NUR 280 exam 3 questions

Which of the following assessment findings is most suggestive of nephrotic syndrome? Hematuria and anemia Proteinuria and generalized edema Increased creatinine with normal blood urea nitrogen Renal colic and increased serum sodium

Proteinuria and generalized edema

A patient has just been diagnosed with acute glomerulonephritis. Which question should the nurse ask this client in attempting to establish a cause? "Have you recently had kidney stones?" "Have you ever been diagnosed with diabetes?" "Do you have a history of heart failure?" "Have you had any type of infection within the last 2 weeks?"

"Have you had any type of infection within the last 2 weeks?"

An adult patient has been diagnosed with polycystic kidney disease. Which of the patient's following statements demonstrates an accurate understanding of this diagnosis? "I suppose I really should have paid more attention to my blood pressure." "I've always been prone to getting UTIs, and now I know why." "I had a feeling that I was taking too many medications, and now I know the damage they can do." "I suppose I should be tested to see if my children might inherit this."

"I suppose I should be tested to see if my children might inherit this."

A 42-year-old male has been diagnosed with renal failure secondary to diabetes mellitus and is scheduled to begin dialysis soon. Which of the following statements by the client reflects an accurate understanding of the process of hemodialysis? "It's stressful knowing that committing to dialysis means I can't qualify for a kidney transplant." "Changing my schedule to accommodate 3 or 4 hours of hemodialysis each day will be difficult." "I know I'll have to go to a hospital or dialysis center for treatment." "I won't be able to go about my normal routine during treatment."

"I won't be able to go about my normal routine during treatment."

Which of the following statements by the husband of a patient with Alzheimer disease demonstrates an accurate understanding of his wife's medication regimen? "We're both holding out hope that this medication will cure her Alzheimer's." "I learned that if we are vigilant about her medication schedule, she may not experience the physical effects of her disease." "I'm really hoping these medications will slow down her mental losses." "I know that this won't cure her, but we learned that it might prevent a bodily decline while she declines mentally."

"I'm really hoping these medications will slow down her mental losses."

A patient with a recent diagnosis of renal failure that will require hemodialysis is being educated in the dietary management of the disease. Which of the patient's following statements shows an accurate understanding of this component of treatment? "I'm going to try a high-protein, low-carbohydrate diet." "I've made a list of high-phosphate foods so that I can try to avoid them." "I don't think I've been drinking enough, so I want to include 8 to 10 glasses of water each day." "I'm making a point of trying to eat lots of bananas and other food rich in potassium."

"I've made a list of high-phosphate foods so that I can try to avoid them."

A 24-year-old college student has presented to the campus medical clinic with complaints of frequent, burning urination and has, subsequent to urinalysis, been diagnosed with an acute lower urinary tract infection (UTI) caused by E. coli. What teaching will the clinician most likely provide to the student? "This should likely resolve itself if you drink a lot of water and especially cranberry or blueberry juice." "Many of these bacteria are now resistant to some antibiotics, but I will take that into account when I choose which antibiotic to prescribe." "Unfortunately, the bacteria causing your infection is no longer responsive to antibiotics, but there are alternative treatments that we can use." "This likely shows that you have some sort of obstruction in your urinary system, so when that is treated your UTI will likely resolve as well."

"Many of these bacteria are now resistant to some antibiotics, but I will take that into account when I choose which antibiotic to prescribe."

A nurse educator is performing client education with a 51-year-old man who has been recently diagnosed with chronic kidney disease. Which of the following statements by the client would the nurse most likely want to correct or clarify? "My heart rate might go up because of my kidney disease, and my blood might be a lot thinner than it should be." "My kidney problems increase my chance of developing high blood pressure or diabetes." "I'll have a risk of either bleeding too easily or possibly clotting too quickly, though dialysis can help minimize these effects." "I'll be prone to anemia, since I'm not producing as much of the hormone that causes my bones to produce red blood cells."

"My kidney problems increase my chance of developing high blood pressure or diabetes."

The clinical nurse educator on a nephrology unit of a large, urban hospital is orientating recent nursing graduates to the unit. Which of the following teaching points about acute tubular necrosis (ATN) should the educator include in the orientation session? "Ureteral and bladder outlet obstructions are often contributors to ATN." "Trauma, burns, and major surgery are common precursors to ATN." "The cardinal signs of ATN are oliguria and retention of potassium, creatinine, and sulfates." "Tubular epithelial cells are sensitive to ischemia and toxins, and damage is irreversible."

"Trauma, burns, and major surgery are common precursors to ATN."

Which of the following clinical findings among older adults is most unlikely to warrant further investigation and possible treatment? An 80-year-old male whose urine dipstick reveals protein is present. A 78-year-old female's GFR has been steadily declining over several years. An 81-year-old male's serum creatinine level has increased sharply since his last blood work. A 90-year-old female's blood urea nitrogen (BUN) is rising.

A 78-year-old female's GFR has been steadily declining over several years.

Which of the following individuals likely faces the greatest risk for the development of chronic kidney disease? A patient with a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or control his diet A patient who experienced a hemorrhagic stroke and now has sensory and motor deficits A first-time mother who recently lost 1.5 L of blood during a postpartum hemorrhage A patient whose diagnosis of thyroid cancer necessitated a thyroidectomy

A patient with a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or control his diet

A patient has a diagnosis of chronic renal failure secondary to diabetic nephropathy. Which of the following hematologic changes may result from this patient's kidney disorder? Leukocytosis Thrombocytopenia Leukopenia Anemia

Anemia

A patient with a diagnosis of chronic kidney disease (CKD) may require the administration of which of the following drugs to treat the consequences of CKD? Opioid analgesics Nonsteroidal anti-inflammatory drugs (NSAIDs) Antihypertensive medications Antiarrhythmic medications

Antihypertensive medications

Which of the following medications would the nurse anticipate being prescribed for the renal failure patient who has hyperphosphatemia? Sensipar (Cinacalcet) Calcium carbonate Levothyroxine (Synthroid) Vitamin D (calcitriol)

Calcium carbonate

An elderly male patient has been brought to the emergency department after experiencing stroke-like symptoms a few hours ago, and has been subsequently diagnosed with an ischemic stroke. The care team is eager to restore cerebral perfusion despite the likely death of the brain cells directly affected by the stroke. What is the rationale for the care team's emphasis on restoring circulation? Cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored. Necrosis will continue unabated throughout the brain unless blood flow is restored. Failure to restore blood flow creates a severe risk for future transient ischemic attacks. Unless blood flow is restored, the patient faces the risk of progressing to hemorrhagic stroke.

Cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored.

An increase in ICP can lead to: Acidosis Brain necrosis Decrease in cerebral perfusion Swallowing difficulty

Decrease in cerebral perfusion

John has been hit in the head with a baseball bat. The nurse knows which would be considered the earliest indicator of a brain injury? Deep slow respirations Ipslateral pupil dilatation Fruity breath Decreased level of consciousness

Decreased level of consciousness

A patient's most recent blood work reveals a blood urea nitrogen (BUN) level of 36 mg/dL (normal range 8 to 25 mg/dL). Which of the following factors may have contributed to this finding? Increased salt intake Parasympathetic nervous stimulation Dehydration Action of ADH

Dehydration

Which of the following integumentary problems most often accompanies chronic kidney disease? Hirsutism and psoriasis Alopecia Dry skin and pruritus Petechiae and purpura

Dry skin and pruritus

A high school senior sustained a concussion during a football game. Which of the following signs and symptoms would indicate the presence of postconcussion syndrome in the days and weeks following his injury? Neck pain and decreased neck range of motion Headaches and memory lapses Unilateral weakness and decreased coordination Recurrent nosebleeds and hypersomnia

Headaches and memory lapses

Which of the following patient complaints most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma? Oliguria Hematuria Urinary urgency Cloudy urine

Hematuria

The nurse is providing care for a patient who has a diagnosis of kidney failure. Which of the following laboratory findings is consistent with this patient's diagnosis? Hypocalcemia Metabolic alkalosis Hypophosphatemia Hypokalemia

Hypocalcemia

A patient has recently undergone successful extracorporeal shock wave lithotripsy (ESWL) for the treatment of renal calculi. Which of the following measures should the patient integrate into his lifestyle to reduce the risk of recurrence? Regular random blood glucose testing Weight loss and blood pressure control Increased physical activity and use of over-the-counter diuretics Increased fluid intake and dietary changes

Increased fluid intake and dietary changes

Which of the following data would a clinician consider as most indicative of acute renal failure? Decreased serum creatinine and blood urea nitrogen (BUN); decreased potassium and calcium levels Alterations in blood pH; peripheral edema Decreased urine output; hematuria; increased GFR Increased nitrogenous waste levels; decreased glomerular filtration rate (GFR)

Increased nitrogenous waste levels; decreased glomerular filtration rate (GFR)

Which of the following pathophysiologic processes occurs in cases of bacterial meningitis? Inflammation allows pathogens to cross into the cerebrospinal fluid. Infection in the cerebrospinal fluid causes vasoconstriction and cerebral hypoxia. Trauma introduces skin-borne pathogens to the cerebrospinal fluid. Infection in the cerebrospinal fluid causes spinal cord compression and neurologic deficits.

Inflammation allows pathogens to cross into the cerebrospinal fluid.

A patient's emergency magnetic resonance imaging (MRI) has been examined by the physician and tPA has been administered to the patient. What was this patient's most likely diagnosis? Ischemic stroke Encephalitis Status epilepticus Subarachnoid hemorrhage

Ischemic stroke

The most recent assessment of a patient with a diagnosis of type 1 diabetes indicates a heightened risk of diabetic nephropathy. Which of the following assessment findings is most suggestive of this increased risk? Diabetic retinopathy Microalbuminuria Hematuria Orthostatic hypotension

Microalbuminuria

Restoration of the integrity of myelin sheaths would likely result in a slowing or stopping of the progression of: Duchenne muscular dystrophy (DMD) Amyotrophic lateral sclerosis (ALS) Paralysis caused by Clostridium botulinum Multiple sclerosis (MS)

Multiple sclerosis (MS)

A 60-year-old woman has been recently diagnosed with multiple sclerosis, a disease in which the oligodendrocytes of the patient's central nervous system (CNS) are progressively destroyed. Which physiologic process within the neurologic system is most likely be affected by this disease process? Neurotransmitter synthesis Production of cerebrospinal fluid Oxygen metabolism Nerve conduction

Nerve conduction

Which of the following physiologic processes is performed by the kidneys and contributes to increased blood pressure? Catalysis of the conversion of angiotensin I to angiotensin II Secretion of aldosterone Production and release of renin Conversion of aldosterone to angiotensin

Production and release of renin

An athlete has become dehydrated during a long race in hot weather. Which of the following physiologic processes will occur in an attempt to protect the athlete's extracellular fluid volume? Increased water reabsorption in the ascending limb of the loop of Henle Increased water reabsorption in the distal convoluted tubule Release of ADH from the posterior pituitary Dilation of the afferent and efferent arterioles

Release of ADH from the posterior pituitary

Which one of the following blood tests reflects the glomerular filtration rate (GFR) and is used to estimate renal function? Blood protein Serum creatinine Blood urea nitrogen Serum ammonia

Serum creatinine

An elderly female patient has been hospitalized for the treatment of acute pyelonephritis. Which of the following characteristics of the patient is most likely implicated in the etiology of her current health problem? The patient recently had a urinary tract infection. The patient has peripheral vascular disease. The patient takes a diuretic and an ACE inhibitor each day for the treatment of hypertension. The patient was diagnosed with type 2 diabetes several years earlier.

The patient recently had a urinary tract infection.

Which of the following descriptions is true of peritoneal dialysis? Treatment involves the introduction of a sterile dialyzing solution, which is drained after a specified time. The dialyzer is usually a hollow cylinder composed of bundles of capillary tubes. Treatments typically occur three times each week for three to four hours. Vascular access is achieved through an internal arteriovenous fistula or an external arteriovenous shunt

Treatment involves the introduction of a sterile dialyzing solution, which is drained after a specified time.

A patient has been diagnosed with a cerebral aneurysm and placed under close observation before treatment commences. Which of the following pathophysiologic conditions has contributed to this patient's diagnosis? Impaired synthesis of clotting factors Increased levels of cerebrospinal fluid Weakness in the muscular wall of an artery Deficits in the autonomic control of blood pressure

Weakness in the muscular wall of an artery

Myasthenia gravis is characterized by muscle weakness caused by antibody-mediated destruction of: acetylcholine receptors. skeletal muscle fibers. thymus gland cells. periorbital muscles.

acetylcholine receptors.

In addition to regulating body fluids and electrolytes, the kidneys function in maintaining bone calcium levels by: activating vitamin D. stimulating bone marrow. synthesizing erythropoietin. excreting bicarbonate.

activating vitamin D.

To maintain hematocrit levels in people with kidney failure, the nurse should be prepared to administer prenatal vitamins twice a day. administer iron dextran intravenously. arrange for frequent blood transfusions in an outpatient clinic. administer a subcutaneous injection of recombinant human erythropoietin (rhEPO).

administer a subcutaneous injection of recombinant human erythropoietin (rhEPO

Glomerulonephritis is usually caused by: glomerular membrane viruses. catheter-induced infection. vesicoureteral reflux. antigen-antibody complexes.

antigen-antibody complexes.

The most common indicator of acute renal failure is: anemia. edema. azotemia. uremia.

azotemia.

The cardinal symptoms of Parkinson disease include: lack of sweating. paresthesia. bradykinesia. hypotonia.

bradykinesia.

The intracranial volume that is most capable of compensating for increasing intracranial pressure is the: cerebrospinal fluid. brain cell tissue. surface sulci fluid. intravascular blood.

cerebrospinal fluid.

The moderate stage of the progressive degenerative Alzheimer-type dementia is manifested by behaviors that include: decreased level of consciousness. social withdrawal. confusion. incontinence.

confusion.

A patient is beginning to recover from acute tubular necrosis. The recovery phase of ATN is characterized by: edema. hypokalemia. proteinuria. diuresis.

diuresis.

A patient's recent diagnosis of Parkinson disease has prompted his care provider to promptly begin pharmacologic therapy. The drugs that are selected will likely influence the patient's levels of: adenosine. serotonin. dopamine. acetylcholine.

dopamine.

Regardless of the cause, chronic kidney disease results in progressive permanent loss of nephrons, glomerular filtration and renal: endocrine functions. vascular pressure. tubule dysplasia. hypophosphatemia.

endocrine functions.

A sudden traumatic complete transection of the spinal cord results in _______ below the level of injury. vasoconstriction flaccid paralysis 3+ tendon reflexes deep visceral pain

flaccid paralysis

High-risk factors for development of adult renal cell cancer include: anorexia/bulimia disorder. inherited renal disease. heavy smoking. adrenal medulla tumors.

heavy smoking.

Only the kidneys can eliminate ____ from the body as a means of regulating body acid-base balance, when urine buffers are present. potassium (K+) hydrogen (H+) phosphate (HPO4) ammonia (NH3)

hydrogen (H+)

A characteristic manifestation of polycystic kidney disease is: alkaline urine. massive proteinuria. renal colic. hypertension.

hypertension.

An intracranial epidural hematoma causes focal symptoms that can include: ipsilateral hemiparesis. diffuse venous bleeding. commuting hydrocephalus. ipsilateral pupil dilation.

ipsilateral pupil dilation.

A patient had excessive blood loss and prolonged hypotension during surgery. His postoperative urine output is sharply decreased and his blood urea nitrogen (BUN) is elevated. The most likely cause for the change is acute: intrarenal nephrotoxicity. ischemic tubular necrosis. prerenal inflammation. bladder outlet obstruction.

ischemic tubular necrosis.

Common manifestations of acute meningococcal meningitis, a highly contagious and lethal form of meningitis, include: focal paralysis. neck pain papilledema. diplopia.

neck pain

The functional unit of the kidney is known as the: bladder cecum trigone nephron

nephron

Coup and contrecoup cerebral contusion caused by blunt head trauma against a fixed object results in: momentary unconsciousness. permanent brain tissue damage. Hemorrhage stroke cerebrovascular infarction.

permanent brain tissue damage.

The initiating event in the development of nephrotic syndrome is a derangement in the glomerular membrane that causes increased permeability to: antibody complexes. plasma proteins. inflammatory cells. red blood cells.

plasma proteins.

The kidney assists in blood pressure regulation by releasing_______ from the juxtaglomerular cells in response to decreased renal blood flow, resulting in efferent arteriole vasoconstriction. aldosterone angiotensin I angiotensin II renin

renin

Transient ischemic attacks (TIAs) are characterized by ischemic cerebral neurologic deficits that: resolve within one hour of onset. cause minor residual deficits. indicate aneurysm leakage. affect diffuse cerebral functions.

resolve within one hour of onset.

The earliest signs of decreased level of consciousness include: stupor, vomiting semicoma, pupil dilation restless, agitation delirium, dementia.

restless, agitation

The edema that develops in persons with glomerulonephritis and nephrotic syndrome reflects: salt and water retention. decreased glomerular permeability. inability to concentrate urine. obstruction and reflux

salt and water retention.

When the glomerular transport maximum for a substance such as blood glucose is exceeded and its renal threshold has been reached, the substance will: spill into the urine. reabsorb quickly. attach to protein carriers. counter-transport sodium.

spill into the urine.

A late indicator of increased intracranial pressure is: Altered level of conciousness unequal pupil response. tachycardia. right-sided heart failure.

unequal pupil response.

The most damaging effects of urinary obstruction are the result of _____ and unrelieved obstruction of urine outflow. urinary stasis renal hypertension kidney hyperplasia concentrated urine

urinary stasis