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 ["A","E","F"]

Explanation

Choice A reason: Postvoid urine residual measurement is a direct method to assess for urinary retention.

Choice B reason: Blood urea nitrogen (BUN) levels may indicate kidney function but not specifically urinary retention.

Choice C reason: A cystourethrogram is used to visualize the bladder and urethra, which may not be the first choice for assessing urinary retention.

Choice D reason: Creatinine levels indicate kidney function but not urinary retention.

Choice E reason: A kidney, ureter, bladder (KUB) x-ray can show the size of the bladder and may indicate retention.

Choice F reason: A bladder scan is a non-invasive way to measure the amount of urine in the bladder and assess for

retention.

A. The erythrocyte sedimentation rate (ESR) B. The hematocrit (Hct) C. The platelet count D. The leukocyte count

Correct Answer is B

Explanation

Choice A reason: The erythrocyte sedimentation rate (ESR) is not directly aﬀected by epoetin alfa therapy, which is used to treat anemia.

Choice B reason: Epoetin alfa stimulates erythropoiesis, leading to an increase in red blood cell production, which would be reﬂected in an increased hematocrit level.

Choice C reason: The platelet count is not directly aﬀected by epoetin alfa therapy.

Choice D reason: The leukocyte count is not directly aﬀected by epoetin alfa therapy.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client in the clinic who has a distended bladder with discomfort over the area and a sense of fullness. Which of the following tests should the nurse expect the health care provider to order to determine if the client has urinary retention? (Select all that apply.)

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

Explanation

A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?

Correct Answer is B

Explanation

A nurse is caring for a female client who has recurrent kidney stones and is scheduled for an intravenous pyelogram. Which of the following statements by the client should the nurse report to the provider?

A nurse is caring for older adult clients at a long-term care facility. Which of the following assessments should the nurse consider when monitoring clients for urinary retention? (Select all that apply.)

The nurse is discharging a client from the hospital who has a new prescription for furosemide. Which of the following client statements indicates an understanding of the teaching?

A nurse is preparing a client for a kidney biopsy. Which of the following client conditions should the nurse identify as a contraindication for this diagnostic test?

A nurse is caring for a male client who reports nausea and vomiting and is receiving IV fluid therapy. His blood urea nitrogen (BUN) is 32 mg/dL, creatinine is 1.1 mg/dL, and hematocrit is 50%. Which of the following nursing interventions is appropriate?

A nurse is caring for a 68-kg (150-lb) client who has dehydration. Which of the following manifestations is an indication of effective treatment?

A nurse is caring for a client who has impaired renal function. For which of the following findings should the nurse notify the provider?

A nurse is caring for a client in a clinic who has foul-smelling urine, a low-grade fever of 37.7°C (100°F), and pain with urination. Which of the following should the nurse expect the health care provider to order? (Select all that apply.)