Which of the following symptoms are seen in Stage 1 chronic kidney disease?
Mild hypertension
Usually no symptoms are seen at this stage
Hyperphosphatemia
Anemia
The Correct Answer is B
A. Mild hypertension can be a cause or a consequence of renal disease, but it is not a specific symptomatic marker for Stage 1. At this early stage, the compensatory mechanisms of the remaining functional nephrons usually prevent overt clinical manifestations of elevated blood pressure. Most patients with a glomerular filtration rate above 90 remain asymptomatic regarding vascular changes.
B. Usually no symptoms are seen at this stage because the kidneys possess a significant functional reserve that masks early damage. Stage 1 is defined by a normal or high glomerular filtration rate (≥ 90 mL/min) with evidence of kidney damage, such as albuminuria. Most individuals are unaware of the condition until it is incidentally discovered during routine laboratory screenings.
C. Hyperphosphatemia typically does not manifest until the later stages of chronic kidney disease, usually Stage 4 or 5. In Stage 1, the kidneys are still sufficiently capable of excreting excess phosphate and maintaining mineral balance through hormonal regulation. Electrolyte imbalances signify a much more advanced degree of nephron loss and a severe decline in filtering capacity.
D. Anemia in chronic kidney disease is primarily caused by a deficiency in erythropoietin production, which generally occurs as the disease progresses to Stage 3. In the initial stage, the peritubular cells are usually still functional enough to stimulate adequate red blood cell production. Clinical anemia is therefore not an expected finding during the very early onset of renal impairment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is C
Explanation
A. Correcting fluid and electrolyte disturbances is vital in AKI management to prevent life-threatening complications like hyperkalemia or pulmonary edema. Because the kidneys cannot effectively regulate potassium or sodium, aggressive monitoring and pharmacological intervention are required. Restoring fluid homeostasis supports the metabolic environment necessary for the survival and regeneration of injured tubular cells.
B. Preventing and treating infections is a critical component of care because sepsis is a leading cause of mortality in patients with acute kidney injury. AKI often induces a state of immune dysfunction, increasing the patient's susceptibility to opportunistic pathogens. Prompt antimicrobial therapy and strict aseptic techniques are essential to prevent further systemic decline during the recovery phase.
C. All the choices are correct because the management of AKI is multifaceted and aims to stabilize the internal milieu while the kidneys recover. This includes the simultaneous control of fluid volume, electrolyte balance, blood pressure, and the prevention of secondary infections. Comprehensive supportive care is the only way to minimize multi-organ failure during the acute phase.
D. Managing blood pressure is essential to ensure adequate renal perfusion without causing further barotrauma to the glomerular capillaries. Maintaining a mean arterial pressure high enough to overcome intrarenal resistance facilitates the recovery of the glomerular filtration rate. Both hypotension and extreme hypertension must be avoided to prevent the transition from AKI to chronic disease.
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