A patient with a history of renal failure presents with confusion. This altered mental status is characteristic of

Hydronephrosis, in which there is increased cerebral edema.

Uremic encephalopathy, caused by excess circulating urea that irritates and inflames the brain.

Metabolic alkalosis, which develops from over-secretion of HCO3 (bicarbonate).

Hypotension caused by hypophosphatemia.

Answer and Explanation

The Correct Answer is B

A. Hydronephrosis may lead to renal dysfunction but does not directly explain the altered mental status or confusion in this context.

B. Uremic encephalopathy occurs due to the accumulation of waste products, particularly urea, in the bloodstream, which can lead to neurotoxicity and confusion.

C. Metabolic alkalosis does not typically cause confusion; it is more related to acid-base disturbances and does not develop from over-secretion of bicarbonate in renal failure.

D. Hypotension due to hypophosphatemia is not a common cause of confusion, and while electrolyte imbalances can affect mental status, this option does not directly connect with renal failure.

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Correct Answer is D

Explanation

A. Serum creatinine levels within the normal range (0.6-1.2) do not specifically indicate intra-renal AKI.

B. A high 24-hour creatinine clearance is not typically associated with intra-renal AKI, as kidney injury often leads to decreased filtration and clearance.

C. A low serum creatinine level (0.5) would generally indicate good kidney function rather than AKI.

D. Casts in the urine are indicative of damage within the kidney tubules, which is a characteristic finding of intra-renal AKI, often due to cellular injury or necrosis within the kidney itself.

A. inflammatory changes in the glomeruli causes "leaky" glomerular capillaries. B. an autoantibody attack to the renal artery, causing ischemia to the kidney glomerulus. C. the pathological leaking of casts from the glomerular capillaries into the urine. D. a substantial increase in the glomerular filtration rate (GFR).

Correct Answer is A

Explanation

A. In post-streptococcal glomerulonephritis, the immune response to strep infection results in inflammatory changes in the glomeruli, making the capillaries "leaky." This allows protein and red blood cells to pass into the urine, causing proteinuria and hematuria.

B. Post-streptococcal glomerulonephritis is not characterized by an autoantibody attack on the renal artery. It is primarily an immune-mediated inflammatory response in the glomeruli.

C. While casts may appear in the urine, the primary issue is glomerular capillary inflammation and permeability rather than direct leaking of casts.

D. Post-streptococcal glomerulonephritis typically results in a decreased GFR due to inflammation and reduced kidney function, not an increase.

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A patient with a history of renal failure presents with confusion. This altered mental status is characteristic of

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Naxlex Comprehensive Predictor Exams

A patient presents with acute oliguria. Lab tests are done to pinpoint the cause. The nurse believes the patient has developed intra-renal acute kidney injury (AKI), based on which typical finding?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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