NURS 5461 Final Quiz Questions And
Correct Answers (Verified Answers) 2026
Renal issues that occur with normal aging
Decreased GFR, decreased diluting capacity, decreased concentration ability,
decreased sodium conservation (volume depletion) decreased sodium
excreation (salt sensitivity/HTN), decreased ammonium & bicarb production
(metabolic acidosis)
Most accurate indicator of renal function in older adults
GFR - declines 8mls per decade starting at age 40
Small amounts of protein in urine
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 INCLUDE TUBULAR EPITHELIAL CELLS &
GRANULAR MUDDY BROWN CASTS - in oliguria FENa >2% - TREATMENT IS
SUPPORTIVE CARE AND OFTEN TIMES REVERSIBLE
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, AND 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 INCREASES 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 clearance - MEDS TO
AVOID / USE W CATION NSAID, CONTRAST, GADOLINIUM,
AMINOGLYCOSIDES, AND AMPHOTERICIN B
What stage to screen for Anemia
CKD stage 3B - ferritin goal should be >100
Correct Answers (Verified Answers) 2026
Renal issues that occur with normal aging
Decreased GFR, decreased diluting capacity, decreased concentration ability,
decreased sodium conservation (volume depletion) decreased sodium
excreation (salt sensitivity/HTN), decreased ammonium & bicarb production
(metabolic acidosis)
Most accurate indicator of renal function in older adults
GFR - declines 8mls per decade starting at age 40
Small amounts of protein in urine
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 INCLUDE TUBULAR EPITHELIAL CELLS &
GRANULAR MUDDY BROWN CASTS - in oliguria FENa >2% - TREATMENT IS
SUPPORTIVE CARE AND OFTEN TIMES REVERSIBLE
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, AND 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 INCREASES 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 clearance - MEDS TO
AVOID / USE W CATION NSAID, CONTRAST, GADOLINIUM,
AMINOGLYCOSIDES, AND AMPHOTERICIN B
What stage to screen for Anemia
CKD stage 3B - ferritin goal should be >100
