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 ["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.
Correct Answer is ["A","B","D","E"]
Explanation
Choice A rationale
Hypertension is a modifiable risk factor for atherosclerosis. Managing blood pressure through lifestyle changes and medication can reduce the risk of developing atherosclerosis.
Choice B rationale
Hypercholesterolemia, or high cholesterol, is another modifiable risk factor. Dietary adjustments, physical activity, and medications can help manage cholesterol levels.
Choice C rationale
Genetic predisposition is not a modifiable risk factor. It is an inherent risk that cannot be changed, but awareness can prompt early monitoring and intervention.
Choice D rationale
Obesity is a modifiable risk factor for atherosclerosis. Weight loss through diet and exercise can significantly reduce the risk.
Choice E rationale
Smoking is a significant modifiable risk factor for atherosclerosis. Quitting smoking can greatly reduce the risk of developing this condition.
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