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 A

Explanation

Choice A rationale
Liver cirrhosis is the most common cause of esophageal varices and portal hypertension. Cirrhosis leads to scarring of the liver, which impedes blood flow through the portal vein, causing increased pressure (portal hypertension) and the development of collateral blood vessels (varices) as the body attempts to bypass the blockage.

Choice B rationale
Throat lacerations are not related to the development of esophageal varices or portal hypertension. They are typically acute injuries and do not cause the chronic changes seen in the vasculature associated with these conditions.

Choice C rationale
Kyphosis, a curvature of the spine, does not cause esophageal varices or portal hypertension. It is a structural skeletal condition and does not affect the vasculature of the esophagus or the portal venous system.

Choice D rationale
While squamous cell cancer can occur in the esophagus, it is not a typical cause of portal hypertension or esophageal varices. These varices are usually a result of increased pressure in the portal vein, not directly from a malignancy.

A. Anxiety B. Impaired skin integrity C. Infection D. Fluid volume deficit E. Disturbed body image

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

Explanation

Choice A rationale
Anxiety, while a valid concern, is not directly a risk associated with the physical complications of an ileal conduit. However, it can be an emotional response to the surgery and the changes it brings.

Choice B rationale
Impaired skin integrity is a significant risk for clients with an ileal conduit due to the potential for irritation from the stoma appliance and the risk of skin breakdown around the stoma site.

Choice C rationale
Infection is a risk due to the potential for bacteria to enter through the stoma or for urinary tract infections to develop, given the changes in the urinary system's structure and function.

Choice D rationale
Fluid volume deficit is a risk for clients with an ileal conduit because of the potential for increased fluid loss through the stoma, necessitating careful monitoring and management of fluid intake and output.

Choice E rationale
Disturbed body image is a risk due to the physical changes and the presence of a stoma, which can affect the client's perception of their body and self-image.

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Naxlex Comprehensive Predictor Exams

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

Correct Answer is A

Explanation

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.)

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

Explanation

A nurse is reviewing the laboratory data of a client following a hemodialysis treatment. The nurse should expect to find a decrease in which of the following laboratory values?

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A nurse is admitting a client who has pyelonephritis. Which of the following manifestations should the nurse expect to be present during the assessment? (Select all that apply.)

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