1
NR
NR 574/ NR574 FINAL EXAM: (NEW 2025/
2026 UPDATE) ACUTE CARE PRACTICUM I
GUIDE| QUESTIONS & ANSWERS| GRADE A|
100% CORRECT (VERIFIED SOLUTIONS)-
CHAMBERLAIN
1. Hepatorenal syndrome (HRS): functional form of renal failure
that occurs primarily in pt with cirrhosis and ascites.
2. Type 1 hepatorenal syndrome is characterized by...: -rapidly
progressive renal impairment
-doubling of initial serum Cr to greater than 2.5mg/dL over a
period less than 2 weeks -without liver transplant prognosis is
very poor
3. Type 2 hepatorenal syndrome is characterized by...: -
moderate form of renal failure
-serum Cr levels between 1.5 to 2.5 mg/dL
reduction in GFR with elevation in serum creatinine
-associated with a more indolent course and improved survival
compared to type 1
4. Risk Factors of hepatorenal syndrome: Dilutional
hyponatremia
Previous episodes of ascites
NR 574
,Presence of esophageal varices
Poor nutritional status
Infections such as spontaneous bacterial peritonitis
Severe urinary sodium retention (urine sodium < 5
milliequivalents/liter [mEq/L])
Large-volume paracentesis without albumin replacement
Acute alcoholic hepatitis
Low mean arterial blood pressure (map <80 mm Hg)
5. subjective clinical presentation of hepatorenal syndrome:
Most clients with HRS have a known diagnosis of acute or
chronic liver disease and present with nonspecific symptoms
including: -dysgeusia (altered taste perception)
-malaise
-fatigue
-decreased urine output.
6. objective clinical presentation of hepatorenal syndrome:
HRS has no characteristic physical exam findings.
It is important to assess the client for stigmata of chronic liver
disease including: -spider nevi
-scleral icterus
-lower extremity edema
-asterixis
-abdominal distention
, -fluid wave
-
paraumbilic
al hernia -
bruits.
7. Dx criteria in hepatorenal syndrome: 1. cirrhosis with ascites
2. increase in Cr >0.3 mg/dL within 48 hrs or >50% increase from
baseline within a
7 day period
3.no response to a 2 consecutive day diuretic withdrawal and
volume expansion w/ albumin 1g/kg body wt
4. absence of shock
5. no nephrotoxic drug use
6. no macroscopic signs of structural kidney injury (proteinuria
>500 milligrams/deciliter[(mg/dL], microhematuria with >50 red
blood cells per high-power field, and/or abnormal renal
ultrasonography)
8. What is the Creatinine criteria when diagnosing
hepatorenal syndrome: increase in serum creatinine of -greater
than or equal to 0.3 mg/dL or
-greater than or equal to 50% increase from baseline Cr
this is within a 7 day period.
NR
NR 574/ NR574 FINAL EXAM: (NEW 2025/
2026 UPDATE) ACUTE CARE PRACTICUM I
GUIDE| QUESTIONS & ANSWERS| GRADE A|
100% CORRECT (VERIFIED SOLUTIONS)-
CHAMBERLAIN
1. Hepatorenal syndrome (HRS): functional form of renal failure
that occurs primarily in pt with cirrhosis and ascites.
2. Type 1 hepatorenal syndrome is characterized by...: -rapidly
progressive renal impairment
-doubling of initial serum Cr to greater than 2.5mg/dL over a
period less than 2 weeks -without liver transplant prognosis is
very poor
3. Type 2 hepatorenal syndrome is characterized by...: -
moderate form of renal failure
-serum Cr levels between 1.5 to 2.5 mg/dL
reduction in GFR with elevation in serum creatinine
-associated with a more indolent course and improved survival
compared to type 1
4. Risk Factors of hepatorenal syndrome: Dilutional
hyponatremia
Previous episodes of ascites
NR 574
,Presence of esophageal varices
Poor nutritional status
Infections such as spontaneous bacterial peritonitis
Severe urinary sodium retention (urine sodium < 5
milliequivalents/liter [mEq/L])
Large-volume paracentesis without albumin replacement
Acute alcoholic hepatitis
Low mean arterial blood pressure (map <80 mm Hg)
5. subjective clinical presentation of hepatorenal syndrome:
Most clients with HRS have a known diagnosis of acute or
chronic liver disease and present with nonspecific symptoms
including: -dysgeusia (altered taste perception)
-malaise
-fatigue
-decreased urine output.
6. objective clinical presentation of hepatorenal syndrome:
HRS has no characteristic physical exam findings.
It is important to assess the client for stigmata of chronic liver
disease including: -spider nevi
-scleral icterus
-lower extremity edema
-asterixis
-abdominal distention
, -fluid wave
-
paraumbilic
al hernia -
bruits.
7. Dx criteria in hepatorenal syndrome: 1. cirrhosis with ascites
2. increase in Cr >0.3 mg/dL within 48 hrs or >50% increase from
baseline within a
7 day period
3.no response to a 2 consecutive day diuretic withdrawal and
volume expansion w/ albumin 1g/kg body wt
4. absence of shock
5. no nephrotoxic drug use
6. no macroscopic signs of structural kidney injury (proteinuria
>500 milligrams/deciliter[(mg/dL], microhematuria with >50 red
blood cells per high-power field, and/or abnormal renal
ultrasonography)
8. What is the Creatinine criteria when diagnosing
hepatorenal syndrome: increase in serum creatinine of -greater
than or equal to 0.3 mg/dL or
-greater than or equal to 50% increase from baseline Cr
this is within a 7 day period.
