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NUR 3125 Pathophysiology Exam 3 with
Correctly Answered Questions Full and
Complete Highly Recommended Exam (Score
A)-Florida State College
The nurse working in an outpatient nephrology clinic knows that which of the following are primary functions of the kidneys? (Select all that apply.) A. Production of clotting factors B. Homeostasis C. Excretion of metabolic wastes D. Regulation of acid-base balance E. Metabolism of fats B, C, D The kidneys do not metabolize fats. Production of clotting factors is a primary function of the liver. The kidneys maintain blood pressure using the RAAS and also produce erythropoietin to stimulate RBC production. In caring for a patient diagnosed with acute kidney injury, the nephrology nurse knows that which of the following tests are specific for renal function? (Select all that apply.)
A. Aspartate aminotransferase (AST) B. Blood urea nitrogen C. Creatinine D. Glomerular filtration rate E. White blood cell count B, C, D AST related to LIVER function In caring for a patient with acute kidney injury the nurse knows that the patient's renal function has returned to normal range when the patient's GFR measures: A. 30-40 mL/min B. 40-50 mL/min C. 70-90 mL/min D. 90-120 mL/min D Normal GFR is 90-120 mL/min Normal Creatinine 0.6-1.1 for females and 0.6-1.2 for males Normal BUN is 10-20 mg/dL *Be sure to know these normal values, you will use them daily as a nurse
D. Infection D Urinary stasis is a risk factor for developing UTI Which of the following is classified as the most common primary mineral salt composition of kidney stones? A. Calcium B. Struvite C. Uric Acid D. Cysteine A A - calcium (i.e. oxalate or phosphate) is most common *Note that a change in urine pH may lead to precipitation of stones Which of the following are risk factors for developing renal tumors? (Select all that apply.) A. Female gender B. Smoking C. Obesity
D. Diabetes E. Hypertension B, C, E risk factors are male gender, smoking, obesity, uncontrolled hypertension The registered nurse would expect which of the following lab values for a patient experiencing acute kidney failure? A. Creatinine 3.5 mg/dL B. Sodium 122 mEq/L C. Albumin 3.5 g/dL D. BUN 10 mg/dL A the normal creatinine level is 0.6 - 1. This BUN is within normal range (BUN would be elevated in acute kidney failure) In caring for a patient experiencing acute kidney injury who has these lab values: urinary output 15 mL/hr, BUN 30 mg/dL, and creatinine 3.5, the nurse knows that the patient is experiencing which phase of acute kidney injury? A. Initiation phase
A 55-year-old male presents reporting urinary retention. Tests reveal that he has a lower urinary tract obstruction. Which of the following is of most concern to the nurse? A. Vesicoureteral reflux and pyelonephritis B. Formation of renal calculi C. Glomerulonephritis D. Increased bladder compliance B urine stasis occurs with urinary tract obstruction and can lead to the formation of renal calculi and UTI A 75-year-old male reports to his primary care provider loss of urine with cough, sneezing, or laughing. Which of the following is the most likely diagnosis the nurse will observe on the chart? A. Urge incontinence B. Overflow incontinence C. Stress incontinence D. Functional incontinence C Reduced resistance is associated with the symptom of stress incontinence, which is incontinence with coughing or sneezing.
A 29-year-old female presents with cloudy urine, flank pain, hematuria, and fever. Which of the following does the nurse suspect the patient is most likely experiencing? A. Acute cystitis B. Renal calculi C. Chronic renal failure D. Postrenal renal failure A acute cystitis is infection/inflammation of bladder (UTI) Although renal calculi can cause pain and hematuria, it is not manifested by fever and cloudy urine. A 30-year-old male is demonstrating hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, with albumin being the major protein. The most probable diagnosis the nurse will see documented on the chart is: A. Cystitis B. Chronic pyelonephritis C. Acute glomerulonephritis D. Renal calculi C Two major symptoms distinctive of more severe glomerulonephritis are:
D
the patient will experience postrenal renal failure due to obstruction by the prostate. What if the test revealed acute tubular necrosis? intrarenal While turning a patient with chronic renal failure, which principle should the nurse recall? Bone fractures are a risk factor in chronic renal failure because: A. Calcium is lost in the urine B. Osteoblast activity is excessive C. The kidneys fail to activate vitamin D D. Autoantibodies to calcium molecules develop C Hypocalcemia is accelerated by impaired renal synthesis of vitamin D The combined effect of vitamin D deficiency can result in renal osteodystrophies with increased risk for fractures. A man was mildly confused, and his family brought him to adult day care during the week. He was incontinent there every day until a nurse suggested that they put a picture of a toilet on the bathroom door, and he became continent. What incontinence is this?
Functional Incontinence A woman has a bladder infection and is distressed to have episodes of sudden strong need to urinate that cause her to become incontinent. What incontinence is this? Urge Incontinence A woman loses a small amount of urine involuntarily every time she sneezes. What incontinence is this? Stress Incontinence A man with a caudal equine involvement in MS became incontinent when his caregiver was late and was not available to assist with the morning catheterization. What incontinence is this? Overflow Incontinence A 50-year-old male is experiencing reflux of chyme from the stomach. He is diagnosed with gastroesophageal reflux. This condition is caused by: A. Fibrosis of lower third of esophagus B. Sympathetic nerve stimulation C. Loss of muscle tone at the lower esophageal sphincter D. Reverse peristalsis of the stomach C
Ulcerative colitis is manifested by fever, elevated pulse rate, frequent diarrhea (10 to 20 stools/day), urgency, obviously bloody stools, and continuous lesions present in the colon. Hiatal hernia is most often asymptomatic and would not be manifested by abdominal pain. Pyloric obstruction would be manifested by forceful or projectile vomiting. Achalasia would be manifested by difficulty or uncomfortable swallowing. A 16-year-old female presents with abdominal pain in the right lower quadrant. Physical examination reveals rebound tenderness and a low-grade fever. A possible diagnosis would be: A. Colon cancer B. Pancreatitis C. Appendicitis D. Hepatitis C Appendicitis is manifested by RLQ pain with rebound tenderness. A 54-year-old male complains that he has been vomiting blood. Tests reveal portal hypertension. Which of the following is the most likely cause of his condition?
A. Thrombosis in the spleen B. Cirrhosis of the liver C. Left ventricular failure D. Renal stenosis B Portal hypertension occurs secondarily to cirrhosis of the liver. Manifestations associated with hepatic encephalopathy from chronic liver disease are the result of: A. Hyperbilirubinemia and jaundice B. Fluid and electrolyte imbalances C. Impaired ammonia metabolism D. Decreased cerebral blood flow C Impaired ammonia metabolism leads to the symptoms of hepatic encephalopathy. The icteric phase of hepatitis is characterized by which of the following clinical manifestations? A. Fatigue, malaise, vomiting B. Jaundice, dark urine, enlarged liver
C. Hematemesis D. Occult bleeding B Melena is black tarry stools Occult bleeding is where there are broken down products of blood are present in the stool While reading a patient's diagnostic evaluation, the nurse notes that the patient's GI tract has a cobblestone appearance. This is present in which disorder? A. Ulcerative colitis B. Irritable bowel disease C. Crohn disease D. Infective enterocolitis C Note also that ulcerative colitis is confined to the colon or rectum Crohn's disease may occur in various sites of GI tract While reading the patient's diagnostic evaluation, the nurse reads that the patient has experienced a twisting of the bowel. This type of obstruction is known as: A. Volvulus B. Intussusception
C. Hernia D. Adhesion A In caring for a patient experiencing liver failure, which of the following lab values does the nurse expect to be elevated? (Select all that apply.) A. Aspartate Aminotransferase (AST) B. Alanine Aminotransferase (ALT) C. Albumin D. Ammonia E. Bilirubin A, B, D, E Albumin would be decreased A teenage boy sustains a severe closed head injury following an all-terrain vehicle (ATV) accident. He is in a state of deep sleep that requires vigorous stimulation to elicit eye opening. How should the nurse document this in the chart? A. Confusion B. Coma C. Obtundation D. Stupor D
Agnosia is the failure to recognize the form and nature of objects A nurse thinks a patient may be experiencing dementia. Which assessment finding will most help support this diagnosis? A. Violent behavior B. Hyperactivity C. Depression D. Loss of recent and remote memory D Dementia is characterized by loss of recent and remote memory. The patient is experiencing an increase in intracranial pressure. This increase results in: A. Brain tissue hypoxia B. Intracranial hypotension C. Ventricular swelling D. Expansion of cranial vault A
Brain tissue hypoxia occurs as a result of increased intracranial pressure as it places pressure on the brain A 51-year-old male is admitted to the neuro ICU with a severe closed head injury. All four extremities are in rigid extension, his forearm is hyperpronated, and his legs are in plantar extension. How should the nurse chart this condition? A. Decorticate posturing B. Decerebrate posturing C. Caloric posturing D. Excitation posturing B A 20-year-old male is admitted to the neurological critical care unit with a severe closed head injury. When an intraventricular catheter is inserted, the ICP is recorded at 24 mm Hg. How should the nurse interpret this reading? This reading is: A. Higher than normal B. Lower than normal C. Normal D. Borderline A Normal ICP is 1 to 15 mm Hg
