Nokea
One of the primary functions of the kidney is to filter blood in order to remove substances that have no useful function in the body. Which of the following is the correct path of blood from the abdominal aorta to the inferior vena cava (IVC)?
- A. abdominal aorta – renal arteries – segmental arteries – interlobar arteries – arcuate arteries – interlobular arteries – efferent arteries – glomerulus – afferent arteries – peritubular capillaries – interlobular veins – arcuate veins – interlobar veins – renal veins – inferior vena cava
- B. abdominal aorta – renal arteries – interlobar arteries – segmental arteries – arcuate arteries – interlobular arteries – afferent arteries – glomerulus – efferent arteries – peritubular capillaries – interlobular veins – arcuate veins – interlobar veins – renal veins – inferior vena cava
- C. abdominal aorta – renal arteries – segmental arteries – interlobar arteries – arcuate arteries – interlobular arteries – afferent arteries – glomerulus – efferent arteries – peritubular capillaries – interlobular veins – arcuate veins – interlobar veins – renal veins – inferior vena cava
- D. abdominal aorta – renal arteries – interlobar arteries – interlobular arteries – segmental arteries – arcuate arteries – afferent arteries – glomerulus – efferent arteries – peritubular capillaries – interlobular veins – arcuate veins – interlobar veins – renal veins – inferior vena cava
Correct Answer: C
Rationale: The correct path of blood flow in the kidney is from the abdominal aorta to the renal arteries, then to the segmental arteries, followed by interlobar arteries, arcuate arteries, interlobular arteries, afferent arteries, glomerulus, efferent arteries, peritubular capillaries, interlobular veins, arcuate veins, interlobar veins, renal veins, and finally to the inferior vena cava. Choice C accurately follows this sequential flow of blood, making it the correct answer.
Explanation for why other choices are incorrect:
- Choice A has the incorrect sequence of interlobar and interlobular arteries, which disrupts the correct flow.
- Choice B also has an incorrect sequence of interlobar and interlobular arteries, leading to an inaccurate path.
- Choice D has the interlobar and interlobular arteries in the wrong order, deviating from the correct blood flow pathway.
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What manifestation in the patient will indicate the need for restriction of dietary protein in management of acute poststreptococcal glomerulonephritis (APSGN)?
- A. Hematuria
- B. Proteinuria
- C. Hypertension
- D. Elevated blood urea nitrogen (BUN)
Correct Answer: B
Rationale: The correct answer is B: Proteinuria. In APSGN, glomerular inflammation leads to impaired filtration, causing loss of protein in urine. Restricting dietary protein helps reduce proteinuria and slows kidney damage. Hematuria (A) is common but not a direct indication for dietary protein restriction. Hypertension (C) may require dietary sodium restriction. Elevated BUN (D) indicates impaired kidney function, but not a direct indication for protein restriction. In summary, in APSGN, proteinuria is the key manifestation necessitating dietary protein restriction to manage kidney damage.
Clients who have had a ureterolithotomy should be taught to expect
- A. a great deal of postoperative pain
- B. postoperative depression
- C. enforced bed rest for a week postoperatively
- D. large amounts of drainage from the tissue drain
Correct Answer: D
Rationale: The correct answer is D because after a ureterolithotomy, there may be drainage from the tissue drain, which is a normal occurrence. This drainage helps to prevent complications such as infection and promotes healing. The drainage should decrease over time as the body heals. Choices A, B, and C are incorrect as they do not align with the typical expectations following a ureterolithotomy procedure. Postoperative pain should be managed with medication, postoperative depression may occur but is not a universal expectation, and enforced bed rest for a week is not typically necessary.
Thirty percent of patients with kidney cancer have metastasis at the time of diagnosis. Why does this occur?
- A. The only treatment modalities for the disease are palliative.
- B. Diagnostic tests are not available to detect tumors before they metastasize.
- C. Classic symptoms of hematuria and palpable mass do not occur until the disease is advanced.
- D. Early metastasis to the brain impairs the patient’s ability to recognize the seriousness of symptoms.
Correct Answer: D
Rationale: The correct answer is D because early metastasis to the brain can impair the patient's ability to recognize the seriousness of symptoms. This can delay diagnosis and treatment, leading to a higher percentage of patients having metastasis at the time of diagnosis.
A is incorrect because there are treatment modalities for kidney cancer beyond palliative care. B is incorrect as diagnostic tests like imaging studies can detect tumors before they metastasize. C is incorrect because while classic symptoms may not always be present, other symptoms and diagnostic tests can still lead to an earlier diagnosis.
Which of the following diuretics needs close monitoring with use of * potassium sparing diuretics such as spironolactone?
- A. Furosemide
- B. Captopril
- C. Verapamil
- D. Hydrochlorothiazid
Correct Answer: A
Rationale: The correct answer is A: Furosemide. Furosemide is a loop diuretic that can cause potassium depletion, which can be exacerbated when used with potassium-sparing diuretics like spironolactone. This combination can lead to hyperkalemia, necessitating close monitoring of potassium levels.
B: Captopril is an ACE inhibitor, not a diuretic.
C: Verapamil is a calcium channel blocker, not a diuretic.
D: Hydrochlorothiazide is a thiazide diuretic that can also cause potassium depletion, but it does not specifically need close monitoring when used with potassium-sparing diuretics.
What is the most appropriate intervention for Susan who is eating less protein than prescribed?
- A. Praise her for cutting back even further than instructed on protein
- B. Suggest that if she eats less protein she should increase carbohydrates
- C. Recommend eating the amount of protein prescribed
- D. Refer her to the dietician
Correct Answer: C
Rationale: The correct answer is C: Recommend eating the amount of protein prescribed. This is the most appropriate intervention because it aligns with the prescribed dietary requirements for Susan's health. By following the prescribed protein intake, Susan can ensure she is meeting her nutritional needs and promoting optimal health.
Explanation:
1. A (Praise her for cutting back even further than instructed on protein): This choice is incorrect as it encourages behavior that goes against the prescribed dietary recommendation, which could negatively impact Susan's health.
2. B (Suggest that if she eats less protein she should increase carbohydrates): This choice is incorrect as it does not address the issue of inadequate protein intake and may lead to an imbalance in her macronutrient intake.
3. D (Refer her to the dietician): While referring her to a dietician may be beneficial for further guidance, it does not directly address the immediate issue of Susan not consuming the prescribed amount of protein.