Adult Critical Care Specialty (ACCS) Practice Exam

A 45-year-old female with multiple injuries has low urine output and high creatinine levels. What should be treated urgently?

1. Congestive heart failure

2. A renal failure

3. Hepatic failure

4. Hypervolemia

The correct answer is: Congestive heart failure

In a scenario where a patient presents with low urine output and high creatinine levels, the critical focus should be on the renal failure that likely indicates acute kidney injury (AKI). This condition can arise from various causes, including low blood flow to the kidneys due to trauma, dehydration, or other systemic factors often associated with multiple injuries. Promptly addressing renal failure is essential, as the kidneys play a crucial role in filtering waste products and maintaining fluid and electrolyte balance. High creatinine levels signal a significant reduction in kidney function, which can lead to life-threatening complications if not treated. Appropriately managing renal failure might involve ensuring adequate renal perfusion, correcting fluid imbalances, and considering renal support therapies such as dialysis if the condition worsens. While congestive heart failure could contribute to low urine output by reducing kidney perfusion, its urgent treatment scenario should be evaluated in the context of the overall clinical picture. However, the key factor here is that renal failure resulting from acute injury takes precedence, especially when there are clear indicators of kidney distress. Thus, addressing renal failure urgently is vital to stabilize the patient's condition, prevent further complications, and protect long-term kidney function.