A nurse is reviewing the BUN and creatinine levels of an older adult patient with chronic kidney disease. The nurse should anticipate which of the following findings?
BUN 8 mg/dL and creatinine 0.7 mg/dL
BUN 45 mg/dL and creatinine 8 mg/dL
BUN 23 mg/dL and creatinine 1.0 mg/dL
BUN 10 mg/dL and creatinine 0.3 mg/dL
The Correct Answer is B
Choice A reason:
A BUN level of 8 mg/dL and a creatinine level of 0.7 mg/dL are within normal ranges for a healthy individual without kidney disease. In chronic kidney disease (CKD), we would expect these values to be elevated due to the kidneys' reduced ability to filter waste products from the blood.
Choice B reason:
A BUN level of 45 mg/dL and a creatinine level of 8 mg/dL are significantly higher than the normal range, which is consistent with impaired kidney function seen in CKD. These elevated levels indicate that the kidneys are not effectively filtering urea and creatinine from the blood, leading to their accumulation.
Choice C reason:
A BUN level of 23 mg/dL and a creatinine level of 1.0 mg/dL could be seen in the early stages of CKD. While the creatinine level is within the normal range, the BUN level is slightly elevated, which may suggest a decline in kidney function.
Choice D reason:
A BUN level of 10 mg/dL and a creatinine level of 0.3 mg/dL are both below the normal range. This is an unlikely finding for a patient with CKD, as kidney impairment typically leads to increased levels of these substances in the blood.
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Correct Answer is C
Explanation
Choice A reason:
Hay fever allergy, also known as allergic rhinitis, is primarily associated with the action of Immunoglobulin E (IgE) antibodies and not directly with T-cells. T-cells can contribute to the regulation of the immune response in allergies, but IgE is the main immunoglobulin involved in the typical symptoms of hay fever.
Choice B reason:
Anaphylaxis is a severe, potentially life-threatening allergic reaction that involves the release of large amounts of histamine and other chemicals from mast cells and basophils, often triggered by IgE antibodies. While T-cells can play a role in the sensitization phase of allergy, anaphylaxis itself is not directly caused by T-cells.
Choice C reason:
Transplant rejection is a process in which T-cells play a central role. When a transplant recipient's immune system recognizes the donated organ as foreign, T-cells can mediate the rejection by attacking the transplanted tissue, leading to its failure.
Choice D reason:
Bacterial phagocytosis is primarily the function of phagocytes like neutrophils and macrophages. T-cells are involved in the adaptive immune response and can activate phagocytes, but they do not directly perform phagocytosis.
Correct Answer is A
Explanation
Choice A reason:
Difficulty with abduction of the arm at the shoulder is a common finding in clients with a rotator cuff injury. The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint and facilitate its movement. When these muscles or tendons are injured, movements such as lifting the arm away from the body (abduction) can become painful and difficult.
Choice B reason:
Alteration in the contour of the joint is not typically associated with a rotator cuff injury. This finding is more indicative of conditions that cause changes in the bone structure, such as arthritis or dislocation.
Choice C reason:
A positive Tinel's sign is used to diagnose nerve compression or nerve damage, particularly in conditions like carpal tunnel syndrome. It is not a test used to assess rotator cuff injuries.
Choice D reason:
A negative drop arm test would suggest that the client does not have a rotator cuff injury. The drop arm test is performed by having the client lift the arm to 90 degrees and then slowly lower it. If the client can control the motion and lower the arm smoothly, the test is negative. A positive drop arm test, where the client cannot control the descent of the arm, would indicate a rotator cuff injury.