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Mr. James, a 65-year-old male with chronic kidney disease (CKD), is admitted with symptoms of fatigue, dizziness, and shortness of breath. His laboratory results show low hemoglobin levels and elevated creatinine. What is the most likely cause of Mr. James' low hemoglobin levels?
a) Chronic blood loss from gastrointestinal bleeding
b) Decreased erythropoietin production due to renal failure
c) Acute blood loss from surgery
d) Hemolytic anemia due to kidney damage
b) Decreased erythropoietin production due to renal failure
A 50-year-old female patient with suspected acute kidney injury (AKI) presents with dark, concentrated urine and edema. The nurse observes that protein and blood cells are present in the urine sample. What does the presence of these components in the urine suggest about the patient's renal function?
a) The kidneys are functioning normally, as these substances are typically found in urine.
b) The patient may be experiencing renal dysfunction, possibly related to glomerular damage.
c) The patient is likely dehydrated, causing increased urine concentration.
d) The presence of blood and protein indicates a urinary tract infection (UTI) rather than renal dysfunction.
b) The patient may be experiencing renal dysfunction, possibly related to glomerular damage.
A 45-year-old patient reports frequent heartburn and acid regurgitation, especially after meals and at night. Lifestyle changes have provided minimal relief. Which medication is the most appropriate prescription?
a) Metoprolol
b) Omeprazole
c) Albuterol
d) Furosemide
b) Omeprazole
Which of the following are potential side effects of low blood pressure (hypotension) in older adults? (Select all that apply)
A. Dizziness or lightheadedness, especially when standing
B. Increased risk of falls
C. Blurred vision
D. Increased urine output
E. Fatigue or weakness
A. Dizziness or lightheadedness, especially when standing
B. Increased risk of falls
C. Blurred vision
E. Fatigue or weakness
Mr. Johnson, a 68-year-old male with a history of heart failure and hypertension, is admitted to the hospital with complaints of shortness of breath, swelling in his legs, and a sudden weight gain of 7 pounds in the past week. His current medications include lisinopril, metoprolol, and a newly prescribed furosemide (Lasix).
Assessment Findings:
BP: 138/82 mmHg
HR: 88 bpm
RR: 20 breaths per minute
O2 Sat: 96% on room air
2+ pitting edema in lower extremities
Crackles heard in the lower lung fields
Serum potassium: 3.2 mEq/L (low)
What is the primary reason Mr. Johnson was prescribed furosemide (Lasix)?
a) To reduce blood pressure
b) To decrease fluid overload
c) To increase potassium levels
d) To treat an irregular heartbeat
b) To decrease fluid overload
A 62-year-old patient with hypertension is started on an ACE inhibitor to reduce fluid retention. The nurse is explaining how this medication works. Which of the following mechanisms is most involved in maintaining renal perfusion in response to blood pressure changes?
a) The release of aldosterone from the pituitary
b) The activation of the renin-angiotensin-aldosterone system (RAAS)
c) The secretion of glucagon from the pancreas
d) The regulation of blood glucose by the kidneys
b) The activation of the renin-angiotensin-aldosterone system (RAAS)
A patient with heart failure is prescribed furosemide (Lasix) to manage fluid retention. After a few days of therapy, the nurse notices that the patient's potassium level has dropped significantly. Which of the following nursing actions is most appropriate for preventing the potential adverse effect of hypokalemia in this patient?
a) Increase potassium-rich foods in the patient's diet
b) Increase the patient's fluid intake to flush out potassium
c) Administer an additional dose of diuretic to remove excess fluid
d) Monitor blood glucose levels closely, as low potassium may impact insulin secretion
a) Increase potassium-rich foods in the patient's diet
true/false
Surgical intervention is always required for treating Benign Prostatic Hyperplasia (BPH).
False
A patient with chronic kidney disease (CKD) has developed anemia. The nurse understands that this is primarily due to which of the following?
A) Decreased erythropoietin production
B) Decreased white blood cell count
C) Increased blood urea nitrogen (BUN) levels
D) Decreased iron absorption
A) Decreased erythropoietin production
Mr. Johnson, a 68-year-old male with a history of heart failure and hypertension, is admitted to the hospital with complaints of shortness of breath, swelling in his legs, and a sudden weight gain of 7 pounds in the past week. His current medications include lisinopril, metoprolol, and a newly prescribed furosemide (Lasix).
Assessment Findings:
BP: 138/82 mmHg
HR: 88 bpm
RR: 20 breaths per minute
O2 Sat: 96% on room air
2+ pitting edema in lower extremities
Crackles heard in the lower lung fields
Serum potassium: 3.2 mEq/L (low)
Which assessment finding is most concerning and requires immediate intervention?
a) Weight gain of 7 pounds in one week
b) Blood pressure of 138/82 mmHg
c) Serum potassium level of 3.2 mEq/L
d) 2+ pitting edema in lower extremities
c) Serum potassium level of 3.2 mEq/L
A premature infant is struggling with breathing shortly after birth. Which factor might increase the risk of respiratory issues in this neonate?
a) High levels of lung surfactant
b) Insufficient lung development
c) Excessive fluid production in the airways
d) Increased respiratory drive
b) Insufficient lung development
A patient with asthma is prescribed medication to relieve airway constriction during an acute attack. What is the intended effect of this medication?
a) To increase the thickness of mucus
b) To reduce airway inflammation
c) To relax the smooth muscles around the airways
d) To decrease respiratory rate
c) To relax the smooth muscles around the airways
A nurse is teaching a student about the structure and function of the nephron. Which of the following is the main function of the proximal convoluted tubule (PCT) in the nephron?
A) Secretion of hydrogen ions to help regulate blood pH
B) Reabsorption of water and solutes like sodium into the blood
C) Concentration of urine by recovering water and sodium chloride
D) Filtration of blood to remove waste products
B) Reabsorption of water and solutes like sodium into the blood
A nurse is explaining the renin-angiotensin-aldosterone system (RAAS) to a student nurse. What are the correct order of steps in the RAAS pathway, starting with the detection of low blood pressure?
Renin is released from the kidneys in response to low blood pressure.
Renin converts angiotensinogen into angiotensin I.
Angiotensin I is converted to angiotensin II by ACE in the lungs.
Angiotensin II stimulates the release of aldosterone, which increases sodium and water reabsorption by the kidneys, raising blood pressure
Mr. Johnson, a 68-year-old male with a history of heart failure and hypertension, is admitted to the hospital with complaints of shortness of breath, swelling in his legs, and a sudden weight gain of 7 pounds in the past week. His current medications include lisinopril, metoprolol, and a newly prescribed furosemide (Lasix).
Assessment Findings:
BP: 138/82 mmHg
HR: 88 bpm
RR: 20 breaths per minute
O2 Sat: 96% on room air
2+ pitting edema in lower extremities
Crackles heard in the lower lung fields
Serum potassium: 3.2 mEq/L (low)
Which patient statement indicates the need for further teaching about diuretic therapy? (Select all that apply)
a) "I will take my furosemide in the morning to avoid nighttime trips to the bathroom."
b) "I don’t need to worry about eating potassium-rich foods while on this medication."
c) "I should monitor my weight daily and report sudden changes."
d) "If I feel better, I can stop taking my diuretic."
e) "I will drink extra fluids to counteract the effects of the diuretic."
b) "I don’t need to worry about eating potassium-rich foods while on this medication."
d) "If I feel better, I can stop taking my diuretic."
e) "I will drink extra fluids to counteract the effects of the diuretic."
A nurse is educating a patient on diuretic therapy. Which statements indicate the need for further teaching? (Select all that apply)
a) "I will monitor my weight daily."
b) "I should increase my potassium intake when taking a loop diuretic."
c) "I should avoid standing up quickly while on this medication."
d) "I don’t need to worry about dehydration with diuretics."
e) "Diuretics will help my body retain extra fluid."
f) "I can stop taking my diuretic if I feel better."
g) "Since I am on a diuretic, I don’t need to watch my sodium intake."
d) "I don’t need to worry about dehydration with diuretics."
e) "Diuretics will help my body retain extra fluid."
f) "I can stop taking my diuretic if I feel better."
g) "Since I am on a diuretic, I don’t need to watch my sodium intake."
Which of the following is true about the glomerulus in the nephron?
A. It actively reabsorbs glucose and amino acids from the filtrate.
B. It is where the filtration of blood plasma into Bowman's capsule occurs.
C. It reabsorbs most of the water and electrolytes back into the bloodstream.
D. It regulates sodium and potassium levels under hormonal influence.
B. It is where the filtration of blood plasma into Bowman's capsule occurs.
Which part of the nephron is primarily responsible for concentrating urine by recovering water and sodium chloride from the filtrate?
A) Glomerulus
B) Proximal convoluted tubule (PCT)
C) Loop of Henle
D) Collecting duct
C) Loop of Henle
A nurse is assessing a patient with a urinary tract obstruction and asks about the patient's medical history. The nurse notes that the patient has a history of benign prostatic hyperplasia (BPH). What type of urinary tract obstruction is most likely in this patient?
A) Congenital obstruction
B) Acute obstruction
C) Chronic obstruction
D) Acquired obstruction
D) Acquired obstruction
A nurse is caring for a patient suspected of having atelectasis. Which of the following diagnostic tests is most useful in confirming the diagnosis?
A) Chest radiograph (X-ray)
B) Arterial blood gas (ABG) analysis
C) Pulmonary function tests
D) Sputum culture
A) Chest radiograph (X-ray)
A nurse is explaining the pathophysiology of pneumonia to a patient. Which of the following correctly describes what happens in the lungs during pneumonia?
A) The alveolar sacs become inflamed and fill with fluid, RBCs, WBCs, and pathogens, leading to impaired gas exchange.
B) The alveolar sacs lose their ability to produce surfactant, leading to increased lung compliance and improved oxygenation.
C) The alveolar sacs expand due to the accumulation of pus, which helps with ventilation.
D) The alveolar sacs constrict and prevent the entry of pathogens into the lungs.
A) The alveolar sacs become inflamed and fill with fluid, RBCs, WBCs, and pathogens, leading to impaired gas exchange.
A nurse is assessing a patient who is at risk for developing atelectasis. Which of the following factors increases the patient's risk for this condition?
A) Smoking, and immobility
B) Low oxygen levels, increased physical activity, and regular hydration
C) Eating a high-fat diet, excessive fluid intake, and poor posture
D) Exposure to allergens, physical exercise, and frequent handwashing
A) Smoking, and immobility
Which of the following interventions would the nurse most likely implement to help a patient with atelectasis?
A) Restricting fluid intake to reduce lung congestion
B) Encouraging deep breathing, coughing, and the use of incentive spirometry
C) Administering diuretics to reduce lung edema
D) Encouraging the patient to lie flat in bed to increase lung expansion
B) Encouraging deep breathing, coughing, and the use of incentive spirometry
A nurse is educating a patient about viral rhinitis (common cold). Which of the following symptoms is most commonly associated with this condition?
A) High-grade fever and persistent cough
B) Nasal congestion, rhinorrhea, and sore throat
C) Severe body rash and joint pain
D) Nausea and vomiting with abdominal pain
B) Nasal congestion, rhinorrhea, and sore throat
A nurse is assessing a patient with chronic obstructive pulmonary disease (COPD). The patient is using pursed-lip breathing and has a pink complexion. Which of the following types of COPD is the patient most likely experiencing?
A) Chronic Bronchitis
B) Emphysema
C) Asthma
D) Pulmonary embolism
B) Emphysema