Renal and Kidneys Patho Week 5

Cryptorchidism is a. associated with an increased incidence of testicular cancer. b. an extremely uncommon disorder. c. rarely treated. d. a consequence of gonorrhea.

associated with an increased incidence of testicular cancer.

Uterine prolapse is caused by a relaxation of the a. cardinal ligaments. b. abdominal organs. c. cervix. d. vaginal musculature

cardinal ligaments

malpositioning of the urinary meatus (hypospadias) is ___ while phimosis is an acquired anomaly.

congenital anomaly

What reproductive tract disorder is most likely to be associated with urinary incontinence? a. Rectocele b. Menopause c. Cystocele d. Cervicitis

cystocele

Excessive vomiting in pregnant women is known as a. placenta previa. b. hyperemesis gravidarum. c. abruptio placentae. d. spontaneous abortion.

hyperemesis gravidarum.

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

hyperparathyroidism.

A person is unaware that his bladder is full of urine, but complains that he is leaking urine almost constantly. The most accurate term for this type of incontinence is a. overflow. b. stress. c. urge. d. mixed.

overflow

Urinary retention with consistent or intermittent dribbling of urine is called - mixed incontinence -enuresis -stress incontinence -overflow incontinence

overflow incontinence

The most common cause of ischemic acute tubular necrosis (ATN) in the United States is -hypotension -hypovolemia -renal artery stenosis -sepsis

sepsis

The normal post-void residual urine in the bladder is - less than 100mL - 150 to 200 mL - 250 to 300 mL - none of these; no normal residual volume is identified

less than 100 mL

The individual at highest risk of pyelonephritis who requires monitoring for signs of its occurrence is the - woman who is paraplegic. - woman who is pregnant. - man who has glomerulonephritis. - man who has chronic urinary tract infections.

man who has chronic urinary tract infections.

It is true that fibrocystic breast disease - commonly progresses to breast cancer - may be exacerbated by methylxanthines - is characterized by painless breast lumps - is a contraindication for progesterone birth control pills

may be exacerbated by methylxanthines

The pain that accompanies kidney disorders is called - nephritic. - nephralgia. - nephrotic. - nephronitis.

nephralgia

The disorder characterized by a neurologic lesion that affects bladder control is a. neurogenic bladder. b. detrusor inactivity. c. bladder prolapse. d. cystitis.

neurogenic bladder.

The urinalysis finding most indicative of cystitis includes the presence of - WBCs and RBCs - nitrites - casts - bacteria

nitrites

The defining characteristic of severe acute kidney injury is -proteinuria -oliguria -hematuria -diuresis

oliguria

The most common sign/symptom of renal calculi is - pain -vomiting -hematuria -oliguria

pain

The direct cause of stress incontinence is - the effect of aging - pelvic muscle weakness -neurologic conditions - detrusor muscle overactivity

pelvic muscle weakness

treatment of a uterine prolapse may involve the insertion of a(n) ________ to hold the uterus in place - catheter - IUD - pessary - endopelvic mesh implant

pessary

Erectile dysfunction is rarely because of a. drug side effects. b. psychological factors. c. primary causes. d. vascular diseases.

primary causes

A progressive decrease in the force of the urinary stream, dribbling of urine, and difficulty initiating urinary stream are characteristics of - prostatitis - urinary calculi - bladder carcinoma - prostatic enlargement

prostatic enlargement

A 52-year-old female had a surgical procedure in which the breast, lymphatics, and underlying muscle were removed. The procedure performed was a. radical mastectomy. b. modified radical mastectomy. c. mastectomy. d. lumpectomy.

radical mastectomy.

The main clinical manifestation of a kidney stone obstructing the ureter is - oliguria. - renal colic. - urge incontinence. - an abdominal mass.

renal colic.

Prerenal acute kidney injury may be caused by - severe hypotension - glomerulonephritis - bilateral kidney stones. - acute tubular necrosis.

severe hypotension

The greatest risk factor for bladder cancer is a. smoking. b. recurrent bladder infections. c. low fluid intake. d. family history of bladder cancer.

smoking

The pathology report for a patient with penile cancer has this statement: The tumor involves the shaft of the penis. The cancer is at what stage? - stage I - stage II - stage III - stage IV

stage II

Sudden, severe testicular pain is indicative of - prostatitis - testicular cancer - testicular torsion - epididymitis

testicular torsion

The HPV vaccine is recommended for 11- to 12 year-old girls, but can be administered to girls as young as _____ years of age. - 7 - 8 - 9 - 10

9

The condition characterized by oliguria and hematuria is -acute glomerulonephritis -polycystic kidney disease. -cystitis. -renal insufficiency

acute glomerulonephritis

Dysfunctional uterine bleeding (DUB) is caused by - endometrial inflammation - reproductive tract malignancies - endometrial fibroid tumors - absent or diminished levels of progesterone

absent or diminished levels of progesterone

Activation of parasympathetic nerves to the bladder will cause a. bladder contraction. b. bladder relaxation. c. sphincter contraction. d. urine reflux.

bladder contraction.

Detrusor muscle overactivity can be improved by administration of - alpha-receptor agonists - botulinum toxin - cholinergic agents - nonsteroidal antiinflammatory agents

botulinum toxin

A breast lump that is painless, hard, and unmoving is most likely - fibrocystic breast disease - fibroadenoma - papilloma - carcinoma

carcinoma

Hyperlipidemia occurs in nephrotic syndrome because -hepatocytes synthesize excessive lipids. -lipids are not excreted in the urine. -body fats are catabolized. -muscles stop burning triglycerides for energy.

hepatocytes synthesize excessive lipids.

Calcium oxylate stone formation is facilitated by - hypercalciuria. - hypoparathyroidism. - low urine pH. - protein intake.

hypercalciuria.

One of the most frequent causes of chronic kidney disease is - hypertension. - glomerulonephritis. - chronic pyelonephritis. - polycystic kidney disease.

hypertension

The most common types of uterine tumors are known as - ovarian cysts - endometriomas - hydatidiform moles - leiomyomas

leiomyomas

Nephrotic syndrome does not usually cause - hyperlipidemia. - proteinuria. - hematuria. - generalized edema.

hematuria

The most frequent initial symptom of bladder cancer is - bladder infection. - hematuria. - sudden incontinence. - dysuria.

hematuria

In addition to renal colic pain, signs or symptoms of ureteral stones may frequently include a. hematuria. b. postrenal renal failure. c. urinary urgency. d. proteinuria.

hematuria.

A patient being treated for acute tubular necrosis (ATN) develops mild polyuria. The nurse responds to questions about why this occurring by stating - "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." - "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." - "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." - "We had better measure his blood sugar. He may have developed diabetes, and what you see is osmotic diuresis from glucose in the urine."

"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."

A patient, age 3, has vesicoureteral reflux. "Why does that make him have so many bladder infections?" asks his mother. The nurse's best response is - "When he urinates, the urine makes a fluid trail to the bladder, and if he does not clean himself well, bacteria will enter and make a bladder infection." -"When he urinates, urine runs back toward his kidneys and then into the bladder again, making it easy for bacteria to grow if they reach the bladder." - "When he urinates, urine leaks into his bowel and bacteria from the bowel leak into the bladder, where they grow and make a bladder infection." -"When he urinates, urine stays in his bladder and the normal bacteria that live in the bladder have a chance to grow and cause a bladder infection."

"When he urinates, urine runs back toward his kidneys and then into the bladder again, making it easy for bacteria to grow if they reach the bladder."

A patient has cancer of the penis that involves only the shaft. When asked about prognosis, what statement by the nurse is best? a. "I am not able to provide that information based on this result." b. "With the cancer limited to the shaft, the 5-year survival rate is 65% to 90%." c. "This type of cancer is so rare, no one really knows about prognosis." d. "All cases of penile cancer have very poor outcomes."

"With the cancer limited to the shaft, the 5-year survival rate is 65% to 90%."

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 - "The doctors are not sure what caused your husband's acute kidney injury, but they are working to help him recover." - "Your husband's kidney injury did not start in the kidney itself, but rather in the blood flow to the kidney." - "Your husband's kidney injury is only the beginning of the problems that are expected, so they are being vigilant." - "Acute kidney injury is a new term for what people used to call acute renal failure."

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

A patient who reported a very painful sore throat 3 weeks ago is now diagnosed with acute post-streptococcal glomerulonephritis. When asked, "Why is my urine the color of coffee?", the nurse responds - "Your immune system was activated by your sore throat and has caused some damage in your kidneys that allows red blood cells to leak into the fluid that becomes urine and make it coffee-colored." -"Normally, red blood cells that enter the urine are taken back into the blood, but in glomerulonephritis, the kidney disease you have, they stay in the urine and make it coffee-colored." - "The bacteria that caused your sore throat have traveled to your kidneys and are causing a little damage there that allows some red blood cells to leak into your urine and make it orange-colored." -"When parts of your kidneys stopped working, your blood kept flowing and broke some of your little blood vessels, so red blood cells are flowing

"Your immune system was activated by your sore throat and has caused some damage in your kidneys that allows red blood cells to leak into the fluid that becomes urine and make it coffee-colored."

Which medications can be prescribed for the treatment of premature ejaculation? (Select all that apply.) a. Clomipramine b. Paroxetine c. Lidocaine/prilocaine cream d. Sildenafil e. Tadalafil

- Clomipramine - Paroxetine - Lidocaine/prilocaine cream

Which of the following are correctable causes of male infertility? (Select all that apply.) a. Cryptorchidism b. Varicocele c. Retractile testes d. Bilateral testicular atrophy e. Ductal obstruction

- Cryptorchidism - Varicocele - Retractile testes - Ductal obstruction

Which pharmacologic treatments may be seen in a patient with breast cancer? (Select all that apply.) a. Estrogen receptor modulators b. Estrogen antagonists c. Anti-inflammatory agents d. Estrogen/progesterone combination therapies e. Antineoplastic agents

- Estrogen receptor modulators - Estrogen antagonists - Antineoplastic agents

Which medication classes does the nurse educate men on for the treatment of erectile dysfunction (ED)? (Select all that apply.) a. Beta-blockers b. Monoamine oxidase inhibitors c. Anti-convulsants d. Phosphodiesterase inhibitors e. Papaverine phentolamine

- Phosphodiesterase inhibitors - Papaverine phentolamine

Characteristics of vesicoureteral reflux in children include which of the following? (Select all that apply.) a. Possibly being genetic in nature b. Often leading to recurrent urinary tract infections c. Possibly resulting in hypertension d. Usually requiring surgical intervention e. Most common cause of enuresis

- Possibly being genetic in nature - Often leading to recurrent urinary tract infections - Possibly resulting in hypertension

Which symptoms would be manifested in a woman diagnosed with pregnancy-induced hypertension (PIH)? (Select all that apply.) a. Excessive vomiting b. Proteinuria c. Peripheral edema d. Increased arterial pressure e. Hemorrhage

- Proteinuria - Peripheral edema - Increased arterial pressure

Which situations increase the risk of urge incontinence? (Select all that apply.) a. Aging b. Bladder infections c. Obesity d. Prostate enlargement e. Diuretics

- aging - bladder infections - prostate enlargement - diuretics

A sustained, painful erection is known as

- priapism

Renal insufficiency occurs when _____ of the nephrons are not functional. -25% -50% -75% to 90% -more than 90%

75% to 90%

Which intervention has been found to retard the advancement of chronic kidney disease? - Calcium supplementation - Erythropoietin - Insulin - ACE inhibitors

ACE inhibitors

A patient has ureteral colic. The manifestation that requires immediate notification of the physician is - severe flank pain - vomiting - pink-tinged urine - chills and fever

Chills and fever

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

Decreased secretion of erythropoietin

A patient presenting with a urethral stricture may experience which symptoms? (Select all that apply.) a. Decreased urinary stream b. Urethral discharge c. Infection d. Urine retention e. Inability to retract the glans of the penis

Decreased urinary stream Urethral discharge Infection Urine retention

The microorganism that causes the vast majority of urinary tract infections is - Klebsiella. - Escherichia coli. - herpes simplex virus. - Candida albicans.

Escherichia coli.

In patients with polycystic kidney disease, renal failure is expected to progress over time as the cystic process destroys more nephrons. At what point will a patient reach end-stage renal disease? -Greater than 15% -Greater than 25% nephron loss -Greater than 50% nephron loss -Greater than 90% nephron loss

Greater than 90% nephron loss

Cervical cancer can be detected in the early, curable stage by the ________ test. a. Papanicolaou b. human papillomavirus c. gonorrhoeae d. vaginal pH

Papanicolaou

Which group is at the highest risk for urinary tract infection? a. Infants and children b. Sexually active women c. Adult males d. Patients taking diuretics

Sexually active women

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

a 70-year-old patient with heart failure

A ureterocele is a. an abnormally placed ureter. b. an additional ureter. c. a cystic dilation of a ureter. d. fusion of both ureters at the bladder junction.

a cystic dilation of a ureter.

Abnormal uterine bleeding in perimenopausal women is caused by a. endometrial inflammation. b. reproductive tract malignancies. c. endometrial fibroid tumors. d. absent or diminished levels of progesterone.

absent or diminished levels of progesterone.

Dysfunctional uterine bleeding (DUB) is caused by - endometrial inflammation. - reproductive tract malignancies. - endometrial fibroid tumors. - absent or diminished levels of progesterone.

absent or diminished levels of progesterone.

Absence of menstruation is called - amenorrhea - metrorrhagia - menorrhagia - dysmenorrhea

amenorhhea

the pathophysiologic basis of acute glomerulonephritis is - renal ischemia. - bacterial invasion of the glomerulus. - an anaphylactic reaction. - an immune complex reaction.

an immune complex reaction.

The most common type of renal stone is - uric acid. - calcium. - struvite. - cysteine.

calcium

Infection by ________ accounts for nearly half of all reported cases of vulvovaginitis. - Chlamydia trachomatis - Candida albicans - Neisseria gonorrhoeae - Pseudomonas

candida albicans

A major modifiable risk factor for nephrolithiasis is - positive family history. - dehydration. - smoking. - drinking alcohol.

dehydration

A 32-year-old female complaining of severe pain with menstruation and inability to participate in her routine household activities is likely experiencing - dysmenorrhea - menorrhagia - amenorrhea - metrorrhagia

dysmenorrhea

A potential risk factor for breast cancer includes a. a history of fibrocystic breast disease. b. more than three pregnancies prior to age 35. c. malnourishment. d. early menarche and late first pregnancy.

early menarche and late first pregnancy.

Endometriosis is a condition in which a. the endometrium sloughs continuously. b. ectopic endometrial tissue is present. c. an abnormal Pap smear is diagnostic. d. the endometrium proliferates and does not shed.

ectopic endometrial tissue is present.

The patient most at risk for postrenal acute kidney injury is a(n) - elderly patient with hypertrophy of the prostate. - middle-aged woman with bladder infection. - young child with reflux at the ureterovesical junction. - patient who has both hypertension and diabetes.

elderly patient with hypertrophy of the prostate.

A patient diagnosed with a micropenis must be evaluated for -endocrine disorders -vascular abnormalities -female sex assignment -epispadias

endocrine disorders

The condition in which the urethra opens on the dorsal aspect of the penis is known as a. hypospadias. b. urethral fistula. c. epispadias. d. priapism.

epispadias.

Appropriate management of end-stage renal disease includes -potassium supplementation. -a high-protein diet. -erythropoietin administration. -a high-phosphate diet.

erythropoietin administration.

A person with acute pyelonephritis would most typically experience - fever - oliguria - edema - hypertension

fever

The oliguric phase of acute tubular necrosis is characterized by -fluid excess and electrolyte imbalance. -fever and diminishing cognition. -sodium retention and potassium loss in the urine. -magnesium and phosphorus loss in the urine

fluid excess and electrolyte imbalance.

A patient who has difficulty walking without assistance is incontinent of urine when help doesn't get to her quickly enough. The term for this type of incontinence is a. extraurethral. b. functional. c. urge. d. stress.

functional

The major cause of glomerulonephritis is - infection of the glomerular capsule secondary to a urinary tract infection. - immune system damage to the glomeruli. - hydronephrosis resulting from kidney stones. - Streptococcus infection that migrates from the bloodstream to the glomerulus.

immune system damage to the glomeruli.

Phimosis is a disorder of the penis characterized by - sustained, painful erection - inability to retract foreskin - inability to achieve erection - malpositioning of the urinary meatus

inability to retract the foreskin.

Vesicoureteral reflux is associated with a. increased serum creatinine. b. incompetent valve at the ureterovesical junction c. polycystic renal disease. d. proteinuria.

incompetent valve at the ureterovesical junction

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

increased serum creatinine.

A change occurring in a pregnant woman that is indicative of a potential disorder is a. increased metabolic rate. b. 30% to 40% increase in cardiac output. c. increased oxygen consumption. d. increased urinary protein.

increased urinary protein

the most common direct cause of acute pyelonephritis is -urine obstruction - systemic bacteremia - urethral catheterization - infection by E. Coli.

infection by E. Coli

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 -initiation of dialysis -fluid restriction -antibiotics -phlebotomy

initiation of dialysis

The patient reports persistent pelvic pain and urinary frequency and urgency. She says the pain improves when she empties her bladder. She does not have a fever and her repeated urinalyses over the past months have been normal, although she has a history of frequent bladder infections. She also has a history of fibromyalgia and hypothyroidism. Based on her history and complaints, her symptoms are characteristic of - neuroses -ureteral stone - neurogenic bladder - interstitial cystitis

interstitial cystitis

The expected treatment of a pregnant woman with hyperemesis gravidarum is a. immediate cesarean section. b. seizure prophylaxis. c. surgical removal of uterine contents. d. intravenous therapy.

intravenous therapy.

The difference between stress incontinence and urge incontinence is that stress incontinence - occurs in women, whereas urge incontinence occurs in both men and women. - occurs during sleep, whereas urge incontinence occurs during the waking hours. - is caused by a pelvic floor muscle problem, whereas urge incontinence is caused by a problem with the detrusor muscle. - is caused by a detrusor muscle problem, whereas urge incontinence is caused by a neurologic problem.

is caused by a pelvic floor muscle problem, whereas urge incontinence is caused by a problem with the detrusor muscle.

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

ischemic conditions

When a patient experiencing nephrotic syndrome asks, "What causes my urine to be so full of protein," the nurse's response is based on the knowledge that - his glomeruli have been damaged by his own immune system. - the glomerular membrane has increased permeability. - his liver is extremely active in synthesizing protein. - his renal tubules are full of cellular debris.

the glomerular membrane has increased permeability.

impotence is known as

the inability to achieve an erection

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

they are deficient in active vitamin D.

The prognosis of penile carcinoma depends upon the stage of the disease - true - false

true

The most commonly ordered diagnostic test for evaluation of the urinary system is - KUB - cystogram - ultrasonography - cystography

ultrasonography

Pelvic floor muscle training is appropriate for a. overflow incontinence. b. reflux prevention. c. urge incontinence. d. functional incontinence.

urge incontinence.

A patient with gouty arthritis develops renal calculi. The composition of these calculi is most likely to be - potassium oxalate. - struvite. - cysteine. - uric acid crystals.

uric acid crystals

In addition to E. coli, a risk factor for development of pyelonephritis is - urinary retention and reflux. - nephrotic syndrome. - respiratory disease. - glomerulonephritis.

urinary retention and reflux.