A client is admitted with the diagnosis of "left-sided embolic stroke". Which explanation best describes the most likely cause of the stroke?

Choice A reason: Fewer numbers of parietal cells in the gastric mucosa is not the best explanation because it is a condition that affects the production of gastric acid, not the development of duodenal ulcers. Parietal cells are the cells that secrete hydrochloric acid and intrinsic factor in the stomach. Hydrochloric acid helps to digest food and kill bacteria, while intrinsic factor helps to absorb vitamin B12. Fewer numbers of parietal cells can cause hypochlorhydria, which is a low level of gastric acid, or pernicious anemia, which is a deficiency of vitamin B12. Hypochlorhydria can increase the risk of bacterial overgrowth and infections, while pernicious anemia can cause symptoms such as fatigue, weakness, and neurological problems.

Choice B reason: Helicobacter pylori infection is the best explanation because it is the most common cause of duodenal ulcers, which are sores that form in the lining of the first part of the small intestine, called the duodenum. Helicobacter pylori is a type of bacteria that can survive in the acidic environment of the stomach and the duodenum. It can damage the protective layer of mucus that covers the lining of the digestive tract, exposing it to the gastric acid and causing inflammation and ulceration. Helicobacter pylori infection can also increase the production of gastrin, which is a hormone that stimulates the secretion of gastric acid, and decrease the production of somatostatin, which is a hormone that inhibits the secretion of gastric acid.

Choice C reason: Slowed gastric emptying is not the best explanation because it is a condition that affects the movement of food from the stomach to the small intestine, not the development of duodenal ulcers. Gastric emptying is the process of passing the food that has been partially digested in the stomach to the duodenum, where it is further broken down and absorbed. Slowed gastric emptying can be caused by various factors, such as diabetes, medications, or nerve damage, and can result in symptoms such as nausea, vomiting, bloating, or fullness.

Choice D reason: Frequent use of acetaminophen is not the best explanation because it is a factor that affects the development of gastric ulcers, not duodenal ulcers. Acetaminophen is a type of medication that is used to relieve pain and fever. It can cause gastric ulcers by inhibiting the synthesis of prostaglandins, which are substances that protect the lining of the stomach from the gastric acid and promote healing. Acetaminophen can also cause liver damage if taken in high doses or for a long time.

Choice A reason: Glomerulonephritis is an inflammation of the glomeruli, the filtering units of the kidneys. It can cause damage to the renal tissue and lead to intrinsic acute kidney injury, not prerenal acute kidney injury.

Choice B reason: Fluid volume deficit is a condition in which the body loses more fluid than it takes in. It can cause hypovolemia, which reduces the blood flow to the kidneys and impairs their function. This is the most common cause of prerenal acute kidney injury, which is a result of decreased perfusion to the kidneys.

Choice C reason: Neurogenic bladder is a dysfunction of the bladder caused by a nerve problem. It can affect the ability to store or empty urine. It can cause urinary retention, which increases the pressure in the urinary tract and damages the kidneys. This is a type of postrenal acute kidney injury, which is a result of obstruction to the urine outflow.

Choice D reason: Renal calculus is a solid mass formed from crystals in the urine. It can block the ureter, the tube that carries urine from the kidney to the bladder. It can cause hydronephrosis, which is a swelling of the kidney due to accumulation of urine. This is another type of postrenal acute kidney injury.