N363 Exam 2

What is a safety concern for older adults on antihypertensive medications?

Falls risk

True or False: A patient has a respiratory rate of 38 bpm due to acute anxiety. This patient is at risk for respiratory acidosis.

False

True or False: Patients with UTIs should discontinue antibiotics as soon as symptoms resolve to lower the risk of antibiotic resistance.

False

True or False: The presence of residual urine is an abnormal assessment finding that necessitates medical and nursing interventions.

False

True or False: Secondary HTN has no underlying cause

False - Secondary HTN is caused by an underlying condition or cause

What is not a function of the kidney? a) Metabolizing ammonia b) Controlling blood pressure c) Regulating acid-base balance d) Producing red blood cells

A

What type of diet should patients with kidney disease follow? a) Low-potassium and low-sodium b) Low-calcium and high-potassium c) High-sodium and low-fat d) High-calcium and high-potassium

A

Which serum lab value can assist in diagnosing heart failure? a) Brain natriuretic peptide (BNP) b) Blood urea nitrogen (BUN) c) Blood pressure d) Cardiac catheterization

A

You are providing care for a patient with acute glomerulonephritis. Which is your priority assessment? a) Daily weights b) Ankle-brachial index c) Pain assessment d) Blood glucose levels

A

A patient waiting for kidney transplant asks what the signs and symptoms are of rejection. You respond (SATA): a) Oliguria b) Shortness of breath c) Fever d) Pain or swelling at the site

A, C, D

Your patient has an elevated BUN and creatinine. What assessment data is relevant to renal function? (SATA) a) Voiding disorders b) Occupation c) History of hypertension d) History of diabetes e) Financial status f) Ability of patient to manage ADLs

A, C, D

These measurements are considered more accurate than a standard office visit.

Home BP measurements or Ambulatory measurements

What are the 6 P's of a neurovascular assessment on an extremity?

Pain, Pallor, Pulses (diminished/absent), paresthesia, poikilothermia (coldness), and paralysis

What foods should a client taking a thiazide diuretic encourage?

Potassium-Rich Foods

A client with primary hypertension comes to the clinic reporting a gradual onset of blurry vision and decreased visual acuity over the past several weeks. The nurse is aware that these symptoms could be indicative of which condition?

Retinal Blood vessel damage/Retinal changes

A client with a blood pressure of 133/80 would fall into what classification of blood pressure?

Stage 1 HTN

How long should bed-rest be maintained post cardiac catheterization?

2-8 hours

A level of 100 pg/mL or greater of this neurohormone is indicative of Heart Failure.

BNP

A patient is being seen for possible kidney disease. Which labs do you anticipate drawing to assess renal function? (3 main ones)

BUN, creatinine, GFR

What medications should be avoided prior to a stress test?

Beta blockers, CCBs, and Digoxin

How long can the recovery period of AKI take? a) 1 to 2 weeks b) 6 to 12 weeks c) 2 to 4 months d) 3 to 12 months

D

A 36-year-old woman is complaining of incontinence when she runs hard while playing soccer. This woman most likely has: a) urge incontinence b) functional incontinence c) stress incontinence d) iatrogenic incontinence

C

The nurse is caring for a client with a blood pressure of 210/100 mm Hg in the emergency room. What is the most appropriate route of administration for antihypertensive agents?

IV

What cardiac biomarker is unique to the heart and is the most reliable protein to diagnose an MI?

Troponin

True or False: A patient with hypovolemia is likely to have a weak, rapid pulse, and hypotension.

True

True or False: An older adult with benign prostatic hyperplasia (BPH) is at risk for the post renal type of acute renal failure.

True

This drug class is associated with anigoedema, hyperkalemia, and a cough that does not go away

an ACE-I

Which describes a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage?

hypertensive emergency

The nurse auscultates the PMI (point of maximal impulse) at which anatomic location?

left midclavicular line, fifth intercostal space

1) What complication can occur after administration of IV contrast with a cardiac catheterization or CT w/ contrast and 2) what is the nursing management of this condition?

1) Contrast-Induced Nephropathy/Acute Renal Failure 2) Increase PO/IV intake, monitor I&Os, administer sodium bicarbonate, and monitor BUN & Creatinine

A patient is admitted for hypovolemic shock. Which type of acute kidney injury (AKI) is this patient at risk for? a) Prerenal b) Intrarenal c) Postrenal d) End-stage kidney disease

A

A nurse is concerned for the presence of peripheral artery disease in a client with decreased circulation of the lower extremities. What technique can the nurse use to evaluate for presence of PAD?

Ankle-Brachial Index

Upon assessment, the nurse notes a patient has crackles and dyspnea. What does this indicate? a) The patient's right side of the heart is affected. b) The patient's left side of the heart is affected. c) The patient has systolic heart failure. d) The patient has diastolic heart failure.

B

What is required when a patient is in end-stage kidney disease (ESKD)? a) Beta blockers b) Renal replacement therapy c) Ventricular assist device d) Continuous oxygen therapy

B

What is the best laboratory test for evaluating kidney function? a) Creatinine b) Creatinine clearance c) Urine specific gravity d) Blood urea nitrogen (BUN)

B

You suspect a patient who is receiving NG suctioning has hypokalemia. What manifestations would you expect to find? a) Hyperactive bowel sounds b) EKG changes c) Increased muscle strength d) Agitation

B

Your patient with renal failure complains of tingling in her lips and fingers. What electrolyte disorder do you suspect? a) Hyponatremia b) Hypocalcemia c) Hypermagnesemia d) Hyperkalemia

B

A nurse is administering a beta blocker to a patient who has heart failure. Which statement may be part of the nurse's patient education? a) "This medication will help your heart beat faster." b) "This medication will help your symptoms only." c) "This medication will improve your survival and symptoms of heart failure." d) "This medication helps get rid of the extra fluid in your body."

C

A patient has an ejection fraction (EF) of 35%. What does this indicate? a) The patient has an optimally functioning heart. b) The patient is in diastolic heart failure. c) The patient is in systolic heart failure. d) The patient is at risk for developing heart failure.

C

A patient is diagnosed with stage 3 chronic kidney disease (CKD). At what level is this patient's glomerular filtration rate (GFR)? a) Level 1 b) Level 2 c) Level 3 d) Level 5

C

A patient with ESRD is scheduled to begin hemodialysis. The dialysis nurse is aware the patient is vulnerable to: a) Urosepsis b) Abdominal pain c) Hypotension d) Metabolic acidosis

C

What type of medications puts a patient at risk for intrarenal acute kidney injury (AKI)? a) Beta blockers b) Insulin c) Antibiotics d) Proton pump inhibitors

C

Which statement accurately describes acute kidney injury (AKI)? a) It has a slow onset over many years. b) Diabetes mellitus is a primary cause for AKI. c) AKI has an abrupt onset. d) AKI primarily affects the liver with minor kidney implications

C

Which type of renal replacement therapy requires the patient to be in a critical care unit receiving dialysis because their condition is too unstable for conventional dialysis? a) Peritoneal dialysis b) Hemodialysis c) Continuous renal replacement therapy d) Intensive care dialysis

C

An elderly man in the ED has recent episodes of confusion, incontinence and a temp of 100.5. What do you suspect? a) Urinary retention b) Urinary trauma c) Urinary calculi d) Urinary tract infection

D

Which is not a common cause of heart failure? a) Coronary artery disease (CAD) b) Myocardial infarction (MI) c) Hypertension d) Hypothyroidism

D

Your patient has returned from a CT with contrast to rule out renal calculi. What steps do you take to prevent AKI? a) Administer pain medication. b) Strain all urine. c) Monitor for hematuria. d) Encourage high volume fluid intake.

D

Name two atypical signs of HTN in an older adult.

Dull headache, impaired memory, disorientation, confusion, epistaxis, or a slow tremor

The nurse is assessing a client who is 30 weeks pregnant and hears a low pitched whooshing sound with the bell of their stethoscope. What is the nurse most likely hearing?

a murmur (physiologic)

This drug class should not be stopped abruptly due to rebound HTN and is contraindicated in clients with Asthma/COPD.

beta blocker

A nurse is assessing a client with a blood pressure of 190/120 who reports feelings of dizziness and right arm numbness. What is the client most likely experiencing?

cerebrovascular accident (CVA)/Stroke

What paradoxical blood pressure condition occurs when the BP is normal at a clinic but elevated at home?

masked HTN

What is a common potential cause of hypertensive urgency?

non-adherence to medication regimen

A client who is on 3 or more meds from different classes, including a diuretic, is said to have what?

resistant HTN