The nurse has noted the high incidence of urinary tract obstructions of a variety of etiologies. Which individuals are at risk of developing urinary obstructions? (Select all that apply).
A 69 year old female with anemia secondary to insufficient erythropoietin production
A 70 year old male with benign prostatic hyperplasia (BPH)
A 58 year old male with renal calculi
A 29 year old female, pregnant for the first time
Correct Answer : B,C,D,E
A. A 69-year-old female with anemia secondary to insufficient erythropoietin production: While anemia can occur due to chronic kidney disease, it does not directly cause urinary tract obstruction. The lack of erythropoietin affects red blood cell production, not urine flow.
B. A 70-year-old male with benign prostatic hyperplasia (BPH): BPH is a common cause of urinary obstruction in older men. The enlarged prostate compresses the urethra, leading to impaired urine outflow and increased risk of urinary retention.
C. A 58-year-old male with renal calculi: Kidney stones are a frequent cause of urinary tract obstruction. They can block the flow of urine in the ureters, renal pelvis, or bladder, leading to pain, hydronephrosis, and infection risk.
D. A 29-year-old female, pregnant for the first time: Pregnancy can cause urinary obstruction due to the enlarged uterus compressing the ureters, especially in the second and third trimesters, resulting in reduced urine flow and potential hydronephrosis.
E. A 28-year-old male with a neurogenic bladder secondary to spinal cord injury: Neurogenic bladder disrupts normal bladder function and control, which can lead to urinary retention and obstruction due to poor coordination of bladder muscle and sphincter activity.
F. A 43-year-old male with an acid-base imbalance secondary to malnutrition: While malnutrition can affect many organ systems, acid-base imbalance by itself is not a direct cause of urinary tract obstruction.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
A. Blood glucose levels in DKA are typically higher than in HHS: In fact, HHS usually presents with higher blood glucose levels than DKA—often exceeding 600 mg/dL, while DKA typically ranges from 250 to 600 mg/dL.
B. DKA involves significant ketosis and metabolic acidosis, while HHS typically does not: DKA is characterized by the breakdown of fats into ketones, leading to metabolic acidosis. HHS typically lacks significant ketosis because insulin levels, while low, are still sufficient to suppress ketogenesis.
C. DKA is more common in type 1 diabetes, while HHS is more common in type 2 diabetes: DKA usually occurs in individuals with type 1 diabetes due to absolute insulin deficiency. HHS is more often seen in type 2 diabetics who still produce some insulin but not enough to prevent severe hyperglycemia and dehydration.
D. None of the above: This choice is incorrect, as B, C, and E are valid differences between DKA and HHS.
E. HHS patients often have more severe dehydration than DKA patients: HHS leads to profound osmotic diuresis over a longer period, causing extreme dehydration. DKA progresses faster but with less total fluid loss compared to HHS.
Correct Answer is A
Explanation
A. The Somogyi effect results from an excessive insulin dose causing hypoglycemia overnight, triggering a rebound hyperglycemia via release of glucagon, cortisol, and growth hormone. In contrast, the dawn phenomenon is a natural early morning rise in blood glucose due to circadian increases in cortisol and growth hormone without preceding hypoglycemia.
B. The Somogyi effect happens only in type 2 diabetes, while the dawn phenomenon happens only in type 1 diabetes: Both effects can occur in either type 1 or type 2 diabetes depending on insulin therapy and individual physiology.
C. Both the Somogyi effect and the dawn phenomenon occur due to nighttime hyperglycemia: The Somogyi effect starts with nighttime hypoglycemia, not hyperglycemia, while the dawn phenomenon involves a gradual early morning rise in glucose levels.
D. The Somogyi effect is caused by insufficient insulin at night, while the dawn phenomenon is caused by excessive nighttime insulin: The Somogyi effect is caused by excessive insulin leading to hypoglycemia, not insufficient insulin. The dawn phenomenon is unrelated to nighttime insulin dosing and is caused by hormonal changes.
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