An older client with long-term type 2 DM is seen in the clinic for routine health assessment. Which assessment would the nurse complete to determine if a patient with type 2 DM is experiencing long-term complications? (SATA)

Correct Answer: A

Rationale: To assess long-term complications of type 2 diabetes mellitus (DM), the nurse should evaluate visual acuity (A), sensation in the feet and legs (B), and serum creatinine and BUN (C). DM can cause retinopathy (affecting vision), peripheral neuropathy (numbness or tingling in extremities), and nephropathy (kidney damage reflected in elevated creatinine/BUN). These are classic microvascular complications monitored over time. Respiratory infection signs (D) are unrelated to DM's chronic effects unless secondary to another condition, making A, B, and C the most relevant assessments.

Correct Answer: C

Rationale: Net Filtration Pressure (NFP) is calculated using the formula: NFP = Glomerular Hydrostatic Pressure (HPG) - (Oncotic Pressure of Glomerular Blood (OPG) + Capsular Hydrostatic Pressure (HPC)). Given HPG = 30 mmHg, OPG = 25 mmHg, and HPC = 15 mmHg, we compute: NFP = 30 - (25 + 15) = 30 - 40 = -10 mmHg. A negative NFP means filtration is not occurring, as opposing forces exceed the driving pressure, making C correct.

Correct Answer: B

Rationale: If GFR is too high (e.g., above 125 ml/min), excessive filtrate overwhelms tubular reabsorption capacity, leading to loss of water and electrolytes in urine, risking dehydration and depletion. Option A is incorrect as wastes are still excreted, C is false as flow increases, and D applies to low GFR, making B the correct physiological consequence.

Correct Answer: D

Rationale: The distal convoluted tubule (DCT) has the highest secretion rate for specific ions like H⁺ and K⁺, and some drugs, via active transport mechanisms. The proximal convoluted tubule (PCT) secretes organic ions (e.g., creatinine), but DCT's role in fine-tuning ion balance exceeds it. The thin limbs of the Loop of Henle focus on reabsorption, not secretion, making D correct.

Correct Answer: D

Rationale: Normal adult blood pH ranges from 7.35 to 7.45, maintained by buffers, respiration, and kidneys to ensure metabolic stability. Below 7.35 is acidosis, above 7.45 is alkalosis. Option A exceeds this, B includes acidic values, and C is nonsensical, making D the correct physiological range.