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RN 2023 cutie > INTENSIVE RENAL FABS > Flashcards

INTENSIVE RENAL FABS Flashcards

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1
Q
  1. One of the manifestations seen in a patient diagnosed with nephrotic syndrome is edema, commonly seen in the eyes, dependent areas and abdomen. This manifestation primarily resulted from the:

*
1 point
a. Inability of the kidneys to excrete protein, resulting to hyperalbuminemia
b. Decrease in the oncotic pressure due to hypoalbuminemia
c. Fluid moving from the extracellular space to the vascular space
d. Stimulation of the rennin-angiotensin-aldosterone hormonal system inhibiting the release of aldosterone

A

b. Decrease in the oncotic pressure due to hypoalbuminemia

R: Hypoalbuminemia from proteinuria

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2
Q
  1. The nephron which is the functional unit of the kidneys is comprised of all the following EXCEPT:

*
1 point
a. Glomus
b.Glomerulus
c. Bowman’s capsule
d.Convoluted tubules

A

a. Glomus

Glomus is a specialized sensory receptor for heart

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3
Q

3.The urinary bladder can hold urine to a maximum amount of:

*
1 point
a.500 ml
b.1000 ml
c.1500 ml
d.2000 ml

A

b.1000 ml

500 mL - you will feel the urge
1500-2000 - over distended bladder

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4
Q

4.Leo, a 28-year-old employee of an insurance company, is having his free annual general check up. Part of the routine assessment in a general check up is urinalysis. Which of the following results from the urinalysis is an abnormal finding?

*
1 point
a.Urine pH: 6
b.Urine specific gravity: 1.020
c.Protein Trace
d.Cloudy urine

A

d.Cloudy urine

R: indicates infection

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5
Q
  1. If a client with acute renal failure experiences a continuous increase in serum potassium level, which of the following emergencies should the nurse be prepared for?

*
1 point
a. Paralysis of the respiratory muscle
b.Hemorrhage
c.Pulmonary edema
d. Cardiac arrest

A

d. Cardiac arrest

R: This is due to dysrhythmias

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6
Q
  1. A nurse should be aware that benign prostatic hypertrophy (BPH):

*
1 point
a. Is a congenital abnormality
b. Usually becomes malignant
c. Predisposes to hydronephrosis
d. Causes an elevated acid phosphatase

A

c. Predisposes to hydronephrosis

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7
Q
  1. Which of the following substances is secreted and synthesized by the kidneys?

*
1 point
a. Vitamin D
b. Erythropoietin
c. Prostaglandin E
d. All of the above

A

d. All of the above

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8
Q

8.The definitive diagnosis of benign prostatic hypertrophy is arrived at by:

*
1 point
a.Rectal examination
b.Biopsy of the prostatic tissue
c.Pap smear of prostatic fluid
d.Serum phosphatase studies

A

b.Biopsy of the prostatic tissue

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9
Q

9.A patient with cystitis will most likely experience pain on which of the following areas?

*
1 point
a.Flank
b. Costovertebral angle
c. Suprapubic area
d. Perineum and rectum

A

c. Suprapubic area

Flank and costovertebral angle: Kidney
Perineum and rectum: Prostate

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10
Q

10.From the peritubular capillaries, the renal blood will flow through:

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1 point
a. arcuate vein, interlobar vein, interlobular vein, renal vein, inferior vena cava
b. interlobular vein, arcuate vein, interlobar vein, renal vein, inferior vena cava
c. renal vein, interlobar vein, interlobular vein, arcuate vein, inferior vena cava
d. renal vein, interlobar vein, arcutae vein, interlobular vein, inferior vena cava

A

b. interlobular vein, arcuate vein, interlobar vein, renal vein, inferior vena cava

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11
Q

11.What is the most common initial manifestation in acute renal failure?

*
1 point
a. Diuresis
b. Hematuria
c. Dysuria
d. Oliguria

A

d. Oliguria

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12
Q

12.What does the skin of a patient with end stage renal disease (ESRD) look like?

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1 point
a. Dry and flaky
b. Pruritic
c. Gray-bronze skin color
d. All of the above

A

d. All of the above

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13
Q

13.Stage 2 of chronic renal failure is characterized by which of the following?

*
1 point
a. loss of ability to concentrate urine
b. all of the normal functions of the kidney are severely impaired
c. 40% to 75% loss of nephron function
d. dialysis is usually indicated at this stage

A

a. loss of ability to concentrate urine

B: stage 3
C: stage 1
D: stage 3

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14
Q

14.If the cause of the acute renal failure of a client is said to be postrenal, which of the following conditions most likely caused it?

*
1 point
a. Myocardial infarction
b. Acute pyelonephritis
c. Sepsis
d. Benign prostatic hyperplasia

A

d. Benign prostatic hyperplasia

A: Pre-renal
B: Intra-renal
C: Pre-renal

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15
Q

15.Which of the following laboratory findings should a nurse expect to see on a patient with acute renal failure?

*
1 point
a. decreased BUN, decreased creatinine, decreased potassium
b. decreased BUN, increased creatinine, decreased potassium
c. increased BUN, increased creatinine, increased potassium
d. increased BUN, increased creatinine, decreased potassium

A

c. increased BUN, increased creatinine, increased potassium

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16
Q

16.Which of the following clinical findings is usually seen in a patient with chronic renal failure?

*
1 point
a. Metabolic alkalosis
b. Hypokalemia
c. Polycythemia vera
d. Hypertension

A

d. Hypertension

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17
Q

17.If the BUN of a patient with acute renal failure is elevated, it indicates that there is:

*
1 point
a. Increased protein catabolism
b. Decreased erythropoietin production
c. Damage of kidney cells
d. Decreased protein breakdown

A

a. Increased protein catabolism - in the liver

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18
Q

18.A client with stones lodged in the ureter will most likely experience pain that is:

*
1 point
a. Excruciating, wavelike, and radiating towards the genitalia
b. Dull and continuous at the suprapubic area
c. Located at the periumbilical area that progresses to the right lower quadrant
d. Dull and aching at the costovertebral area

A

a. Excruciating, wavelike, and radiating towards the genitalia

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19
Q
  1. After experiencing myocardial infarction, a 55-year-old patient has now developed acute renal failure. In explaining this to the family, the nurse responds based on the understanding that the ARF is:

*
1 point
a. a result of actual parenchymal damage
b. a result of hypoperfusion of the kidney
c. a result of an infectious process
d. a result of an obstruction distal to the kidneys

A

b. a result of hypoperfusion of the kidney

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20
Q

20.When collecting a 24-hour urine specimen, the nurse should:

*
1 point
a. Check if any preservatives need to be added
b. Weigh the client before starting the collection
c. Discard the last voided specimen of the 24-hour period
d. Check the intake and output for the previous 24-hour period

A

a. Check if any preservatives need to be added

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21
Q
  1. When teaching a female client with recurrent urinary tract infections, the nurse states that women are most susceptible because of:

*
1 point
a. Inadequate fluid intake
b. Poor hygienic practices
c. The length of the urethra
d. Continuity of the mucous membrane

A

c. The length of the urethra

22
Q
  1. Which of the following clinical manifestations is the most indicative of acute pyelonephritis?

*
1 point
a. nausea and vomiting
b. CVA tenderness
c. polyuria
d. leucopenia

A

b. CVA tenderness

23
Q
  1. The nurse should monitor a client with end-stage renal disease for the occurrence of:

*
1 point
a. Polyuria
b. Jaundice
c. Azotemia
d. Hypotension

A

c. Azotemia - all systemic manifestations

24
Q
  1. Which laboratory test is the most accurate indicator of a client’s renal function?

*
1 point
a. Creatinine clearance
b. Blood urea nitrogen
c. Urinalysis
d. Serum creatinine

A

a. Creatinine clearance

25
Q
  1. A client with a genitourinary problem is being examined in the emergency department. When palpating the client’s kidneys, the nurse should keep which anatomical fact in mind?
    *
    1 point
    a. The kidneys are located just above the adrenal glands.
    b. The average kidney is approximately 7 cm long and 3 cm wide.
    c. The kidneys lie between the 11th and 12th thoracic vertebrae.
    d. The left kidney is slightly higher than the right one.
A

d. The left kidney is slightly higher than the right one.

26
Q
  1. When examining a client’s genitourinary system, the nurse assesses for tenderness at the costovertebral angle by placing the left hand over this area and striking it with the right fist. Normally, this percussion technique produces which sound?

*
1 point
a. Dull sound
b. Flat sound
c. Tympany
d. Hyperresonance

A

a. Dull sound

B: Bones & Muscles
C: Stomach
D: Lungs

27
Q
  1. A client comes to the emergency department complaining of a sudden onset of sharp, severe pain in the lumbar region, which radiates around the side and toward the bladder. The client also reports nausea and vomiting and appears pale, diaphoretic, and anxious. The physician tentatively diagnoses renal calculi and orders flat-plate abdominal X-rays. Renal calculi can form anywhere in the urinary tract. What is their most common formation site?

*
1 point
a. Bladder
b. Ureter
c. Urethra
d. Kidney

A

d. Kidney

Ureter: least common site

28
Q
  1. The nurse is reviewing the report of a client’s routine urinalysis. Which value should the nurse consider abnormal?

*
1 point
a. Absence of glucose
b. Trace protein
c. Urine pH of 3.0
d. Urine specific gravity of 1.03

A

c. Urine pH of 3.0

29
Q
  1. A client receiving total parental nutrition is prescribed a 24-hour urine test. When initiating a 24-hour urine specimen, the collection time should:

*
1 point
a. always be with first morning urine.
b. start with the first voiding.
c.always be the last evening’s void as the last sample.
d. start after a known voiding.

A

d. start after a known voiding.

30
Q
  1. The client with acute renal failure complains of tingling of the fingers and toes and muscle twitching. This is caused by:

*
1 point
a. Acidosis
b. Calcium depletion
c. Potassium retention
d. Sodium chloride depletion

A

b. Calcium depletion

31
Q
  1. A client admitted with a gunshot wound in the abdomen is transferred to the intensive care unit after an exploratory laparotomy. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)?

*
1 point
a. Serum creatinine level of 1.2 mg/dl
b. Urine output of 400ml/24 hours
c. Temperature of 100.2F (37.8C)
d. Blood urea nitrogen (BUN) level of 22 mg/dl

A

b. Urine output of 400ml/24 hours

32
Q
  1. A client is admitted to the urology unit with a diagnosis of chronic renal failure (CRF). Which diagnostic test results are consistent with CRF?

*
1 point
a. Blood urea nitrogen (BUN) 100 mg/dL and serum creatinine 6.5 mg/dl
b. Increased serum levels of potassium, magnesium, and calcium
c. Uric acid analysis 3.5 mg/dL and phenolsulfonphthalein (PSP) excretion 75%
d. Increased pH with decreased hydrogen ions

A

a. Blood urea nitrogen (BUN) 100 mg/dL and serum creatinine 6.5 mg/dl

33
Q
  1. A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client’s risk of:

*
1 point
a. an increased serum calcium level secondary to kidney failure.
b. water and sodium retention secondary to a severe decrease in the glomerular filtration rate.
c. metabolic alkalosis secondary to retention of hydrogen ions
d. a decreased serum phosphate level secondary to kidney failure.

A

b. water and sodium retention secondary to a severe decrease in the glomerular filtration rate.

34
Q
  1. Which of the following laboratory values supports a diagnosis of pyelonephritis?

*
1 point
a. Low white blood cell (WBC) count
b. Ketonuria
c. Myoglobinuria
d. Pyuria

A

d. Pyuria - pus in the urine

35
Q
  1. A client experiences difficulty in voiding after an indwelling urinary catheter is removed. This is probably related to:

*
1 point
a. Fluid imbalances
b. The client’s recent sedentary lifestyle
c. An interruption in normal voiding habits
d. Nervous tension following the procedure

A

c. An interruption in normal voiding habits

36
Q
  1. A client with renal dysfunction of acute onset comes to the emergency department complaining of fatigue, oliguria, and cola-colored urine. When obtaining the client’s history to check for significant findings, the nurse should ask about:

*
1 point
a. childhood asthma.
b. chronic, excessive acetaminophen use.
c. family history of pernicious anemia.
d. recent streptococcal infection.

A

d. recent streptococcal infection.

37
Q
  1. A client with suspected renal insufficiency is scheduled for a comprehensive diagnostic workup. After the nurse explains the diagnostic tests, the client asks which part of the kidney “does the work.” Which answer is correct?

*
1 point
a. The tubular system
b. The glomerulus
c. The nephron
d. Bowman’s capsule

A

c. The nephron

38
Q

38 A client is admitted with a diagnosis of acute renal failure. The nurse should monitor closely for:

*
1 point
a. Lethargy
b. Insomnia
c. Enuresis
d. Drug toxicity

A

d. Drug toxicity - due to renal failure, the drug may retain longer inside the body which could lead to toxicity

39
Q
  1. A client is admitted for treatment of glomerulonephritis. On initial assessment, the nurse detects one of the classic signs of acute glomerulonephritis of sudden onset. Such signs include:

*
1 point
a.polyuria.
b. generalized edema, especially of the face and periorbital area.
c. moderate to severe hypotension.
d. green-tinged urine.

A

b. generalized edema, especially of the face and periorbital area.

40
Q
  1. A client with chronic renal failure (CRF) has developed faulty red blood cell (RBC) production. The nurse should monitor this client for:

*
1 point
a. Fatigue and weakness.
b. Dyspnea and cyanosis.
c. Thrush and circumoral pallor.
d. Nausea and vomiting.

A

a. Fatigue and weakness.

41
Q
  1. During a routine examination, the nurse notes that the client seems unusually anxious. Anxiety can affect the genitourinary system by:

*
1 point
a. decreasing potassium excretion.
b. slowing the glomerular filtration rate
c. stimulating or hindering micturition.
d. increasing sodium resorption.

A

c. stimulating or hindering micturition.

42
Q
  1. A client with decreased urine output refractory to fluid challenges is evaluated for renal failure. Which condition may cause the intrinsic (intrarenal) form of acute renal failure?

*
1 point
a. Damage to cells in the adrenal cortex
b. Nephrotoxic injury secondary to use of contrast media
c. Obstruction of the urinary collecting system
d. Poor perfusion to the kidneys

A

b. Nephrotoxic injury secondary to use of contrast media

43
Q
  1. In order to understand fluid balance, the nurse needs to recognize that:

*
1 point
a. Glomerular filtration occurs in the glomeruli, which are small arteries in the kidneys
b. The high resistance characteristic of the glomerular capillaries tends to increase the glomerular filtration rate
c. The volume of urine secreted is regulated mainly by mechanisms that control the glomerular filtration rate
d. An increase in the hydrostatic pressure in Bowman’s capsule tends to increase the glomerular filtration rate

A

b. The high resistance characteristic of the glomerular capillaries tends to increase the glomerular filtration rate

44
Q
  1. Which of the following factors would put the client at increased risk for pyelonephritis?

*
1 point
a. History of ureteral reflux
b. Intake of large quantity of juice
c. History of hypertension
d. Fluid intake of 2000 ml/day

A

a. History of ureteral reflux - Hydronephrosis

45
Q
  1. A client with acute kidney failure becomes confused and irritable. The nurse realizes that this behavior may be caused by:

*
1 point
a. Hyperkalemia
b. Hypernatremia
c. An elevated BUN
d. Limited fluid intake

A

c. An elevated BUN

46
Q
  1. Mr. Perez, a 55-year-old client is admitted to the hospital for evaluation of renal function. In assessing the urinary function of the client, the urine specific gravity measures the:
    *
    1 point
    a. Density of particles in the urine
    b. Number of leukocytes in the urine
    c. Presence of ketones bodies in the urine
    d. Osmolarity of active particles in the urine
A

a. Density of particles in the urine

47
Q
  1. The nurse understands that metabolic acidosis develops in kidney failure as a result of:

*
1 point
a. Inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate
b. Inability of the renal tubules to reabsorb water to dilute the acid contents of blood
c. Depression of respiratory rate by metabolic wastes causing carbon dioxide retention
d.Impaired glomerular filtration causing retention of sodium and metabolic waste products

A

a. Inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate

48
Q
  1. When a client has hematuria, the nurse should observe for:

*
1 point
a. Diarrhea
b. Acetone in urine
c. Symptoms of peritonitis
d. Gross blood in the urine

A

d. Gross blood in the urine

49
Q
  1. A male client is to have the urethra dilated by the physician. The nurse understands that the structure that encircles the male urethra is the:

*
1 point
a. Epididymis
b. Prostate gland
c. Seminal vesicle
d. Bulbourethral gland

A

b. Prostate gland

50
Q
  1. A routine urinalysis is ordered for a client. If the specimen cannot be sent immediately to the laboratory, the nurse should:

*
1 point
a. Take no special action
b. Refrigerate the specimen
c. Store on “dirty” side of utility room
d. Discard and collect a new specimen later

A

b. Refrigerate the specimen

RN 2023 cutie (11 decks)

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