Question 1

One of the most common causes of acute tubular necrosis (ATN)is

Accepted Answer

A)  ischemic conditions. 
B)  cytotoxic agents. 
C)  immune reaction. 
D)  prolonged postrenal kidney injury. 
A)  ischemic conditions. 
B)  cytotoxic agents. 
C)  immune reaction. 
D)  prolonged postrenal kidney injury. A

Question 2

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

Accepted Answer

A) True 
 B)False  False

Question 3

Osteoporosis commonly occurs in patients with end-stage renal disease because of

Accepted Answer

A)  hyperparathyroidism. 
B)  hypercalcemia. 
C)  excess active vitamin D. 
D)  phosphorous deficiency. 
A)  hyperparathyroidism. 
B)  hypercalcemia. 
C)  excess active vitamin D. 
D)  phosphorous deficiency. A

Question 4

A patient with renal disease is at risk for developing uremia as the nephrons progressively deteriorate,because

Accepted Answer

A)  the basement membrane becomes increasingly permeable. 
B)  filtration exceeds secretory and reabsorptive capacity. 
C)  excessive solute and water are lost in the urine. 
D)  GFR declines. 
A)  the basement membrane becomes increasingly permeable. 
B)  filtration exceeds secretory and reabsorptive capacity. 
C)  excessive solute and water are lost in the urine. 
D)  GFR declines.

Question 5

Postrenal acute kidney injury may be caused by

Accepted Answer

A)  severe hypotension. 
B)  glomerulonephritis. 
C)  bilateral kidney stones. 
D)  acute tubular necrosis. 
A)  severe hypotension. 
B)  glomerulonephritis. 
C)  bilateral kidney stones. 
D)  acute tubular necrosis.

Question 6

Anemia in people who have end-stage chronic renal disease is caused by

Accepted Answer

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. 
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.

Question 7

The most likely cause of anemia in a patient with end-stage renal disease is

Accepted Answer

A)  insufficient erythropoietin. 
B)  blood loss secondary to hematuria. 
C)  vitamin B₁₂ deficiency secondary to deficient intrinsic factor. 
D)  iron deficiency. 
A)  insufficient erythropoietin. 
B)  blood loss secondary to hematuria. 
C)  vitamin B₁₂ deficiency secondary to deficient intrinsic factor. 
D)  iron deficiency.

Question 8

The most likely cause of acidosis in a patient with end-stage renal disease is

Accepted Answer

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. 
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.

Question 9

The effect on the renal tubules during the postoliguric phase of acute tubular necrosis involves

Accepted Answer

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. 
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.

Question 10

The defining characteristic of severe acute kidney injury is

Accepted Answer

A)  proteinuria. 
B)  oliguria. 
C)  hematuria. 
D)  diuresis. 
A)  proteinuria. 
B)  oliguria. 
C)  hematuria. 
D)  diuresis.

Question 11

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

Accepted Answer

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." 
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."

Question 12

Appropriate management of end-stage renal disease includes

Accepted Answer

A)  potassium supplementation. 
B)  a high-protein diet. 
C)  erythropoietin administration. 
D)  a high-phosphate diet. 
A)  potassium supplementation. 
B)  a high-protein diet. 
C)  erythropoietin administration. 
D)  a high-phosphate diet.

Question 13

Individuals with end-stage chronic renal disease are at risk for renal osteodystrophy and spontaneous bone fractures,because

Accepted Answer

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. 
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.

Question 14

In patients with polycystic kidney disease,renal failure is expected to progress over time as the cystic process destroys more nephrons.At what point will a patient reach end-stage renal disease?

Accepted Answer

A)  Greater than 15% 
B)  Greater than 25% nephron loss 
C)  Greater than 50% nephron loss 
D)  Greater than 90% nephron loss 
A)  Greater than 15% 
B)  Greater than 25% nephron loss 
C)  Greater than 50% nephron loss 
D)  Greater than 90% nephron loss

Question 15

The most common cause of intrinsic kidney injury is _____ injury.

Accepted Answer

A)  glomerular 
B)  tubular 
C)  interstitial 
D)  vascular 
A)  glomerular 
B)  tubular 
C)  interstitial 
D)  vascular

Question 16

Renal insufficiency occurs when _____ of the nephrons are not functional.

Accepted Answer

A)  25% 
B)  50% 
C)  75% to 90% 
D)  more than 90% 
A)  25% 
B)  50% 
C)  75% to 90% 
D)  more than 90%

Question 17

Gastrointestinal drainage,perioperative and postoperative hypotension,and hemorrhage may all contribute to renal failure by causing

Accepted Answer

A)  hydronephrosis. 
B)  acute tubular necrosis. 
C)  nephrosis. 
D)  renal inflammation. 
A)  hydronephrosis. 
B)  acute tubular necrosis. 
C)  nephrosis. 
D)  renal inflammation.

Question 18

A patient being treated for acute tubular necrosis (ATN)develops mild polyuria.The nurse responds to questions about why this occurring by stating

Accepted Answer

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." 
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."

Question 19

At his most recent clinic visit,a patient with end-stage renal disease is noted to have edema,congestive signs in the pulmonary system,and a pericardial friction rub.Appropriate therapy at this time would include

Accepted Answer

A)  initiation of dialysis. 
B)  fluid restriction. 
C)  antibiotics. 
D)  phlebotomy. 
A)  initiation of dialysis. 
B)  fluid restriction. 
C)  antibiotics. 
D)  phlebotomy.

Question 20

What problem is a patient likely to experience in end-stage renal disease?

Accepted Answer

A)  Hypokalemia 
B)  Polyuria and nocturia 
C)  Uremia 
D)  Hematuria 
A)  Hypokalemia 
B)  Polyuria and nocturia 
C)  Uremia 
D)  Hematuria

Exam 28: Acute Kidney Injury and Chronic Kidney Disease

One of the most common causes of acute tubular necrosis (ATN)is

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

Osteoporosis commonly occurs in patients with end-stage renal disease because of

A patient with renal disease is at risk for developing uremia as the nephrons progressively deteriorate,because

Postrenal acute kidney injury may be caused by

Anemia in people who have end-stage chronic renal disease is caused by

The most likely cause of anemia in a patient with end-stage renal disease is

The most likely cause of acidosis in a patient with end-stage renal disease is

The effect on the renal tubules during the postoliguric phase of acute tubular necrosis involves

The defining characteristic of severe acute kidney injury is

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

Appropriate management of end-stage renal disease includes

Individuals with end-stage chronic renal disease are at risk for renal osteodystrophy and spontaneous bone fractures,because

In patients with polycystic kidney disease,renal failure is expected to progress over time as the cystic process destroys more nephrons.At what point will a patient reach end-stage renal disease?

The most common cause of intrinsic kidney injury is _____ injury.

Renal insufficiency occurs when _____ of the nephrons are not functional.

Gastrointestinal drainage,perioperative and postoperative hypotension,and hemorrhage may all contribute to renal failure by causing

A patient being treated for acute tubular necrosis (ATN)develops mild polyuria.The nurse responds to questions about why this occurring by stating

At his most recent clinic visit,a patient with end-stage renal disease is noted to have edema,congestive signs in the pulmonary system,and a pericardial friction rub.Appropriate therapy at this time would include

What problem is a patient likely to experience in end-stage renal disease?

Introduction to Pathophysiology

Homeostasis, Allostasis, and Adaptive Responses to Stressors

Cell Structure and Function

Cell Injury, Aging, and Death

Genome Structure, Regulation, and Tissue Differentiation

Genetic and Developmental Disorders

Neoplasia

Infectious Processes

Inflammation and Immunity

Alterations in Immune Function

Malignant Disorders of White Blood Cells

HIV Disease and Aids

Alterations in Oxygen Transport

Alterations in Homeostasis and Blood Coagulation

Alterations in Blood Flow

Alterations in Blood Pressure

Cardiac Function

Alterations in Cardiac Function

Heart Failure and Dysrhythmias: Common Sequelae of Cardiac Diseases

Shock

Respiratory Function and Alterations in Gas Exchange

Obstructive Pulmonary Disorders

Restrictive Pulmonary Disorders

Fluid and Electrolyte Homeostasis and Imbalances

Acid-Base Homeostasis and Imbalances

Renal Function

Intrarenal Disorders

Disorders of the Lower Urinary Tract

Male Genital and Reproductive Function

Alterations in Male Genital and Reproductive Function

Female Genital and Reproductive Function

Alterations in Female Genital and Reproductive Function

Sexually Transmitted Infections

Gastrointestinal Function

Gastrointestinal Disorders

Alterations in Function of the Gallbladder and Exocrine Pancreas

Liver Diseases

Endocrine Physiology and Mechanisms of Hypothalamic-Pituitary Regulation

Disorders of Endocrine Function

Diabetes Mellitus

Alterations in Metabolism and Nutrition

Structure and Function of the Nervous System

Acute Disorders of Brain Function

Chronic Disorders of Neurologic Function

Alterations in Special Sensory Function

Pain

Neurobiology of Psychotic Illnesses

Neurobiology of Nonpsychotic Illnesses

Structure and Function of the Musculoskeletal System

Alterations in Musculoskeletal Function: Trauma, Infection, and Disease

Alterations in Musculoskeletal Function: Rheumatic Disorders

Alterations in the Integumentary System

Burn Injuries

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