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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Correct Answer is A

Explanation

Choice A reason: Metastasis refers to the process by which cancer cells spread from the primary tumor site to distant organs or tissues. This can occur through the bloodstream or lymphatic system, leading to the formation of secondary tumors in other parts of the body.

Choice B reason: This statement is incorrect because metastasis, by definition, involves the spread of cancer cells to multiple locations, not their confinement to a single area.

Choice C reason: The description provided in this choice is more indicative of metaplasia, which is a change in the type of cells, and not metastasis, which is the spread of cancer cells.

Choice D reason: This choice is incorrect as it does not describe metastasis. Cancer cells do not stop growing because they run out of space; they continue to proliferate and can invade other tissues.

A. "A low-protein diet will reduce the risk for hyperkalemia." B. "A low-protein diet reduces the risk for uremia." C. "A low-protein diet reduces the risk for edema." D. "A low-protein diet will decrease the nitrogenous waste in the blood."

Correct Answer is B

Explanation

Choice A reason: While a low-protein diet can help manage electrolyte imbalances, it is not specifically targeted at reducing the risk for hyperkalemia. Hyperkalemia is more directly managed by restricting foods high in potassium.

Choice B reason: A low-protein diet helps reduce the risk for uremia, which is the accumulation of waste products in the blood due to impaired kidney function. By consuming less protein, there is less urea and other nitrogenous wastes for the kidneys to filter, which can help delay the progression of kidney disease.

Choice C reason: Edema is related to ﬂuid retention and not directly to protein intake. A low-protein diet does not specifically reduce the risk for edema unless it is associated with kidney dysfunction aﬀecting ﬂuid balance.

Choice D reason: A low-protein diet will indeed decrease the amount of nitrogenous waste in the blood because less protein breakdown means less waste for the kidneys to remove. However, this choice is less specific than Choice B, which directly addresses the condition of uremia that is a concern for patients with chronic kidney failure.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has kidney cancer and has been informed that it has metastasized. Which of the following statements should the nurse make when the client asks what metastasis means?

Correct Answer is A

Explanation

A nurse is teaching a client who has chronic kidney failure about planning a low-protein diet. The client asks, "Why do I have to be concerned about protein?" Which of the following responses should the nurse make?

Correct Answer is B

Explanation

A nurse manager at a skilled nursing facility has noticed an increase in urinary tract infections (UTIs) by 12% in the past year. In an e?ort to decrease this rate, which of the following should the nurse manager teach the nursing sta?? (Select all that apply.)

A nurse is teaching a group of unlicensed assistive personnel about urinary tract infections (UTIs) in clients who have vaginas. When describing why clients who have vaginas have higher rates of UTIs than clients who do not have vaginas, which of the following explanations should the nurse use?

A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect?

A nurse is providing teaching to a client who has renal failure and an elevated phosphorous level. The provider instructed the client to take aluminum hydroxide 300 mg PO three times daily. For which of the following adverse effects should the nurse inform the client?

A nurse is providing dietary teaching to a client who has nephropathy secondary to diabetes mellitus and plans to make dietary adjustments. Which of the following instructions should the nurse include?

A nurse is teaching a client who has acute kidney disease about fluid restrictions. Which of the following statements by the client should the nurse identify as understanding of the teaching?