Nokea
Which of the following patients is at the greatest risk of developing acute kidney injury? A patient who
- A. has been on aminoglycosides for the past 6 days
- B. has a history of controlled hypertension with a blood pressure of 138/88 mm Hg
- C. was discharged 2 weeks earlier after aminoglycoside therapy of 2 weeks
- D. has a history of fluid overload as a result of heart failure
Correct Answer: D
Rationale: The correct answer is D because a patient with a history of fluid overload due to heart failure is at the greatest risk of developing acute kidney injury. Heart failure can lead to decreased kidney perfusion causing acute kidney injury. In this scenario, the patient's fluid overload exacerbates the situation, further compromising kidney function.
Choice A is incorrect as aminoglycosides can cause kidney injury but the duration of 6 days is less concerning compared to chronic fluid overload from heart failure in choice D. Choice B is incorrect because controlled hypertension does not directly increase the risk of acute kidney injury. Choice C is incorrect as the patient being discharged 2 weeks earlier after aminoglycoside therapy does not necessarily indicate a higher risk compared to chronic fluid overload.
You may also like to solve these questions
What must the patient must be able of in order to provide informed consent?
- A. Be capable of independent breathing.
- B. Have knowledge and competence to make the decision .
- C. Nod head to agree to the procedure.
- D. Both read and write in English.
Correct Answer: B
Rationale: The correct answer is B because informed consent requires the patient to have knowledge and competence to make a decision. This involves understanding the risks, benefits, and alternatives of the proposed treatment. Choice A is incorrect as it pertains to a physical ability unrelated to decision-making. Choice C is incorrect as consent must be verbal or written, not just nodding. Choice D is incorrect as consent can be obtained in various ways, not specifically through reading and writing in English.
When fluid is present in the alveoli what is the result?
- A. Alveoli collapse and atelectasis occurs.
- B. Diffusion of oxygen and carbon dioxide is impaired.
- C. Hypoventilation occurs.
- D. The patient is in heart failure.
Correct Answer: A
Rationale: The correct answer is A: Alveoli collapse and atelectasis occurs. When fluid is present in the alveoli, it impairs the surface tension necessary for the alveoli to remain open, leading to collapse and atelectasis. This prevents proper gas exchange, resulting in hypoxemia. Choice B is incorrect because impaired gas diffusion typically occurs with conditions affecting the alveolar-capillary membrane, not fluid in the alveoli. Choice C is incorrect as hypoventilation refers to decreased ventilation, not specifically related to fluid in the alveoli. Choice D is incorrect as fluid in the alveoli is not a direct indicator of heart failure.
What is the focus of the synergy model of practice?
- A. Allowing unrestricted visiting for the patient 24 hours aebaircbh.c odma/tye.s t
- B. Providing holistic and alternative therapies.
- C. Considering the needs of patients and their families, w hich drives nursing competency.
- D. Addressing the patients’ needs for energy and support.
Correct Answer: C
Rationale: The correct answer is C because the synergy model of practice emphasizes considering the needs of patients and their families, which in turn drives nursing competency. This approach recognizes that patient care is not just about the individual but also about the broader support system. This holistic viewpoint helps nurses tailor their care to meet the unique needs of each patient and their family, ultimately leading to better outcomes.
Choices A, B, and D are incorrect:
A: Allowing unrestricted visiting for the patient 24 hours is not directly related to the focus of the synergy model which is more about patient-centered care.
B: Providing holistic and alternative therapies is a valid approach, but it is not the primary focus of the synergy model.
D: Addressing the patients' needs for energy and support is important but does not capture the comprehensive nature of the synergy model which encompasses the needs of both patients and their families.
In which situation would a healthcare surrogate or proxy a ssume the end-of-life decision-making role for a patient?
- A. When a dying patient requires extensive heavy sedatioanb,i rbs.ucocmh/ taesst benzodiazepines and narcotics, to control distressing symptoms
- B. When a dying patient who is competent requests to wi thdraw treatment against the wishes of the family
- C. When a dying patient who is competent requests to con tinue treatment against the recommendations of the healthcare team
- D. When a dying patient who is competent is receiving pr n treatment for pain and anxiety
Correct Answer: A
Rationale: The correct answer is A because in this situation, the patient is no longer able to make decisions for themselves due to being heavily sedated. The healthcare surrogate or proxy steps in to make decisions on behalf of the patient to ensure their comfort and well-being.
Choice B is incorrect because the patient is competent and able to make their own decisions, so there is no need for a surrogate to take over decision-making.
Choice C is incorrect because the patient is competent and has the right to make decisions about their own treatment, even if they go against medical recommendations.
Choice D is incorrect because the patient is competent and receiving appropriate treatment for their pain and anxiety, so there is no need for a surrogate to intervene in this scenario.
A 45-year-old postsurgical patient is on a ventilator in the critical care unit has been tolerating the ventilator well and has not required any sedation. The apbairtbi.ecnomt /bteesct omes tachycardic and hypertensive with a respiratory rate that has increased to 28 breaths/min. The ventilator is set on synchronized intermittent mandatory ventilation (SIMV ) at a rate of 10 breaths/min. The patient has been suctioned recently via existing endotracheal tube until airway is clear. When the patient responds appropriately to the nurse’s command s, what should be the nurse’s priority intervention?
- A. Assessing the patient’s level of pain
- B. Decreasing the SIMV rate on the ventilator
- C. Providing sedation as ordered
- D. Suctioning the patient again
Correct Answer: A
Rationale: The correct answer is A: Assessing the patient's level of pain. In this situation, the patient's tachycardia, hypertension, and increased respiratory rate could be indicative of pain. By assessing the patient's pain level, the nurse can address any discomfort the patient may be experiencing, which could be contributing to these physiological responses.
Summary of other choices:
B: Decreasing the SIMV rate on the ventilator - This is not the priority intervention as the patient's symptoms are more likely related to pain rather than the ventilator settings.
C: Providing sedation as ordered - Sedation is not the priority in this case as the patient has been tolerating the ventilator well without requiring sedation.
D: Suctioning the patient again - Since the airway has been recently cleared, suctioning again is not necessary at this point and would not address the underlying cause of the patient's symptoms.