A nurse is caring for a client who has an acute kidney injury caused by acute tubular necrosis. The client asks why their glomerular filtration rate (GFR) keeps decreasing. Which of the following pathophysiological changes occurring in the kidney should the nurse explain as the cause of the decrease?

Inflammatory cells invade the already damaged kidneys.

There is a reduction of blood flow to the kidneys.

There is injury to the renal tubular cells.

There is obstruction leading to the filtration system backing up and eventually shutting the kidneys down.

Answer and Explanation

The Correct Answer is C

Choice A rationale
While inflammation can affect the kidneys, the presence of inflammatory cells alone does not typically cause a decrease in GFR. Inflammatory cells invading the kidneys is more associated with conditions like glomerulonephritis rather than acute tubular necrosis.

Choice B rationale
A reduction in blood flow to the kidneys, known as prerenal azotemia, can indeed lead to a decreased GFR. However, in the context of acute tubular necrosis, the primary issue is damage to the renal tubules rather than blood flow.

Choice C rationale
Acute tubular necrosis is characterized by damage to the renal tubular cells, which can lead to a decrease in GFR. This damage impairs the kidney's ability to filter waste products from the blood, resulting in a lower GFR.

Choice D rationale
Obstruction of the urinary tract can lead to postrenal azotemia, which may decrease GFR if severe enough. However, this is not the typical pathophysiological change seen in acute tubular necrosis, which primarily involves tubular cell injury.

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Correct Answer is D

Explanation

Choice A rationale
Jaundice of the sclera is indicative of hyperbilirubinemia, which can occur in various liver diseases but is not specifically associated with Grey Turner's sign or pancreatitis.

Choice B rationale
Bluish discoloration of the periumbilical area, known as Cullen's sign, is another indicator of severe pancreatitis but is distinct from Grey Turner's sign, which specifically refers to the flank area.

Choice C rationale
Left abdominal pain that occurs with movement may be a symptom experienced by patients with pancreatitis, but it is not referred to as Grey Turner's sign, which is a physical finding rather than a symptom.

Choice D rationale
Grey Turner's sign is characterized by bluish discoloration of the flank area. It is a sign of retroperitoneal hemorrhage, which can occur in severe cases of pancreatitis due to the spread of pancreatic enzymes to surrounding tissues, leading to localized bleeding.

A. Anorexia B. Rectal bleeding C. Left lower quadrant pain D. Right lower quadrant pain E. Steatorrhea

Correct Answer is ["A","B","C","E"]

Explanation

Choice A rationale
Anorexia, or loss of appetite, is common in UC due to abdominal pain and discomfort, as well as the psychological impact of chronic illness.

Choice B rationale
Rectal bleeding is a hallmark symptom of UC, indicating moderate to severe inflammation of the colon, which can lead to ulcers and bleeding.

Choice C rationale
Left lower quadrant pain is typical in UC because the disease often affects the descending colon, which is located in this area.

Choice D rationale
Right lower quadrant pain is more characteristic of conditions like appendicitis. UC typically does not cause pain in this area unless it is extensive and involves the right colon.

Choice E rationale
Steatorrhea, or fatty stools, can occur in UC if the disease affects the ileum, leading to malabsorption of fats.

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Naxlex Comprehensive Predictor Exams

Which finding for a patient with pancreatitis is termed Grey Turner's sign?

Correct Answer is D

Explanation

After assessing a patient with ulcerative colitis (UC), the nurse concludes that the patient has moderate disease. Which patient symptoms support the nurse's conclusion? (Select all that apply.)

Correct Answer is ["A","B","C","E"]

Explanation

A patient who has is hospitalized with hyperkalemia. Which information will the nurse monitor to evaluate the effectiveness of the acute glomerulonephritis prescribed calcium gluconate IV?

A patient is admitted with esophageal varices and portal hypertension. Which underlying cause of these conditions would the nurse suspect?

Which interventions would the nurse expect in the treatment plan for a patient who is admitted to the hospital with ascites? (Select all that apply.)

A nurse is providing teaching to a client who has stable angina and a new prescription for transdermal nitroglycerin. Which of the following instructions should the nurse include? (Select all that apply.)

A nurse is caring for an older adult client who has significant issues with ascites related to end-stage liver disease. Which of the following precautions is most important for the nurse to include in the teaching?

A nurse is caring for a client in the outpatient cardiologist's office. The client is alert and oriented. Lung sounds with crackles are heard bilaterally. Dyspnea is observed on exertion, and heart sounds reveal an S3 gallop. Which of the following findings is the nurse most likely to expect?

A nurse is teaching a client who has chronic kidney disease about limiting foods that are high in potassium. Which of the following foods should the nurse instruct the client to avoid? (Select all that apply.)

A nurse is developing a plan of care for a client who has a new ileal conduit. Which of the following should the nurse include as risks for the client? (Select all that apply.)