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 D

Explanation

Choice A reason: Blood-tinged dialysate outflow can occur initially due to the surgical procedure and is not typically a cause for immediate concern unless it persists or is accompanied by other symptoms.

Choice B reason: Dialysate leakage during inflow might indicate a problem with the catheter placement or integrity but is not usually an emergency. It should be monitored and reported if it continues.

Choice C reason: Discomfort during dialysate inflow is common, especially in new patients, as they adjust to the sensation of fluid being infused. It should be reported if the discomfort is severe or persistent.

Choice D reason: Purulent dialysate outflow indicates an infection, such as peritonitis, which is a serious complication

of peritoneal dialysis. This requires immediate atention and intervention by the healthcare provider.

A. Metastasis occurs when cancerous growths are located in the kidneys and also in another part of the body. B. Metastasis means a group of abnormal kidney cells is localized to a single location. C. Metastasis is when a group of kidney cells have changed to more closely resemble intestinal cells. D. Metastasis occurs when cancer cells grow until they run out of space and stop growing.

Correct Answer is A

Explanation

Choice A reason: Metastasis refers to the process by which cancer cells spread from the primary tumor site to distant organs or tissues. This can occur through the bloodstream or lymphatic system, leading to the formation of secondary tumors in other parts of the body.

Choice B reason: This statement is incorrect because metastasis, by definition, involves the spread of cancer cells to multiple locations, not their confinement to a single area.

Choice C reason: The description provided in this choice is more indicative of metaplasia, which is a change in the type of cells, and not metastasis, which is the spread of cancer cells.

Choice D reason: This choice is incorrect as it does not describe metastasis. Cancer cells do not stop growing because they run out of space; they continue to proliferate and can invade other tissues.

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Naxlex Comprehensive Predictor Exams

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

Correct Answer is D

Explanation

A nurse is caring for a client who has kidney cancer and has been informed that it has metastasized. Which of the following statements should the nurse make when the client asks what metastasis means?

Correct Answer is A

Explanation

A nurse is preparing to administer prescribed intravenous potassium replacement supplements to a client who has a potassium level of 2.5 mEq/L (normal range: 3.5 to 5 mEq/L). Which of the following actions should the nurse plan to include? (Select all that apply.)

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

A nurse is assessing a client who has end-stage kidney disease and is receiving hemodialysis. Which of the followingfindings should the nurse identify as an indication the client is experiencing fluid overload?

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.)

A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect?

A nurse is gathering medical history from a client admited for pyelonephritis. Which of the following should the nurse expect the client to report when asked about their medical history?

A nurse is caring for a client immediately following a hemodialysis treatment. For which of the following manifestations will the nurse administer a PRN dose of phenytoin?

A nurse in the emergency department is caring for a client who collapsed after playing football on a hot day. After reviewing the admission laboratory findings, the nurse recognizes that these findings are consistent with which of the following conditions?