Question 1

Which of the following is associated with CAPD?

Accepted Answer

A)  Catheter placed in the central circulation 
B)  Catheter providing access to the abdominal cavity 
C)  Dialysis shunt in either arm 
D)  Dialysis fistula in either arm

Question 2

A 40-year-old female presents with hemorrhage from her dialysis graft. She states that she just got back from dialysis when the bleeding started. There is a significant amount of blood on the chair and floor. To control the bleeding, you would immediately:

Accepted Answer

A)  place a tourniquet proximal to the graft. 
B)  place a tourniquet distal to the graft. 
C)  apply direct pressure over the graft. 
D)  apply ice to the area and elevate the extremity.

Question 3

Oliguria is defined as:

Accepted Answer

A)  urine output of less than 400-500 mL daily. 
B)  urine output of less than 4000-5000 mL daily. 
C)  urine output of less than 100-200 mL daily. 
D)  urine output of less than 1000-2000 mL daily.

Question 4

All of the following may be associated with urinary tract infection EXCEPT:

Accepted Answer

A)  cystitis. 
B)  cholecystitis. 
C)  prostatitis. 
D)  pyelonephritis.

Question 5

Acute renal failure occurs when a patient loses ________ of the functioning nephrons.

Accepted Answer

A)  80% 
B)  70% 
C)  60% 
D)  50%

Question 6

A patient with no prior history of renal disease is experiencing restlessness, agitation, dysuria, and flank pain radiating into the groin. Appropriate treatment for this patient would consist of all of the following EXCEPT:

Accepted Answer

A)  IV fluid therapy. 
B)  fentanyl. 
C)  Lasix IV. 
D)  morphine.

Question 7

You are called to a local physician's office where you find a 52-year-old male patient with a history of chronic renal failure. He is conscious but disoriented. The physician reports that the patient's wife brought him in because he has had a "chest cold," missed dialysis yesterday, and is now "acting strangely." Physical examination reveals cool, diaphoretic skin; edema to dependent areas, and lung sounds with rhonchi in the right upper lobe. HR = 118, BP = 142/100, RR = 20 and deep, SaO2 = 97%, blood glucose = 79 mg/dL. Bloodwork performed by the physician in his office indicates a pH of 7.2. In addition to 15 liters per minute of oxygen by nonrebreathing mask and an IV of normal saline at a keep-open rate, which of the following is most appropriate for this patient in the prehospital setting?

Accepted Answer

A)  IV sodium bicarbonate, 1 mEq/kg 
B)  IV magnesium sulfate, 10 gm 
C)  IV dextrose, 25 gm 
D)  IV furosemide, 120 mg

Question 8

Your patient is a 32-year-old female who is alert and complaining of dysuria. She describes a three-day history of pain with urination and urinary urgency and difficulty. She describes the pain as a 5 on a scale of 0 to 10. Physical examination reveals tenderness on palpation of the lower abdomen bilaterally and warm, dry skin. HR = 88, BP = 126/78, RR = 12. The most appropriate action is:

Accepted Answer

A)  oxygen, IV fluids, morphine. 
B)  Expedite transport in position of comfort. 
C)  oxygen, IV fluids. 
D)  IV fluids, morphine.

Question 9

You respond to a call of a patient experiencing back pain. Upon your arrival, the patient is curled into the fetal position and feels warm to the touch. You suspect:

Accepted Answer

A)  acute renal failure. 
B)  acute renal calculi. 
C)  acute pyelonephritis. 
D)  acute urinary tract infection.

Exam 7: Urology and Nephrology