PATHO 370-CH 27, 28, 29, 31, 33

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

"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 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.

GFR declines.

A patient being treated for acute tubular necrosis (ATN) develops mild polyuria. The nurse responds to questions about why this occurring by stating a. "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." b. "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." c. "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." 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."

a. "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."

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

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

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

an immune complex reaction.

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

d.severe hypotension.

A person with acute pyelonephritis would most typically experience a. fever. b. hypertension. c. edema. d. oliguria.

fever

It is true that polycystic kidney disease is a. always rapidly fatal .b. due to a streptococcal infection. c. associated with supernumerary kidney. d. genetically transmitted.

genetically transmitted.

Nephrotic syndrome does not usually cause a.hematuria. b.proteinuria. c.generalized edema. d.hyperlipidemia.

hematuria

The most frequent initial symptom of bladder cancer is A. bladder infection. B. hematuria. C. sudden incontinence. D. dysuria.

hematuria

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.

hydronephrosis

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

hypercalciuria

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

hyperkalemia.

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

increased urinary protein.

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

infection by E. coli.

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

man who has chronic urinary tract infections.

The pain that accompanies kidney disorders is called a. nephritic. b. nephronitis. c. nephralgia. d. nephrotic.

nephralgia

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

nephrotic syndrome.

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

oliguria

One cause of an extrinsic renal system obstruction is a. clot. b. papillary necrosis. c. pelvic tumor. d. neurogenic bladder.

pelvic tumor

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

primary causes

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

serum creatinine

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

smoking

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

testicular torsion.

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

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 a. potassium oxalate. b. cysteine. c. uric acid crystals. d. struvite.

uric acid crystals.

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. "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." b. "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." 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."

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

Escherichia coli

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

b. they are deficient in active vitamin D.

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

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

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

c. inability to retract the foreskin.

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

c. the glomerular membrane has increased permeability.

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

calcium

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

cardinal ligaments.

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.

crescentic glomerulonephritis