NUR 5463 FInal 2025/2026 COMPLETE QUESTIONS
WITH CORRECT DETAILED ANSWERS
Terms in this set (413)
Common initial symptom of ACS in pts >80 years? SOB
Initial dx test of stable coronary ischemia? Stress Test
What drugs are Indicated for all CAD pts regardless of Statins
LDL?
Med of choice after MI, EF <40%, and tx of angina? Beta Blocker
Antischemic agent if BB CI? Calcium Channel Blocker
STEMI or MI with new left BBB? PCI within 6-12hour or 90-120 min of admission
Gold standard diagnosis of coronary artery lesion coronary angiography
severity?
Corneal arcus (arcus senilis) This grayish white arc or circle not quite at the edge of the cornea; normal with
aging, or with cholesterol and LDL levels
Positive ischemic change on ECG? ST depression by.08
PVCs cause? A decrease in CO, more dangerous when present with heart disease
The decrease in CO, more dangerous when present with left sided heart failure
heart disease
left ventricle thickens without enlargement? Hypertropic Cardiomyopathy
paresis weakness
,plegia paralysis
when to start daily ICS in COPD patients? FEV1 <60%, Gold 3- severe
Tiotropium (Spiriva)? LAMA
Ipratropium (Atrovent)? SAMA
What fev level confirms persistent airflow obstruction in FEV1/FVC <70% post bronchodilator
COPD?
Renal problems associated with normal aging Decreased:
- GFR
- diluting capacity
- concentration ability
- sodium conservation (volume depletion)
- sodium excreation (salt sensitivity/HTN),
- ammonium & HCO3 production (metabolic acidosis)
What is the Most sensitive indicator of renal function in GFR - declines 8mls per decade starting at age 40
aging?
Microalbuminuria Chronic nephrosclerosis from HTN
renal artery stenosis partial or complete blocking of one or both renal arteries - THIS ACTIVATES THE
RENIN ANGIOTENSION ALDOSTERONE SYSTEM AND CAUSES SYSTEMIC
HYPERTENSION TO ATTEMPT TO PERFUSE THE KIDNEY - if pt has a 30% increase
in creatinine after starting an ACE or ARB - think renal artery stenosis - risk factors
include smoking, HTN, hyperlipidemia, DM, aneurysms - renal stenting isn't
indicated except in extreme cases when you can't control BP or there is
progressive kidney failure.
Most common cause of AKI Acute tubular necrosis (ATN) followed by prerenal azotemia
Acute Tubular Necrosis (ATN) Damage to the renal tubules due to presence of toxins in the urine or to ischemia.
Results in oliguria.
Prerenal azotemia Due to decreased blood flow to kidneys; common cause of acute renal failure -
increase bun and decreased renal flow - treat with volume resuscitation
acute tubular necrosis diagnostic criteria DIAGNOSIS: URINE SEDIMENT WILL CONTAIN TUBULAR EPITHELIAL CELLS &
GRANULAR MUDDY BROWN CASTS - in oliguria FENa >2% - TREATMENT IS
SUPPORTIVE CARE AND OFTEN TIMES REVERSIBLE
What is acute interstitial nephritis? - Drug-induced hypersensitivity involving the interstitium and tubules
- Results in acute renal failure (intrarenal azotemia)
- Most commone antibiotics to cause this
are: PENICILLINS
CEPHLOSPORINS
FLUOROQUINOLONES (floxacins)
, multiple myeloma "myeloma kidney" malignant neoplasm of bone marrow. Proteins light & heavy chains will deposit in
parenchyma - pt will present with lower back pain - seen AA women - will see
sever proteinurea, low anion gap, hypercalcemia, anemia, and bone pain - treat w
chemotherapy (melphalan and prednisone)
3 types of glomerular disease Acute nephritic syndrome
Post infection glomerulonephritis (step/staph)
IgA nephropathy
Nephrotic syndrome URINATING >3.5G OF PROTEIN PER DAY! WITH HYPOALBUMINEMIA, HLD, AND
EDEMA - Can be from primary glomerular disease, infection, malignancy,
exposure to allergen/medication, DM, or HTN.
◦RENAL BIOPSY IS ESSENTIAL FOR EARLY DIAGNOSIS
◦ THERAPY - CONTROLL BP, USE RASS BLOCKERS, SODIUM
RESTICTION, STATINS, ANTICOAGULATION WHEN ALBUMIN IS <2.8
What do RAAS inhibitors do? Decrease proteinuria
Chronic Kidney Disease (CKD) progressive, irreversible loss of kidney function - RENAL GLOMERULAR AND
TUBULOINTERSTITIAL FIBROSIS INCREASE WITH AGE LEADING TO CKD -
presents with a decompensation of the pts preexisting medical problems. - HTN
AND DM ARE HIGH RISK FACTORS FOR CKD
RAAS - renin-angiotensin-aldosterone system Renin is released by kidneys in response to decreased blood volume; causes
angiotensinogen to split & produce angiotensin I; lungs convert angiotensin I to
angiotensin II; angiotensin II stimulates adrenal gland to release aldosterone &
causes an increase in peripheral vasoconstriction
Medications to avoid in CKD -NSAIDs- block the synthesis of the renal prostaglandins that promote
vasodilation, and this can worsen renal hypoperfusion
-DEMEROL: Metabolized to normeperidine in the liver, which kidneys excrete
-AMINOGLYCOSIDES, PENICILLIN, AND TETRACYCLINES: Nephrotoxic
Medication use can be complicated by decreased renal MEDS TO AVOID / USE W CATION NSAID, CONTRAST, GADOLINIUM,
clearance AMINOGLYCOSIDES, AND AMPHOTERICIN B
What stage to screen for Anemia CKD stage 3B - ferritin goal should be >100
Erythropoiesis stimulating agents Can be used to prevent blood transfusion but iron should be replaced prior to
starting ESA - do not initate if hemoglobin is greater than 10 without signs or
symptoms.
renal osteodystrophy a general term that refers to bone disease related to CKD and caused by
over- or underproduction of parathyroid hormone or by exposure to aluminum
SCREEN FOR CALCIUM, PHOSPHORUS, AND PTH ABNORMALITIES BEINING IN
STAGE 3
MAINTAIN PHOSPHORUS BETWEEN 2.7 AND 4.6 IN PTS STAGE 3-4 RESTRICT
DIETARY PHOS IF PTH IS INCREASED AND USE PHOSPHOURS BINDERS
WITH CORRECT DETAILED ANSWERS
Terms in this set (413)
Common initial symptom of ACS in pts >80 years? SOB
Initial dx test of stable coronary ischemia? Stress Test
What drugs are Indicated for all CAD pts regardless of Statins
LDL?
Med of choice after MI, EF <40%, and tx of angina? Beta Blocker
Antischemic agent if BB CI? Calcium Channel Blocker
STEMI or MI with new left BBB? PCI within 6-12hour or 90-120 min of admission
Gold standard diagnosis of coronary artery lesion coronary angiography
severity?
Corneal arcus (arcus senilis) This grayish white arc or circle not quite at the edge of the cornea; normal with
aging, or with cholesterol and LDL levels
Positive ischemic change on ECG? ST depression by.08
PVCs cause? A decrease in CO, more dangerous when present with heart disease
The decrease in CO, more dangerous when present with left sided heart failure
heart disease
left ventricle thickens without enlargement? Hypertropic Cardiomyopathy
paresis weakness
,plegia paralysis
when to start daily ICS in COPD patients? FEV1 <60%, Gold 3- severe
Tiotropium (Spiriva)? LAMA
Ipratropium (Atrovent)? SAMA
What fev level confirms persistent airflow obstruction in FEV1/FVC <70% post bronchodilator
COPD?
Renal problems associated with normal aging Decreased:
- GFR
- diluting capacity
- concentration ability
- sodium conservation (volume depletion)
- sodium excreation (salt sensitivity/HTN),
- ammonium & HCO3 production (metabolic acidosis)
What is the Most sensitive indicator of renal function in GFR - declines 8mls per decade starting at age 40
aging?
Microalbuminuria Chronic nephrosclerosis from HTN
renal artery stenosis partial or complete blocking of one or both renal arteries - THIS ACTIVATES THE
RENIN ANGIOTENSION ALDOSTERONE SYSTEM AND CAUSES SYSTEMIC
HYPERTENSION TO ATTEMPT TO PERFUSE THE KIDNEY - if pt has a 30% increase
in creatinine after starting an ACE or ARB - think renal artery stenosis - risk factors
include smoking, HTN, hyperlipidemia, DM, aneurysms - renal stenting isn't
indicated except in extreme cases when you can't control BP or there is
progressive kidney failure.
Most common cause of AKI Acute tubular necrosis (ATN) followed by prerenal azotemia
Acute Tubular Necrosis (ATN) Damage to the renal tubules due to presence of toxins in the urine or to ischemia.
Results in oliguria.
Prerenal azotemia Due to decreased blood flow to kidneys; common cause of acute renal failure -
increase bun and decreased renal flow - treat with volume resuscitation
acute tubular necrosis diagnostic criteria DIAGNOSIS: URINE SEDIMENT WILL CONTAIN TUBULAR EPITHELIAL CELLS &
GRANULAR MUDDY BROWN CASTS - in oliguria FENa >2% - TREATMENT IS
SUPPORTIVE CARE AND OFTEN TIMES REVERSIBLE
What is acute interstitial nephritis? - Drug-induced hypersensitivity involving the interstitium and tubules
- Results in acute renal failure (intrarenal azotemia)
- Most commone antibiotics to cause this
are: PENICILLINS
CEPHLOSPORINS
FLUOROQUINOLONES (floxacins)
, multiple myeloma "myeloma kidney" malignant neoplasm of bone marrow. Proteins light & heavy chains will deposit in
parenchyma - pt will present with lower back pain - seen AA women - will see
sever proteinurea, low anion gap, hypercalcemia, anemia, and bone pain - treat w
chemotherapy (melphalan and prednisone)
3 types of glomerular disease Acute nephritic syndrome
Post infection glomerulonephritis (step/staph)
IgA nephropathy
Nephrotic syndrome URINATING >3.5G OF PROTEIN PER DAY! WITH HYPOALBUMINEMIA, HLD, AND
EDEMA - Can be from primary glomerular disease, infection, malignancy,
exposure to allergen/medication, DM, or HTN.
◦RENAL BIOPSY IS ESSENTIAL FOR EARLY DIAGNOSIS
◦ THERAPY - CONTROLL BP, USE RASS BLOCKERS, SODIUM
RESTICTION, STATINS, ANTICOAGULATION WHEN ALBUMIN IS <2.8
What do RAAS inhibitors do? Decrease proteinuria
Chronic Kidney Disease (CKD) progressive, irreversible loss of kidney function - RENAL GLOMERULAR AND
TUBULOINTERSTITIAL FIBROSIS INCREASE WITH AGE LEADING TO CKD -
presents with a decompensation of the pts preexisting medical problems. - HTN
AND DM ARE HIGH RISK FACTORS FOR CKD
RAAS - renin-angiotensin-aldosterone system Renin is released by kidneys in response to decreased blood volume; causes
angiotensinogen to split & produce angiotensin I; lungs convert angiotensin I to
angiotensin II; angiotensin II stimulates adrenal gland to release aldosterone &
causes an increase in peripheral vasoconstriction
Medications to avoid in CKD -NSAIDs- block the synthesis of the renal prostaglandins that promote
vasodilation, and this can worsen renal hypoperfusion
-DEMEROL: Metabolized to normeperidine in the liver, which kidneys excrete
-AMINOGLYCOSIDES, PENICILLIN, AND TETRACYCLINES: Nephrotoxic
Medication use can be complicated by decreased renal MEDS TO AVOID / USE W CATION NSAID, CONTRAST, GADOLINIUM,
clearance AMINOGLYCOSIDES, AND AMPHOTERICIN B
What stage to screen for Anemia CKD stage 3B - ferritin goal should be >100
Erythropoiesis stimulating agents Can be used to prevent blood transfusion but iron should be replaced prior to
starting ESA - do not initate if hemoglobin is greater than 10 without signs or
symptoms.
renal osteodystrophy a general term that refers to bone disease related to CKD and caused by
over- or underproduction of parathyroid hormone or by exposure to aluminum
SCREEN FOR CALCIUM, PHOSPHORUS, AND PTH ABNORMALITIES BEINING IN
STAGE 3
MAINTAIN PHOSPHORUS BETWEEN 2.7 AND 4.6 IN PTS STAGE 3-4 RESTRICT
DIETARY PHOS IF PTH IS INCREASED AND USE PHOSPHOURS BINDERS
