Question

Choose the correct answer

• Indicate a rational for the answer

II. A 47-year-old African American male with a 10-year history of hypertension presents to his provider with complaints of swelling in both legs, a moist cough, and fatigue. The patient states he has been compliant with his prescribed medications and his diet; he is prescribed metoprolol 25 mg PO twice daily and furosemide 10 mg daily. His only other history of significance in addition to his hypertension is a previous exploratory surgery for a small bowel obstruction.

7) If this patient is developing renal impairment due to acute kidney injury, over what period would you expect him to demonstrate signs of this condition?

a) A few hours to 3 days

b) 1 year

c) 2 to 3 months

d) 1 to 2 weeks

8) Which of the following are important for the nurse assess for a patient receiving metoprolol?

a) Presence of dry cough and respiratory rate

b) Blood pressure and heart rate

c) Urine output and lung sounds

d) Lungs sounds and respiratory rate

9) The patient is admitted to the hospital for ongoing diagnostic testing and interventions; he has a peripherally inserted central venous catheter placed. Which of the following hemodynamic changes would you expect to occur with renal impairment?

a) Hypotension and tachycardia

b) Increased central venous pressure (CVP) and jugular vein distension

c) Edema and hypertension

d) Hypotension and tachycardia

10) In monitoring the patient's urine output, the nurse observes that his urine output has been approximately 5 to 20 mL/hour. This is considered ___.

a) Anuria

b) Within expected output range

c) Oliguria

d) Polyuria

11) Which of the following medications would you expect to administer to the patient to improve his urine output?

a) norepinephrine 2 mcg/min as continuous infusion

b) dobutamine 2 mcg/kg/min as continuous infusion

c) furosemide 40 mg IV bolus

d) heparin drip at 1100 units/hr

Answer 1

Answer 1: (D) 1 to 2 weeks ( As soon as the kidney injury occurs, the process of filteration slowly gets disturbed and causes accumulation of waste materials.This also causes loss of important ions and within a week symptoms of renal failure starts to occur.

Answer 2: (B) Blood pressure and heart rate. ( The side effects of the metoprolol includes bradycardia (heart rate that’s slower than normal)

Answer 3: (D) Hypotension and tachycardia (decreased renal perfusion, often because of volume depletion), intrinsic renal (caused by a process within the kidneys), and postrenal (caused by inadequate drainage of urine distal to the kidneys)

Answer 4: ( C) Oliguria. ( Oliguria is a condition where the urine output that is less than 1 mL/kg/h in infants, less than 0.5 mL/kg/h in children, and less than 400 mL or 500 mL per 24h in adults - this equals 17 or 21 mL/hour.)

Answer 5: (C) furosemide 40 mg IV bolus.