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,NURS 6550 FINAL EXAM
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
Answer:
C. Grave's disease
QUESTION 3
1. Systemic lupus erythematosis (SLE) is a multiorgansystem
autoimmune disorder that can prevent with a wide variety of
manifestations. Which clinical triad should prompt an evaluation for
SLE?
A. Fever, normal white count, elevated sedimentation rate
B. Hyperkalemia, hyponatremia, low blood pressure
C. Leukocytosis, hyperglycemia, hypokalemia
D. Joint pain, rash, fever
1 points