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 ["0.5"]

Explanation

Step 1: The total amount of digoxin required per dose is 125 mcg. We need to convert this to mg because the available tablets are in mg. We know that 1 mg = 1000 mcg, so 125 mcg = 125 ÷ 1000 mg = 0.125 mg.

Step 2: Each tablet contains 0.25 mg of digoxin.

Step 3: To find out how many tablets are needed, we divide the total amount required by the amount in each tablet. So, (0.125 mg ÷ 0.25 mg/tablet).

Step 4: The result is 0.5 tablets.

So, the nurse should administer 0.5 tablets per dose. This is already rounded to the nearest tenth.

A. Maintain the client in a left lateral position during dialysis. B. Monitor vital signs every 2 hours during the procedure. C. Warm the dialysate solution prior to instillation. D. Place the drainage bag above the level of the client's abdomen.

Correct Answer is C

Explanation

Choice A reason: Maintaining the client in a left lateral position is not specifically required for peritoneal dialysis. Positioning may vary based on the individual's comfort and specific medical needs.

Choice B reason: While monitoring vital signs is important during any medical procedure, it is not an intervention that directly ensures proper dialysate exchange in peritoneal dialysis.

Choice C reason: Warming the dialysate solution prior to instillation is a standard practice in peritoneal dialysis. It helps to promote patient comfort and more efficient exchange of wastes and fluids.

Choice D reason: Placing the drainage bag above the level of the client's abdomen would impede gravity drainage, which is necessary for proper dialysate exchange. The drainage bag should be placed below the level of the client's abdomen.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has heart failure and a prescription for digoxin 125 mcg PO daily. Available is digoxin PO 0.25 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["0.5"]

Explanation

A nurse is developing a plan of care for a client who is to begin receiving peritoneal dialysis. Which of the following interventions should the nurse implement to ensure proper dialysate exchange?

Correct Answer is C

Explanation

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 caring for a client who has end-stage renal disease (ESRD). Which of the following are expected findings? (Select all that apply).

A nurse is caring for a client who is receiving peritoneal dialysis for kidney failure. Which additional condition in the client's medical history puts the client at increased risk for the development of peritonitis?

A nurse is caring for a client admited for pyelonephritis. The client's history includes frequent urinary tract infections (UTI). Which of the following statements by the client indicates that they are su?ering from a psychosocial effect from frequent UTIs?

A nurse is caring for a client who has acute kidney injury (AKI). Which of the following arterial blood gas (ABG) values would the nurse expect this client to have?

A nurse is caring for a client who has polycystic kidney disease (PKD). The client is admited to the hospital for renal calculi and reports that their abdomen has been getting bigger. Which of the following statements by the nurse is the best explanation for the increase in abdominal girth?

A nurse is discussing laboratory values associated with the renal system with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the values?