The nurse is caring for a client with stage 4 chronic kidney disease. Which interpretation should the nurse make about the client's glomerular filtration rate (GFR)?

Severely decreased GFR.

Mildly decreased GFR.

Kidney damage with increased GFR.

Moderately decreased GFR.

Answer and Explanation

The Correct Answer is A

A. Severely decreased GFR:

In stage 4 chronic kidney disease (CKD), the glomerular filtration rate (GFR) is indeed severely decreased. Stage 4 CKD is characterized by a GFR between 15 and 29 mL/min/1.73 m² according to the Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines. At this stage, there is significant kidney damage, resulting in a substantial reduction in kidney function and GFR. Clients with stage 4 CKD require close monitoring and management to prevent further progression of kidney disease and associated complications.

B. Mildly decreased GFR:

This choice is incorrect. Stage 4 CKD is not associated with a mildly decreased GFR. A mildly decreased GFR would typically be indicative of earlier stages of CKD. In stage 4 CKD, the reduction in GFR is severe, falling below 30 mL/min/1.73 m².

C. Kidney damage with increased GFR:

This interpretation is inaccurate. In stage 4 CKD, kidney damage leads to a progressive decline in GFR, rather than an increase. An increased GFR is not typical of advanced CKD stages; instead, it may occur in conditions such as hyperfiltration in early stages of diabetic nephropathy.

D. Moderately decreased GFR:

This option is also incorrect. Stage 4 CKD is not associated with a moderately decreased GFR. A moderately decreased GFR would typically be indicative of stage 3 CKD, where the GFR ranges from 30 to 59 mL/min/1.73 m². In stage 4 CKD, the reduction in GFR is more severe, falling below 30 mL/min/1.73 m².

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Correct Answer is C

Explanation

A. Herpes simplex virus:

While herpes simplex virus (HSV) infection is a sexually transmitted infection that can cause genital ulcers and lesions, it is not directly associated with an increased risk of cervical cancer. However, individuals with genital herpes may have an increased risk of acquiring human papillomavirus (HPV), which is a significant risk factor for cervical cancer.

B. Vulvovaginitis:

Vulvovaginitis refers to inflammation or infection of the vulva and vagina and can be caused by various factors, including bacterial, fungal, or viral infections. While chronic inflammation or infection may contribute to cellular changes in the cervix, it is not a direct risk factor for cervical cancer.

C. Human papillomavirus (HPV):

Human papillomavirus (HPV) infection is the most significant risk factor for developing cervical cancer. Certain high-risk strains of HPV, particularly HPV types 16 and 18, are strongly associated with the development of cervical dysplasia and cervical cancer. Persistent infection with high-risk HPV strains can lead to cellular changes in the cervix, eventually progressing to cervical cancer.

D. Chronic yeast infections:

Chronic yeast infections, also known as recurrent vulvovaginal candidiasis, are caused by the overgrowth of Candida species in the vaginal area. While chronic yeast infections can cause discomfort and recurrent symptoms, they are not directly linked to an increased risk of cervical cancer. However, chronic irritation or inflammation in the genital area may increase the susceptibility to other infections, including HPV.

A. Arterial endothelium injury causes Inflammation. B. Vessel narrowing results in ischemia. C. Foam cells release growth factors for smooth muscle cells. D. Macrophages consume low-density lipoprotein (LDL), creating foam cells. E. Smooth muscle grows over fatty streaks creating fibrous plaques.

Correct Answer is A,D,C,E,B

Explanation

This sequence starts with an injury to the arterial endothelium, leading to inflammation. Macrophages then consume LDL, forming foam cells. These foam cells release growth factors that stimulate the growth of smooth muscle cells. The smooth muscle cells grow over the fatty streaks, creating fibrous plaques. Finally, as these plaques grow, they narrow the vessel, which can result in ischemia. This is a simplified explanation of a complex process that involves many other factors and steps. It’s also important to note that this process can take many years to develop.

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The nurse is caring for a client with stage 4 chronic kidney disease. Which interpretation should the nurse make about the client's glomerular filtration rate (GFR)?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A,D,C,E,B

Explanation

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