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PCCN Renal Exam with Questions solved 100% correct
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PCCN Renal Exam with Questions solved100% correct
Excellent strategies for protecting renal function include: limiting intravascular dehydration,
limiting and correcting hypotension and most commonly limiting exposure to nephrotoxins-
pharmacokinetic therapy for patients on nephrotoxic drugs, renal protection for those receiving
contrast dye would also be included in this function.
Preventive measures for the onset of acute kidney injury include:
a. Intravenous isotonic hydration before nephrotoxins are administered
b. Maintenance of adequate mean arterial pressure (MAP)
c. Use of N-acetylcysteine for renal protection
d. All of the above - Correct Answer-d. All of the above
Renal protection includes: intravenous (IV) hydration before administering nephrotoxins, such as
intravenous contrast dye. Maintenance of an adequate MAP to perfuse the kidneys, use of drugs
to further protect the kidneys; the use of N-acetylcysteine before IV contrast dye (this is na
oxygen radical scavenger that protects the nephrons from injury that occurs with IV contrast
dye).
Pre renal failure is caused byL
a. Poor cardiac output
b. Poor volume status
c. Renal artery stenosis
d. All of the above - Correct Answer-d. All of the above
The three main causes of pre-renal failure are: poor cardiac function, poor volume status, and
renal artery stenosis. All three prevent blood from reaching the kidneys.
,In oliguric phase of acute renal failure, the urine output
a. Is less than 400 mL/24 hours
b. Is greater than 500 mL/24 hours
c. Totally ceases
d. Is not measured - Correct Answer-a. Is less than 400 mL/24 hours
This is the marker of oliguria to the neurologist. If the urine output is less than 400 mL/24
hours, the patient is said to be oliguric.
In the diuretic phase of renal failure:
a. Urine output does not change
b. Oxygenation becomes worse
c. Urine output slowly increases
d. Electrolytes improve - Correct Answer-c. Urine output slowly increases
In this phase of acute renal failure, urine output begins to improve and the mortality of the
patient also improves. The electrolytes are still abnormal and the patient remains with a
metabolic acidosis. The oxygenation of the patient should improve since the patient is
eliminating extra fluid.
In the recovery phase of acute renal failure, the:
a. Patient is completely well
b. Urine output is normal
c. Patient still has a mortality of over 50%
d. BUN/Creatinine ration is completely normal - Correct Answer-b. Urine output is normal
Although the patient now has normal urine output, electrolytes may still be abnormal and need
to be corrected and watched carefully. The patient's mortality decreases and the BUN/Creatinine
ration may still be abnormal due to electrolyte dysfunction. The recovery phase may take 3-12
months.
, Which of the following laboratory findings would be congruent with metabolic
alkalosis? a. pH 7.48; PaCO2 42 mmHg, serum potassium 3.0 mEq/L b. pH 7.40; PaCO2
40 mmHg, serum potassium 4.0 mEq/L c. pH 7.44; PaCO2 38 mmHg, serum potassium
6.0 mEq/L
d. pH 7.30; PaCO2 44 mmHg, serum potassium 3.5 mEq/L - Correct Answer-a. pH 7.48; PaCO2
42 mmHg, serum potassium 3.0 mEq/L
The pH is alkalotic - 7.48
The PaCO2 is normal - 42 mmHg
The potassium is very low - 3.0 mEq/L
A very slow potassium can cause a metabolic alkalosis.
Serum sodium levels below 120 mEq/L are often associated with
a. Seizure activity
b. Diminished or changes in the level of consciousness
c. Syndrome of inappropriate diuretic hormone (SIADH)
d. All of the above - Correct Answer-d. All of the above
When serum sodium levels are this low, the patient may become very symptomatic. Seizure
activity, diminished or changed LOC and behavioral changes may be related to SIADH
(water intoxication associated with lower sodium levels).
The following drug or drugs may be administered to remove potassium from the body in the
patient with hyperkalemia secondary to acute renal failure:
a. Sodium bicarbonate
b. Calcium chloride
c. Glucose and insulin infusion
d. Kayexalate and sorbitol - Correct Answer-d. Kayexalate and sorbitol
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