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. Drink plenty of fluids to stay well hydrated. Hydration is crucial for clients with sickle cell disease as it helps prevent blood thickening and reduces the risk of sickling crises.

B. Limit your intake of fruits and vegetables to avoid complications. Fruits and vegetables are essential for balanced nutrition and are not contraindicated in sickle cell disease. Limiting them is unnecessary and could lead to nutritional deficiencies.

C. You can stop your prescribed antibiotics once you feel better. Antibiotics should always be completed as prescribed to fully treat any infection and prevent resistance, especially in individuals with weakened immune responses.

D. Take your pain medications only when you have severe pain. Clients with sickle cell disease should take pain medications as needed, even for mild pain, to prevent escalation of pain and a sickle cell crisis.

A. Initiation of a high-sodium diet B. Application of a cast to the affected limb C. Administration of anticoagulant therapy D. Administration of bronchodilators

Correct Answer is C

Explanation

A. Initiation of a high-sodium diet. A high-sodium diet is not indicated in pulmonary embolism management; it could worsen fluid retention and cardiovascular strain.

B. Application of a cast to the affected limb. Casting is not appropriate for pulmonary embolism, as it is not an orthopedic injury. Immobilization could increase the risk of further clot formation.

C. Administration of anticoagulant therapy. Anticoagulant therapy, such as heparin or warfarin, is the primary treatment for pulmonary embolism to prevent further clot formation and allow the body to dissolve the clot.

D. Administration of bronchodilators. Bronchodilators may alleviate respiratory symptoms but do not treat the underlying clot in pulmonary embolism. Anticoagulation remains the primary treatment.

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Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching to a client with sickle cell disease. Which of the following instructions should the nurse include?

Correct Answer is A

Explanation

A patient is diagnosed with a pulmonary embolism. Which of the following treatments should the nurse anticipate?

Correct Answer is C

Explanation

A patient who recently underwent percutaneous transluminal coronary angioplasty (PTCA) is being discharged. Which of the following statements made by the patient indicates the need for further teaching?

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

A client presents with conductive hearing loss. Which of the following conditions is the most likely cause?

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 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.)

A nurse is teaching a patient newly diagnosed with Parkinson’s disease about the pathophysiology of the condition. Which of the following explanations best describes the underlying cause of Parkinson's disease?

A patient who underwent gastric surgery is being educated on preventing dumping syndrome. Which of the following dietary recommendations should the nurse include in the teaching?

A 65-year-old patient presents to the emergency department with sudden numbness and weakness in the face, arm, and leg on one side of the body difficulty speaking, and severe headache with no known cause. Which of the following is the most likely diagnosis?