PCU PCU Neurological & Renal Care 1 — Questions and Answers
Question 1: A PCU patient with altered mental status has a Glasgow Coma Scale (GCS) score of 10. Which component scores are being assessed?
- Eye opening, verbal response, motor response (Correct answer)
- Pupils, reflexes, orientation
- Blood pressure, heart rate, respirations
- Level of consciousness, orientation, memory
Correct answer: Eye opening, verbal response, motor response
The GCS assesses eye opening, verbal response, and motor response, with a maximum score of 15 and minimum of 3.
Question 2: A PCU patient develops sudden-onset severe headache, neck stiffness, and photophobia. What condition should the nurse suspect first?
- Hypertensive emergency
- Subarachnoid hemorrhage (Correct answer)
- Migraine with aura
- Meningitis
Correct answer: Subarachnoid hemorrhage
Sudden severe 'thunderclap' headache with meningeal signs in a PCU patient is a classic presentation of subarachnoid hemorrhage until proven otherwise.
Question 3: Which neurological assessment finding requires IMMEDIATE physician notification in a PCU patient?
- Mild hand tremors
- Unequal pupil size (anisocoria) with decreased responsiveness (Correct answer)
- Complaint of mild headache
- Difficulty recalling recent events
Correct answer: Unequal pupil size (anisocoria) with decreased responsiveness
Unequal pupils with decreased responsiveness indicate possible herniation or increased intracranial pressure and require immediate intervention.
Question 4: A PCU patient has a serum creatinine of 3.8 mg/dL and BUN of 58 mg/dL. What nursing priority is most appropriate?
- Encourage increased oral fluid intake
- Administer a nephrotoxic antibiotic as ordered
- Review and hold nephrotoxic medications pending physician review (Correct answer)
- Prepare patient for immediate hemodialysis
Correct answer: Review and hold nephrotoxic medications pending physician review
Elevated creatinine and BUN indicate impaired renal function; the nurse should identify and hold nephrotoxic agents and notify the physician.
Question 5: Which urine output value over 8 hours most indicates acute kidney injury (AKI) in a PCU patient weighing 70 kg?
- 350 mL
- 280 mL
- 200 mL
- 150 mL (Correct answer)
Correct answer: 150 mL
Oliguria in AKI is defined as less than 0.5 mL/kg/hr; for a 70 kg patient over 8 hours, this threshold is 280 mL, so 150 mL is severely below normal.
Question 6: A PCU patient receiving IV contrast for a CT scan has a creatinine of 2.1 mg/dL. Which pre-procedure intervention is most important?
- Administer furosemide to increase urine output
- Restrict fluids to prevent fluid overload
- Provide IV hydration with normal saline to protect renal function (Correct answer)
- Administer corticosteroids to prevent allergic reaction
Correct answer: Provide IV hydration with normal saline to protect renal function
IV hydration with isotonic saline before and after contrast administration reduces the risk of contrast-induced nephropathy in patients with pre-existing renal impairment.
PCU PCU Neurological & Renal Care 1
A PCU patient with altered mental status has a Glasgow Coma Scale (GCS) score of 10.
Which component scores are being assessed?