Nokea
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.
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The patient has just returned from having an arteriovenous fistula placed. The patient asks, “When will they be able to use this and take this other catheter out?” The nurse should reply,
- A. “It can be used immediately, so the catheter can come out anytime.”
- B. “It will take 2 to 4 weeks to heal before it can be used.”
- C. “The fistula will be usable in about 4 to 6 weeks.”
- D. “The fistula was made using graft material, so it depends on the manufacturer.”
Correct Answer: C
Rationale: The correct answer is C: “The fistula will be usable in about 4 to 6 weeks.” This is because arteriovenous fistulas typically require a maturation period of 4 to 6 weeks before they can be used for dialysis. During this time, the fistula will develop into a strong, durable access point for hemodialysis.
Choice A is incorrect because the fistula needs time to mature before it can be used, and immediate use may damage it. Choice B is incorrect as it underestimates the maturation period required. Choice D is incorrect as the maturation time does not depend on the manufacturer but on the patient's physiology and healing process.
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.
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.
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).
The nurse is caring for a patient receiving peritoneal dialysis. The patient suddenly complains of abdominal pain and chills. The patient’s temperature is elevated. The nurse should
- A. assess peritoneal dialysate return.
- B. check the patient’s blood sugar.
- C. evaluate the patient’s neurological status.
- D. inform the provider of probable visceral perforation.
Correct Answer: D
Rationale: The correct answer is D: inform the provider of probable visceral perforation. This is the most urgent action as sudden abdominal pain, chills, and elevated temperature in a patient receiving peritoneal dialysis could indicate a serious complication like visceral perforation, which requires immediate medical attention to prevent further complications. Assessing peritoneal dialysate return (A) may provide some information but does not address the urgent need to address a potential visceral perforation. Checking the patient's blood sugar (B) and evaluating the patient's neurological status (C) are not priorities in this situation and do not address the potential life-threatening complication of visceral perforation.