Which of the following eGFR values reflects Stage 2 chronic kidney disease (CKD)?
30-59 mL/min
15-29 mL/min
60-89 mL/min
≥90 mL/min
The Correct Answer is C
A. An estimated glomerular filtration rate (eGFR) between 30 and 59 mL/min signifies Stage 3 chronic kidney disease, indicating a moderate reduction in renal function. At this level, patients often begin to manifest complications such as secondary hyperparathyroidism, anemia, and early bone disease. It represents a more advanced decline than Stage 2.
B. The eGFR range of 15 to 29 mL/min is classified as Stage 4 chronic kidney disease, which is a severe reduction in kidney function. Patients at this stage are typically being prepared for renal replacement therapy, such as dialysis or transplantation. This reflects significant nephron loss and a high risk for systemic metabolic acidosis.
C. Stage 2 chronic kidney disease is defined by an eGFR of 60 to 89 mL/min, representing a mild reduction in renal filtration. To meet the diagnostic criteria for CKD at this stage, there must also be evidence of structural kidney damage, such as persistent albuminuria. It indicates the early stages of progressive renal impairment.
D. An eGFR ≥90 mL/min is considered Stage 1 chronic kidney disease if there is concurrent evidence of kidney damage, such as proteinuria or structural abnormalities. This value represents normal or high filtration capacity. In the absence of other markers of damage, this range is simply considered normal physiological renal function for most adults.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Identifying red blood cells in the urine, or hematuria, can occur with a UTI but is non-specific and can be caused by stones, trauma, or malignancy. While it provides additional clinical context, the presence of RBCs alone is not a primary diagnostic criterion for an uncomplicated infection. The focus of the diagnosis remains on markers of bacterial presence and the host's inflammatory response.
B. A urine culture is the gold standard for identifying bacteria, but it is generally not recommended for the initial diagnosis of an uncomplicated UTI in healthy women. Cultures take 24 to 48 hours to yield results, whereas treatment is usually initiated based on rapid screening and clinical symptoms. Cultures are reserved for complicated cases, pregnancy, or when initial treatment has failed.
C. A urine dipstick is the primary recommended tool for diagnosing uncomplicated UTIs because it provides immediate results for leukocyte esterase and nitrites. Leukocyte esterase indicates the presence of white blood cells (pyuria), while nitrites indicate the presence of gram-negative bacteria like E. coli that reduce nitrates. This rapid test allows for the prompt initiation of targeted antibiotic therapy
D. A renal ultrasound is an imaging study used to visualize the structure of the kidneys and is not indicated for the diagnosis of an uncomplicated UTI. It is used primarily to rule out complications like hydronephrosis, abscesses, or structural abnormalities in patients with recurrent or severe infections. For a standard, simple bladder infection, imaging provides no useful diagnostic information and increases healthcare costs.
Correct Answer is C
Explanation
A. Folate deficiency results in megaloblastic anemia due to impaired DNA synthesis, which leads to a significant decrease in the production of mature erythrocytes. The complete blood count will demonstrate a reduction in both hemoglobin and hematocrit. These patients typically show macrocytic red blood cell indices on the laboratory report.
B. Pernicious anemia is a specific type of B-12 deficiency caused by a lack of intrinsic factor, preventing the effective production of red blood cells. As erythropoiesis fails, the total volume of red cells and the concentration of hemoglobin drop below the established reference range. This results in the classic clinical findings of anemia on a CBC.
C. All choices are correct because folate deficiency, pernicious anemia, and iron deficiency all share the common physiological endpoint of reduced red cell mass. While the underlying mechanisms differ—ranging from DNA synthesis failure to impaired heme production—the laboratory manifestation is consistently a low hemoglobin and hematocrit. These parameters are the standard metrics for identifying anemia.
D. Iron deficiency anemia occurs when depleted iron stores prevent the synthesis of the heme portion of the hemoglobin molecule. This leads to a quantitative decrease in the total amount of hemoglobin and a corresponding drop in the hematocrit percentage. It is the most common cause of microcytic anemia found on a standard CBC.
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