CPNRE Complex Care 4

Question 1

A client with chronic kidney disease (CKD) stage 4 has a serum potassium of 6.2 mEq/L. Which dietary instruction is the priority?

Accepted Answer

Avoid high-potassium foods such as bananas and potatoes

Answer

Hyperkalemia in CKD is life-threatening and requires immediate dietary restriction of high-potassium foods to prevent cardiac dysrhythmias.

Question 2

A nurse is caring for a client on mechanical ventilation with a PEEP of 10 cmH2O. The client's blood pressure drops suddenly to 80/50 mmHg. What is the most likely cause?

Accepted Answer

Decreased venous return from high PEEP

Answer

High PEEP increases intrathoracic pressure, reducing venous return to the heart and causing decreased cardiac output and hypotension.

Question 3

A client with a traumatic brain injury (TBI) has a GCS score of 8 and demonstrates Cushing's triad. Which set of vital signs is consistent with Cushing's triad?

Accepted Answer

HR 48, BP 180/100, RR 8 irregular

Answer

Cushing's triad indicates increased intracranial pressure and presents with bradycardia, hypertension (widened pulse pressure), and irregular respirations.

Question 4

A client receiving total parenteral nutrition (TPN) develops fever, chills, and glucose of 22 mmol/L. The most appropriate initial nursing action is to:

Accepted Answer

Change the TPN bag and tubing and notify the physician

Answer

Fever and chills with TPN suggest catheter-related bloodstream infection; changing the bag and tubing and notifying the physician addresses both the potential contamination source and escalates care.

Question 5

A client with acute respiratory distress syndrome (ARDS) is being ventilated with a tidal volume of 6 mL/kg ideal body weight. What is the rationale for this low tidal volume strategy?

Accepted Answer

To prevent ventilator-induced lung injury and volutrauma

Answer

Lung-protective ventilation with low tidal volumes in ARDS prevents overdistension of alveoli (volutrauma) and reduces ventilator-induced lung injury.

CPNRE - Canadian Practical Nurse Registration Examination Practice Test

CPNRE - Canadian Practical Nurse Registration Examination Practice Test

CPNRE Complex Care 4