A patient with a history of renal failure presents with confusion. This altered mental status is characteristic of

Hydronephrosis, in which there is increased cerebral edema.

Uremic encephalopathy, caused by excess circulating urea that irritates and inflames the brain.

Metabolic alkalosis, which develops from over-secretion of HCO3 (bicarbonate).

Hypotension caused by hypophosphatemia.

Answer and Explanation

The Correct Answer is B

A. Hydronephrosis may lead to renal dysfunction but does not directly explain the altered mental status or confusion in this context.

B. Uremic encephalopathy occurs due to the accumulation of waste products, particularly urea, in the bloodstream, which can lead to neurotoxicity and confusion.

C. Metabolic alkalosis does not typically cause confusion; it is more related to acid-base disturbances and does not develop from over-secretion of bicarbonate in renal failure.

D. Hypotension due to hypophosphatemia is not a common cause of confusion, and while electrolyte imbalances can affect mental status, this option does not directly connect with renal failure.

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Correct Answer is A

Explanation

A. Long-term hypertension can lead to renal damage, resulting in glomerular injury and subsequent hematuria and proteinuria. ACE inhibitors help to protect renal function by reducing pressure in the glomeruli.

B. Venous insufficiency is generally not a direct complication of hypertension; it is more associated with conditions affecting venous return.

C. Increased elastase activity is related to the breakdown of elastin and is not a direct consequence of hypertension or the primary focus of ACE inhibitor therapy.

D. Decreased high-density lipoproteins (HDL) is not a direct complication of hypertension and does not specifically relate to the effects of ACE inhibitors.

A. The kidneys will excrete more HCO3 into the urine. B. The respiratory system will increase RR. C. The kidneys will create more HCO3. D. The respiratory system will decrease respiratory rate (RR).

Correct Answer is D

Explanation

A. While the kidneys do excrete HCO3 to help in metabolic compensation, this process is slower than respiratory compensation.

B. An increase in respiratory rate would further decrease CO2, worsening the alkalosis rather than compensating for it.

C. Creating more HCO3 would not compensate for respiratory alkalosis and would actually increase the pH further.

D. The body will decrease the respiratory rate to retain more CO2, helping to lower the pH and partially correct the alkalosis.

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A patient with a history of renal failure presents with confusion. This altered mental status is characteristic of

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Naxlex Comprehensive Predictor Exams

A patient with a blood pressure of 170/110 is prescribed an ACE (angiotensin-converting enzyme) inhibitor. The nurse stresses the need to take his ACE inhibitor as prescribed to prevent which complication associated with the long-term effects of hypertension?

Correct Answer is A

Explanation

A patient's ABG results are: pH 7.50, PCO2 25, HCO3 25, PO2 80. Which finding should the nurse expect as the body compensates for the acid-base imbalance?

Correct Answer is D

Explanation

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