The nurse is caring for a client with stage 4 chronic kidney disease. Which interpretation should the nurse make about the client's glomerular filtration rate (GFR)?
Severely decreased GFR.
Mildly decreased GFR.
Kidney damage with increased GFR.
Moderately decreased GFR.
The Correct Answer is A
A. Severely decreased GFR:
In stage 4 chronic kidney disease (CKD), the glomerular filtration rate (GFR) is indeed severely decreased. Stage 4 CKD is characterized by a GFR between 15 and 29 mL/min/1.73 m² according to the Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines. At this stage, there is significant kidney damage, resulting in a substantial reduction in kidney function and GFR. Clients with stage 4 CKD require close monitoring and management to prevent further progression of kidney disease and associated complications.
B. Mildly decreased GFR:
This choice is incorrect. Stage 4 CKD is not associated with a mildly decreased GFR. A mildly decreased GFR would typically be indicative of earlier stages of CKD. In stage 4 CKD, the reduction in GFR is severe, falling below 30 mL/min/1.73 m².
C. Kidney damage with increased GFR:
This interpretation is inaccurate. In stage 4 CKD, kidney damage leads to a progressive decline in GFR, rather than an increase. An increased GFR is not typical of advanced CKD stages; instead, it may occur in conditions such as hyperfiltration in early stages of diabetic nephropathy.
D. Moderately decreased GFR:
This option is also incorrect. Stage 4 CKD is not associated with a moderately decreased GFR. A moderately decreased GFR would typically be indicative of stage 3 CKD, where the GFR ranges from 30 to 59 mL/min/1.73 m². In stage 4 CKD, the reduction in GFR is more severe, falling below 30 mL/min/1.73 m².
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Acne vulgaris is a common skin condition characterized by various types of lesions, including comedones, papules, and pustules, primarily affecting areas with a high density of sebaceous glands, such as the face, neck, chest, and upper back. Here's why option C is the correct choice:
A) Small, skin-colored, pedunculated papules in areas of skin folds and on other areas as skin tags:
This description is more characteristic of acrochordons or skin tags, which are benign skin growths commonly found in areas of friction or skin folds. Skin tags are not typically associated with acne vulgaris.
B) Hyperpigmented areas that vary in form and color and are slightly elevated from the skin:
This description suggests post-inflammatory hyperpigmentation, which can occur after resolution of inflammatory lesions in acne vulgaris. However, it does not capture the primary pathological findings observed in active acne lesions.
C) Hyperactive sebaceous areas forming comedones, papules, pustules on the face, neck, and upper back:
Correct. Acne vulgaris is characterized by the formation of various lesions, including comedones (open and closed), papules, and pustules, resulting from the obstruction of hair follicles and overactivity of sebaceous glands. These lesions typically appear on areas with a high density of sebaceous glands, such as the face, neck, chest, and upper back.
D) Sharply demarcated silvery scaling plaques with underlying redness on the elbows and knees:
This description is more indicative of psoriasis, a chronic autoimmune skin condition characterized by sharply demarcated, raised, silvery scaling plaques commonly affecting extensor surfaces such as the elbows and knees. Psoriasis lesions are distinct from those seen in acne vulgaris.
Correct Answer is C
Explanation
Intermittent claudication is a common symptom experienced by individuals with peripheral artery disease (PAD). It occurs due to the underlying pathophysiology of arterial occlusion and ischemia during physical activity. Here's why option C is the correct choice:
A) Reduced blood flow occurs when legs are elevated:
This statement is not accurate regarding the pathophysiology of intermittent claudication in PAD. When legs are elevated, gravity assists venous return, which may actually improve blood flow temporarily. However, intermittent claudication occurs during activity, not when the legs are elevated.
B) Reddened color occurs when the feet are dependent:
This statement is unrelated to the pathophysiology of intermittent claudication. Redness when the feet are dependent may suggest venous insufficiency rather than arterial occlusion characteristic of PAD.
C) Arterial occlusion causes ischemic pain during activity:
Correct. Intermittent claudication is caused by inadequate blood flow to the muscles during physical activity due to arterial occlusion in PAD. As the demand for oxygen increases during exercise, the narrowed arteries cannot supply sufficient blood flow, leading to ischemic pain in the affected muscles. This pain typically resolves with rest and recurs upon resuming activity.
D) Reduction in blood supply leads to muscle atrophy:
Muscle atrophy may occur in severe cases of PAD with chronic ischemia, but it is not the primary cause of intermittent claudication. Intermittent claudication is primarily attributed to inadequate blood flow during activity, which results in ischemic pain rather than muscle atrophy.
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