describes a normal physical assessment of the urinary system by the nurse?

Correct Answer: B

Rationale: The correct answer is B because palpating an empty bladder at the level of the symphysis pubis is a standard step in assessing the urinary system. This helps determine the size, shape, and tenderness of the bladder. Auscultating for fluid sounds in the lower abdominal quadrants (choice A) is incorrect as this is done to assess bowel sounds, not the urinary system. Percussing the kidney (choice C) is not a common practice as it may cause harm. Positioning the patient prone to palpate the kidneys (choice D) is incorrect as the kidneys are typically palpated with a posterior approach while the patient is in a supine or side-lying position.

Correct Answer: C

Rationale: Rationale for Choice C: 1. Glomerulonephritis is an immune-mediated condition where the accumulation of immune complexes in the glomeruli triggers inflammation and damages the kidney. 2. Immune complexes can form due to various reasons like infections or autoimmune disorders, leading to glomerular injury. 3. This immune complex deposition activates the complement system and attracts inflammatory cells, causing further damage to the glomeruli. Summary of Other Choices: A. Growth of microorganisms in the glomeruli is not a characteristic feature of glomerulonephritis, as it is primarily an immune-mediated condition. B. The release of bacterial substances toxic to the glomeruli is not the primary mechanism of injury in glomerulonephritis. D. Hemolysis of red blood cells circulating in the glomeruli is not a direct cause of glomerulonephritis; it is more characteristic of conditions like hemolytic uremic syndrome.

Correct Answer: D

Rationale: Rationale for correct answer (D): Chronic, recurrent nephrolithiasis is a risk factor for both kidney and bladder cancer. Kidney stones can cause chronic irritation and inflammation, leading to cell changes that increase cancer risk in the urinary system. Summary of incorrect choices: A: Smoking is a risk factor for bladder cancer, but not specifically for kidney cancer. B: Family history of cancer may increase overall cancer risk, but it is not specifically associated with kidney or bladder cancer. C: Chronic use of phenacetin is a risk factor for renal pelvis cancer, not necessarily kidney or bladder cancer.

Correct Answer: C

Rationale: Metabolic acidosis in AKI oliguric phase is due to impaired bicarbonate excretion. In AKI, damaged kidneys cannot adequately excrete acids, leading to acidosis. Option C is correct because impaired bicarbonate excretion results in decreased buffering capacity, leading to metabolic acidosis. Option A (ammonia synthesis) helps in renal acid excretion. Option B (sodium excretion) does not directly impact acid-base balance. Option D (potassium conservation) is unrelated to acidosis in AKI.

Correct Answer: B

Rationale: The correct answer is B: Rejection. Rejection is a critical complication post-transplantation where the recipient's immune system recognizes the transplanted organ as foreign and attacks it. Assessing for rejection is crucial to decrease the risk of mortality as it can lead to organ failure. In contrast, while infection (choice A), malignancy (choice C), and cardiovascular disease (choice D) are also potential complications post-transplantation, rejection poses the most immediate threat to the survival of the transplanted organ and patient. Regular monitoring, prompt identification, and intervention for rejection are essential in improving transplant outcomes.