CCRN Gastrointestinal and Renal Care 3

Question 1

A patient with end-stage renal disease misses dialysis and has peaked T waves on ECG. What is the priority treatment?

Accepted Answer

IV calcium gluconate

Answer

Peaked T waves indicate hyperkalemia, and IV calcium gluconate stabilizes the cardiac membrane immediately.

Question 2

Which acid-base disturbance is most characteristic of chronic kidney disease?

Accepted Answer

Metabolic acidosis

Answer

The failing kidney cannot excrete hydrogen ions or regenerate bicarbonate, causing metabolic acidosis.

Question 3

A patient develops disequilibrium syndrome during hemodialysis. What causes this?

Accepted Answer

Rapid shift of solutes causing cerebral edema

Answer

Rapid urea removal creates an osmotic gradient that draws water into brain cells, causing cerebral edema.

Question 4

Which lab finding best distinguishes prerenal azotemia from intrinsic renal failure?

Accepted Answer

BUN-to-creatinine ratio greater than 20:1

Answer

A BUN:creatinine ratio over 20:1 suggests prerenal azotemia from hypoperfusion rather than intrinsic damage.

Question 5

A patient with a small bowel obstruction is at greatest risk for which complication?

Accepted Answer

Bowel ischemia and perforation

Answer

Increasing intraluminal pressure can compromise blood flow, leading to bowel ischemia and perforation.

CCRN Review Practice Test