What situation(s) may cause an intrarenal acute kidney injury (AKI)? (Select all that apply)
Pyelonephritis
Nephrotoxins
Bladder tumor
Dehydration
Ureteral obstruction
Correct Answer : A,B
Choice A reason: Pyelonephritis, a bacterial kidney infection, causes intrarenal AKI by directly damaging renal parenchyma through inflammation and tubular injury. The infection disrupts nephron function, reducing filtration and leading to acute kidney injury, making this a correct cause of intrarenal damage.
Choice B reason: Nephrotoxins, such as certain drugs or chemicals, cause intrarenal AKI by directly injuring tubular epithelial cells. This disrupts renal filtration and reabsorption, leading to acute kidney injury through toxic cellular damage, making this a correct cause of intrarenal AKI.
Choice C reason: A bladder tumor causes postrenal AKI by obstructing urine outflow, leading to backpressure on the kidneys. It does not directly damage renal parenchyma, as intrarenal AKI requires, making this choice incorrect for intrarenal causes of kidney injury.
Choice D reason: Dehydration causes prerenal AKI by reducing blood volume and renal perfusion, not directly damaging the renal parenchyma. Intrarenal AKI involves intrinsic kidney damage, so dehydration’s hypoperfusion effect makes this choice incorrect for intrarenal AKI.
Choice E reason: Ureteral obstruction causes postrenal AKI by blocking urine flow, increasing pressure on the kidneys. It does not involve direct parenchymal damage, as required for intrarenal AKI, making this choice incorrect for the specified type of kidney injury.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B"]
Explanation
Choice A reason: Diabetes insipidus causes excessive water loss via dilute urine, leading to dehydration and decreased blood volume, resulting in hypotension. Reduced vascular pressure is a direct consequence, making this a correct manifestation.
Choice B reason: Increased thirst (polydipsia) occurs in diabetes insipidus as the body compensates for massive water loss through dilute urine, triggered by low antidiuretic hormone or kidney response, making this a correct manifestation.
Choice C reason: Decreased heart rate is not typical; diabetes insipidus causes tachycardia due to dehydration and low blood volume, as the heart compensates for hypotension. Bradycardia does not fit, making this incorrect.
Choice D reason: Decreased urine output is incorrect; diabetes insipidus causes polyuria due to inability to concentrate urine, resulting from deficient antidiuretic hormone or renal response, making this choice incorrect.
Choice E reason: Increased glucose level is unrelated to diabetes insipidus, which affects water balance, not glucose metabolism. Hyperglycemia occurs in diabetes mellitus, not insipidus, making this choice incorrect.
Correct Answer is A
Explanation
Choice A reason: Prolonged nasogastric suctioning removes gastric acid (HCl), reducing hydrogen ions in the blood, leading to metabolic alkalosis. This is reflected by elevated pH (7.50) and increased HCO3 (28 mEq/L), with normal PaCO2 as the lungs have not yet compensated. This matches the expected acid-base imbalance, making it correct.
Choice B reason: This result shows a slightly acidic pH (7.34) with normal PaCO2 and low HCO3, suggesting metabolic acidosis. Nasogastric suctioning causes loss of acid, not base, so it does not lead to acidosis. This imbalance is inconsistent with the alkalosis expected from gastric acid loss, making it incorrect.
Choice C reason: This result indicates a low pH (7.32) and elevated PaCO2, suggesting respiratory acidosis with partial compensation (normal HCO3). Nasogastric suctioning affects gastric acid, causing metabolic, not respiratory, alkalosis. The respiratory parameters here do not align with the condition’s pathophysiology, making this choice incorrect.
Choice D reason: This result shows an elevated pH (7.46) and low PaCO2, indicating respiratory alkalosis, likely from hyperventilation, with normal HCO3. Nasogastric suctioning causes metabolic alkalosis due to acid loss, not respiratory changes. The low PaCO2 does not fit the expected metabolic profile, making this choice incorrect.
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