NURS 6550 FINAL EXAM 1 – QUESTION AND ANSWERS.

NURS 6550 FINAL EXAM 1 – QUESTION AND ANSWERS.QUESTION 1 1. Mr. Jeffers was admitted 2 days ago for a carotid endarterectomy. A Foley catheter was inserted intraoperatively and remains in place. His urine output has declined markedly despite continued IV fluid infusion. Today his morning labs reveal a BUN of 19 mg/dL and a creatinine of 2 mg/dL. A leading differential includes: A. Foley lodged in the urethra causing post-renal failure B. Decreased renal perfusion causing prerenal failure C. Age-related decreased eGFR causing prerenal failure D. Post-surgical rhabdomyolysis causing intrarenal failure Answer: • D. Post-surgical rhabdomyolysis causing intrarenal failure During surgery, muscles and injured. This can result into rhabdomyolysis, which is the breakdown of muscles to release proteins. The excess proteins causes an increased level of creatinine. Mr. Jeffers is from surgery (post-surgical) and his creatinine levels are above normal. The normal creatinine levels range from 0.6mg/dl to 1.2mg/dl. Thus, the most likely differential is: Post-surgical rhabdomyolysis causing intrarenal failure. 1 points QUESTION 2 1. Janet is admitted with symptomatic tachycardia. Her pulse is 160 b.p.m. and she is weak, diaphoretic, and anxious. Physical examination reveals a 5’4” 107 lb black female who is awake, alert, and oriented, anxious, with moist skin and racing pulse. Her blood pressure is 140/100 mm Hg. Temperature and respiratory rate are within normal limits. The patient admits to having a “thyroid condition” but she never followed up on it when she was advised to see an endocrinologist. The AGACNP anticipates a diagnosis of: A. Hashimoto’s thyroiditis B. Cushing’s syndrome C. Grave’s disease D. Addison’s disease 1 points