A patient presents to the clinic complaining of nausea, vomiting, ...

[amal]

A patient presents to the clinic complaining of nausea, vomiting, and fatigue. Lab results reveal elevated BUN and creatinine levels. Which acute condition is this patient at most risk for developing?
 
  a. Influenza
  b. Mononucleosis
  c. Acute renal failure
  d. Pneumonia

Question 2

An 80-year-old male patient is in the intensive care unit has suffered a fractured femur. You are making rounds and notice he is somnolent, with no response to verbal or physical stimulation.
 
  He has been on round the clock opioid doses q 4 hours. What is the nurse's first action?
  a. Call the rapid response team to care for the patient immediately.
  b. Discontinue the opioids on the medication administration record.
  c. Assess the patient's blood pressure and pain level.
  d. Start a second intravenous line with a large bore catheter.

[31809pancho]

Answer to Question 1

ANS: C
The patient's symptoms are most congruent with dehydration. Hypovolemia, due to dehydration, can lead to decreased perfusion to the kidneys resulting in acute renal failure. Influenza symptoms include headache, fever, body aches, and fatigue. Mononucleosis can manifest as severe fatigue. Pneumonia presents with cough, respiratory distress, and decreases in oxygen saturation.

Answer to Question 2

ANS: B
After establishing unresponsiveness, the next action is to call a Rapid Response. The patient is not able to subjectively describe pain if unresponsive. Another IV line may be needed, but first the nurse should call for help. The opioids should be discontinued on the MAR; however the priority action is to call for help.

[amal]

Excellent

[mjenn52]

Great answer, keep it coming