Which of the following clinical findings among older adults is most likely to be viewed as a normal part of aging?
90 year old female whose blood urea nitrogen (BUN) is rising
81 year old male whose serum creatinine level has increased sharply since his last blood work
80 year old male whose dipstick urine reveals protein is present
78 year old female whose GFR has been steadily declining over several years
The Correct Answer is D
A. 90-year-old female whose blood urea nitrogen (BUN) is rising: An isolated rise in BUN can indicate dehydration, gastrointestinal bleeding, or renal impairment. While BUN may increase slightly with age, a significant rise should not be dismissed as normal aging and warrants further investigation.
B. 81-year-old male whose serum creatinine level has increased sharply since his last blood work: A sharp increase in creatinine is not typical with aging and may suggest acute kidney injury or worsening chronic kidney disease. In older adults, even small creatinine changes can be significant due to reduced muscle mass.
C. 80-year-old male whose dipstick urine reveals protein is present: Proteinuria is not a normal part of aging and may indicate underlying kidney damage, hypertension, or diabetes. Even trace amounts of protein in the urine of older adults should prompt further evaluation to rule out nephropathy.
D. 78-year-old female whose GFR has been steadily declining over several years: A gradual decline in glomerular filtration rate (GFR) is expected with aging due to nephron loss and reduced renal perfusion. This change is a normal physiologic part of aging, provided there are no abrupt drops or accompanying signs of renal disease.
Nursing Test Bank
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 C
Explanation
A. Tubular necrosis: Tubular necrosis refers to the death of tubular epithelial cells in the kidneys, commonly due to ischemia or toxins. This is not the primary defect in Potter syndrome, which involves developmental abnormalities rather than acute tubular injury.
B. Renal hyperplasia: Hyperplasia means increased cell number leading to organ enlargement. Potter syndrome typically involves renal hypoplasia or agenesis rather than hyperplasia, so this is not consistent with the syndrome’s defect.
C. Renal failure: Potter syndrome primarily results from bilateral renal agenesis or severe renal dysplasia, leading to absent or nonfunctional kidneys and subsequent renal failure. The lack of functional kidneys leads to oligohydramnios and the characteristic features of Potter syndrome.
D. Renal metaplasia: Metaplasia refers to abnormal transformation of one differentiated tissue type into another. This process is not the main defect in Potter syndrome, which is related to kidney development failure rather than abnormal tissue differentiation.
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