A 65-year-old male patient presents with sudden onset of oliguria and signs of dehydration His blood pressure is 90/60 mmHg, heart rate is 110 bpm and he has poor skin turgor. Laboratory results show elevated blood urea nitrogen (BUN and creatinine levels. Which of the following is the most likely cause of his acute kidney injury (AKI)?

Hypovolemia leading to decreased renal perfusion

Acute tubular necrosis

Urinary tract obstruction

Chronic kidney disease

Answer and Explanation

The Correct Answer is A

A. Hypovolemia leading to decreased renal perfusion. Hypovolemia from dehydration and low blood pressure reduces blood flow to the kidneys, resulting in pre-renal AKI, characterized by elevated BUN and creatinine.

B. Acute tubular necrosis. Acute tubular necrosis may cause AKI but is often due to prolonged hypoperfusion, nephrotoxic drugs, or ischemia, not the immediate presentation seen here.

C. Urinary tract obstruction. A urinary tract obstruction leads to post-renal AKI, often with symptoms like flank pain or difficulty urinating, not dehydration and low blood pressure.

D. Chronic kidney disease. Chronic kidney disease is a long-term condition and would not cause the acute symptoms or sudden onset of AKI as seen in this patient.

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Correct Answer is ["A","C","E"]

Explanation

A. A clean catch urinalysis and urine culture: A urinalysis and culture are essential to identify the presence of infection, type of bacteria, and appropriate antibiotic sensitivity.

B. Foley catheter placement: Foley catheters are not routinely indicated for suspected urinary tract infections (UTIs) unless there is an issue with urinary retention or other specific medical indication.

C. Broad-spectrum antibiotic: Initiating a broad-spectrum antibiotic may be appropriate while waiting for culture results to address infection.

D. 0.9% sodium chloride infusion at 100 ml/hr: IV fluids are not typically necessary for a UTI unless the patient is dehydrated or unable to take oral fluids.

E. WBC count: A WBC count can help assess the systemic inflammatory response and gauge the severity of the infection.

F. Blood cultures × 2: Blood cultures are generally reserved for cases where a systemic infection or sepsis is suspected, which is not indicated by this patient's symptoms alone.

A. I understand that CAD is caused by the build up of fat deposits in my arteries B. Only people with a family history of heart disease are at risk for CAD. C. CAD can be completely cured with a healthy diet and exercise. D. I should avoid all physical activity to prevent worsening my CAD.

Correct Answer is A

Explanation

A. "I understand that CAD is caused by the buildup of fat deposits in my arteries." CAD is caused by the accumulation of plaque (cholesterol, fats, and other substances) within the coronary arteries, which restricts blood flow to the heart muscle.

B. "Only people with a family history of heart disease are at risk for CAD." Although a family history can increase risk, many other factors, like high blood pressure, smoking, high cholesterol, and lifestyle, contribute to CAD risk.

C. "CAD can be completely cured with a healthy diet and exercise." While lifestyle changes can significantly reduce the progression of CAD and improve symptoms, they do not cure the disease.

D. "I should avoid all physical activity to prevent worsening my CAD." Physical activity, when performed safely and under medical guidance, is beneficial for CAD management and can help improve cardiovascular health.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client in a clinic who has foul, smelling urine, a low-grade fever of 37.7° C (100° F), and pain with urination. Which of the following should the nurse expect the health care provider to order?

Correct Answer is ["A","C","E"]

Explanation

A nurse is teaching a patient about coronary artery disease (CAD). Which of the following statements made by the patient demonstrates understanding of the disease?

Correct Answer is A

Explanation

A 45-year-old male patient present to the emergency department with a severe head injury following a car accident. His Glasgow Coma Scale (GCS) score is 8, and he shows signs of increased intracranial pressure (ICP). Which of the following interventions should be prioritized to manage his ICP?

A. Consume small frequent meals throughout the day. Small, frequent meals reduce the volume of food entering the small intestine at one time, helping to prevent symptoms of dumping syndrome.

A nurse is caring for a client who sustained burns in an enclosed space and is exhibiting singed nasal hair, black sputum and smoky smelling breath. What is the nurse’s priority intervention?

A patient with multiple sclerosis (MS) is receiving treatment with methylprednisolone during an acute exacerbation. Which of the following is the expected therapeutic effect of this treatment?

A nurse is gathering medical history from a client admitted for pyelonephritis. Which of the following should the nurse expect the client to report when asked about their medical history?

A nurse is assisting with the care of a postoperative client following a total knee replacement. Which of the following medications should the nurse anticipate the provider to prescribe to prevent the formulation of a deep vein thrombosis (DVT)?

A nurse is assisting with preparations for administering intravenous potassium replacement supplements to a client who has a potassium level of 2.5 mEq/L. Which of the following actions should the nurse plan to include? (Select All that Apply.)