and individualized care as primary nursing.