Module 13: Pre-test & Final

Which information will help the nurse determine the severity of a patient's urinary tract obstruction? A. Duration of blockage B. Supersaturation C. Aggregation D. Precipitation of salts

A. Duration of blockage -The severity of an obstructive uropathy is determined by (1) the location of the obstructive lesion, (2) the involvement of one or both upper urinary tracts, (3) the severity (completeness) of the blockage, (4) the duration of the blockage, and (5) the nature of the obstructive lesion.

Which of the following concepts should the nurse include when describing the pathophysiology for chronic renal disease? A. Glomerulosclerosis, tubulointerstitial inflammation, and proteinuria B. Glomerular hypotension, fibrosis, and aldosterone C. Glomerulonephritis, IgA neuropathy, and antidiuretic hormone D. Glomerular compensatory hypertrophy, pyelonephritis, and natriuretic peptide

A. Glomerulosclerosis, tubulointerstitial inflammation, and proteinuria

A patient has IgA nephropathy (Berger disease). What classic finding will the nurse assess for in this patient? A. Hematuria after a GI viral infection B. Renal colic after stone formation C. Large tumor on kidney x-ray D. Uncontrolled HTN

A. Hematuria after a GI viral infection

A nurse is asked why hyperlipidemia occurs in nephrotic syndrome. What is the nurse's best response? A. Loss of albumin stimulates lipoprotein synthesis by the liver and hyperlipidemia results. B. Loss of immunoglobulins stimulates the liver to produce more lipoproteins. C. Sloughing of tubular cells results in scarring and liver production of lipoproteins. D. dium retention is common, causing the liver to overproduce lipoproteins.

A. Loss of albumin stimulates lipoprotein synthesis by the liver and hyperlipidemia results.

A patient has bladder cancer. Which assessment finding is most typical for this patient? A. Painless hematuria B. Stones in the urine C. Jaundice D. Fever

A. Painless hematuria

A patient has a loss of urine when laughing or sneezing. Which type of incontinence does the nurse suspect the patient is experiencing? A. Stress B. Urge C. Overflow D. Functional

A. Stress

A patient has pyelonephritis from chronic backup of urine into the ureters and kidneys. Which predisposing factor does this patient have for pyelonephritis? A. Vesicoureteral reflux B. Neurogenic bladder C. Instrumentation D. Kidney stones

A. Vesicoureteral reflux

Which patient is most prone to the development of pyelonephritis? A patient with: A. Urinary reflux B. Nephrotic syndrome C. respiratory disease. D. glomerulonephritis.

A. urinary reflux -When a bacterial, fungal, or viral infection is present in the urinary tract, urinary retention and reflux increase the risk of the infection ascending the ureter to the kidneys, resulting in pyelonephritis

A patient has a dilated ureter from an obstructed upper urinary tract. Which term will the nurse use to describe this condition? A. Hydronephrosis B. Hydroureter C. Ureterohydronephrosis D. Ureterduct

B. Hydroureter -Dilation of the ureter is referred to as hydroureter (accumulation of urine in the ureter).

A patient has prerenal acute renal failure/acute kidney injury. What does the nurse suspect caused this condition? A. Enlarged prostate B. Hypovolemia C. Tubular necrosis D. Glomerulonephritis

B. Hypovolemia -Hypovolemia, hemorrhage, and shock are examples of prerenal acute renal failure/acute kidney injury.

The patient is admitted to the hospital with acute renal failure or acute kidney injury. Which assessment finding will the nurse observe initially? A. Proteinuria B. Oliguria C. Hematuria D. Diuresis

B. Oliguria

The nurse is describing the pathophysiology of post-streptococcal glomerulonephritis. Which information should the nurse include? The cause of this type of glomerulonephritis is: A. infection of the glomerular capsule secondary to a urinary tract infection. B. antigen-antibody complexes that deposit on the glomerular membrane. C. hydronephrosis from kidney stones. D. viral infection in the blood stream that migrates to the glomerulus.

B. antigen-antibody complexes that deposit on the glomerular membrane. -The cause of glomerulonephritis is the formation of antigen-antibody complexes in which the antigen is a nonrenal streptococcal infection. The antigen-antibody complexes are deposited in the glomerular membrane, where an injurious inflammatory response ensues.

A major modifiable risk factor for the development of renal calculi in the general population is: A. Obesity B. Dehydration C. Smoking D. Drinking alcohol

B. dehydration

A consequence of an upper urinary tract obstruction is: A. renal stone formation. B. hydronephrosis. C. dilation of urethra D. nephrolithiases

B. hydronephrosis. -Dilation of the urinary tract occurs proximal to the obstruction. In this case the proximal renal pelvis and kidney would enlarge, causing a condition known as hydronephrosis.

A nurse is describing the following conditions: detrusor hyperreflexia, vescicosphincter dyssynergia, and detrusor areflexia/acontractile. Which type of urinary disorder is the nurse discussing? A. Pyelonephritis B. Overactive bladder syndromes C. Neurogenic bladder D. Renal calculi complications

C. Neurogenic bladder

A nurse is teaching about end-stage renal failure. Which information should the nurse include? End-stage renal failure refers to a decline in renal function to ____ or less of normal. A. 75% B. 50% C. 25% D. 10%

D. 10%

A patient with glomerulonephritis has nephritic type sediment. What will the nurse observe in the urine? A. Massive amts of protein B. Waxy and granular casts C. Very little hematuria with lipids D. Hematuria with red cell casts

D. Hematuria with red cell casts -Urine with nephritic sediment is characterized by the presence of blood with red cell casts, white cell casts, and varying degrees of protein, which usually is not severe.

A patient had both kidneys obstructed but is now unobstructed and urinating large amounts of urine. What term should the nurse use to describe this process? A. Tubulointerstitial fibrosis B. Obligatory and compensatory growth C. Hypoperfusion D. Postobstructive diuresis

D. Postobstructive diuresis

What type of diet will the nurse encourage for a patient with nephrotic syndrome? A. High caloric B. High carbohydrate C. Protein restricted D. Sodium restricted

D. Sodium restricted -Nephrotic syndrome is commonly treated by adhering to a normal-protein (i.e., 1 g/kg body weight/day, some may need supplements), low-fat, salt-restricted diet.

A nurse assesses a patient with chronic renal failure for osteomalacia and spontaneous bone fractures because: A: excess potassium leaches calcium from the bone. B. erythropoietin secretion is impaired. C. bilirubin causes demineralization of the bone tissue. D. of a vitamin D deficiency.

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