A nurse is caring for a client who reports to the clinic for laboratory tests. The client has an acute kidney injury caused by acute tubular necrosis and 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?

The glomerular filtration rate decreases because there is injury to the renal tubular cells.

The glomerular filtration rate decreases because there is obstruction leading to the filtration system backing up and eventually shutting the kidneys down.

The glomerular filtration rate decreases because in?ammatory cells invade the already damaged kidneys.

The glomerular filtration rate decreases because there is a reduction of blood flow to the kidneys.

Answer and Explanation

The Correct Answer is A

Choice A reason: Acute tubular necrosis (ATN) is a condition where there is damage to the renal tubular cells, which can lead to a decrease in GFR. This is because the tubular cells are responsible for reabsorbing substances from the filtrate back into the blood. When these cells are injured, they cannot function properly, leading to a buildup of waste products and a decrease in GFR.

Choice B reason: While obstruction can lead to a decrease in GFR, it is not the primary cause in the context of acute tubular necrosis. Obstruction typically occurs in postrenal causes of acute kidney injury.

Choice C reason: In?ammatory cells do invade damaged kidneys, but this is more characteristic of conditions such as acute interstitial nephritis rather than ATN. In ATN, the primary issue is the injury to the tubular cells themselves.

Choice D reason: A reduction of blood flow to the kidneys, or prerenal azotemia, can indeed lead to a decrease in GFR. However, in the context of ATN, the primary issue is not the blood flow but the damage to the renal tubules.

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Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A reason: Hyperkalemia is not typically associated with corticosteroid therapy. Corticosteroids can lead to increased excretion of potassium, not retention.

Choice B reason: Hypokalemia is a common side effect of corticosteroid therapy due to increased excretion of potassium in the urine.

Choice C reason: Hypomagnesemia is not commonly associated with corticosteroid therapy.

Choice D reason: Hypermagnesemia is not typically induced by corticosteroid therapy.

A. The client admitted to the hospital who has clinical findings of periorbital edema, dark frothy urine, and elevated blood pressure. B. The client admitted to the hospital who has clinical findings of severe flank pain, nausea, and vomiting. C. The client admitted to the hospital who has clinical findings of polyuria, nocturia, proteinuria, and a palpable kidney mass. D. The client admitted to the hospital who has clinical findings of urinary urgency, weak urine stream, and dysuria.

Correct Answer is B

Explanation

Choice A reason: Periorbital edema, dark frothy urine, and elevated blood pressure are more indicative of conditions like nephrotic syndrome rather than kidney stones.

Choice B reason: Severe flank pain, nausea, and vomiting are classic symptoms associated with kidney stones, and such clients should be educated on kidney stone prevention.

Choice C reason: Polyuria, nocturia, proteinuria, and a palpable kidney mass could suggest other renal issues, but not specifically kidney stones.

Choice D reason: Urinary urgency, weak urine stream, and dysuria could be symptoms of a urinary tract infection or prostate issues in males, rather than kidney stones.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has nephrotic syndrome and is receiving high-dose corticosteroid therapy. For which of the following electrolyte imbalances should the nurse monitor?

Correct Answer is B

Explanation

A nurse is caring for four clients on the urology unit. Which of the following clients should the nurse plan to teach about kidney stone prevention?

Correct Answer is B

Explanation

A nurse is caring for a client following his first hemodialysis treatment. The client reports a headache, nausea, and restlessness. The nurse should identify these findings as manifestations of which of the following complications?

A nurse is providing discharge teaching to a client who will be performing continuous ambulatory peritoneal dialysis (CAPD) at home. Which of the following statements from the client indicates an understanding of this type of dialysis management? (Select all that apply)

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A nurse is preparing to administer prescribed intravenous potassium replacement supplements to a client who has a potassium level of 2.5 mEq/L (normal range: 3.5 to 5 mEq/L). Which of the following actions should the nurse plan to include? (Select all that apply.)

A nurse is caring for a client who has end-stage renal disease (ESRD). Which of the following are expected findings? (Select all that apply).

A charge nurse is teaching a newly licensed nurse about fluid shifts. The newly licensed nurse asks why sodium levels are high during dehydration. Which of the following responses should the charge nurse provide?

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