PCU PCU Neurological & Renal Care 2 — Questions and Answers
Question 1: A PCU patient with chronic kidney disease has a potassium level of 6.2 mEq/L. Which ECG change is the nurse most likely to observe?
- Prolonged PR interval
- Peaked T waves (Correct answer)
- ST depression
- Widened QRS with delta waves
Correct answer: Peaked T waves
Hyperkalemia classically produces peaked (tall, narrow, tent-shaped) T waves on the ECG, which can progress to widened QRS and sine wave pattern.
Question 2: Which intervention is the nurse's FIRST priority when a PCU patient develops status epilepticus?
- Administer IV lorazepam as ordered
- Protect the airway and ensure patient safety (Correct answer)
- Obtain IV access immediately
- Place a tongue depressor in the mouth
Correct answer: Protect the airway and ensure patient safety
Airway protection and patient safety are the first priorities during seizure activity, followed by medication administration and IV access.
Question 3: A PCU patient with a history of alcohol use disorder is admitted for pneumonia. On day 2, the nurse notes tremors, diaphoresis, and agitation. What complication is developing?
- Pneumonia-related sepsis
- Alcohol withdrawal syndrome (Correct answer)
- Medication-induced tremor
- Hypoglycemia
Correct answer: Alcohol withdrawal syndrome
Tremors, diaphoresis, and agitation appearing 24–72 hours after the last drink are classic signs of alcohol withdrawal syndrome (AWS).
Question 4: Which assessment finding indicates increased intracranial pressure (ICP) in a PCU patient?
- Bradycardia with widened pulse pressure and irregular respirations (Correct answer)
- Tachycardia with narrowed pulse pressure
- Hypotension with tachycardia
- Hyperthermia with tachypnea
Correct answer: Bradycardia with widened pulse pressure and irregular respirations
Cushing's triad — bradycardia, widened pulse pressure, and irregular respirations — is a late sign of dangerously elevated ICP.
Question 5: A PCU patient on continuous renal replacement therapy (CRRT) develops hypotension. What is the nurse's first action?
- Increase the CRRT ultrafiltration rate
- Slow or stop the ultrafiltration rate and notify the physician (Correct answer)
- Administer a fluid bolus without contacting the physician
- Increase vasopressor infusion without notifying the physician
Correct answer: Slow or stop the ultrafiltration rate and notify the physician
CRRT-associated hypotension is often due to excess fluid removal; slowing or stopping ultrafiltration and notifying the physician is the appropriate first response.
Question 6: Which laboratory value indicates the greatest concern for a PCU patient with suspected rhabdomyolysis?
- Sodium 138 mEq/L
- Creatine kinase (CK) 12,000 U/L (Correct answer)
- Hemoglobin 11.2 g/dL
- Albumin 3.1 g/dL
Correct answer: Creatine kinase (CK) 12,000 U/L
A markedly elevated CK (>10,000 U/L) confirms rhabdomyolysis and indicates high risk of acute kidney injury from myoglobinuria.
PCU PCU Neurological & Renal Care 2
A PCU patient with chronic kidney disease has a potassium level of 6.2 mEq/L.
Which ECG change is the nurse most likely to observe?