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","D","E"]

Explanation

A. Ensure that the client's urine output is at least 1 ml/kg/hr. Adequate urine output is essential before administering IV potassium to ensure the kidneys are functioning properly and can handle the increased potassium load, preventing hyperkalemia.

B. Ensure potassium infusion is prepared with 5% dextrose solution. While IV potassium can be mixed with normal saline or dextrose solutions, the specific diluent will depend on the clinical scenario. This isn't necessarily a standard requirement, so it may not be appropriate for all situations.

C. Educate the client regarding high-potassium foods. Education on high-potassium foods helps the client maintain potassium levels after treatment, reducing the need for future supplementation.

D. Repeat blood serum potassium levels. Rechecking potassium levels ensures the patient reaches a safe and therapeutic range and helps monitor for signs of overcorrection or continued hypokalemia.

E. Cardiac monitoring during infusion. Cardiac monitoring is critical, as hypokalemia and potassium replacement can affect heart rhythm and lead to arrhythmias.

A. Increased pulse, respirations and blood pressure with dysphagia and respiratory distress B. Hypotension, diarrhea and increased salivation C. Bradycardia and hypothermia D. Tachypnea and hyperactive deep tendon reflexes

Correct Answer is A

Explanation

A. Increased pulse, respirations and blood pressure with dysphagia and respiratory distress. A myasthenic crisis is characterized by severe muscle weakness that can lead to respiratory failure, dysphagia, and increased vital signs due to the stress of respiratory distress.

B. Hypotension, diarrhea, and increased salivation. These symptoms are more indicative of a cholinergic crisis, which is due to excess acetylcholine.

C. Bradycardia and hypothermia. Bradycardia and hypothermia are not characteristic signs of a myasthenic crisis.

D. Tachypnea and hyperactive deep tendon reflexes. While tachypnea can occur in respiratory distress, hyperactive reflexes are not typical in myasthenic crisis, as it involves neuromuscular weakness.

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Naxlex Comprehensive Predictor Exams

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.)

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

Explanation

A patient with myasthenia gravis is admitted to the hospital with signs of a myasthenic crisis. Which of the following symptoms should the nurses expect to observe?

Correct Answer is A

Explanation

A nurse is caring for a client who develops a fat embolism after sustaining multiple fractures in a motor vehicle accident. Which of the following interventions should the nurse implement first?

A nurse is reinforcing teaching with a client who needs to have a cholecystectomy due to gallstones. Which of the following is the best response from the nurse to explain what caused this problem?

A patient with Crohn’s disease is experiencing an exacerbation. Which if the following symptoms should the nurse expect to find?

A nurse is developing a care plan for a patient with hearing loss. Which of the following interventions is most appropriate to promote effective communication with the patient?

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 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 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?