Week 5: Supplemental

The best intervention for acute kidney injury (AKI) is prevention True or False

True

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

d. an immue complex reaction

The patient most at risk for postrenal acute kidney injury is a(n)a. elderly patient with hypertrophy of the prostateb. middle aged woman with bladder infectionc. young child with reflux at the ureterovesical junctiond. patient who has both hypertension and diabetes

a. elderly patient with hypertrophy of the prostate

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

a. fever

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

a. fluid administration

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 phosphorus loss in the urine

a. fluid excess and electrolyte imbalance

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 trilycerides for energy

a. hepatocytes synthesize excessive lipids

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

a. high-serum potassium levels. c. high-serum phosphorous. d. high-blood urea nitrogen. e. anemia.

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

a. hypercalciuria

Osteoporosis commonly occurs in patients with end-stage renal disease because of a. hyperparathyroidism b. hypercalcemia c. excess active vitamin D d. phosphorous deficiency

a. hyperparathyroidism

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

a. hypertension

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

a. insufficient erythropoietin

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

a. struvite

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

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

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

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

A, B, D, E

Hypotension is a both a cause of chronic kidney and result of chronic kidney disease

False

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

a. acute glomerulonephritis.

The most common agent resulting in nephrotoxicity and subsequent acute tubular necrosis (ATN) in hospitalized patient is a. contrast media b. antibiotics c. cancer chemotherapy d. recreational drugs

a. contrast media

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

d. uric acid crystals

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

d.increased serum creatinine.

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

A, B, E

The physiology that explains the intermittent nature of pain caused by a kidney stone is that a. ureters use peristalsis and gravity to move urine. b. ureters insert into the bladder at an angle. c. in men, the prostate gland surrounds the urethra. d. in men, the urethra is longer than in women.

a. ureters use peristalsis and gravity to move urine.

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

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

b. Escherichia coli.

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

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

b. calcium

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.

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

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

b. nephralgia

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

b. oliguria

The main clinical manifestations of a kidney stone obstructing the ureter is a. oliguria b. renal colic c. urge incontinence d. an abdonmial mass

b. renal colic

Acute tubular necrosis can occur from a.increased ammonia levels from liver failure. b.contrast dyes used for radiologic studies. c.ischemia because of hypovolemia. d.antibiotics that are nephrotoxic.

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

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 offers when _________ of nephrons are not functional a. 25% b. 50% c. 75% to 90% d. more than 90%

c. 75% to 90%

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

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. high-protein diet c. erythropoietin administration d. a high-phosphate diet

c. erythropoietin administration

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

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

c. hematuria

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

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

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 re-absorptive capacity c. excessive solute and water are lost in the urine d. GFR declines

d. GFR declines

It is true that polycytic kidney disease is a. always rapidly fatal b. caused by streptococcal infection c. associated with supernumerary kidney d. genetically transmitted

d. genetically transmitted

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

d. hyperkalemia

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.

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

d. nephrotic syndrome