PATHOPHYSIOLOGY EXAM 3
PRACTICE QUESTIONS AND
ANSWERS
The nurse working in an outpatient nephrology clinic knows that which of the followi
vz vz vz vz vz vz vz vz vz vz vz vz vz
ng are primary functions of the kidneys? (Select all that apply.)
vz vz vz vz vz vz vz vz vz vz
A. Production of clotting factors
vz vz vz vz vz
B. Homeostasis
vz vz
C. Excretion of metabolic wastes
vz vz vz vz vz
D. Regulation of acid-base balance
vz vz vz vz
E. Metabolism of fats - ANSWERS-B, C, D
vz vz vz vz vz vz vz
The kidneys do not metabolize fats.
vz vz vz vz vz vz
Production of clotting factors is a primary function of the liver.
vz vz vz vz vz vz vz vz vz vz
The kidneys maintain blood pressure using the RAAS and also produce erythropoie
vz vz vz vz vz vz vz vz vz vz vz
tin to stimulate RBC production.
vz vz vz vz
In caring for a patient diagnosed with acute kidney injury, the nephrology nurse kno
vz vz vz vz vz vz vz vz vz vz vz vz vz
ws that which of the following tests are specific for renal function?
vz vz vz vz vz vz vz vz vz vz vz
(Select all that apply.)
vz vz vz vz
A. Aspartate aminotransferase (AST)
vz vz vz vz
B. Blood urea nitrogen
vz vz vz
C. Creatinine
vz
D. Glomerular filtration rate
vz vz vz
E. White blood cell count - ANSWERS-B, C, D
vz vz vz vz vz vz vz vz
AST related to LIVER function
vz vz vz vz
In caring for a patient with acute kidney injury the nurse knows that the patient's re
vz vz vz vz vz vz vz vz vz vz vz vz vz vz vz
nal function has returned to normal range when the patient's GFR measures:
vz vz vz vz vz vz vz vz vz vz vz
A. 30-40 mL/min
vz vz
B. 40-50 mL/min
vz vz
C. 70-90 mL/min
vz vz
D. 90-120 mL/min - ANSWERS-D
vz vz vz vz
Normal GFR is 90-120 mL/min vz vz vz vz
Normal Creatinine 0.6-1.1 for females and 0.6-1.2 for males
vz vz vz vz vz vz vz vz
Normal BUN is 10-20 mg/dL vz vz vz vz
*Be sure to know these normal values, you will use them daily as a nurse
vz vz vz vz vz vz vz vz vz vz vz vz vz vz
The nursing working in a geriatric living facility understands that as patients age, w
vz vz vz vz vz vz vz vz vz vz vz vz vz
hich change in glomerular filtration rate is expected?
vz vz vz vz vz vz vz
A. Increased GFR
vz vz
B. Decreased GFR
vz vz
C. Same GFR
vz vz
,D. No GFR - ANSWERS-B
vz vz vz vz
Aging and renal function:
vz vz vz vz
Decrease in renal blood flow and GFR → altered sodium and water balance
vz vz vz vz vz vz vz vz vz vz vz vz
Number of nephrons decrease due to renal vascular and perfusion changes
vz vz vz vz vz vz vz vz vz vz
Response to acid-base changes is delayed vz vz vz vz vz
Increased risk for drug toxicity vz vz vz vz vz
Alterations in thirst and water intake vz vz vz vz vz
Get dehydrated very easily; do not recognize thirst and heat
vz vz vz vz vz vz vz vz vz vz
Decreased muscle mass may lead to decreased creatinine values
vz vz vz vz vz vz vz vz
An older patient is experiencing urinary stasis. The registered nurse knows that urin
vz vz vz vz vz vz vz vz vz vz vz vz
ary stasis may lead to which of the following?
vz vz vz vz vz vz vz vz
A. Increased GFR
vz vz
B. Hypocoagulation
vz
C. Hypertension
vz
D. Infection - ANSWERS-D
vz vz vz vz
Urinary stasis is a risk factor for developing UTI
vz vz vz vz vz vz vz vz
Which of the following is classified as the most common primary mineral salt comp
vz vz vz vz vz vz vz vz vz vz vz vz vz
osition of kidney stones? vz vz vz
A. Calcium
vz
B. Struvite
vz
C. Uric Acid
vz vz
D. Cysteine - ANSWERS-A
vz vz vz
A - calcium (i.e. oxalate or phosphate) is most common
vz vz vz vz vz vz vz vz vz
*Note that a change in urine pH may lead to precipitation of stones
vz vz vz vz vz vz vz vz vz vz vz vz
Which of the following are risk factors for developing renal tumors?
vz vz vz vz vz vz vz vz vz vz
(Select all that apply.)
vz vz vz vz
A. Female gender
vz vz
B. Smoking
vz
C. Obesity
vz
D. Diabetes
vz
E. Hypertension - ANSWERS-B, C, E
vz vz vz vz vz
risk factors are male gender, smoking, obesity, uncontrolled hypertension
vz vz vz vz vz vz vz vz
The registered nurse would expect which of the following lab values for a patient ex
vz vz vz vz vz vz vz vz vz vz vz vz vz vz
periencing acute kidney failure? vz vz vz
A. Creatinine 3.5 mg/dL
vz vz vz
B. Sodium 122 mEq/L
vz vz vz
C. Albumin 3.5 g/dL
vz vz vz
D. BUN 10 mg/dL - ANSWERS-A
vz vz vz vz vz vz
the normal creatinine level is 0.6 - 1.2
vz vz vz vz vz vz vz
, This BUN is within normal range (BUN would be elevated in acute kidney failure)
vz vz vz vz vz vz vz vz vz vz vz vz vz
In caring for a patient experiencing acute kidney injury who has these lab values: u
vz vz vz vz vz vz vz vz vz vz vz vz vz vz
rinary output 15 mL/hr, BUN 30 mg/
vz vz vz vz vz vz
dL, and creatinine 3.5, the nurse knows that the patient is experiencing which phas
vz vz vz vz vz vz vz vz vz vz vz vz vz
e of acute kidney injury?
vz vz vz vz
A. Initiation phase
vz vz vz
B. Oliguric phase
vz vz
C. Recovery (polyuric) phase
vz vz vz
D. I don't remember the normal lab values - ANSWERS-B
vz vz vz vz vz vz vz vz vz
Remember that there are phases of acute kidney injury - vz vz vz vz vz vz vz vz vz vz
Initiation phase is when the injury is just beginning and prevention is still possible
vz vz vz vz vz vz vz vz vz vz vz vz vz
Next is the oliguric phase where urinary output is decreased and nitrogenous waste
vz vz vz vz vz vz vz vz vz vz vz vz
products are maintained (BUN and Creatinine)
vz vz vz vz vz vz
There is also the recovery or polyuric/diuretic phase -
vz vz vz vz vz vz vz vz
diuresis is common and BUN and creatinine decline
vz vz vz vz vz vz vz vz
A 25-year-
vz
old female is diagnosed with urinary tract obstruction. While planning care, the nurs
vz vz vz vz vz vz vz vz vz vz vz vz
e realizes that the patient is expected to have hydronephrosis and a decreased glo
vz vz vz vz vz vz vz vz vz vz vz vz vz
merular filtration rate caused by: vz vz vz vz
A. Decreased renal blood flow
vz vz vz vz
B. Decreased peritubular capillary pressure
vz vz vz vz
C. Dilation of renal pelvis and calyces proximal to blockage
vz vz vz vz vz vz vz vz vz
D. Stimulation of antidiuretic hormone - ANSWERS-C
vz vz vz vz vz vz
Hydroureter; dilation of ureter vz vz vz vz
Hydronephrosis: dilation/enlargement of renal pelvis and calyces vz vz vz vz vz vz vz
Ureterohydronephrosis: dilation of ureter AND renal pelvis and calyces vz vz vz vz vz vz vz vz
A 55-year-
vz
old male presents reporting urinary retention. Tests reveal that he has a lower urina
vz vz vz vz vz vz vz vz vz vz vz vz vz
ry tract obstruction. Which of the following is of most concern to the nurse?
vz vz vz vz vz vz vz vz vz vz vz vz vz
A. Vesicoureteral reflux and pyelonephritis
vz vz vz vz
B. Formation of renal calculi
vz vz vz vz vz
C. Glomerulonephritis
vz vz
D. Increased bladder compliance - ANSWERS-B
vz vz vz vz vz
urine stasis occurs with urinary tract obstruction and can lead to the formation of re
vz vz vz vz vz vz vz vz vz vz vz vz vz vz
nal calculi and UTI
vz vz vz
A 75-year-
vz
old male reports to his primary care provider loss of urine with cough, sneezing, or
vz vz vz vz vz vz vz vz vz vz vz vz vz vz vz
laughing. Which of the following is the most likely diagnosis the nurse will observe
vz vz vz vz vz vz vz vz vz vz vz vz vz vz
on the chart?
vz vz
A. Urge incontinence
vz vz
B. Overflow incontinence
vz vz
C. Stress incontinence
vz vz vz
PRACTICE QUESTIONS AND
ANSWERS
The nurse working in an outpatient nephrology clinic knows that which of the followi
vz vz vz vz vz vz vz vz vz vz vz vz vz
ng are primary functions of the kidneys? (Select all that apply.)
vz vz vz vz vz vz vz vz vz vz
A. Production of clotting factors
vz vz vz vz vz
B. Homeostasis
vz vz
C. Excretion of metabolic wastes
vz vz vz vz vz
D. Regulation of acid-base balance
vz vz vz vz
E. Metabolism of fats - ANSWERS-B, C, D
vz vz vz vz vz vz vz
The kidneys do not metabolize fats.
vz vz vz vz vz vz
Production of clotting factors is a primary function of the liver.
vz vz vz vz vz vz vz vz vz vz
The kidneys maintain blood pressure using the RAAS and also produce erythropoie
vz vz vz vz vz vz vz vz vz vz vz
tin to stimulate RBC production.
vz vz vz vz
In caring for a patient diagnosed with acute kidney injury, the nephrology nurse kno
vz vz vz vz vz vz vz vz vz vz vz vz vz
ws that which of the following tests are specific for renal function?
vz vz vz vz vz vz vz vz vz vz vz
(Select all that apply.)
vz vz vz vz
A. Aspartate aminotransferase (AST)
vz vz vz vz
B. Blood urea nitrogen
vz vz vz
C. Creatinine
vz
D. Glomerular filtration rate
vz vz vz
E. White blood cell count - ANSWERS-B, C, D
vz vz vz vz vz vz vz vz
AST related to LIVER function
vz vz vz vz
In caring for a patient with acute kidney injury the nurse knows that the patient's re
vz vz vz vz vz vz vz vz vz vz vz vz vz vz vz
nal function has returned to normal range when the patient's GFR measures:
vz vz vz vz vz vz vz vz vz vz vz
A. 30-40 mL/min
vz vz
B. 40-50 mL/min
vz vz
C. 70-90 mL/min
vz vz
D. 90-120 mL/min - ANSWERS-D
vz vz vz vz
Normal GFR is 90-120 mL/min vz vz vz vz
Normal Creatinine 0.6-1.1 for females and 0.6-1.2 for males
vz vz vz vz vz vz vz vz
Normal BUN is 10-20 mg/dL vz vz vz vz
*Be sure to know these normal values, you will use them daily as a nurse
vz vz vz vz vz vz vz vz vz vz vz vz vz vz
The nursing working in a geriatric living facility understands that as patients age, w
vz vz vz vz vz vz vz vz vz vz vz vz vz
hich change in glomerular filtration rate is expected?
vz vz vz vz vz vz vz
A. Increased GFR
vz vz
B. Decreased GFR
vz vz
C. Same GFR
vz vz
,D. No GFR - ANSWERS-B
vz vz vz vz
Aging and renal function:
vz vz vz vz
Decrease in renal blood flow and GFR → altered sodium and water balance
vz vz vz vz vz vz vz vz vz vz vz vz
Number of nephrons decrease due to renal vascular and perfusion changes
vz vz vz vz vz vz vz vz vz vz
Response to acid-base changes is delayed vz vz vz vz vz
Increased risk for drug toxicity vz vz vz vz vz
Alterations in thirst and water intake vz vz vz vz vz
Get dehydrated very easily; do not recognize thirst and heat
vz vz vz vz vz vz vz vz vz vz
Decreased muscle mass may lead to decreased creatinine values
vz vz vz vz vz vz vz vz
An older patient is experiencing urinary stasis. The registered nurse knows that urin
vz vz vz vz vz vz vz vz vz vz vz vz
ary stasis may lead to which of the following?
vz vz vz vz vz vz vz vz
A. Increased GFR
vz vz
B. Hypocoagulation
vz
C. Hypertension
vz
D. Infection - ANSWERS-D
vz vz vz vz
Urinary stasis is a risk factor for developing UTI
vz vz vz vz vz vz vz vz
Which of the following is classified as the most common primary mineral salt comp
vz vz vz vz vz vz vz vz vz vz vz vz vz
osition of kidney stones? vz vz vz
A. Calcium
vz
B. Struvite
vz
C. Uric Acid
vz vz
D. Cysteine - ANSWERS-A
vz vz vz
A - calcium (i.e. oxalate or phosphate) is most common
vz vz vz vz vz vz vz vz vz
*Note that a change in urine pH may lead to precipitation of stones
vz vz vz vz vz vz vz vz vz vz vz vz
Which of the following are risk factors for developing renal tumors?
vz vz vz vz vz vz vz vz vz vz
(Select all that apply.)
vz vz vz vz
A. Female gender
vz vz
B. Smoking
vz
C. Obesity
vz
D. Diabetes
vz
E. Hypertension - ANSWERS-B, C, E
vz vz vz vz vz
risk factors are male gender, smoking, obesity, uncontrolled hypertension
vz vz vz vz vz vz vz vz
The registered nurse would expect which of the following lab values for a patient ex
vz vz vz vz vz vz vz vz vz vz vz vz vz vz
periencing acute kidney failure? vz vz vz
A. Creatinine 3.5 mg/dL
vz vz vz
B. Sodium 122 mEq/L
vz vz vz
C. Albumin 3.5 g/dL
vz vz vz
D. BUN 10 mg/dL - ANSWERS-A
vz vz vz vz vz vz
the normal creatinine level is 0.6 - 1.2
vz vz vz vz vz vz vz
, This BUN is within normal range (BUN would be elevated in acute kidney failure)
vz vz vz vz vz vz vz vz vz vz vz vz vz
In caring for a patient experiencing acute kidney injury who has these lab values: u
vz vz vz vz vz vz vz vz vz vz vz vz vz vz
rinary output 15 mL/hr, BUN 30 mg/
vz vz vz vz vz vz
dL, and creatinine 3.5, the nurse knows that the patient is experiencing which phas
vz vz vz vz vz vz vz vz vz vz vz vz vz
e of acute kidney injury?
vz vz vz vz
A. Initiation phase
vz vz vz
B. Oliguric phase
vz vz
C. Recovery (polyuric) phase
vz vz vz
D. I don't remember the normal lab values - ANSWERS-B
vz vz vz vz vz vz vz vz vz
Remember that there are phases of acute kidney injury - vz vz vz vz vz vz vz vz vz vz
Initiation phase is when the injury is just beginning and prevention is still possible
vz vz vz vz vz vz vz vz vz vz vz vz vz
Next is the oliguric phase where urinary output is decreased and nitrogenous waste
vz vz vz vz vz vz vz vz vz vz vz vz
products are maintained (BUN and Creatinine)
vz vz vz vz vz vz
There is also the recovery or polyuric/diuretic phase -
vz vz vz vz vz vz vz vz
diuresis is common and BUN and creatinine decline
vz vz vz vz vz vz vz vz
A 25-year-
vz
old female is diagnosed with urinary tract obstruction. While planning care, the nurs
vz vz vz vz vz vz vz vz vz vz vz vz
e realizes that the patient is expected to have hydronephrosis and a decreased glo
vz vz vz vz vz vz vz vz vz vz vz vz vz
merular filtration rate caused by: vz vz vz vz
A. Decreased renal blood flow
vz vz vz vz
B. Decreased peritubular capillary pressure
vz vz vz vz
C. Dilation of renal pelvis and calyces proximal to blockage
vz vz vz vz vz vz vz vz vz
D. Stimulation of antidiuretic hormone - ANSWERS-C
vz vz vz vz vz vz
Hydroureter; dilation of ureter vz vz vz vz
Hydronephrosis: dilation/enlargement of renal pelvis and calyces vz vz vz vz vz vz vz
Ureterohydronephrosis: dilation of ureter AND renal pelvis and calyces vz vz vz vz vz vz vz vz
A 55-year-
vz
old male presents reporting urinary retention. Tests reveal that he has a lower urina
vz vz vz vz vz vz vz vz vz vz vz vz vz
ry tract obstruction. Which of the following is of most concern to the nurse?
vz vz vz vz vz vz vz vz vz vz vz vz vz
A. Vesicoureteral reflux and pyelonephritis
vz vz vz vz
B. Formation of renal calculi
vz vz vz vz vz
C. Glomerulonephritis
vz vz
D. Increased bladder compliance - ANSWERS-B
vz vz vz vz vz
urine stasis occurs with urinary tract obstruction and can lead to the formation of re
vz vz vz vz vz vz vz vz vz vz vz vz vz vz
nal calculi and UTI
vz vz vz
A 75-year-
vz
old male reports to his primary care provider loss of urine with cough, sneezing, or
vz vz vz vz vz vz vz vz vz vz vz vz vz vz vz
laughing. Which of the following is the most likely diagnosis the nurse will observe
vz vz vz vz vz vz vz vz vz vz vz vz vz vz
on the chart?
vz vz
A. Urge incontinence
vz vz
B. Overflow incontinence
vz vz
C. Stress incontinence
vz vz vz
