A patient in the ICU develops acute exacerbation of chronic kidney disease (CKD) with hyperkalemia and metabolic acidosis. What intervention should the healthcare team prioritize to manage the patient's metabolic derangements?

Correct Answer: D

Rationale: In the scenario described, with the patient having an acute exacerbation of chronic kidney disease (CKD) leading to hyperkalemia and metabolic acidosis, the priority intervention to manage the metabolic derangements is to perform emergent hemodialysis for potassium removal. Hemodialysis is the most effective and rapid method to lower dangerously high potassium levels in the blood. It is crucial in cases of severe hyperkalemia where other measures such as medications or dietary modifications may not be sufficient or fast enough to correct the elevated potassium levels. Additionally, hemodialysis can also help in improving metabolic acidosis by removing waste products and excess electrolytes from the blood. Overall, emergent hemodialysis is the most appropriate intervention for managing the acute metabolic abnormalities in this critically ill patient.

Correct Answer: A

Rationale: Rheumatoid arthritis is a common cause of secondary osteoporosis. Chronic inflammation in rheumatoid arthritis can lead to bone loss due to increased osteoclast activity and decreased bone formation. Patients with rheumatoid arthritis are at an increased risk for developing osteoporosis, resulting in decreased bone density and increased fracture risk. Monitoring and managing bone health is an important aspect of care for individuals with rheumatoid arthritis to help prevent osteoporosis-related complications.

Correct Answer: A

Rationale: The presentation of flank pain, hematuria, and a palpable mass in the abdomen is characteristic of renal cell carcinoma. Renal cell carcinoma is a common type of kidney cancer that often presents with these symptoms. The presence of a solid renal mass with calcifications on imaging further supports this diagnosis, as renal cell carcinoma is known to have this appearance on imaging studies. It is important to promptly evaluate and manage patients with suspected renal cell carcinoma to optimize outcomes.

Correct Answer: B

Rationale: Urinary incontinence is a common complication associated with prostatectomy for the treatment of benign prostatic hyperplasia (BPH). Prostate surgery, such as a prostatectomy, can disrupt the sphincter muscle that controls the flow of urine from the bladder, leading to temporary or even long-term urinary incontinence in some patients. This usually improves over time with pelvic floor exercises and other treatment options, but it is an important consideration when discussing the potential risks and benefits of prostate surgery with patients. While erectile dysfunction and retrograde ejaculation can also be potential side effects of prostate surgery, urinary incontinence is specifically associated with issues related to bladder control following the procedure. Urethral stricture, although it can occur post prostate surgery, is less common compared to urinary incontinence.

Correct Answer: B

Rationale: Nephrotic syndrome is a kidney disorder characterized by increased glomerular permeability, leading to protein loss in the urine. One of the hallmarks of nephrotic syndrome is hypoalbuminemia, which refers to low levels of albumin in the blood due to its excessive loss in the urine. This loss of albumin results in decreased oncotic pressure, leading to edema and ascites. Hematuria (choice A) is not typically found in nephrotic syndrome but may be present in other kidney conditions. Hyperkalemia (choice C) is not specific to nephrotic syndrome and may be more common in conditions affecting potassium regulation. Hypocalcemia (choice D) is also not a characteristic feature of nephrotic syndrome.