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.
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Congestive heart failure is not directly associated with an increased risk of developing acute pancreatitis. While it can contribute to overall health deterioration, it does not cause the condition.
Choice B rationale
Emphysema primarily affects the lungs and does not increase the risk of acute pancreatitis. It is a chronic obstructive pulmonary disease and is unrelated to pancreatic function.
Choice C rationale
Alcohol abuse is a well-known risk factor for acute pancreatitis. It can lead to repeated episodes of inflammation in the pancreas, which can eventually become chronic and lead to acute pancreatitis.
Choice D rationale
Diabetes mellitus is a result of chronic pancreatitis or can be a comorbidity, but it is not a direct cause of acute pancreatitis. However, it can be associated with complications related to the pancreas.
Correct Answer is ["A","B","C","E"]
Explanation
Choice A rationale
Proteinuria, or the presence of an abnormal amount of protein in the urine, is a hallmark sign of glomerulonephritis. It occurs due to the increased permeability of the glomerular filtration barrier.
Choice B rationale
Hypertension is often associated with glomerulonephritis. The damage to the glomeruli can lead to salt and water retention, contributing to high blood pressure.
Choice C rationale
Periorbital edema, which is swelling around the eyes, is a common early symptom of glomerulonephritis. It is caused by fluid retention and leakage into the tissue.
Choice D rationale
Hypotension is not typically associated with glomerulonephritis. In fact, hypertension is more common due to the reasons mentioned above.
Choice E rationale
Hematuria, or blood in the urine, is another common finding in glomerulonephritis. It results from the inflammation and damage to the glomeruli, allowing red blood cells to leak into the urine.
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