CYU #5

T/F: Hypotension is both a cause of chronic kidney disease and a result of chronic kidney disease.

FALSE Hypertension is both a cause of chronic kidney disease and a result of chronic kidney disease.

T/F: The majority of penile cancer cases are classified as basal cell carcinoma.

FALSE The majority of penile cancer cases are classified as squamous cell carcinoma.

A patient diagnosed with a micropenis must be evaluated for a) Endocrine disorders b) Vascular abnormalities c) Female sex assignment d) Epispadias

a) Endocrine disorders Penile development and growth are both testosterone-dependent. Patients with micropenis must be evaluated for endocrine abnormalities. Micropenis has been shown to be related to vascular disorders. Female sex assignment is considered only after treatment failure. Epispadias is an abnormality of the urethral opening and unrelated to micropenis

The condition characterized by oliguria and hematuria is a) acute glomerulonephritis. b) polycystic kidney disease. c) cystitis. d) renal insufficiency.

a) acute glomerulonephritis Acute glomerulonephritis is characterized by oliguria and hematuria.

Absence of menstruation is called a) amenorrhea. b) metrorrhagia. c) menorrhagia. d) dysmenorrhea.

a) amenorrhea Amenorrhea is the absence or suppression of menstruation in a female aged 16 or older.

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

a) associated with an increased incidence of testicular cancer. Several studies have revealed an increased prevalence of testicular tumors in subjects with a history of cryptorchidism. The incidence of cryptorchidism is about 0.7% to 1.0% of male infants at 1 year of age. Because of the increased risk of malignancy and infertility, treatment at an early age to bring the testis into a normal scrotal position is recommended. The cause of the condition is uncertain but may be related to an intrinsic testicular defect or a subtle hormonal deficiency.

T/F: Erection requires the release of nitrous oxide into the corpus cavernosum during sexual stimulation. A. True B. False

A. True

T/F: The best intervention for acute kidney injury (AKI) is prevention. A. True B. False

A. True

T/F: Infection can lead to bladder stone formation.

TRUE Infection can lead to bladder stone formation.

T/F: The most common cause of urinary obstruction in male newborns and infants is urethral valves.

TRUE The most common cause of urinary obstruction in male newborns and infants is urethral valves.

T/F: The prognosis of penile carcinoma depends upon the stage of the disease.

TRUE The prognosis of penile carcinoma depends upon the stage of the disease.

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

a) bladder contraction. Stimulation of the PARAsympathetic nerves to the bladder will cause bladder contraction. Stimulation of the Sympathetic nerves to the bladder will cause bladder RELAXATION and allow for storage of urine. Stimulation of the parasympathetic nerves to the bladder will cause bladder, not sphincter, contraction. Stimulation of the parasympathetic nerves to the bladder does not cause urine reflux.

A common component of renal calculi is a) calcium. b) cholesterol. c) creatinine. d) urobilirubin.

a) calcium Renal calculi most commonly are formed from calcium oxalate. Cholesterol, creatinine, and urobilirubin are NOT common components of renal calculi.

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

a) cardinal ligaments.

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. The most common agent resulting in nephrotoxicity and subsequent ATN is contrast media. Antibiotics, Cancer chemotherapy, and recreational drugs are NOT the most common agents resulting in nephrotoxicity and subsequent ATN.

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

a) dysmenorrhea. Dysmenorrhea is menstruation that is painful enough to limit normal activity or to cause a woman to seek health care. -Menorrhagia is an often debilitating increase in the amount or duration of menstrual bleeding. -Amenorrhea is the absence or suppression of menstruation in a female aged 16 years or older; it occurs if a woman misses three or more periods in a row. -Metrorrhagia, or bleeding between menstrual periods, usually results from slight physiologic bleeding from the endometrium during ovulation, but may also result from other causes such as uterine malignancy, cervical erosions, and endometrial polyps or as a side effect of estrogen therapy.

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

a) elderly patient with hypertrophy of the prostate. Postrenal acute kidney injury is caused by obstruction in the urinary tract below the level of the kidneys. Elderly men with prostatic hypertrophy are at risk for urinary retention. Bladder infection generally does not obstruct urine flow. Ureterovesical junction reflux is likely to cause pyelonephritis, but not obstruction. Diabetes and hypertension result in intra-renal disease.

Appropriate therapy for PRErenal kidney injury includes a) fluid administration. b) potassium supplementation. c) fluid restriction. d) protein restriction.

a) fluid administration. Appropriate therapy for prerenal oliguria includes fluid administration; most often prerenal kidney injury is because of fluid volume deficit.

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 oliguric phase of ATN is characterized by fluid excess and electrolyte imbalance. During this phase SODIUM is lost in the urine and POTASSIUM is not excreted, and magnesium and phosphorous are retained in the body. Fever and diminishing cognition are not typical manifestations of ATN oliguric phase.

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.

a) hematuria Hematuria often occurs with ureteral stones as a result of irritation of the ureteral wall. Postrenal renal failure, urinary urgency, and proteinuria do NOT generally occur with ureteral stones.

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

a) hepatocytes synthesize excessive lipids Hyperlipidemia in nephrotic syndrome is caused by increased hepatic synthesis of lipids. People who have nephrotic syndrome have both hyperlipidemia and lipiduria.

Calcium oxylate stone formation is facilitated by a) hypercalciuria. b) hypoparathyroidism. c) low urine pH. d) protein intake.

a) hypercalciuria Hypercalciuria facilitates calcium oxylate stone formation. Hyperparathyroidism and high urine pH facilitate calcium stone formation. Protein intake does NOT facilitate calcium stone formation.

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

a) hypertension Hypertension and diabetes are the most common causes of chronic kidney disease.

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 Dialysis is the appropriate therapy at end-stage renal disease.

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. Ischemia and nephrotoxic agents are the most common causes of ATN. Cytotoxic agents, immune reaction, and prolonged postrenal kidney injury are NOT the most common causes of ATN.

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

a) less than 100mL The normal post-void residual urine in the bladder is less than 100 mL.

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

a) neurogenic bladder. Neurogenic bladder is a condition in which neurologic lesions cause bladder dysfunction. Neurologic lesions can be characteristic of detrusor overactivity, not detrusor inactivity. Neurologic lesions are NOT characteristic of bladder prolapse. Neurologic lesions are NOT characteristic of cystitis, although stasis of urine as a result of neurologic lesions may increase the risk of cystitis.

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.

a) overflow This type of incontinence is called overflow incontinence is when bladder is full of urine, but complains that he is leaking urine almost constantly -Stress incontinence is because of increased intra-abdominal pressure. -Urge incontinence is associated with a sudden need to void and involuntary leakage of urine. -Mixed incontinence is a combination of both stress incontinence and urge incontinence.

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

a) radical mastectomy

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. Serum creatinine is the most stable and accurate reflection of renal function. Serum potassium is affected by many factors and thus NOT the most helpful value in monitoring the progression of this disease. Blood urea nitrogen is NOT as stable as serum creatinine; it is affected by muscle breakdown, protein intake, and so forth. Mental status changes can occur as a result of multiple factors other than renal function.

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

a) severe hypotension Prerenal acute kidney injury occurs when blood flow to the kidneys is compromised. Severe hypotension from heart failure, hypovolemia, or shock is a leading cause.

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

a) smoking Smoking is the greatest risk factor for bladder cancer. Although recurrent bladder infections, low fluid intake, and a family history of bladder cancer increase the risk of cancer resulting from inflammation, these are NOT the greatest risk factor.

The urea-splitting bacteria contribute to the formation of ________ kidney stones. a) struvite b) calcium oxalate c) uric acid d) cystine

a) struvite Struvite kidney stones are caused by the urea-splitting bacteria. Calcium oxalate, uric acid, and cystine stones are NOT caused by the urea-splitting bacteria.

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

a) urinary retention and reflux When E. coli is present, urinary retention and reflux increase the risk of the infection ascending the ureter to the kidneys, causing pyelonephritis

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 a) "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." b) "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." c) "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." d) "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."

b) "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." Vesicoureteral reflux causes urine to reflux into the ureters during bladder contraction; the urine then falls into the bladder again, making it easy for bacteria to grow if they reach the bladder.

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." The problem that triggers prerenal acute kidney injury occurs before the blood circulates to the kidney. Hypovolemia is a common cause of prerenal acute kidney injury. Providing the patient's family with specific information is most effective.

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 a) "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." b) "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." c) "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." d) "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 into your urine and making it coffee-colored."

b) "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." The immune system damages glomeruli in post-streptococcal glomerulonephritis causing red blood cells to leak into the urine, making it coffee-colored. Red blood cells that enter the urine are not taken back into the blood. Red blood cells cause urine to turn coffee-colored, not orange. Capillary breakage is not the cause of the red blood cells entering the urine.

The organism most commonly associated with acute pyelonephritis is a) Streptococcus. b) Escherichia coli. c) Klebsiella. d) Enterobacter.

b) Escherichia coli Escherichia coli is the most common cause of acute pyelonephritis.

The microorganism that causes the vast majority of urinary tract infections is a) Klebsiella. b) Escherichia coli. c) herpes simplex virus. d) Candida albicans.

b) Escherichia coli. 80% of all UTIs are caused by Escherichia coli.

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? a) Stage I b) Stage II c) Stage III d) Stage IV

b) Stage II Penile carcinoma is staged as follows: Stage I: The lesion is limited to the glans or foreskin. Stage II: The tumor involves the shaft of the penis. Stage III: The inguinal nodes are involved, but the lesion is operable. Stage IV: Disseminated disease.

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. Gastrointestinal drainage, perioperative and postoperative hypotension, and hemorrhage may all contribute to renal failure by causing acute tubular necrosis. Gastrointestinal drainage, perioperative and postoperative hypotension, and hemorrhage do NOT cause hydronephrosis, nephrosis, or renal inflammation.

A person who is diagnosed with nephrotic syndrome is also experiencing hypoalbuminemia. This happens because a) hepatocyte failure decreases albumin synthesis. b) albumin is excreted in the urine. c) albumin leaks into the interstitial spaces. d) malnutrition is part of nephrotic syndrome.

b) albumin is excreted in the urine. Hypoalbuminemia in nephrotic syndrome is caused by massive albumin excretion in the urine. Hepatocyte failure, malnutrition, and albumin leakage into the interstitial spaces are NOT characteristic of nephrotic syndrome.

Detrusor muscle overactivity can be improved by administration of a) alpha-receptor agonists. b) botulinum toxin. c) cholinergic agents. d) nonsteroidal antiinflammatory agents.

b) botulinum toxin Detrusor muscle overactivity can be improved by administration of botulinum toxin.

The most common type of renal stone is a) uric acid. b) calcium. c) struvite. d) cysteine.

b) calcium The most common type of renal stone is calcium oxalate (75%). -Uric acid stones account for 7% to 10%. -Struvite stones account for 7% to 10%. -Cysteine stones account for 1% to 3%.

Infection by ________ accounts for nearly half of all reported cases of vulvovaginitis. a) Chlamydia trachomatis b) Candida albicans c) Neisseria gonorrhoeae d) Pseudomonas

b) candida albicans Infection by Candida albicans (formerly called Monilia) accounts for approximately half of all reported cases of vulvovaginitis.

The type of glomerulonephritis which is most likely to result in a swift decline in renal function that then progresses to acute kidney injury is? a) acute glomerulonephritis. b) crescentic glomerulonephritis. c) post-streptococcal glomerulonephritis. d) chronic glomerulonephritis.

b) crescentic glomerulonephritis. Crescentic glomerulonephritis results in a swift decline in renal function that progresses to acute renal injury. Acute glomerulonephritis, post-streptococcal glomerulonephritis, and chronic glomerulonephritis do NOT develop into acute renal injury.

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.

b) ectopic endometrial tissue is present. Endometriosis is the presence of endometrial tissue outside the lining of the uterine cavity. The only normal location for endometrial tissue is the endometrial lining of the uterus, but with endometriosis, the tissue is found outside the uterine cavity. Endometriosis is NOT diagnosed with a Pap smear. Diagnosis is made by a physician based on symptoms. The most prominent symptom of endometriosis is dysmenorrheal.

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.

b) functional. Functional incontinence is secondary to a motor or cognitive deficit. -Extraurethral incontinence occurs when an individual has a fistula. -Urge incontinence involves immediate voiding after the urge occurs. -Stress incontinence occurs from increased abdominal pressure and sphincter laxity.

The consequence of an upper urinary tract obstruction in a single ureter is a) kidney stone formation. b) hydronephrosis. c) dilation of the urethra. d) anuria.

b) hydronephrosis. Dilation of the urinary tract occurs proximal to the obstruction. In this case, the proximal ureter and renal pelvis would enlarge, causing hydronephrosis. Kidney stones are causes, rather than consequences, of an upper urinary tract obstruction. Urine production will continue to occur if one ureter is blocked.

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

b) hyperemesis gravidarum. Hyperemesis gravidarum is a Latin term for excess of vomiting in pregnant women. Although transient nausea and vomiting occur in about half of women in the first trimester of pregnancy, in a few women these symptoms continue throughout the entire course of pregnancy. Placenta previa is a condition in which the placenta is implanted abnormally over the internal cervical os. Abruptio placentae is premature separation of the placenta before delivery of the fetus. Spontaneous abortion is expulsion of the products of conception from the uterus before the period of fetal viability.

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

b) immune system damage to the glomeruli. The major cause of glomerulonephritis is immune system damage to glomeruli. Glomerulonephritis is NOT an infection, but an inflammatory glomerulopathy. Hydronephrosis does NOT cause glomerulonephritis.

Phimosis is a disorder of the penis characterized by a) sustained, painful erection. b) inability to retract the foreskin. c) inability to achieve erection. d) malpositioning of the urinary meatus.

b) inability to retract the foreskin Phimosis is a disorder of the foreskin, associated with chronic inflammation, and results in a foreskin that cannot be retracted.

Is it true that fibrocystic breast disease a) commonly progresses to breast cancer. b) may be exacerbated by methylxanthines. c) is characterized by painless breast lumps. d) is a contraindication for progesterone birth control pills.

b) may be exacerbated by methylxanthines. In fibrocystic breast disease, it is thought that methylxanthines tend to stimulate cyclic adenosine monophosphate and thus increase metabolic activity in the breast. Nutritional therapies have shown success in some women, particularly in avoidance of foods with methylxanthines such as tea, coffee, cola, and chocolate. Recent research has disproved the theory that fibrocystic breast disease leads to cancer. Fibrocystic breast disease is characterized by tenderness or pain in one or both breasts. Oral contraceptives have been recommended to control symptoms of fibrocystic breast disease.

The urinalysis finding most indicative of cystitis includes the presence of a) WBCs and RBCs b) Nitrites c) Casts d) Bacteria

b) nitrites Nitrites in the urine along with leukocyte esterase are definitive for cystitis. Urine may have a few WBCs and RBCs without the presence of cystitis. Casts may be present without cystitis. A few bacteria in the urine is common without the presence of cystitis.

The direct cause of stress incontinence is a) the effect of aging. b) pelvic muscle weakness. c) neurologic conditions. d) detrusor muscle overactivity.

b) pelvic muscle weakness. The primary cause of stress incontinence is loss of pelvic muscles and/or fascial support of the bladder and urethra.

Signs consistent with a diagnosis of glomerulonephritis include? a) anuria. b) proteinuria. c) red blood cell casts in the urine. d) foul-smelling urine.

b) proteinuria. Glomerulonephritis leads to proteinuria.

Vesicoureteral reflux is associated with a) increased serum creatinine. b) recurrent cystitis. c) polycystic renal disease. d) proteinuria.

b) recurrent cystitis Recurrent cystitis is associated with vesicoureteral reflux.

The main clinical manifestation of a kidney stone obstructing the ureter is a) pyuria. b) renal colic. c) urge incontinence. d) an abdominal mass.

b) renal colic. Renal colic is the flank pain that occurs with obstruction of the proximal ureter or renal pelvis. Oliguria may occur with kidney stone obstruction, but renal colic is the main clinical manifestation of this condition. Urge incontinence normally occurs when a kidney stone is obstructing the lower urinary tract. Kidney stones are small and located in a retroperitoneal position in the ureter, so they generally do not form a palpable mass.

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

b) sexually active women Sexually active women are at the highest risk for urinary tract infection. Infants and children, adult males, and patients taking diuretics are NOT at the highest risk for urinary tract infection.

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 a) his glomeruli have been damaged by his own immune system. b) the glomerular membrane has increased permeability. c) his liver is extremely active in synthesizing protein. d) his renal tubules are full of cellular debris.

b) the glomerular membrane has increased permeability. Massive proteinuria occurs in nephrotic syndrome because the glomerular membrane has increased permeability that causes the leakage of protein.

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

b) tubular Tubular injury (acute tubular necrosis) is the most common cause of acute kidney injury.

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."

Renal insufficiency occurs when _____ of the nephrons are not functional. a) 25% b) 50% c) 75% to 90% d) more than 90%

c) 75% to 90% In renal insufficiency, 75% to 90% of the nephrons are not functional. When 25% to 50% of nephrons are not functional, it is decreased renal reserve. When 90% of nephrons are not functional, it is end-stage renal disease.

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

c) 9 The HPV vaccine is recommended for 11- to 12-year-old girls, but can be administered to girls as young as 9 years of age. The HPV vaccine is recommended for girls above the age of 9. The vaccine also is recommended for 13- to 26-year-old females who have not yet received or completed the vaccine series. The HPV vaccine is NOT recommended for females under the age of 9.

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

c) Cystocele A cystocele is a protrusion of a portion of the urinary bladder into the anterior of the vagina at a weakened part of the vaginal musculature. In moderate to severe cases, a sensation of pressure can be felt in the vagina, along with dysuria, incontinence, and back pain. Clinical manifestations of rectocele would involve difficulties in bowel evacuation or constipation. Urinary stress incontinence is not a manifestation of menopause. Cervicitis is not associated with urinary stress incontinence.

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. Decreased secretion of erythropoietin is the major cause of anemia in end-stage chronic renal disease.

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 a raised level in the blood of urea and other nitrogenous waste compounds that are normally eliminated by the kidneys.

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. Bilateral kidney stones can cause POSTrenal acute kidney injury as a result of obstruction of normal outflow of urine from the kidneys.

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.

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

c) erythropoietin administration Erythropoietin administration is appropriate, as the kidneys are not able to secrete erythropoietin.

Findings that should prompt an evaluation for renal cancer include a) bacteria in the urine. b) intermittent urinary colic. c) hematuria. d) red blood cell casts in the urine.

c) hematuria Hematuria is a frequent sign of renal cancer.

The most likely cause of acidosis in a patient with end-stage renal disease is? a) insufficient filtration of bicarbonate ions at the glomerulus. b) excessive production of respiratory and metabolic acids. c) insufficient metabolic acid excretion resulting from nephron loss. d) hypoventilation secondary to uremic central nervous system depression.

c) insufficient metabolic acid excretion resulting from nephron loss. The most likely cause of acidosis in a patient with end-stage renal disease is insufficient metabolic acid excretion resulting from nephron loss.

Treatment of a uterine prolapse may involve the insertion of a(n) ________ to hold the uterus in place. a) catheter. b) IUD. c) pessary. d) endopelvic mesh implant.

c) pessary. Uterine prolapse is one of the most common reasons for hysterectomy usually from the vaginal approach. In patients who are at poor risk for surgery or who choose NOT to have a hysterectomy, a pessary, which is a small supportive device, is inserted to hold the uterus in place

Sexual impotence is rarely because of a) drug side effects. b) psychological factors. c) primary causes. d) vascular diseases.

c) primary cases Primary impotence is rare and refers to the inability to attain an erection throughout life. Impotence has been determined to be a side effect of certain medications.

Sudden, severe testicular pain is indicative of a) prostatitis. b) testicular cancer. c) testicular torsion. d) epididymitis.

c) testicular torsion A twisting of the spermatic cord with subsequent testicular ischemia and infarction, testicular torsion, commonly presents with sudden onset of severe testicular pain.

The most commonly ordered diagnostic test for evaluation of the urinary system is a) KUB. b) cystogram. c) ultrasonography. d) cystography.

c) ultrasonography. The most commonly ordered diagnostic test for evaluation of the urinary system is ultrasonography because it provides excellent visualization of the urinary tract without the use of radiation or contrast media, and it is painless.

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

c) urge incontinence Pelvic floor muscle training is appropriate for urge incontinence. These exercises will help strengthen the pelvic muscles so the patient is able to hold urine in the bladder longer. Pelvic floor muscle training is NOT appropriate for overflow incontinence, reflux prevention, or functional incontinence.

Which intervention has been found to retard the advancement of chronic kidney disease? a) Calcium supplementation b) Erythropoietin c) Insulin d) ACE inhibitors

d) ACE inhibitors ACE inhibitors or A-II receptor blockers have been found to retard the advancement of chronic kidney disease by reducing proteinuria. Calcium supplementation, erythropoietin, and insulin have NOT been found to retard the advancement of chronic kidney disease.

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. A patient with renal disease is at risk for developing uremia as his nephrons progressively deteriorate because GFR declines. The basement membrane does NOT become increasingly permeable. Filtration does not exceed secretory and reabsorptive capacity. Excessive solute and water are not lost in the urine.

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? a) Greater than 15% b) Greater than 25% nephron loss c) Greater than 50% nephron loss d) Greater than 90% nephron loss

d) Greater than 90% nephron loss End-stage renal disease occurs when greater than 90% of the nephrons have been lost.

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

d) MAN who has chronic urinary tract infections. Anyone who has chronic urinary tract infections is at high risk of developing pyelonephritis. Although pregnancy and stasis of urine with paraplegia do increase the risk of pyelonephritis, another individual has an even higher risk because of an active urinary tract infection. Glomerulonephritis is not an infection.

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

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

d) absent or diminished levels of progesterone. The term dysfunctional uterine bleeding is used to describe abnormal endometrial bleeding not associated with tumor, inflammation, pregnancy, trauma, or hormonal effects. Absent or diminished levels of progesterone will result in a thick and extremely vascular endometrium that lacks structural support. As a result of this fragile structure, spontaneous and superficial hemorrhage occurs randomly throughout the endometrium.

The pathophysiologic basis of acute glomerulonephritis is a) renal ischemia. b) bacterial invasion of the glomerulus. c) an anaphylactic reaction. d) an immune complex reaction.

d) an immune complex reaction Acute glomerulonephritis is an immune complex reaction that involves IgG

The pathophysiologic basis of acute glomerulonephritis is a) renal ischemia. b) bacterial invasion of the glomerulus. c) an anaphylactic reaction. d) an immune complex reaction.

d) an immune complex reaction. Acute glomerulonephritis is an immune complex reaction that involves IgG. Acute glomerulonephritis is NOT caused by renal ischemia, bacterial invasion, or anaphylactic reaction.

A patient has ureteral colic. The manifestation that requires immediate notification of the physician is a) Severe flank pain b) Vomiting c) Pink-tinged urine d) Chills and fever

d) chills and fever Chills and fever are NOT commonly associated with ureteral colic unless infection exists. This should be reported to the physician. Severe flank pain is common in ureteral colic. Nausea and vomiting are common with ureteral colic resulting from the common dermatomes. Pink-tinged urine is common in ureteral colic, as the stone irritates the ureteral wall and causes minor bleeding.

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.

d) early menarche and late first pregnancy. It has been observed in many research studies that giving birth at a young age (less than 18 years) is associated with a decreased risk of breast cancer, and that giving birth for the first time aged 35 years or older increases the risk.

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.

d) increased urinary protein. Pregnancy-induced hypertension is characterized by a rapid rise in arterial blood pressure associated with the loss of large amounts of protein in the urine. An increased metabolic rate and increased cardiac output and increase in O2 is a normal finding in a pregnant woman.

The most common direct cause of acute pyelonephritis is a) urine obstruction. b) systemic bacteremia. c) urethral catheterization. d) infection by E. coli.

d) infection by E. coli. Infection by E. coli is the most common cause of acute pyelonephritis. Although urine obstruction or reflux can cause acute pyelonephritis, the most common cause is infection by E. coli. Systemic bacteremia may lead to pyelonephritis, but it is NOT the most common direct cause. Urethral catheterization may cause infection, which could subsequently result in acute pyelonephritis, but catheterization is NOT the most common direct cause.

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.

d) intravenous therapy. Intravenous therapy to correct metabolic and nutritional abnormalities, antiemetic agents, and supportive care in a hospital environment may be needed to resolve the symptoms of hyperemesis gravidarum.

The most common types of uterine tumors are known as? a) ovarian cysts. b) endometriomas. c) hydatidiform moles. d) leiomyomas.

d) leiomyomas. A benign smooth muscle tumor, usually in the uterus or gastrointestinal tract. Also called fibroid.

Glomerular disorders include a) pyelonephritis b) obstructive uropathy c) interstitial cystitis. d) nephrotic syndrome.

d) nephrotic syndrome. The pathophysiology of nephrotic syndrome occurs at the glomerular membrane. Pyelonephritis generally does NOT affect the glomerulus. Obstructive uropathy affects the upper and lower urinary tract but does NOT directly involve the glomerulus. Interstitial cystitis is a bladder disorder.

Urinary retention with consistent or intermittent dribbling of urine is called? a) mixed incontinence. b) enuresis. c) stress incontinence. d) overflow incontinence.

d) overflow incontinence.

Which condition is caused by a genetic defect? a) Acute pyelonephritis b) Hydroureter c) Incontinence d) Polycystic kidney disease

d) polycystic kidney disease Polycystic kidney disease is caused by a genetic defect.

If acute tubular necrosis (ATN) does not resolve and continued tubular dysfunction ensues, the patient will then experience a) oliguria and sodium retention. b) infections and sepsis. c) magnesium and phosphorus loss in urine. d) polyuria and sodium wasting.

d) polyuria and sodium wasting If ATN does not resolve, the high blood urea nitrogen (BUN) creates osmotic diuresis; the urine is high in sodium content.

Nephrotic syndrome involves loss of large amounts of ________ in the urine. a) blood b) sodium c) glucose d) protein

d) protein By definition, nephrotic syndrome involves loss of large amounts of protein in the urine. Sodium and water are reabsorbed in nephrotic syndrome. Hematuria and glucose loss in urine are NOT characteristic of nephrotic syndrome.

The major underlying factor leading to the edema associated with glomerulonephritis and nephrotic syndrome is a) hematuria. b) bacteriuria. c) glycosuria. d) proteinuria.

d) proteinuria Proteinuria is the major factor underlying the edema associated with nephrotic syndrome and glomerulonephritis.

The effect on the renal tubules during the postoliguric phase of acute tubular necrosis involves a) reconstruction of the basement membrane. b) blocking the tubule lumens by dead cells. c) making the glomeruli patent again. d) regeneration of the renal tubular epithelium.

d) regeneration of the renal tubular epithelium During the postoliguric phase of acute tubular necrosis, the renal tubular epithelium is regenerating.

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 Vitamin D, required for calcium absorption in the digestive tract, is activated in the kidneys. With chronic renal failure, vitamin D is not activated.

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

d) uric acid crystals. Gout may lead to uric acid crystals because of elevated serum uric acid levels. -Calcium oxalate, not potassium oxalate, stones are associated with hypercalcemia. -Struvite calculi are associated with urinary tract infections. -Cysteine calculi are associated with a genetic defect.