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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Free Nursing Study Resources

Correct Answer is D

Explanation

Choice A rationale
Palpating over the maxillary sinuses is not typically associated with oral cancer assessment. This action is more relevant to sinus issues and does not provide information about oral cancer.

Choice B rationale
Asking about a productive cough can be relevant in assessing respiratory conditions but is not a direct method for evaluating oral cancer. Oral cancer symptoms are more localized to the mouth area.

Choice C rationale
Observing for purulent nasal drainage is not a standard action in assessing for oral cancer. Nasal drainage would be more indicative of sinus or respiratory issues, not oral pathology.

Choice D rationale
Checking the mouth for leukoplakia is a key action when assessing for oral cancer. Leukoplakia presents as thickened, white patches inside the mouth and can be precancerous, making it a critical observation in potential oral cancer cases.

A. Hemoglobin from hemolyzed RBCs B. Benign prostatic hyperplasia C. Prostate cancer D. Myoglobin release from necrotic muscle cells E. Nephrotoxins

Correct Answer is ["A","D","E"]

Explanation

Choice A rationale
Hemoglobin released from hemolyzed red blood cells (RBCs) can cause intrarenal acute kidney injury by obstructing the renal tubules and damaging the nephrons.

Choice B rationale
Benign prostatic hyperplasia is a cause of postrenal, not intrarenal, acute kidney injury as it can obstruct the flow of urine out of the bladder.

Choice C rationale
Prostate cancer, similar to benign prostatic hyperplasia, typically leads to postrenal acute kidney injury due to urinary obstruction.

Choice D rationale
Myoglobin released from necrotic muscle cells, as seen in conditions like rhabdomyolysis, can cause intrarenal acute kidney injury by precipitating in the renal tubules.

Choice E rationale
Nephrotoxins, such as certain medications, chemicals, or toxins, can directly damage the kidney tissue, leading to intrarenal acute kidney injury.

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Naxlex Comprehensive Predictor Exams

Which action will the nurse take when assessing a patient with possible oral cancer?

Correct Answer is D

Explanation

Which of the following are causes of intrarenal acute kidney injury? (Select all that apply.)

Correct Answer is ["A","D","E"]

Explanation

A nurse is caring for a patient diagnosed with peptic ulcer disease. Which complication would result in gastric contents spilling into the patient's peritoneal cavity?

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Which clinical manifestation of inflammatory bowel disease is common to both patients with ulcerative colitis (UC) and Crohn's disease?

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