Try Naxlex NCLEX-RN (Free-Trial)

Question 28

A nurse is discussing laboratory values associated with the renal system with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the values?

Potassium levels are increased in clients who have polyuria

Creatinine levels are decreased in clients who have acute kidney injury

Specific gravity is decreased in clients who have hypovolemia

BUN is increased in clients who have dehydration

Answer and Explanation

The Correct Answer is D

Choice A reason: Polyuria, excessive urine output, typically leads to potassium loss, causing hypokalemia, not hyperkalemia. In conditions like diabetes insipidus, increased urination reduces serum potassium as the kidneys excrete more fluid and electrolytes. Elevated potassium is more associated with reduced renal excretion, as in kidney failure, not polyuria.

Choice B reason: Creatinine levels increase in acute kidney injury due to reduced glomerular filtration, impairing the kidneys’ ability to clear creatinine, a muscle metabolism byproduct. Decreased creatinine levels are rare and may reflect low muscle mass, not kidney injury, making this statement incorrect as it contradicts the pathophysiology of renal impairment.

Choice C reason: Specific gravity is increased in hypovolemia, as the kidneys conserve water, producing concentrated urine (high specific gravity, >1.020). Decreased specific gravity occurs in conditions like diabetes insipidus, where dilute urine is produced. This statement is incorrect, as hypovolemia leads to higher, not lower, urine specific gravity.

Choice D reason: Blood urea nitrogen (BUN) increases in dehydration due to reduced renal perfusion, causing the kidneys to reabsorb urea to conserve water. This elevates serum BUN levels, often with a normal creatinine, reflecting prerenal azotemia. This statement correctly aligns with the pathophysiology of dehydration’s effect on renal laboratory values.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A reason: The cause of the burn (e.g., thermal, chemical, electrical) influences treatment specifics, such as decontamination for chemical burns. However, it is not the primary factor in assessing severity. The location, particularly face and neck, is critical due to airway risk, making cause secondary in the initial assessment of burn severity.

Choice B reason: Associated medical history, such as diabetes or heart disease, affects long-term management and healing but is not the immediate priority in burn assessment. The location of burns, especially on the face and neck, poses a higher risk of airway compromise, making it more critical in determining initial severity and urgency.

Choice C reason: The location of burns, especially on the face, neck, and upper extremities, is the priority in assessing severity. Burns in these areas risk airway edema, respiratory compromise, and functional impairment. The ABCDE approach emphasizes airway and breathing, making location critical due to potential for rapid deterioration and need for intubation.

Choice D reason: Age influences burn outcomes, as elderly or pediatric patients have reduced physiological reserve and higher complication risks. However, it is not the primary factor in initial severity assessment. Location, particularly face and neck burns, takes precedence due to immediate threats to airway and breathing, which are prioritized in emergency care.

A. PaCO2 greater than 50 mm Hg B. Bradycardia C. PaO2 less than 60 mm Hg D. Peripheral edema

Correct Answer is C

Explanation

Choice A reason: PaCO2 greater than 50 mm Hg indicates hypercapnia, characteristic of hypercapnic respiratory failure due to hypoventilation, as seen in COPD or neuromuscular disorders. Hypoxemic respiratory failure is defined by low oxygen levels (PaO2 <60 mm Hg) with normal or low PaCO2, making hypercapnia less relevant.

Choice B reason: Bradycardia is not a primary feature of hypoxemic respiratory failure. Hypoxemia typically causes tachycardia as a compensatory response to low oxygen delivery. Bradycardia may occur in severe, late-stage hypoxia but is not the most indicative finding compared to PaO2, which directly measures oxygenation status.

Choice C reason: Hypoxemic respiratory failure is defined by a PaO2 less than 60 mm Hg, indicating severe impairment in oxygen transfer due to conditions like ARDS or pulmonary edema. This low arterial oxygen level, despite adequate ventilation, is the hallmark finding, requiring urgent intervention to restore tissue oxygenation.

Choice D reason: Peripheral edema suggests fluid overload, often seen in heart failure, which may contribute to pulmonary edema and hypoxemia. However, it is not a direct indicator of hypoxemic respiratory failure. PaO2 <60 mm Hg specifically defines the condition, as it reflects the primary issue of inadequate oxygenation.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Question 28

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing the depth and extent of injury on a client who has severe burns to the face, neck, and upper extremities. Which of the following factors is the nurse's priority when assessing the severity of the client's burns?

Correct Answer is C

Explanation

Which clinical finding is most indicative of hypoxemic respiratory failure?

Correct Answer is C

Explanation

Which intervention should be prioritized for a client experiencing acute hypoxemic respiratory failure?

A client with respiratory failure has a respiratory rate of 6 breaths/min and an oxygen saturation (SpO2) of 88%. The client is increasingly lethargic. Which intervention will the nurse anticipate?

A client with diabetic ketoacidosis (DKA) is admitted to the ICU. The nurse notes a fruity breath odor and rapid, deep respirations. Which intervention should the nurse prioritize?

A nurse is caring for a client in the ICU with suspected cardiogenic shock following a myocardial infarction. The client has a blood pressure of 85/50 mm Hg and cool, clammy skin. Which intervention should the nurse prioritize?

A client who has broken his femur presents to the emergency department with the following signs and symptoms: cool, moist skin, increased heart rate, and falling blood pressure. The nurse suspects the client is experiencing:

A nurse in the emergency department is caring for a client who has extensive partial and full-thickness burns of the head, neck, and chest. While planning the client's care, the nurse should identify which of the following risks as the priority for assessment and intervention?

This is an extra credit question: A nurse is caring for a client receiving hemodialysis. Exhibits A nurse is for a client who has received hemodialysis. Which of the following assessment findings require follow-up?