A patient presents to the emergency department (ED) complaining of nausea, vomiting, and the “worst headache he has ever experienced.”. While examining the patient, the nurse notes left leg and arm weakness.The patient is immediately sent to the radiology department for a CT scan. The registered nurse (RN) identifies the immediate need for treatment because:
A hemorrhagic brain attack is more common than an ischemic brain attack.
A thrombolytic drug will cause the peripheral and central reflexes to become hyper-reactive.
A hemorrhagic brain attack requires immediate intervention to prevent further damage.
An ischemic brain attack is less severe than a hemorrhagic brain attack.
The Correct Answer is C
Choice A rationale
A hemorrhagic brain attack (stroke) is less common than an ischemic brain attack. Ischemic strokes account for the majority of strokes.
Choice B rationale
Thrombolytic drugs are used to treat ischemic strokes, not hemorrhagic strokes. They do not cause hyper-reactive reflexes.
Choice C rationale
A hemorrhagic brain attack requires immediate intervention to prevent further damage. Hemorrhagic strokes involve bleeding in the brain, which can rapidly worsen and cause severe damage.
Choice D rationale
An ischemic brain attack is not necessarily less severe than a hemorrhagic brain attack. Both types of strokes are serious, but hemorrhagic strokes often require more urgent intervention due to the risk of ongoing bleeding.
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Correct Answer is C
Explanation
Choice A rationale
Urine specific gravity of 1.029 indicates concentrated urine, which is common in dehydration but not specific to prerenal AKI. It reflects the kidney’s ability to concentrate urine in response to fluid deficit.
Choice B rationale
BUN of 28 mg/dL can indicate dehydration or renal impairment. However, it is not as specific as creatinine in diagnosing prerenal AKI. BUN can be elevated due to other factors like high protein intake or gastrointestinal bleeding.
Choice C rationale
Creatinine of 2.4 mg/dL is a critical indicator of kidney function. Elevated creatinine levels are more specific to renal impairment, including prerenal AKI, as they reflect the kidney’s ability to filter waste products.
Choice D rationale
Dry mucous membranes are a sign of dehydration but are not specific to prerenal AKI. They indicate fluid volume deficit but do not directly reflect kidney function.
Correct Answer is A
Explanation
Choice A rationale
A hypertensive crisis is characterized by severely elevated blood pressure, which can cause severe headache and blurred vision due to increased intracranial pressure.
Choice B rationale
Migraines can cause severe headaches and visual disturbances, but in a patient with a history of hypertension, a hypertensive crisis is more likely.
Choice C rationale
Sinus infections can cause headaches and facial pain, but not typically blurred vision.
Choice D rationale
Gastroenteritis causes gastrointestinal symptoms like diarrhea and vomiting, not headaches and blurred vision.