The HCP suspects intrarenal causes of acute kidney injury in your patient. Which diagnostic test will be the best to confirm intrarenal causes of AKI?
Renal biopsy
CT scan with IV contrast
MRI with Gadolinium
ABG
The Correct Answer is A
A. Renal biopsy is correct because it is the gold standard for diagnosing intrarenal (intrinsic) causes of AKI, such as acute tubular necrosis, glomerulonephritis, or interstitial nephritis. A biopsy allows direct histological examination of kidney tissue, confirming the exact type of injury and guiding treatment decisions.
B. CT scan with IV contrast is incorrect because contrast media is nephrotoxic and can actually precipitate contrast-induced AKI. While CT may detect structural abnormalities or obstruction, it does not confirm intrinsic renal pathology.
C. MRI with Gadolinium is incorrect because gadolinium-based contrast is also nephrotoxic in patients with renal impairment, and MRI primarily provides structural imaging rather than histological confirmation of intrarenal injury.
D. ABG is incorrect because arterial blood gas analysis evaluates acid-base balance, oxygenation, and ventilation, not the underlying renal pathology. While ABGs may show metabolic acidosis secondary to AKI, they cannot confirm intrarenal causes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Cerebral vasodilation and increased ICP is correct because PaCO2 is a potent regulator of cerebral blood flow (CBF). A PaCO2 of 60 mmHg indicates hypercapnia, which causes cerebral vasodilation, increasing blood volume in the brain and raising intracranial pressure (ICP). This effect can further compromise cerebral perfusion, especially when CPP is already low.
B. Cerebral vasoconstriction and decreased ICP is incorrect because hypocapnia (low PaCO2), not hypercapnia, causes cerebral vasoconstriction, which temporarily reduces cerebral blood flow and ICP.
C. No effect on ICP is incorrect because PaCO2 directly influences cerebral vessel tone. Changes in PaCO2 significantly affect ICP and are a key consideration in mechanically ventilated patients with traumatic brain injury.
Correct Answer is B
Explanation
A. Elevated body temp, systolic hypertension and irregular respirations is incorrect because while hyperthermia may accompany severe brain injury, it is not part of the classic signs indicating brainstem compression.
B. Systolic hypertension with widening pulse pressure, bradycardia with a full and bounding pulse, and irregular respirations is correct. This combination is known as Cushing’s triad, which is a hallmark of increased intracranial pressure causing brainstem compression. These findings indicate impending herniation and potential deathif not managed immediately. The triad occurs due to autonomic nervous system responses to rising ICP, with systolic hypertension attempting to maintain cerebral perfusion, bradycardia resulting from baroreceptor reflex, and irregular respirations caused by brainstem dysfunction.
C. Tachycardia and hypertension is incorrect because tachycardia is not typical in Cushing’s triad; bradycardia is the key cardiac sign associated with rising ICP and impending brainstem herniation.
D. Dizziness, fever and headache is incorrect because these are nonspecific symptomsand do not reliably indicate brainstem compression or imminent death. They may be seen in early or mild ICP elevation but are not diagnostic of severe brain injury.
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