ATI RN
Critical Care Nursing Exam Questions Questions
Question 1 of 5
The term used to describe an increase in blood urea nitrogen (BUN) and serum creatinine is
Correct Answer: B
Rationale: The correct answer is B: azotemia. Azotemia refers to an increase in BUN and serum creatinine levels, indicating impaired kidney function. Oliguria (A) is a decrease in urine output, not specific to BUN and creatinine levels. Acute kidney injury (C) is a broader term encompassing various causes of kidney dysfunction, not specific to elevated BUN and creatinine. Prerenal disease (D) refers to conditions affecting blood flow to the kidneys, not directly related to elevated BUN and creatinine levels.
Question 2 of 5
The patient is admitted with complaints of general malaise and fatigue, along with a decreased urinary output. The patient’s urinalysis shows coarse, muddy brown granular casts and hematuria. The nurse determines that the patient has:
Correct Answer: C
Rationale: The correct answer is C: intrarenal disease, probably acute tubular necrosis. The patient's symptoms of general malaise, fatigue, decreased urinary output, along with the presence of coarse, muddy brown granular casts and hematuria in the urinalysis indicate kidney damage. Acute tubular necrosis is a common cause of acute kidney injury characterized by damage to the renal tubules, leading to impaired kidney function. The presence of granular casts and hematuria suggests tubular injury and bleeding within the kidney. Choices A and B are incorrect as they refer to prerenal and postrenal causes of kidney injury, respectively, which do not align with the patient's symptoms and urinalysis findings. Choice D is incorrect as a urinary tract infection would typically present with different symptoms and urinalysis findings.
Question 3 of 5
The patient’s potassium level is 7.0 mEq/L. Besides dialysis, which of the following actually reduces plasma potassium levels and total body potassium content safely in a patient with renal dysfunction?
Correct Answer: C
Rationale: Correct Answer: C - Regular insulin Rationale: 1. Insulin promotes cellular uptake of potassium. 2. When insulin is administered, it moves potassium from extracellular to intracellular space. 3. This decreases plasma potassium levels safely. 4. Other options do not directly lower potassium levels in the same manner. Summary of Other Choices: A: Sodium polystyrene sulfonate - exchanges sodium for potassium in the intestines, not reducing total body potassium. B: Sodium polystyrene sulfonate with sorbitol - similar to A, does not reduce total body potassium. D: Calcium gluconate - does not directly lower potassium levels, used for treating hyperkalemia-induced cardiac toxicity.
Question 4 of 5
The patient is in a progressive care unit following arteriovenous fistula implantation in his left upper arm, and is due to have blood drawn with his next set of vital signs and assessment. When the nurse assesses the patient, the nurse should
Correct Answer: D
Rationale: The correct answer is D because after arteriovenous fistula implantation, it is essential to assess for the presence of a bruit (audible sound caused by turbulent blood flow) and thrill (vibratory sensation) in the access site, which indicates proper functioning of the fistula. This assessment ensures that blood is flowing adequately through the newly created access for dialysis or other procedures. Drawing blood or taking blood pressures from the fistula arm can lead to complications such as clot formation or damage to the fistula. Starting a new IV line in the same arm is contraindicated to avoid compromising the newly created fistula. Thus, auscultating for a bruit and palpating for a thrill are the appropriate nursing actions in this scenario.
Question 5 of 5
Continuous venovenous hemofiltration is used to
Correct Answer: A
Rationale: The correct answer is A because continuous venovenous hemofiltration (CVVH) primarily removes fluids and solutes through the process of convection. In CVVH, blood flows through a filter where hydrostatic pressure drives plasma water and solutes across a semipermeable membrane. This process mimics the natural filtration that occurs in the kidneys. Choice B is incorrect because CVVH does not specifically target plasma water only but also removes solutes. Choice C is incorrect because CVVH does not involve adding dialysate to remove plasma water and solutes. Choice D is incorrect because while CVVH may involve ultrafiltration and convection, it does not typically include dialysis as a primary mechanism for solute removal.