Nokea
The nurse is providing insulin education for an elderly patient with long-standing
diabetes. A prescription has been written for the patient to take 20 units of insulin glargine at 10
PM nightly. The nurse should instruct the patient that the peak of the insulin action for this agent
is
- A. 200
- B. 400
- C. 800
- D. peakless
Correct Answer: D
Rationale: The correct answer is D: peakless. Insulin glargine is a long-acting insulin with a smooth, consistent release of insulin over 24 hours, providing a steady level of insulin without a pronounced peak. This characteristic helps in maintaining stable blood glucose levels. Options A, B, and C are incorrect as they refer to peak values that do not apply to insulin glargine.
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The patient undergoes a cardiac catheterization that requires the use of contrast dyes during the procedure. To detect signs of contrast-induced kidney injury, the nurse should
- A. not be concerned unless urine output decreases.
- B. evaluate the patient’s serum creatinine for up to 72 hours after the procedure.
- C. obtain an order for a renal ultrasound.
- D. evaluate the patient’s postvoid residual volume to detect intrarenal injury.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Contrast dyes can cause kidney injury due to their nephrotoxic effects.
2. Serum creatinine levels are a reliable indicator of kidney function.
3. Evaluating serum creatinine for up to 72 hours after the procedure allows detection of any contrast-induced kidney injury.
4. Monitoring serum creatinine helps in early identification and intervention for renal complications.
Summary:
A: Incorrect. Urine output alone is not a definitive indicator of kidney injury.
C: Incorrect. Renal ultrasound is not typically used for detecting contrast-induced kidney injury.
D: Incorrect. Postvoid residual volume is not specific for contrast-induced kidney injury.
A patient presents to the emergency department with the following clinical signs: Pulse: 132 beats/min Blood pressure: 88/50 mm Hg Respiratory rate: 32 breaths/min Temperature: 8°F Chest x-ray: Findings consistent with congestive heart failure Cardiac rhythm: Atrial fibrillation with rapid ventricular response These signs are consistent with which disorder?
- A. Adrenal crisis
- B. Myxedema coma
- C. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
- D. Thyroid storm
Correct Answer: D
Rationale: Rationale: The clinical signs indicate a hypermetabolic state with tachycardia, hypotension, tachypnea, and potential fever, typical of a thyroid storm. The presence of congestive heart failure and atrial fibrillation further support this diagnosis due to the hyperthyroid state exacerbating cardiovascular symptoms. Adrenal crisis (A) would present with hypotension and shock, but not with the hypermetabolic state seen here. Myxedema coma (B) would present with hypothermia, bradycardia, and altered mental status, which are not present in this case. SIADH (C) would typically present with hyponatremia and concentrated urine, which are not seen here.
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.
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
Identify which substances in the glomerular filtrate would indicate a problem with renal function. (Select all that apply.)
- A. Protein
- B. Sodium
- C. Creatinine
- D. Red blood cells
Correct Answer: A
Rationale: The presence of protein in the glomerular filtrate indicates a problem with renal function as healthy kidneys should not allow large molecules like proteins to pass through the filtration barrier. This could be a sign of kidney damage or dysfunction. Sodium, creatinine, and red blood cells are normally present in the filtrate and are not specific indicators of renal function issues. Sodium is actively reabsorbed in the renal tubules, creatinine is a waste product filtered by the kidneys, and a small number of red blood cells may pass through the filtration barrier under normal circumstances.