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 B

Explanation

Choice A rationale

An increasing hemoglobin level does not indicate the resolution of acute pancreatitis. Hemoglobin levels can fluctuate due to various factors, including hydration status and blood loss, but are not directly related to the resolution of pancreatitis.

Choice B rationale

During an episode of acute pancreatitis, serum concentrations of amylase and lipase rise significantly, often within hours of pancreatic injury. These elevated enzyme levels are key components in diagnosing the condition. As the inflammation subsides and the pancreas begins to heal, the levels of these enzymes typically decrease, returning to normal ranges. Therefore, a declining serum amylase level suggests that the acute inflammatory process is resolving.

Choice C rationale

Serum bilirubin levels are indicative of liver function and bile metabolism. Elevated bilirubin may occur if pancreatitis leads to bile duct obstruction or liver involvement. However, a decrease in bilirubin levels addresses biliary system recovery rather than directly reflecting pancreatic inflammation resolution.

Choice D rationale

An increasing serum alkaline phosphatase level is generally associated with bile duct obstruction or bone disease and does not indicate the resolution of acute pancreatitis. This enzyme is found in several tissues throughout the body, including the liver and bones.

A. Pericardiocentesis B. Septal myectomy C. Pericardial window D. Synchronized electrical cardioversion

Correct Answer is D

Explanation

Choice A rationale
Pericardiocentesis is a procedure used to remove fluid from the pericardial sac and is not typically used to treat atrial fibrillation. It is more commonly indicated for conditions such as pericardial effusion or cardiac tamponade.

Choice B rationale
Septal myectomy is a surgical intervention to remove part of the thickened septal wall that separates the ventricles of the heart. It is primarily used to treat hypertrophic cardiomyopathy, not atrial fibrillation.

Choice C rationale
A pericardial window is a procedure that creates an opening in the pericardium to allow fluid to drain into the surrounding chest cavity. This procedure is not a treatment for atrial fibrillation.

Choice D rationale
Synchronized electrical cardioversion is a procedure where a controlled electric shock is delivered to the heart to restore a normal rhythm. It is a common and effective treatment for atrial fibrillation, especially when the condition is causing significant symptoms like palpitations, lightheadedness, and shortness of breath.

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Naxlex Comprehensive Predictor Exams

Which laboratory finding indicates the resolution of a patient's acute pancreatitis?

Correct Answer is B

Explanation

A nurse is planning care for a client who has atrial fibrillation and reports heart palpitations, lightheadedness, and shortness of breath. Which of the following procedures should the nurse anticipate for this client?

Correct Answer is D

Explanation

A nurse is educating the public at a health fair about colorectal cancer. Which of the following risk factors increase the risk of developing colorectal cancer? (Select all that apply.)

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

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 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?

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.)

What should the nurse ask the patient about to determine possible causes of acute glomerulonephritis?

A nurse is providing teaching on common symptoms of glomerulonephritis. What assessment findings are consistent with this diagnosis? (Select all that apply.)

A nurse is teaching a client who has peripheral venous disease about the management of symptoms. Which of the following client statements indicates an understanding of the teaching?