You are taking care of a patient who has acute tubular necrosis (ATN), which of the following questions would you want to ask the patient when taking their history?
Do you have a history of asthma?
Who is your nephrologist?
Which medications are you currently taking or have taken recently?
What is your blood type?
The Correct Answer is C
A. Do you have a history of asthma? is incorrect because asthma is not directly related to the development of acute tubular necrosis. While general health history is important, asthma does not contribute to ATN pathophysiology.
B. Who is your nephrologist? is incorrect because while it is helpful to know the healthcare provider involved in the patient’s care, this information does not identify risk factors or causes of ATN.
C. Which medications are you currently taking or have taken recently? is correct because medication history is critical in assessing risk factors for ATN. Certain medications, such as aminoglycoside antibiotics, NSAIDs, contrast dyes, or chemotherapeutic agents, can be nephrotoxic and directly cause tubular injury. Identifying recent or ongoing use helps determine the etiology of ATN and guide interventions to prevent further kidney damage.
D. What is your blood type? is incorrect because blood type is not relevant to the development or management of ATN unless considering transplant, which is unrelated to the acute event.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. The patient has a cough for the last 5 days is incorrect because while a prolonged cough may require assessment and management, it is not immediately life-threatening in the context of ICP monitoring. It is a secondary concern compared to potential complications of the monitoring system itself.
B. Cloudy cerebrospinal fluid drainage is correct because cloudy CSF is a sign of possible infection, such as ventriculitis or meningitis. Patients with ventriculostomy drains or ICP monitors are at high risk for infections due to the direct access of the central nervous system. Infection in this context is a serious and urgent concern that can increase ICP, worsen neurological status, and rapidly become life-threatening. Immediate notification of the healthcare provider and implementation of infection-control measures are required.
C. You notice a rash developing on his coccyx is incorrect because while a pressure injury is concerning and requires intervention, it is not as immediately critical as signs of CNS infection in a patient with ICP monitoring.
D. Cerebrospinal fluid production at 20 mL/hr is incorrect because normal CSF production ranges from approximately 20–30 mL/hr (about 500 mL/day). This rate is within expected limits and not concerning in itself.
Correct Answer is B
Explanation
A. Blood covering the whole gauze is incorrect because this suggests active bleeding only. It does not demonstrate separation of cerebrospinal fluid from blood and therefore does not indicate a cerebrospinal fluid leak.
B. There will be a circle of blood in the center of the gauze with a yellow ring around it is correct because this finding represents the positive Halo (or ring) sign. When cerebrospinal fluid is mixed with blood, the blood remains concentrated in the center while the clearer CSF migrates outward, forming a yellow or straw-colored ring. This indicates a possible CSF leak, commonly associated with a basilar skull fracture, and is a medical emergency due to the risk of meningitis.
C. There will be a greenish-colored fluid present on the gauze is incorrect because CSF is typically clear or straw-colored, not green. Green drainage is more suggestive of infection or purulent nasal discharge rather than a CSF leak.
D. There will be multiple circles of blood noted on the gauze is incorrect because multiple blood spots do not demonstrate the characteristic separation pattern seen with CSF. The halo sign specifically involves a central blood spot with a surrounding clear or yellow ring.
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