Nokea
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: The correct answer is A. Bladder catheterization helps relieve urinary obstruction, a common postrenal cause of acute kidney injury. It allows urine to drain freely from the bladder.
- B: Increasing fluid volume intake may worsen the condition by increasing the pressure on the obstructed kidneys.
- C: Ureteral stenting is used for intrarenal causes, not postrenal causes.
- D: Placement of nephrostomy tubes bypasses the obstruction but is usually reserved for more severe cases.
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Daily weights are being recorded for the patient with a urine output that has been less than the intravenous and oral intake. The weight yesterday was 5 kg. This morning it is 99 kg. The nurse understands that this corresponds to a(n)
- A. fluid retention of 1.5 liters.
- B. fluid loss of 1.5 liters.
- C. equal intake and output due to insensible losses.
- D. fluid loss of 0.5 liters.
Correct Answer: A
Rationale: The correct answer is A: fluid retention of 1.5 liters. The weight gain from 5 kg to 99 kg indicates an increase of 94 kg. Since 1 kg of weight gain is approximately equal to 1 liter of fluid retention, the patient has retained 94 liters of fluid. Therefore, the correct choice is fluid retention of 1.5 liters.
Choice B is incorrect because the weight gain indicates fluid retention, not loss. Choice C is incorrect as it mentions equal intake and output, which does not match the weight gain observed. Choice D is incorrect as it suggests fluid loss, which contradicts the weight gain.
The patient is on intake and output (I&O), as well as daily weights. The nurse notes that output is considerably less than intake over the last shift, and daily weight is 1 kg more than yesterday. The nurse should
- A. draw a trough level after the next dose of antibiotic.
- B. obtain an order to place the patient on fluid restriction.
- C. assess the patient’s lungs.
- D. insert an indwelling catheter.
Correct Answer: C
Rationale: The correct answer is C: assess the patient's lungs. The discrepancy between intake, output, and weight gain indicates a potential fluid imbalance. By assessing the patient's lungs, the nurse can identify signs of fluid overload, such as crackles or difficulty breathing, which could explain the weight gain and imbalance. This step is crucial in determining the underlying cause and guiding further interventions. Drawing a trough level (A) or inserting an indwelling catheter (D) are not necessary at this point and may not address the immediate issue. Placing the patient on fluid restriction (B) should only be considered after a thorough assessment to determine the cause of the imbalance.
A normal urine output is considered to be
- A. 80 to 125 mL/min.
- B. 180 L/day.
- C. 80 mL/min.
- D. 1 to 2 L/day.
Correct Answer: D
Rationale: The correct answer is D: 1 to 2 L/day. Normal urine output typically ranges from 1 to 2 liters per day, which is considered adequate for maintaining proper hydration and eliminating waste products. A: 80 to 125 mL/min is too low for daily output. B: 180 L/day is excessively high and unrealistic. C: 80 mL/min is also too low for daily urine output. Therefore, D is the most appropriate choice based on standard guidelines for urine excretion.
Which of the following would be seen in a patient with myxedema coma?
- A. Decreased reflexes
- B. Hyperthermia
- C. Hyperventilation
- D. Tachycardia
Correct Answer: A
Rationale: The correct answer is A: Decreased reflexes. In myxedema coma, a severe form of hypothyroidism, patients often present with decreased mental status, hypothermia, and bradycardia. Decreased reflexes are a common neurological manifestation due to the slowing of metabolic processes and the central nervous system depression associated with this condition. Hyperthermia (B) is not typically seen in myxedema coma, as patients usually have low body temperature. Hyperventilation (C) is also unlikely, as respiratory depression is more common. Tachycardia (D) is incorrect because bradycardia is more characteristic of myxedema coma.
The patient’s potassium level is 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: A
Rationale: The correct answer is A: Sodium polystyrene sulfonate. It works by exchanging sodium ions for potassium ions in the colon, leading to potassium excretion. A is the safest option without the risk of causing hypernatremia or intestinal necrosis like B. Regular insulin (C) may cause hypoglycemia and is not as effective as A in reducing potassium levels. Calcium gluconate (D) does not directly reduce potassium levels and is used for treating hyperkalemia-related cardiac toxicity.