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100

With sudden cessation of renal function, all body systems are affected by the inability to maintain fluid and electrolyte balance and eliminate metabolic waste. In critically ill patients, what statement regarding renal dysfunction is true?

  1. It is a very rare problem.
  2. It affects nearly two thirds of patients.
  3. It has a low mortality once renal replacement therapy has been initiated.
  4. It has little effect on morbidity, mortality, or quality of life.



Correct Answer: 2

2. It affects nearly two thirds of patients.


100

The nurse caring for an elderly patient who was admitted with renal insufficiency realizes that with advance age often comes declining renal function. What is an expected laboratory finding for this patient?

  1. An increased glomerular filtration rate (GFR).
  2. A normal serum creatinine level
  3. Lower serum levels of prescribed medications
  4. Hypokalemia



Correct Answer: 2

2. A normal serum creatinine level

100

Which of the following patients is at the greatest risk of developing acute kidney injury?

  1. One who had a diagnostic test using a radiocontrast media 6 days.
  2. One with a history of controlled hypertension with a blood pressure of 138/88 mm Hg.
  3. One discharged 2 weeks earlier after aminoglycoside therapy of 2 weeks.
  4. One with a history of fluid overload as a result of heart failure.

    




Correct Answer: 3

3. One discharged 2 weeks earlier after aminoglycoside therapy of 2 weeks.

100

The nurse notices that patient’s oral cavity is only slightly moist and contains a scant amount of thick saliva even though the patient’s fluid intake has been sufficient. What is the likely cause of the condition of the patient’s mouth?

  1. Thoughts of food
  2. Sympathetic nerve stimulation
  3. Overstimulation of the sublingual glands
  4. Parasympathetic nerve stimulation

Correct Answer: 2

2. Sympathetic nerve stimulation

100

The nurse is assessing the patient admitted diagnosed with pancreatitis. In doing so, the nurse takes what action?

  1. Palpates the pancreas for size and shape.
  2. Emphasizes to the patient that pancreatic inflammation does not spread.
  3. Assesses symptoms that could indicate involvement of the stomach.
  4. Explains to the patient that back pain is not a sign of pancreatitis.

Correct Answer: 3

3. Assesses symptoms that could indicate involvement of the stomach.


200

The nurse is caring for a patient who has sustained blunt trauma to the left flank area, and is evaluating the patient’s urinalysis results. What related assessment finding should concern the nurse?

  1. Creatinine levels in the urine are similar to blood levels of creatinine.
  2. Sodium and chloride are found in the urine.
  3. Urine uric acid levels have the same values as serum levels.
  4. Red blood cells and albumin are found in the urine.



Correct Answer: 4

Rationale:

4. Red blood cells and albumin are found in the urine.

200

What term is used to describe an increase in blood urea nitrogen (BUN) and serum creatinine?

  1. Oliguria
  2. Azotemia
  3. Acute kidney injury
  4. Prerenal disease


Correct Answer: 2

2. Azotemia

200

The patient has elevated blood urea nitrogen (BUN) and serum creatinine levels with a normal BUN/creatinine ratio. What do these levels most likely indicate?

  1. Increased nitrogen intake.
  2. Acute kidney injury, such as acute tubular necrosis (ATN)
  3. Hypovolemia
  4. Fluid resuscitation


Correct Answer: 2

2. Acute kidney injury, such as acute tubular necrosis (ATN)

200

The nurse is caring for a patient who has a peptic ulcer. To treat the ulcer and prevent more ulcers from forming, the nurse should be prepared to administer what medication?

  1. H2-histamine receptor blockers
  2. Gastrin
  3. Vagal stimulation
  4. Vitamin B12

Correct Answer: 1

1.H2-histamine receptor blockers

200

The nurse is caring for a patient diagnosed with liver disease. When assessing the patient’s laboratory values, the nurse should take what action?

  1. Disregard the level of conjugated bilirubin.
  2. Review the indirect serum bilirubin.
  3. Call the provider immediately if the direct bilirubin is elevated.
  4. Be aware that unconjugated bilirubin is harmless.

Correct Answer: 2

2. Review the indirect serum bilirubin.


300

What is a normal glomerular filtration rate?

  1. Less than 80 mL/min
  2. 80 to 125 mL/min
  3. 125 to 180 mL/min
  4. More than 189 mL/min

Correct Answer:2

2. 80 to 125 mL/min

300

What is the most common cause of acute kidney injury (AKI) in critically ill patients?

1. Sepsis

2. Fluid overload

3. Medications

4. Hemodynamic instability


Correct Answer: 1

1. Sepsis

300

The patient reporting severe flank pain when urinating. has a urinalysis that shows sediment and crystals along with a few bacteria. This information suggests what about the nature of the condition?

  1. It is prerenal.
  2. It is postrenal.
  3. It is intrarenal.
  4. It is not renal related.

Correct Answer: 2

2. It is postrenal

300

The nurse is caring for a patient who is receiving several cardiac medications designed to stimulate the sympathetic nervous system, as well as vitamin B12, and an H2 blocker. The nurse should do take which of the following actions?

  1. Assess for signs of peptic ulcer.
  2. Be watchful for increased saliva production.
  3. Evaluate for a decrease in potassium level.
  4. Give the patient medications to prevent anemia.

Correct Answer: 1

1. Assess for signs of peptic ulcer.

300

The liver plays what major role in homeostasis?

  1. Synthesizing factor I but not factor II.
  2. Synthesizing clotting factors without the need for vitamin K.
  3. Removing active clotting factors from the circulation.
  4. Synthesizing factor II but not factor I.

Correct Answer: 3

3. Removing active clotting factors from the circulation.


400

What is a normal urine output?

  1. 80 to 125 mL/min
  2. 180 L/day
  3. 80 mL/min
  4. 1 to 2 L/day



Correct Answer: 4

4. 1 to 2 L/day

400

The nurse caring for a patient who has undergone major abdominal surgery notices that the patient’s urine output has been less than 20 mL/hour for the past 2 hours. At 0200 in the morning the patient’s blood pressure is 100/60 mm Hg, and the pulse is 110 beats per minute. Previously, the pulse was 90 beats per minute with a blood pressure of 120/80 mm Hg. The nurse should take what action?

  1. Contact the primary health care provider and expect an order for a normal saline bolus.
  2. Wait until 0900 when the provider makes rounds to report the assessment findings.
  3. Continue to evaluate urine output for 2 more hours.
  4. Ignore the urine output, as this is most likely postrenal in origin.

  

 



Correct Answer(s): 1


  1. Contact the primary health care provider and expect an order for a normal saline bolus.


400

The patient is admitted with constipation. In anticipation of treatment, the nurse prepares to implement what action?

  1. Give medications that will suppress the autonomic nervous system.
  2. Provide therapies that will innervate the autonomic nervous system.
  3. Teach the patient that the submucosa is the innermost part of the gut wall.
  4. Give medications intravenously since the submucosa has no blood vessels.


Correct Answer: 2

2. Provide therapies that will innervate the autonomic nervous system.

400

After gastric bypass surgery, the patient is getting vitamin B12 via injection. The patient asks why the vitamin can’t be given by mouth. What explanation should the nurse provide?

  1. The patient may not have enough intrinsic factor for normal absorption.
  2. The patient would have to drink water, and the small intestine can’t handle water.
  3. The vitamin is absorbed in the upper part of the small bowel and would travel too fast.
  4. All vitamins are absorbed in the terminal ileum and it would take too long for B12.

Correct Answer: 1

  1. The patient may not have enough intrinsic factor for normal absorption.
400

Infection by Helicobacter pylori bacteria is a major cause of what type of ulcer?

  1. Duodenal
  2. Cushing’s
  3. Curling’s
  4. Stress

 Correct Answer: 1

1. Duodenal

500

The most common reasons for initiating dialysis in acute kidney injury include which of the following? (Select all that apply.)

  1. Acidosis
  2. Hypokalemia
  3. Volume overload
  4. Hyperkalemia
  5. Uremia

Correct Answer (s): 1, 3, 4, 5

1. Acidosis

3. Volume overload

4. Hyperkalemia

5. Uremia

 

500

The patient is in the critical care unit and will receive dialysis this morning. The nurse will take which actions: (Select all that apply.)

  1. Evaluate morning laboratory results and report abnormal results.
  2. Administer the patient’s antihypertensive medications.
  3. Assess the dialysis access site and report abnormalities.
  4. Weigh the patient to monitor fluid status.
  5. Give all medications except for antihypertensive medications.

Correct Answer (s): 1, 3, 4

1. Evaluate morning laboratory results and report abnormal results.

3. Assess the dialysis access site and report abnormalities.

4. Weigh the patient to monitor fluid status.

 

500

The patient is admitted with end-stage liver disease. The nurse evaluates the patient for which of the following? (Select all that apply.)

  1. Hypoglycemia
  2. Malnutrition
  3. Ascites
  4. Hypercoagulation
  5. Disseminated intravascular coagulation

Correct Answer(s): 2,3,5

2. Malnutrition

3. Ascites

5. Disseminated intravascular coagulation

500

What are the nursing priorities for the management of acute pancreatitis? (Select all that apply.)

  1. Managing respiratory dysfunction
  2. Assessing and maintaining electrolyte balance
  3. Withholding analgesics that could mask abdominal discomfort
  4. Stimulating gastric content motility into the duodenum
  5. Utilizing supportive therapies aimed at decreasing gastrin release

Correct Answer(s): 1,2,5

1.Managing respiratory dysfunction

2. Assessing and maintaining electrolyte balance

5. Utilizing supportive therapies aimed at decreasing gastrin release

500

When caring for the patient with upper GI bleeding, the nurse assesses for which of the following? (Select all that apply.)

  1. Severity of blood loss
  2. Hemodynamic stability
  3. Vital signs every 30 minutes
  4. Signs of hypervolemic shock
  5. Necessity for fluid resuscitation

Correct Answer(s): 1,2,5

1. Severity of blood loss

2. Hemodynamic stability

5. Necessity for fluid resuscitation