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development of edema? ANS An 81-year-old man with right-sided heart failure and hypothyroidism
er first expect blood to be largely free of plasma proteins? ANS Bowman Space
because he has been awakening three to four times nightly to void and often has a sudden need to void with little warning during the day. What is the man's most likely diagnosis and possible underlying pathophysiologic problem? ANS Overactive bladder that may result from both neurogenic and myogenic sources
risk of developing the prerenal form of acute renal failure? ANS A 22-year-old male who has lost a large amount of blood following a workplace injury
disease is experiencing impaired gas exchange and CO2 retention, despite a rapid respiratory rate. Which of the following phenomena would her care team most realistically anticipate? ANS Her kidneys will adapt with an increase in plasma HCO3- and her pH will
decrease.
hepatic encephalopathy secondary to alcohol abuse. The patient's family is questioning the care team about why his abdomen is so large even though he is undernourished and emaciated. Which of the following statements most accurately underlies the explanation that a member of the care team would provide to the family? ANS The normally small transcellular fluid compartment, or third space, is becoming enlarged.
dicative of acute renal failure? ANS Increased nitrogenous waste levels, decreased glomerular filtration rate (GFR)
prior is distressed that she has had several recent episodes of urinary incontinence. She has asked her nurse practitioner why this is the case. Which of the following statements best captures the facts that would underlie the nurse's response to the patient? ANS She may be unable to sense her bladder filling as a result of her MS.
know how this could happen to me, since I'm so careful about eating a healthy diet." What is the most appropriate response to the man's state- ment? ANS What you eat can influence your risk of stone formation, but many other factors like hormones and your metabolism are involved.
gency department with suspected ketoacidosis. Which of the following di- agnostic results would be most likely to confirm this diagnosis? ANS Increased CO2, increased anion gap, base deficit
thick ascending limb of the loop of Henle? ANS Bumetanide (Bumex)
of repeated urinary tract infections and restlessness is suspected of having urinary retention. Which of the following actions by the care team is most appropriate? ANS Ultrasound bladder scanning to determine the residual volume of urine after voiding
gency department by ambulance. The EMTs report that the boy has denied consuming anything out of the ordinary, but an open antifreeze container was found in the boy's room. Which of the following is likely to be used to treat the patient's symptoms? ANS Fomepizole
likely to be experiencing health problems that may be attributable to kidney disease? ANS An 81-year-old female patient with osteoporosis and anemia
begun retaining urine. Which of the following physiological phenomena would her care providers most realistically expect to be currently occurring as a result of her urinary retention? ANS Hypertrophy of the bladder muscle and increased bladder wall thickness
has been brought to the emergency department by his mother because she noticed blood in the toilet after he last voided. Urinalysis confirms heavy microscopic hematuria as well as proteinuria. What will the care team's initial differential diagnosis most likely be? ANS Alport syndrome
admitted to the intensive care unit of a hospital. Arterial blood gas sampling indicates that the man has an acid-base imbalance. Which of the following
retention? ANS The anticholinergic effects of the medication are impairing normal bladder function.
turned to the desired pH. Which of the following processes could have contributed to the resolution of the patient's health problem? ANS Phosphate and ammonia buffer systems in the renal tubules
kidney disease and will shortly be moving into an assisted living facility from her own apartment. Which of the following findings should staff at the facility be instructed to observe for? ANS Muscular spasms and complaints of cramps
in a panic. Except for a bout with bronchitis a week earlier, he has been healthy his entire life; today he has blood in his urine. What is the most likely cause of his hematuria and how should it be treated? ANS His immunoglobulin A (IgA) nephropathy has no known effective treatments.
urinary tract infection (UTI)? ANS A 30-year-old obese woman with poorly controlled diabetes mellitus
UTIs, and hematuria has been diagnosed with autosomal dominant poly- cystic kidney disease (ADPKD). Which of the following phenomena has most likely contributed to the development of her health problem?
ANS She has inherited a tendency for epithelial cell in her tubules to proliferate inappropriately.
Which of the following teaching points should the nurse include as part of a review of normal glomerular function? ANS "Glomerular filtrate is very similar in composition to blood plasma found elsewhere in circulation."