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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Correct Answer is ["B","C","D"]

Explanation

Choice A reason: Asparagus is not typically high in potassium and does not need to be avoided by clients with chronic

kidney disease.

Choice B reason: Raisins are high in potassium and should be avoided by clients with chronic kidney disease to prevent hyperkalemia.

Choice C reason: Bananas are known to be high in potassium and should be limited or avoided in clients with chronic kidney disease.

Choice D reason: Tomatoes and tomato products are high in potassium and should be avoided to maintain safe

potassium levels.

Choice E reason: Green beans are not considered high in potassium and do not typically need to be avoided by clients with chronic kidney disease.

A. "The kidney infection has caused narrowing of the ureters, and your abdomen has filled with fluid." B. "The kidneys continue to enlarge due to the cysts growing, which increases the girth of your abdomen." C. "The stones might descend into the ureters, blocking the flow of urine and causing an increase in the girth of your abdomen." D. "The in?ammation in your kidneys damages the filtration system, which causes fluid retention in your abdomen."

Correct Answer is B

Explanation

Choice A reason: While kidney infections can cause swelling, they typically do not lead to a significant increase in abdominal girth unless associated with severe obstruction or advanced kidney disease.

Choice B reason: In PKD, the kidneys can become significantly enlarged due to the growth of numerous cysts, which

can indeed lead to an increase in abdominal girth.

Choice C reason: While stones can cause blockage and swelling, they would not typically result in a generalized increase in abdominal girth unless there is an associated infection or severe obstruction.

Choice D reason: Inflammation can lead to fluid retention, but in the context of PKD, it is the cysts' growth that primarily contributes to increased kidney size and abdominal girth.

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Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has chronic kidney disease about limiting foods that are high in potassium. Which of the following foods should the nurse instruct the client to avoid? (Select all that apply.)

Correct Answer is ["B","C","D"]

Explanation

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?

Correct Answer is B

Explanation

A nurse is caring for a client who is undergoing initial peritoneal dialysis. Which of the following should the nursereport immediately to the provider?

A nurse is teaching a client who has acute kidney injury about dietary sources of potassium. Which of the following statements by the client indicates an understanding of the teaching?

A nurse is caring for a client who has polycystic kidney disease (PKD). Which of the following findings should the nurse expect?

The nurse reviews data from a new client's kidney function test. Which of the following standards of transplant nursing practice is the nurse primarily performing?

A nurse is caring for a client who has impaired renal function. For which of the following findings should the nurse notify the provider?

A nurse is caring for a client following his first hemodialysis treatment. The client reports a headache, nausea, and restlessness. The nurse should identify these findings as manifestations of which of the following complications?

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?