Patho Ch. 28 - Acute Kidney Injury and Chronic Kidney Disease

The oliguric phase of acute tubular necrosis is characterized by a. fluid excess and electrolyte imbalance. b. fever and diminishing cognition. c. sodium retention and potassium loss in the urine. d. magnesium and phosphorous loss in the urine.

a. fluid excess and electrolyte imbalance.

The most helpful laboratory value in monitoring the progression of declining renal function is a. serum creatinine. b. serum potassium. c. blood urea nitrogen. d. mental status changes.

a. serum creatinine.

The most common agent resulting in nephrotoxicity and subsequent acute tubular necrosis (ATN) in hospitalized patients is a. contrast media. b. antibiotics. c. cancer chemotherapy. d. recreational drugs.

a. contrast media.

Postrenal acute kidney injury may be caused by a. severe hypotension. b. glomerulonephritis. c. bilateral kidney stones. d. acute tubular necrosis.

c. bilateral kidney stones.

A patient with renal disease is at risk for developing uremia as the nephrons progressively deteriorate, because a. the basement membrane becomes increasingly permeable. b. filtration exceeds secretory and reabsorptive capacity. c. excessive solute and water are lost in the urine. d. GFR declines.

d. GFR declines.

One of the most frequent causes of chronic kidney disease is a. hypertension. b. glomerulonephritis. c. chronic pyelonephritis. d. polycystic kidney disease.

a. hypertension.

Osteoporosis commonly occurs in patients with end-stage renal disease because of a. hyperparathyroidism. b. hypercalcemia. c. excess active vitamin D. d. phosphorous deficiency.

a. hyperparathyroidism.

The risk for contrast media-induced acute tubular necrosis (ATN) is highest in a. a 70-year-old patient with heart failure. b. a 50-year-old patient post gallbladder surgery. c. a 12-year-old patient with recurrent bladder infections. d. a 30-year-old patient with appendicitis.

a. a 70-year-old patient with heart failure.

Signs of late chronic renal failure include (Select all that apply.) a. high-serum potassium levels. b. high-serum calcium. c. high-serum phosphorous. d. high-blood urea nitrogen. e. anemia.

a. high-serum potassium levels. c. high-serum phosphorous. d. high-blood urea nitrogen. e. anemia.

At his most recent clinic visit, a patient with end-stage renal disease is noted to have edema, congestive signs in the pulmonary system, and a pericardial friction rub. Appropriate therapy at this time would include a. initiation of dialysis. b. fluid restriction. c. antibiotics. d. phlebotomy.

a. initiation of dialysis.

The most likely cause of anemia in a patient with end-stage renal disease is a. insufficient erythropoietin. b. blood loss secondary to hematuria. c. vitamin B12 deficiency secondary to deficient intrinsic factor. d. iron deficiency.

a. insufficient erythropoietin.

One of the most common causes of acute tubular necrosis (ATN) is a. ischemic conditions. b. cytotoxic agents. c. immune reaction. d. prolonged postrenal kidney injury.

a. ischemic conditions.

Prerenal acute kidney injury may be caused by a. severe hypotension. b. glomerulonephritis. c. bilateral kidney stones. d. acute tubular necrosis.

a. severe hypotension.

A patient injured severely in a motor vehicle accident is hospitalized with acute kidney injury as well as multiple broken bones and lacerations. When family members ask what is meant by the term 'prerenal,' the nurse responds a. "The doctors are not sure what caused your husband's acute kidney injury, but they are working to help him recover." b. "Your husband's kidney injury did not start in the kidney itself, but rather in the blood flow to the kidney." c. "Your husband's kidney injury is only the beginning of the problems that are expected, so they are being vigilant." d. "Acute kidney injury is a new term for what people used to call acute renal failure."

b. "Your husband's kidney injury did not start in the kidney itself, but rather in the blood flow to the kidney."

Gastrointestinal drainage, perioperative and postoperative hypotension, and hemorrhage may all contribute to renal failure by causing a. hydronephrosis. b. acute tubular necrosis. c. nephrosis. d. renal inflammation.

b. acute tubular necrosis.

Acute tubular necrosis can occur from (Select all that apply.) a. increased ammonia levels from liver failure. b. contrast dyes used for radiologic studies. c. ischemia because of hypovolemia. d. antibiotics that are nephrotoxic.

b. contrast dyes used for radiologic studies. c. ischemia because of hypovolemia. d. antibiotics that are nephrotoxic.

The defining characteristic of severe acute kidney injury is a. proteinuria. b. oliguria. c. hematuria. d. diuresis.

b. oliguria.

The most common cause of intrinsic kidney injury is _____ injury. a. glomerular b. tubular c. interstitial d. vascular

b. tubular

A patient being treated for acute tubular necrosis (ATN) develops mild polyuria. The nurse responds to questions about why this occurring by stating a. "Since he was oliguric for so long, he probably has rebound polyuria. As long as his blood pressure is stable, he is not hypovolemic, so I would not worry." b. "I am glad you noticed this change. It happened so gradually that we did not see it. We should call the doctor and get him to measure ADH." c. "His renal tubules are recovering, so he is making more urine, but he is not able to concentrate urine well, because he is not fully recovered." d. "We had better measure his blood sugar. He may have developed diabetes, and what you see is osmotic diuresis from glucose in the urine."

c. "His renal tubules are recovering, so he is making more urine, but he is not able to concentrate urine well, because he is not fully recovered."

What problem is a patient likely to experience in end-stage renal disease? a. Hypokalemia b. Polyuria and nocturia c. Uremia d. Hematuria

c. Uremia

Anemia in people who have end-stage chronic renal disease is caused by a. chronic loss of blood in the urine. b. poor appetite, with lack of iron intake. c. decreased secretion of erythropoietin. d. increased secretion of aldosterone.

c. decreased secretion of erythropoietin.

The condition associated with end-stage chronic renal disease that is the most immediately life threatening is a. azotemia. b. increased creatinine. c. hypertension. d. hyperkalemia.

d. hyperkalemia.

A primary laboratory finding in end-stage chronic renal disease is a. decreased blood urea nitrogen (BUN). b. decreased serum sodium. c. metabolic alkalosis. d. increased serum creatinine.

d. increased serum creatinine.

The most common cause of ischemic acute tubular necrosis (ATN) in the United States is a. hypotension. b. hypovolemia. c. renal artery stenosis. d. sepsis.

d. sepsis.

Individuals with end-stage chronic renal disease are at risk for renal osteodystrophy and spontaneous bone fractures, because a. excess potassium leaches calcium from bone. b. erythropoietin secretion is impaired. c. urea causes demineralization of bone. d. they are deficient in active vitamin D.

d. they are deficient in active vitamin D.