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

Explanation

A. Reposition the client at least every two hours. Regular repositioning reduces prolonged pressure on specific areas of the body, which helps prevent the formation of pressure injuries.

B. Encourage the client to limit fluid intake. Adequate hydration is important for skin integrity. Limiting fluid intake could lead to dehydration, increasing the risk for skin breakdown.

C. Use a donut-shaped cushion under the client's hips. Donut-shaped cushions can actually increase pressure around the edges of the cushion and restrict blood flow, which could worsen pressure injury risk.

D. Apply a heating pad to the client's back every four hours. Heat can cause skin damage and may increase the risk of burns. Temperature regulation is important, but heating pads are not recommended for pressure injury prevention.

A. Loss of pain temperature, and light touch sensation on the same side as the injury B. Loss of motor function and deep pressure sensation on the opposite side of the injury C. Loss of motor function and position sense on the same side as the injury D. Loss of motor function with preserved pain and temperature sensation in the lower extremities

Correct Answer is C

Explanation

A. Loss of pain, temperature, and light touch sensation on the same side as the injury. In Brown-Sequard syndrome, pain, temperature, and light touch are typically lost on the opposite (contralateral) side of the injury.

B. Loss of motor function and deep pressure sensation on the opposite side of the injury. Motor function and deep pressure sensation loss occur on the same side (ipsilateral) as the injury.

C. Loss of motor function and position sense on the same side as the injury. Brown-Sequard syndrome is a spinal cord hemisection injury leading to loss of motor function and proprioception on the same side as the injury.

D. Loss of motor function with preserved pain and temperature sensation in the lower extremities. Pain and temperature sensations are lost on the opposite side of the injury in Brown-Sequard syndrome, not preserved.

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Naxlex Comprehensive Predictor Exams

The nurse is providing care for a client who is at high risk for developing pressure injuries. Which intervention should the nurse include in the care plan to help prevent the development of pressure Injuries?

Correct Answer is A

Explanation

A patient is diagnosed with Brown-Sequard syndrome after a spinal cord injury. Which of the following symptoms should the nurse expect?

Correct Answer is C

Explanation

The nurse is assessing a patient with suspected bacterial meningitis and notes a positive Kernig sign. How should the nurse interpret this finding?

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