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CCRN Practice Questions – Renal With 100- correct answers.
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CCRN Practice Questions – Renal With 100- correct answers.
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CCRN PracticeQuestions – Renal
With 100% correct
answers
A 48-year-old man is admitted with an acute
myocardial infarction. Assessment reveals the
following:
Vital Signs
Blood pressure - 70/40 mm Hg
Heart rate - 122 beats/min and irregular
Respiratory rate - 26 breaths/min
Urine output - 20 mL over the past 2 hours
Hemodynamics
Pulmonary artery pressure (PAP) - 34/24 mm Hg
Pulmonary artery occlusive pressure (PAOP) - 25
mm Hg
Right atrial pressure (RAP) - 10 mm Hg
Cardiac index (CI) - 1.8 L/min/m2
,Which of the following would be of primary concern
in evaluating the patient's renal status?
a. PAP
b. PAOP
c. RAP
d. CI - answer Correct answer: d
Rationale: Of primary concern is the CI, which
evaluates the cardiac output in regard to the body
surface area. The kidneys receive 20% to 25% of
the cardiac output, which is approximately 1200
mL/min. Without sufficient cardiac output, the
kidneys cannot be perfused properly, and filtration
cannot be effective.
Test-Taking Strategy: If you immediately thought of
mean arterial pressure but could not find it,
remember that MAP = CO × SVR, where CO is
cardiac output and SVR is systemic vascular
resistance. Cardiac output is the pump behind
glomerular filtration rate. Choose option d.
A 48-year-old man is admitted with an acute
myocardial infarction. Assessment reveals the
following:
Vital Signs
Blood pressure - 70/40 mm Hg
,Heart rate - 122 beats/min and irregular
Respiratory rate - 26 breaths/min
Urine output - 20 mL over the past 2 hours
Hemodynamics
Pulmonary artery pressure (PAP) - 34/24 mm Hg
Pulmonary artery occlusive pressure (PAOP) - 25
mm Hg
Right atrial pressure (RAP) - 10 mm Hg
Cardiac index (CI) - 1.8 L/min/m2
What would be the best laboratory test to evaluate
this patient's glomerular filtration rate (GFR)?
a. Blood urea nitrogen
b. Serum creatinine
c. Urine creatinine clearance
d. Serum amylase - answer Correct answer: c
Rationale: Normal GFR is 125 mL/min or about 180
L/day. The creatinine clearance rate reflects the
GFR. It evaluates the ability of the kidneys to filter
a waste product (creatinine) that is neither
reabsorbed nor secreted.
Test-Taking Strategy: Notice that options a, b, and
d are serum values, but option c is a comparison
between the creatinine in the blood and the
, creatinine excreted in the urine. It is logical to
believe that the comparison value would be better.
A 29-year-old woman has been a patient in the
critical care unit for 2 weeks with acute tubular
necrosis (ATN) as a result of crush injuries
experienced in a motor vehicle collision.
She was normotensive on admission.
What would be the most common explanation for
her ATN?
a. Rhabdomyolysis
b. Hemorrhage
c. Creatinine release
d. Cardiac dysrhythmias - answer Correct answer: a
Rationale: The most common cause for ATN in a
normotensive patient who has experienced crush
injuries is rhabdomyolysis with resultant
myoglobinuria. Rhabdomyolysis is acute muscle
destruction and is associated with myoglobinuria.
Myoglobin released from muscle cells may cause
acute kidney injury by having a direct toxic effect
on tubule epithelial cells or inducing intratubular
cast formation.
Test-Taking Strategy: The key points in this
question are that she had a crush injury and that
she was not hypotensive. Hemorrhage or
dysrhythmias significant enough to cause ATN
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