Registered Cardiovascular Invasive Specialist (RCIS) Practice Test

If a patient presents with diabetes and renal failure and has a creatinine of 2.0, what is the appropriate initial treatment?

1. Insulin therapy

2. Fluids to hydrate

3. Dialysis

4. Antihypertensive medication

The correct answer is: Fluids to hydrate

For a patient presenting with diabetes and renal failure, hydration is crucial, especially if the creatinine level is at 2.0. Adequate fluid balance can help improve renal perfusion and function. In cases of renal failure, patients may be at risk of dehydration, which could exacerbate their condition and further impair kidney function. Therefore, providing fluids to hydrate the patient is a critical initial step in managing their treatment. While insulin therapy is essential for managing blood glucose levels in diabetic patients, the immediate concern in the context of renal failure, particularly with elevated creatinine, revolves around stabilizing the patient's fluid status. Dialysis may be considered at a later stage depending on the patient's overall condition and whether their renal function worsens or other complications arise. Antihypertensive medication can also play a role in managing blood pressure, but it would not be the first-line treatment in this immediate scenario focusing on hydration. Thus, initiating hydration can potentially improve kidney function and provides a necessary supportive measure before more aggressive interventions may be required.