The nurse has determined that a client with trigeminal neuralgia has the nursing problem, 'imbalanced nutrition, less than body requirements.' Which cause is most likely contributing to the problem?

Correct Answer: C

Rationale: Pain when eating is the most likely cause of 'imbalanced nutrition, less than body requirements' in trigeminal neuralgia. This condition causes severe, electric-shock-like facial pain, often triggered by chewing or facial movement, leading to avoidance of eating and subsequent weight loss or malnutrition. Altered taste, fatigue, and nausea may contribute to appetite issues, but the hallmark of trigeminal neuralgia is excruciating pain with oral activity, directly impacting nutritional intake and making it the primary cause.

Correct Answer: B

Rationale: The macula densa is a group of specialized cells located in the distal tubule, part of the juxtaglomerular apparatus (JGA), where the tubule contacts the afferent arteriole of the glomerulus. Its function is to act as chemoreceptors or osmoreceptors, sensing changes in sodium chloride concentration or osmolarity of the tubular fluid. These changes trigger signals that stimulate juxtaglomerular cells to secrete renin, regulating blood pressure and glomerular filtration rate (GFR). This specific location and role distinguish it from the other options, making B correct.

Correct Answer: B

Rationale: Denervation of the afferent supply to the urinary bladder, as in conditions like Tabes Dorsalis, interrupts sensory input from stretch receptors. This results in loss of bladder sensations (e.g., urge to void) and reflex micturition, though smooth muscle retains intrinsic tone (atonic bladder). Urine retention with overflow (dribbling) occurs, distinguishing it from hypertonic or spastic states seen with efferent damage, making B the correct characterization.

Correct Answer: A

Rationale: Glucose appears in urine before the overall Tmax (e.g., 375 mg/min) is reached because nephrons have varying Tmax values (splay). Some nephrons saturate earlier, spilling glucose while others still reabsorb, reflecting heterogeneity in reabsorption capacity. Complete reabsorption (B) occurs below Tmax, and tubular damage (D) isn't implied, making A correct.

Correct Answer: D

Rationale: In the ascending Loop of Henle, Na⁺ reabsorption varies: the thin ascending limb reabsorbs Na⁺ and Cl⁻ passively due to concentration gradients, while the thick ascending limb uses active transport via the Na⁺/K⁺/2Cl⁻ cotransporter, diluting the filtrate. This dual mechanism distinguishes it from all passive (A) or all active (B), making D correct.