Patho Exam 3
A patient presents to the emergency room with nausea, vomiting, and diarrhea for three days. The patient's lab values are as follows: K 3.8, Na 149, pH 7.32, HCO3- 20, and PaCO2 40. Which of the following intravenous fluids would you anticipate the doctor to order?
0.45% normal saline with 100mEq/L of sodium bicarbonate (hypotonic solution -> shift water into cells)
The healthcare provider orders an infusion of a hypertonic solution. The nurse knows an appropriate intravenous solution to administer would be:
5% dextrose lactate Ringer's
5. Which of the following statements is true as it relates to acid-base balance? A) Renal mechanisms for correcting an acid-base imbalance are less rapid than respiratory mechanisms, but they continue to function until pH has been returned to a normal or near-normal range. B) pH provides an accurate measure of serum bicarbonate and carbonic acid levels. C) The acid-base buffer systems of the body consist of a weak acid and strong base. D) The body uses respiratory compensatory mechanisms to prevent large changes in pH resulting from respiratory disease.
A) Renal mechanisms for correcting an acid-base imbalance are less rapid than respiratory mechanisms, but they continue to function until pH has been returned to a normal or near-normal range.
What is vasopressin also known as?
Antidiuretic hormone
Insensible water losses are those that occur as the result of water that is lost in
Breathing and sweating
After receiving your report, which patient should you assess first? A. 76 female with pneumonia admitted 3 days ago B. 48 male admitted yesterday with kidney stones C. 52 female admitted yesterday with acute renal failure D. 59 male admitted two days ago with stage 3 bronchiogenic carcinoma complaining of nausea and pain
C. 52 year old female admitted yesterday with acute renal failure
Which is NOT a function of the kidneys? A. regulation of extracellular fluid volume B. maintenance of ion balance in body fluids C. regulation of blood protein levels D. regulation of blood osmolarity E. homeostatic regulation of blood pH
C. regulation of blood protein levels
A patient presents to the emergency room with a K level of 6.5. What potentially life-threatening complication would you assess for?
Cardiac dysrhythmias
The nurse observes tall, peaked T waves on the electrocardiogram (ECG) of a patient with end-stage kidney disease (ESKD). Which is the nurse's best action?
Check serum potassium level
Which of the following serum electrolyte values is not normal? A. Magnesium 2.0mEq/L B. Potassium 4.0mEq/L C. Sodium 138mg/dL D. Calcium 15.0mEq/L
D. Calcium 15.0mEq/L
The RN has just received change-of-shift report. Which of the assigned patients will be assessed first? A. patient with renal insufficiency who is scheduled to have dialysis fistula inserted B. patient with azotemia whose blood urea nitrogen and creatine are increasing C. patient receiving peritoneal dialysis who needs help changing the dialysis bag D. patient with chronic renal failure who was just admitted with shortness of breath
D. patient with chronic renal failure who was just admitted with shortness of breath
A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom?
Hematuria
Bilirubin is a waste product in urine derived from:
Hemoglobin
What happens when the hydrogen ion concentration in the body fluids is too low?
Hydrogen secretion increases
The nurse questions the female patient about perineal cleansing. Which statement by the patient indicates proper technique?
I wipe from front to back
The nurse is planning care for a patient with hypercalcemia secondary to bone metastasis. Which interventions will be included in the plan?
Increasing oral fluids
Which of the following medications would you anticipate to order to treat hyperkalemia?
Kayexalate
The nurse is performing discharge teaching for the patient after nephrectomy for renal carcinoma. Which statement by the patient indicates that teaching has been effective?
My remaining kidney should provide me with normal renal function
Which ion is not directly regulated by the kidney? A. Na+ B. K+ C. Ca2+ D. HCO3- E. OH-
OH-
A patient has a serum creatine level of 2.5mg/dL, a serum potassium level of 6 mmol/L, an arterial pH of 7.32, and a urine output of 250 mL/day. Which phase of acute renal failure is the patient experiencing?
Oliguric
The nurse monitors for which definitive clinical manifestation in a patient with renal impairment associated with polycystic kidney disease?
Palpable kidneys
Urinary flow in men can be compromised by enlargement or growth of what gland?
Prostate
What blood vessels directly supply the kidneys?
Renal artery and renal vein
Which of the following is the nurses highest priority for meeting the needs of a patient who presents with a 3-day history of vomiting and diarrhea, blood pressure of 85/60mmHg, heart rate of 105 bpm, and temp of 99 degrees F?
Replacement of fluid loss
Classify the following arterial blood gas: pH = 7.52, PaCO2 = 30 mm Hg, HCO3- = 24 mEq/L.
Respiratory alkalosis
Which of the following signs would indicate a fluid deficit?
Tachycardia, acute weight loss, weakness, and dry mucous membranes
What does micturition mean?
The process of bladder emptying or urination
The nurse correlates the decreased glomerular filtration rate in the client with acute glomerulonephritis to which pathophysiologic process?
Thickened capillary membranes secondary to immune complex deposition and cellular proliferation
What is the main stimulus for secretion of the hormone aldosterone from the adrenal cortex?
angiotensin II
The primary function of the Bowman's capsule is to:
collect the glomerular filtrate
Metabolic acidosis is caused by the inability of the kidneys to adequately secrete:
hydrogen ions
Urine is produced by the
kidney
Reduced capillary osmotic pressure can be caused by which of the following?
low concentration of plasma proteins
The Bowman's capsule and glomerulus make up the
renal corpuscle
The role of the hormone erythropoietin is to:
stimulate red blood cell production
Urine is carried to the urinary bladder by
the ureters
