A male presents to the emergency department with confusion, lethargy, and a decreased level of consciousness. His friends report that he ingested a large quantity of unknown pills in a suicide attempt. Laboratory results reveal severe metabolic acidosis, high anion gap, and elevated serum creatinine. Which of the following is the most urgent indication for initiating dialysis in this patient?

Overdose

Chronic Kidney Disease

Hypertension

Dehydration

Answer and Explanation

The Correct Answer is A

A. Overdose: The patient has ingested a large quantity of unknown pills, leading to severe metabolic acidosis, high anion gap, and possible toxic accumulation. Dialysis is often indicated to clear toxins in the case of overdose, especially if renal function is impaired (as indicated by elevated creatinine).

B. Chronic Kidney Disease: While chronic kidney disease may eventually require dialysis, the acute overdose and metabolic acidosis are the more immediate concerns requiring urgent dialysis.

C. Hypertension: Hypertension may require management, but it is not the primary reason to initiate urgent dialysis in this scenario. The overdose and metabolic acidosis take precedence.

D. Dehydration: Dehydration alone does not necessitate dialysis. However, the overdose, metabolic acidosis, and renal impairment are the critical reasons for initiating dialysis.

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 ["A","C","D","F"]

Explanation

A. Increased fluid intake and patient education on hydration: Encouraging increased fluid intake helps to flush bacteria from the urinary tract and prevent further infection. Hydration is a key component of managing UTIs, as it dilutes urine and promotes frequent urination, reducing bacterial colonization.

B. Blood cultures: Blood cultures are not typically indicated for uncomplicated UTIs, especially in a patient without signs of systemic infection or sepsis (e.g., high fever, hypotension, tachycardia). Blood cultures are more relevant in severe or complicated UTIs, or when there is concern for urosepsis.

C. Urine culture and sensitivity testing: A urine culture and sensitivity is essential for identifying the specific bacteria causing the infection and determining the appropriate antibiotic for treatment. This is especially important for patients with a history of recurrent UTIs to ensure the right antibiotic is selected and to avoid antibiotic resistance.

D. Repeat urinalysis after antibiotic treatment completion: A repeat urinalysis after antibiotic treatment is often ordered to ensure that the infection has been resolved, particularly in patients with recurrent infections.

E. Foley catheter placement: A Foley catheter is not appropriate for this patient, as there is no indication of urinary retention, and catheterization increases the risk of introducing new infections.

F. Oral antibiotics, such as trimethoprim-sulfamethoxazole or ciprofloxacin: Oral antibiotics like trimethoprim-sulfamethoxazole (TMP-SMX) or ciprofloxacin are commonly prescribed for treating uncomplicated UTIs. Given the patient’s history of recurrent UTIs, empiric antibiotic therapy is appropriate pending urine culture results.

A. I should eat only plant-based proteins to manage my symptoms. B. I should avoid all sources of protein to prevent flare-ups. C. I should follow a low-protein diet to reduce intestinal inflammation. D. I should include high-protein foods like chicken and fish in my diet.

Correct Answer is D

Explanation

A. I should eat only plant-based proteins to manage my symptoms: While plant-based proteins may be a part of the diet, limiting protein intake solely to plant-based sources is not necessary, and animal proteins like chicken and fish are recommended for tissue repair.

B. I should avoid all sources of protein to prevent flare-ups: Protein is necessary for healing and should not be completely avoided.

C. I should follow a low-protein diet to reduce intestinal inflammation: There is no evidence that a low-protein diet helps reduce inflammation in Crohn's disease. High-protein intake is beneficial.

D. I should include high-protein foods like chicken and fish in my diet. During active inflammation in Crohn's disease, a high-protein diet is important for healing and maintaining muscle mass, especially since malabsorption can be a concern.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","C","D","F"]

Explanation

A patient with Crohn's disease is being discharged from the hospital. The nurse is providing dietary teaching to the patient. Which of the following statements by the patient indicates a correct understanding of the dietary recommendations?

Correct Answer is D

Explanation

A patient with ascites has been admitted to your unit. Which of the following safety precautions should you reinforce to prevent complications?

A female presents to the clinic with complaints of dysuria and increased urinary frequency. Which of the following findings on physical examination would most likely support a diagnosis of cystitis?

Which of the following client statements demonstrates a comprehensive understanding of the dietary and lifestyle modifications necessary for managing symptoms associated with a hiatal hernia? (Select all that apply.)

A nurse is caring for a client admitted for renal calculus. Which of the following assessment findings should the nurse associate with renal calculi? (Select All that Apply.)

A nurse is reinforcing dietary instructions with a client who has episodes of biliary colic from chronic cholecystitis. Which of the following diets should the nurse reinforce in the teaching plan?