NORCET -4 , 2023
Medical & Surgical Nursing
Medium
The clinical finding polyuria would not be seen in?
Appeared in: NORCET -4 , 2023
Explanation
- Glomerulonephritis is an inflammatory condition affecting the glomeruli, the primary filtering units of the kidneys.
- This inflammation leads to a decrease in the glomerular filtration rate (GFR), which is the rate at which blood is filtered.
- A reduced GFR results in the kidneys producing less urine, a condition called oliguria (urine output less than 400 mL/day).
- Therefore, polyuria (excessive urine output) is not a characteristic finding of glomerulonephritis; the opposite is true.
Why Other Options Were Wrong
- Option A: Diabetes insipidus is a hallmark cause of polyuria. It is caused by a deficiency of antidiuretic hormone (ADH) or renal resistance to it, leading to the excretion of large volumes of dilute urine.
- Option B: Diabetes mellitus is a common cause of polyuria. High blood glucose levels lead to glucose spilling into the urine, causing an osmotic diuresis where water follows the glucose, increasing urine volume.
- Option D: While not as common as in diabetes, polyuria can occur in pyelonephritis, particularly in the chronic form. Damage to the renal tubules from recurrent infection can impair the kidney's ability to concentrate urine.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Pathophysiology of abnormal urine output in renal and endocrine disorders helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Monitoring urine output is a fundamental nursing assessment that provides critical information about a patient's fluid status and renal function.
- A sudden decrease in urine output (oliguria) is an early warning sign of acute kidney injury (AKI) and must be reported promptly.
- What if? If a patient with known diabetes mellitus suddenly develops oliguria instead of their usual polyuria, the nurse should suspect a new, superimposed problem like acute kidney injury or severe dehydration, requiring urgent assessment.
How to Approach the Question
- First, identify the keyword in the question: 'polyuria', which means excessive urination.
- Next, notice the negative framing: 'would NOT be seen in'. This means you are looking for the condition that does not cause polyuria.
- Recall the classic symptoms of each option. Diabetes mellitus and diabetes insipidus are famously associated with polyuria.
- Consider the pathophysiology. Glomerulonephritis involves inflammation and damage to the kidney's filters, which reduces their function and leads to decreased urine output (oliguria).
- Pyelonephritis is a kidney infection; chronic forms can damage tubules and impair urine concentration, potentially causing polyuria. Therefore, it's not the best answer for a condition where polyuria is absent.
- Select the option that is characterized by the opposite of polyuria, which is glomerulonephritis.
Concept Tested & Keywords
- Concept Tested: Pathophysiology of abnormal urine output in renal and endocrine disorders.
- Stem keywords: polyuria, clinical finding
- Lead-in keywords: not
- Negative lead-in flag: The question asks to identify the condition where polyuria is NOT a feature.
Question ID
QU5wP-uu1OcJrmkcAztR50
Reference Book
E6 Physiology Guyton 4SAE Part 2B p. 89-91
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 p. 11-13
Practise the full NORCET -4 , 2023
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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