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.
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: This statement is incorrect because, during dehydration, water does not move towards areas of lower sodium concentration.
Choice B reason: This is correct because, during dehydration, the body retains sodium, and water follows by osmosis to areas where sodium concentration is higher, which can result in elevated sodium levels.
Choice C reason: Sodium does not typically move across membranes in response to solute concentration gradients; water does.
Choice D reason: Water moves independently of sodium particles, not necessarily together, and it moves towards areas of higher solute concentration.
Correct Answer is B
Explanation
Choice A reason: While fiber is important in a diet, recommending at least 45 g per day does not specifically address the needs of a patient with diabetic nephropathy.
Choice B reason: Consuming less than 0.8 g/kg of body weight of protein per day is recommended for patients with diabetic nephropathy to reduce the workload on the kidneys.
Choice C reason: Limiting cholesterol intake to 300 mg per day is a general recommendation for heart health but is not specific to diabetic nephropathy dietary management.
Choice D reason: The recommendation to consume less than 45% of total calories from carbohydrates is not specific to diabetic nephropathy, and carbohydrate needs can vary based on individual energy requirements.
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