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","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.

A. Calcium level B. Neurologic status C. Cardiac rhythm D. Urine volume

Correct Answer is C

Explanation

Choice A rationale
Monitoring calcium levels is important after administering calcium gluconate IV, but it is not the primary indicator of the medication's effectiveness in treating hyperkalemia. Calcium gluconate is used in hyperkalemia to stabilize the heart muscle, not to correct calcium levels.

Choice B rationale
Neurologic status may be affected by hyperkalemia, but changes in neurologic status are not the most direct measure of calcium gluconate's effectiveness. The medication's primary role is to address cardiac risks associated with high potassium levels.

Choice C rationale
Cardiac rhythm is the most critical aspect to monitor after administering calcium gluconate for hyperkalemia. Hyperkalemia can cause life-threatening cardiac dysrhythmias, and calcium gluconate works by stabilizing the cardiac membrane, thus the effectiveness of the treatment is directly reflected in the stabilization of the cardiac rhythm.

Choice D rationale
While urine volume can indicate kidney function and might indirectly reflect changes in potassium levels, it is not the direct measure of calcium gluconate's effectiveness in the emergency treatment of hyperkalemia.

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Naxlex Comprehensive Predictor Exams

After assessing a patient with ulcerative colitis (UC), the nurse concludes that the patient has moderate disease. Which patient symptoms support the nurse's conclusion? (Select all that apply.)

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

Explanation

A patient who has is hospitalized with hyperkalemia. Which information will the nurse monitor to evaluate the effectiveness of the acute glomerulonephritis prescribed calcium gluconate IV?

Correct Answer is C

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.)

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?

Which finding for a patient with pancreatitis is termed Grey Turner's sign?

A nurse is gathering medical history from a client admitted for pyelonephritis. Which of the following should the nurse expect the client to report when asked about their medical history?

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.)

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

A 72-year-old patient was admitted with epigastric pain caused by a peptic ulcer. Which patient assessment warrants an urgent change in the nursing plan of care?

In an effort to decrease the rate of urinary tract infections, which of the following should the nurse manager teach the nursing staff? (Select all that apply)