Chapter 39- Alterations in Renal and Urologic Function - Practice Questions

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

75% to 90%

An 85-year-old person has a urinary tract infection. What clinical manifestation does the healthcare professional expect to see in this person? Pyuria, urgency, and frequency *Confusion and poorly localized abdominal discomfort Hematuria and flank pain Dysuria, frequency, and suprapubic pain

Confusion and poorly localized abdominal discomfort

A patient exhibits symptoms including hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, with albumin as the major protein. What diagnostic test or treatment regime does the healthcare professional educate the patient on? Intravenous pyelogram Cyclophosphamide Renal biopsy Oral antibiotics

Renal Biopsy

Acute tubular necrosis can occur from (Select all that apply.) contrast dyes used for radiologic studies. increased ammonia levels from liver failure. antibiotics that are nephrotoxic. ischemia because of hypovolemia.

contrast dyes used for radiologic studies. antibiotics that are nephrotoxic. ischemia because of hypovolemia.

Nephrotic syndrome involves loss of large amounts of ________ in the urine. glucose protein sodium blood

protein

The infection frequently associated with development of postinfectious acute glomerulonephritis is pneumonia. urinary tract infection. endocarditis. throat infection.

throat infection

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

uric acid crystals.

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

urinary retention and reflux.

A patient has overactive bladder syndrome. Which classification of drug does the healthcare professional plan to teach the patient about? Anticholinesterase medications Parasympathomimetic medications β-Adrenergic blocking medications α-Adrenergic blocking medications

α-Adrenergic blocking medications

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

proteinuria.

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

proteinuria.

Which renal disorders are considered causes of intrarenal kidney injury? (Select all that apply.) Prostatic hypertrophy Acute glomerulonephritis Allograft rejection Tumors Acute tubular necrosis (ATN)

Acute glomerulonephritis Allograft rejection Tumors Acute tubular necrosis (ATN)

A female patient has been diagnosed with an uncomplicated urinary tract infection. What self-care measure does the healthcare provider teach the patient that is specific to this type of infection? Rest as much as you can in the next few days. Drink at least eight glasses of water a day. After using the bathroom, wipe from front to back. Take medication if you have a fever.

After using the bathroom, wipe from front to back.

In glomerulonephritis, what damages the epithelial cells resulting in proteinuria? (Select all that apply.) Altered membrane permeability Lysosomal enzymes Ischemia Compression from edema Activated complement

Altered membrane permeability Activated complement

Goodpasture syndrome is an example of which of these? Immunoglobulin A (IgA) nephropathy Acute glomerulonephritis Chronic glomerulonephritis Antiglomerular basement membrane disease

Antiglomerular basement membrane disease

Signs of late chronic renal failure include (Select all that apply.) anemia. high-serum phosphorous. high-blood urea nitrogen. high-serum calcium. high-serum potassium levels.

anemia. high-serum phosphorous. high-blood urea nitrogen. high-serum potassium levels.

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

bilateral kidney stones.

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

calcium.

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

decreased secretion of erythropoietin.

When a patient misses two dialysis sessions numerous electrolyte imbalances resulted. The patient will likely demonstrate (Select all that apply.) lethargy because of metabolic acidosis and increased BUN. weight gain of several pounds since her last dialysis session because of hypernatremia. deep rapid breathing because of compensatory mechanism for metabolic acidosis. positive Chvostek and Trousseau signs because of hypomagnesemia. skeletal muscle weakness and possible cardiac dysrhythmias because of hyperkalemia.

deep rapid breathing because of compensatory mechanism for metabolic acidosis. skeletal muscle weakness and possible cardiac dysrhythmias because of hyperkalemia.

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

fever.

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

hematuria.

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

hepatocytes synthesize excessive lipids.

What problem is a patient likely to experience in end-stage renal disease? Polyuria and nocturia Uremia Hypokalemia Hematuria

Uremia

A healthcare professional is assessing a patient who could have either pyelonephritis or cystitis. Which differentiating sign would assist the professional in making this diagnosis? Increased glomerular filtration rate *Urinalysis confirmation of white blood cell casts Spasmodic pain that radiates to the groin Difficulty starting the stream of urine

Urinalysis confirmation of white blood cell casts

A patient has a lesion at the sacral segments below S1. Which conditions would the healthcare professional assess the patient for? (Select all that apply.) Urinary retention Urge incontinence Bladder distension Frequency

Urinary retention Bladder distension

Which urine characteristics are indicative of acute tubular necrosis (ATN) caused by intrinsic (intrarenal) failure? Fractional excretion of sodium (FENa) <1% Urine osmolality >500 mOsm Urine sediment has no cells, some hyaline casts Urine sodium >30 mEq/L

Urine sodium >30 mEq/L

How are glucose and insulin used to treat hyperkalemia associated with acute renal failure?Increasing insulin causes ketoacidosis, which causes potassium to move into the cell in exchange for hydrogen. Potassium attaches to receptors on the cell membrane of glucose and is carried into the cell. Glucose has an osmotic effect, which attracts water and sodium, resulting in more dilute blood and a lower potassium concentration. When insulin transports glucose into the cell, it also carries potassium with it.

When insulin transports glucose into the cell, it also carries potassium with it.

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

oliguria.

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

pain.

A patient who has a history of mildly decreased renal function is admitted to the hospital for IV antibiotics. Which antibiotics would the healthcare professional avoid in this patient? Penicillin and ampicillin Vancomycin and bacitracin Gentamicin and tobramycin Cefazolin and cefepime

Gentamicin and tobramycin

Prerenal injury from poor perfusion can result from which conditions? (Select all that apply.) Hypotension Bilateral ureteral obstruction Hemorrhage Renal artery thrombosis Renal vasoconstriction

Hypotension Hemorrhage Renal artery thrombosis Renal vasoconstriction

A patient who has chronic kidney disease has hemoglobin of 7.2 mg/dL. What treatment does the healthcare professional prepare the patient for? Vitamin D Vitamin B12 Intrinsic factor Erythropoietin

Erythropoietin

A patient has been diagnosed with a renal stone. Based on knowledge of common stone types, what self-care measure does the healthcare professional plan to teach the patient when stone analysis has returned? A. Ingest 1000 mg of calcium a day. B. Decrease soda intake. C. Increase water intake. D. Restrict animal protein in the diet.

Ingest 1000 mg of calcium a day.

What are considered risk factors for developing bladder and kidney cancers? (Select all that apply.) Male gender Exposure to arsenic Below normal body weight Cigarette smoking Hypertension

Male gender Below normal body weight

Which glomerular lesion is characterized by thickening of the glomerular capillary wall with immune deposition of immunoglobulin G (IgG) and C3? Crescentic Mesangial Membranous Proliferative

Membranous

A patient has renal colic. What information about this condition does the healthcare professional give the student? (Select all that apply.) Pain radiated to the groin. Pain originates in the flank area. Renal colic indicates obstruction of the renal pelvis or proximal ureter. Renal colic indicates the presence of renal stones. Renal colic results in mild-to-moderate pain.

Pain radiated to the groin. Pain originates in the flank area. Renal colic indicates obstruction of the renal pelvis or proximal ureter. Renal colic indicates the presence of renal stones.

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

hydronephrosis

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

hyperkalemia.

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

hypertension.

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

immune system damage to the glomeruli.

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

increased serum creatinine.

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

infection by E. coli.

The most likely cause of anemia in a patient with end-stage renal disease is vitamin B12 deficiency secondary to deficient intrinsic factor. insufficient erythropoietin. blood loss secondary to hematuria. iron deficiency.

insufficient erythropoietin.

The diet for a patient with chronic kidney disease (CKD) should include (Select all that apply.) low sodium and potassium. high carbohydrates and fats. low phosphorous. high calorie. high protein.

low sodium and potassium. high carbohydrates and fats. low phosphorous. high calorie.

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 chronic urinary tract infections. man who has glomerulonephritis.

man who has chronic urinary tract infections.

Glomerular disorders include interstitial cystitis. pyelonephritis. obstructive uropathy. nephrotic syndrome.

nephrotic syndrome

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

regeneration of the renal tubular epithelium.

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

renal colic.

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

serum creatinine.

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

severe hypotension.

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

struvite