NR 282 FINAL Study guide(latest version)

A 5-year-old male presents to the E with delirium and sunken eyes. After diagnosing him with severe dehydration, the primary care provider orders fluid replacement. The nurse administers a hypertonic intravenous solution. Which of the following would be expected a. symptoms subside quickly b. increased ICF volume c. Decreased ECF volume d. Intracellular dehydration Correct answer- D. Intracellular dehydration A 10-year-old male is brought to the ER because he is incoherent and semiconscious. CT scan reveals that he is suffering from cerebral edema. This type of edema is referred to as a. localized edema b. generalized edema c. pitting edema d. lymphedema Correct answer- A. Localized edema A 19-year old male presents to his primary care provider reporting restlessness, muscle cramping, and diarrhea. Lab tests reveal that he is hyperkalemia. Which of the following could have caused his condition a. primary hyperaldosteronism b. acidosis c. insulin secretion d. diuretic use Correct answer- B. Acidosis A 25-year old male is diagnosed with a hormone-secreting tumor of the adrenal cortex. Which finding would the nurse expect to see in the lab results a. decreased blood volume b. decreased blood K+ levels c. increased urine Na+ levels d. increased white blood cells Correct answer- B. Decreased blood K+ levels A 35-year-old male weighs 70kg. Approximately how much of this weight is ICF a. 5L b. 10L c. 28L d. 42L Correct answer- D. 42L A 42-year-old female presents to her primary care provider reporting muscle weakness and cardiac abnormalities. Lab tests indicate that she is hypokalemia. Which of the following could be the cause of her condition a. respiratory acidosis b. constipation c. hypoglycemia d. primary hyperaldosteronism Correct answer- D. Primary hyperaldosteronism A 52-year-old diabetic male presents to the ER with lethargy, confusion, and depressed reflexes. His wife indicates that he does not follow the prescribed diet and takes his medication sporadically. Lab results indicate hyperglycemia. Which assessment finding is most likely to occur a. clammy skin b. decreased sodium c. decreased urine formation d. metabolic alkalosis Correct answer- B. Decreased sodium A 54-year-old male with a long history of smoking complains of excessive tiredness, shortness of breath, and overall ill feelings. Lab results reveal decreased pH, increased CO2, and normal bicarbonate ion. These findings help to confirm the diagnosis of a. respiratory alkalosis b. metabolic acidosis c. respiratory acidosis d. metabolic alkalosis Correct answer- C. Respiratory acidosis A 55-year old female presents to her primary care provider and reports dizziness, confusion, and tingling in the extremities. Blood tests reveal an elevated pH, decreased PCO2, and slightly decreased HCO3. Which of the following is the most likely diagnosis a. respiratory alkalosis with renal compensation b. respiratory acidosis with renal compensation c. metabolic alkalosis with respiratory compensation d. meatabolic acidosis with respiratory compensation Correct answer- A. Respiratory alkalosis with renal compensation A 60-year old female is diagnosed with hyperkalemia. Which assessment finding should the nurse expect to observe a. weak pulse b. excessive thirst c. oliguria d. constipation Correct answer- C. Oliguria A 60-year-old male with a 30-year history of smoking is diagnosed with a hormone secreting lung tumor. Further testing indicates that the tumor secrets ADH. Which of the following assessment findings should the nurse expect (mark all that apply) a. confusion b. weakness c. nausea d. muscle twitching e. weight loss Correct answer- B, C, D A 70-year-old male with chronic renal failure presents with edema. Which of the following is the mostly likely cause of his condition a. increased capillary oncotic pressure b. decreased interstitial oncotic pressure c. increased capillary hydrostatic pressure d. increased interstitial hydrostatic pressure Correct answer- C. Increased capillary hydrostatic pressure An experiment was designed to test the effects of the Starling forces on fluid movement. Which of the following alterations would result in fluid moving into the interstitial space a. increased capillary oncotic pressure b. increased interstitial oncotic pressure c. decreased capillary hydrostatic pressure d. increased interstitial oncotic pressure Correct answer- B. Increased interstitial oncotic pressure For a patient experiencing metabolic acidosis, the body will compensate by a. excreting H+ through the kidneys b. hyperventilating c. retaining CO2 in the lungs d. secreting aldosterone Correct answer- B. Hyperventilating For a patient with respiratory acidosis, chronic compensation by the body will include a. kidney excretion of H+ b. kidney excretion of HCO3 c. prolonged exhalations to blow off CO2 d. protein buffering Correct answer- A. Kidney excretion of H+ Hyperlipidemia and hyperglycemia are associated with a. hypernatremia b. hypertonic hypernatremia c. hypokalemia d. acidosis Correct answer- B. Hypertonic hypernatremia THe most common cause of pure water deficit is a. renal water loss b. hyperventilation c. sodium loss d. insufficient water intake Correct answer- A. Renal water loss A nurse is reviewing lab reports. The nurse recalls blood plasma is located in which of the following fluid compartments a. intracellular fluid (ICF) b. extracellular fluid (ECF) c. interstitial fluid d. intravascular fluid Correct answer- D. Intravascular fluid A nurse is teaching the staff about antidiuretic hormone (ADH). Which information should the nurse include. Secretion of ADH is stimulated by a. increased serum potassium b. increased plasma osmolality c. decreased renal blood flow d. generalized edema Correct answer- B. Increased plasma osmolality A nurse recalls regulation of acid-base balance through removal or retention of volatile acids is accomplished by the a. buffer systems b. kidneys c. lungs d. liver Correct answer- C. Lungs The nurse would anticipate the patient with syndrome of inappropriate ADH to demonstrate which of the following symptoms (mark all that apply) a. weakness b. nausea c. headache d. muscle twitching e. weight loss Correct answer- A, D Outcomes of lab tests include an elevated level of natriuretic peptides. Which organ is the priority assessment a. lungs b. heart c. liver d. brain Correct answer- B. Heart Physiologic pH is maintained around 7.4 because carbonic acid and bicarbonate exist in a ratio of a. 20:1 b. 1:20 c. 10:2 d. 2:10 Correct answer- A. 20:1 Water movement between ICF and ECF compartments is determined by a. osmotic forces b. plasma oncotic pressure c. antidiuretic hormone d. buffer system Correct answer- A. Osmotic forces When planning care for a dehydrated patient, the nurse remembers the principle of water balance is closely related to ____ balance a. potassium b. chloride c. bicarbonate d. sodium Correct answer- D. Sodium When planning care for elderly individuals, the nurse remembers the elderly are at a higher risk for developing dehydration because they have a a. higher total body water volume b. decreased muscle mass c. increase in thirst d. increased tendency towards developing edema Correct answer- B. decreased muscle mass When taking care of a patient with hyperkalemia, which principle is priority? Hyperkalemia causes a ____ in resting membrane potential with _____ excitability of cardiac muscle a. increased; increased b. decreased; increased c. increase; decreased d. decreased; decreased Correct answer- A. Increase; increased Which finding would support the diagnosis of respiratory acidosis a. vomiting b. hyperventilation c. pneumonia d. an increase in non-corbonic acids Correct answer- C. Pneumonia Which of the following buffer pairs is considered the major plasma buffering system a. protein/fat b. carbonic acid/bicarbonate c. sodium/potassium d. amylase/albumin Correct answer- B. Carbonic acid/bicarbonate Which of the following conditions would cause the nurse to monitor for hyperkalemia a. excess aldosterone b. acute acidosis c. insulin usage d. metabolic alkalosis Correct answer- B. Acute acidosis Which of the following patients is most prone to hypocholoremia. A patient with a. hypernatremia b. hypokalemia c. hypercalcemia d. increased bicarbonate intake Correct answer- D. Increased bicarbonate intake Which of the following patients is the most at risk for developing hypernatremia? A patient with a. vomiting b. diuretic use c. dehydration d. hypoaldosteronism Correct answer- C. dehydration Which of the following patients should the nurse assess for a decreased oncotic pressure in the capillaries? A patient with a. high protein diet b. liver failure c. low blood pressure d. low blood glucose Correct answer- B. liver failure Which organ system should the nurse monitor when the patient has long-term potassium deficits a. CNS b. lungs c. kidneys d. gastrointestinal tract Correct answer- C. Kidneys Which patient is most prone to metabolic alkalosis? A patient with a. retention of metabolic acids b. hyperaldosteronism c. excessive loss of chloride (Cl) d. hyperventilation Correct answer- C. Excessive loss of chloride (Cl) Which patient should the nurse assess for both hyperkalemia and metabolic acidosis A patient diagnosed with a. diabetes insipidus b. pulmonary disorders c. Cushing syndrome d. renal failure Correct answer- D. Renal failure Which statement by the staff indicates teaching was successful concerning aldosterone? Secretion of aldosterone results in a. decreased plasma osmolality b. increased serum potassium levels c. increased blood volume d. localized edema Correct answer- C. Increased blood volume A 15-year-old male was diagnosed with pharyngitis. Eight days later he developed acute glomerulonephritis. While reviewing the culture results, which of the following is the most likely cause of this disease? Correct answer- Group A B-hemolytic streptococcus A 19-year-old female was involved in a motor vehicle accident during which she sustained a closed head injury. She is now experiencing detrusor sphincter dyssynergia. Which of the following is the most beneficial mediation treatment? Correct answer- Alpha blocker A 24-year-old female is diagnosed with renal calculus that is causing obstruction. Which of the following symptoms would she most likely experience? Correct answer- Flank plain A 25-year-old female is diagnosed with urinary tract obstruction. While planning care, the nurse realizes that the patient is expected to have hydronephrosis and a decreased glomerular filtration rate caused by: Correct answer- dilation of the renal pelvis and calyces proximal to a blockage A 25-year-old female presents with burning urination. She was diagnosed with a urinary tract infection. When the nurse checks the culture results, which of the following organism is most likely infecting her urinary tract? Correct answer- Escherichia coli A 45-year-old female presents with hypertension, anorexia, nausea and vomiting, and anemia. She is diagnosed with chronic renal failure. When the patient asks what caused this anemia, how should the nurse respond? Your anemia is cuased by: Correct answer- Inadequate production of erythropoietin A 25-year-old male was diagnosed with Goodpasture syndrome. While planning care for this patient, which of the following mechanisms would cause tissue injury? Correct answer- Production of antibodies against the glomerular basement membrane A 27-year-old male has severe kidney obstruction leading to removal of the affected kidney. Which of the following should the nurse expect to occur? Correct answer- Compensatory hypertrophy of the remaining kidney A 28-year-old female presents with fever, chills, and flank pain. She is diagnosed with pyelonephritis. A nurse recalls the patient's infection is located in the: Correct answer- Renal pelvis A 29-year-old female presents with cloudy urine, flank pain, hematuria, and fever. Which of the following does the nurse suspect the patient is most likely experiencing? Correct answer- Acute cystitis A 30-year-old male is demonstrating hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, while albumin being the major protein. The most probable diagnosis the nurse will see documented on the chart is: Correct answer- Acute glomerulonephritis A 35-year-old female was severely burned and is hospitalized. She is now suffering from acute tubular necrosis (ATN). Which of the following is the most likely diagnosis the nurse will observe on the chart? Correct answer- Intrarenal A 35-year-old male received a traumatic brain injury in a motor vehicle accident. CT scan revealed a lesion above the pontine micturition center. Which of the following would the nurse expect? Correct answer- Detrusor hyperreflexia A 42-year-old female is diagnosed with chronic renal failure, and the nurse is discussing dietary treatment. Which information indicates the nurse understands dietary regimen? Treatment includes restricting: Correct answer- Proteins A 42-year-old male is involve in a motor vehicle accident during which he loses a lot of blood. The nurse realizes he is in acute renal failure caused by: Correct answer- Inadequate renal blood flow A 45-year-old male presents with oliguria. He is diagnosed with chronic glomerulonephritis. The nurse knows oliguria is related to: Correct answer- Thickening of the glomerular membrane and decreased renal blood flow A 54-year-old female is diagnosed with nephrotic syndrome. Which of the following is a common symptom of this disease? Correct answer- Proteinuria A 55-year-old male presents reporting urinary retention. Tests reveal that he has a lower urinary tract obstruction. Which of the following is of the most concern to the nurse? Correct answer- Formation of renal calculi A 56-year-old male presents with flank pain and polyuria. Tests reveal that he has an enlarged prostate. Which of the following types of renal failure should the nurse monitor for as it is the most likely to occur? Correct answer- Postrenal A 60-year-old male is diagnosed with renal failure. While the nurse is reviewing lab results, which of the following lab values would be most consistent with this diagnosis? Correct answer- Elevated plasma creatinine level A 75-year-old male reports to his primary care provider with loss of urine, cough, sneezing, and laughing. Which of the following is the most likely diagnosis the nurse will observe on the chart? Correct answer- Stress incontinence Anemia accompanies chronic renal failure because of: Correct answer- Inadequate production of erythropoietin A nurse assesses a patient with a complicated urinary tract infection (UTI) for: Correct answer- Other health problems A patient with end-stage renal disease has pruritus. When the patient asks what causes this, what is the nurse's best response? Pruritus, seen in patients with end-stage renal disease, is caused by high levels of: Correct answer- Calcium When a nurse is teaching about urinary pathogens in men, which information should the nurse include? Mechanisms for defense against urinary pathogens in men include (select all that apply): Correct answer- - The long length of the urethra - Antimicrobial secretions from the prostate When a nurse observes poststreptococcal glomerulonephritis as a diagnosis on a patient, which principle will the nurse remember? Acute poststreptococcal glmerulonephritis is primary caused by: Correct answer- Antigen-antibody complex deposition in the glomerular capillaries and inflammatory damage When a patient asks what the most common type of renal stones is composed of, how should the nurse respond? The most common type of renal stone is composed of: Correct answer- Calcium While planning care for a patient who has acute pyelonephritis. A nurse recalls the most common condition associated with the development of acute pyelonephritis is: Correct answer- Urinary tract obstruction While planning care for a patient with renal calculi, the nurse remembers the most important factor in renal calculus formation is: Correct answer- Urine pH While turning a patient with chronic renal failure, which principle should the nurse recall? Bone fractures are a risk factor in chronic renal failure because: Correct answer- The kidneys fail to activate vitamin D. A patient asks where nociceptors can be found. How should you respond? One location in which nociceptors can be found is the? Correct answer- Skin A nurse is reviewing urinalysis results and notices glucose is present in the urine. A nurse realizes glucose will be excreted in the urine when: A. The maximum rate of glucose filtration is achieved B. The carrier molecules have reached their maximum C. Glucose is consumed D. The ability of the kidneys to regulate blood glucose is lost Correct answer- The carrier molecules have reached their maximum A urologist is discussing the phagocytic cells that lie between the layers of the renal corpuscle. What is the urologist describing? A. Podocytes B. Macula densa cells C. Mesangial cells D. Filtration slits Correct answer- Mesangial cells A 35-year-old hypertensive male begins taking a diuretic. Which of the following common side effects of this medication should the nurse monitor? A. Hypokalemia B. Hyponatremia C. Increased uric acid secretion D. Hypermagnesemia Correct answer- Hypokalemia If a nurse wants to obtain the best estimate of renal function, which test should the nurse monitor? A. Glomerular filtration rate (GFR) B. Circulating antidiuretic hormone (ADH) levels C. Volume of urine output D. Urine-specific gravity Correct answer- GFR A kidney has a glomerular capillary hydrostatic pressure of 50 mm Hg, a Bowman capsule hydrostatic pressure of 15 mm Hg, and a glomerular capillary oncotic pressure of 12 mm Hg. The net filtration pressure is ____ mm Hg. A. 23 B. 27 C. 35 D. 38 Correct answer- 23 mmHg A nurse is preparing to teach about the collecting ducts. Reabsorption of water in the collecting ducts requires which of these hormones? A. Antidiuretic hormone (ADH) B. Atrial natriuretic factor (ANP) C. Renin D. Aldosterone Correct answer- ADH A nurse is preparing to teach about the loop of Henle. Which information should be included? The descending segment of the loop of Henle primarily allows for: A. Sodium secretion B. Potassium secretion C. Hydrogen ion reabsorption D. Water reabsorption Correct answer- Water reabsorption A nurse is teaching the staff about the kidneys. Which information should the nurse include? The region of the kidneys that contains the glomeruli is the: A. Medulla B. Cortex C. Pyramids D. Columns Correct answer- Cortex A nurse recalls the blood vessels of the kidneys are innervated by the: A. Vagus nerve B. Sympathetic nervous system C. Somatic nervous system D. Parasympathetic nervous system Correct answer- Sympathetic nervous system A nurse recalls the glomerular filtration rate (GFR) and plasma creatinine (Pcr) concentration are _____ related. A. Directly B. Indirectly C. Inversely D. Not Correct answer- Inversely On average the kidneys receive approximately _____ of the cardiac output. A. 10% to 14% B. 15% to 19% C. 20% to 25% D. 26% to 35% Correct answer- 20-25% A urologist is discussing a structure that supplies blood to the medulla. What is the urologist describing? A. Renal arteries B. Arcuate arteries C. Peritubular capillaries D. Vasa recta Correct answer- Vasa recta A urologist is discussing the phagocytic cells that lie between the layers of the renal corpuscle. What is the urologist describing? A. Podocytes B. Macula densa cells C. Mesangial cells D. Filtration slits Correct answer- Mesangial cells The urologist is teaching about the nephrons that determine the concentration of the urine. The urologist is discussing the _____ nephrons. A. Juxtamedullary B. Midcortical C. Cortical D. Medullary Correct answer- Juxtamedullary When a nurse is checking the urinalysis, plasma proteins should be absent from the urine because: A. All proteins filtered are subsequently reabsorbed. B. All of the plasma proteins are too large to fit through the filtration slits. C. All proteins filtered are subsequently degraded before elimination. D. The negative charge of the glomerular filtration membrane repels the plasma proteins. Correct answer- The negative charge of the glomerular filtration membrane repels theplasma proteins. When a nurse is preparing to teach about urine, which information should the nurse include? Just before entering the ureter, urine passes through the: A. Collecting duct B. Renal pelvis C. Urethra D. Major calyx Correct answer- Renal pelvis When a patient asks what role the kidneys play in vitamin D function, how should the nurse reply? A. Synthesizes vitamin D from cholesterol B. Activates intestinally absorbed vitamin D C. Metabolizes and breaks down vitamin D D. Excretes excess vitamin D Correct answer- Activates intestinally absorbed vitamin D When a patient's renal system secretes rennin, what effect will that cause in the body? It causes the direct activation of: A. Angiotensin I B. Angiotensin II C. Antidiuretic hormone D. Aldosterone Correct answer- Angiotensin I When a staff member asks which of the following substances are actively secreted by the renal tubules, what is the nurse's best response? A. Sodium and chlorine B. Phosphate and calcium C. Hydrogen and potassium D. Bicarbonate and carbonic acid Correct answer- Hydrogen and potassium When describing the male urinary anatomy, which information should the nurse include? The portion of the male urethra that is closest to the bladder is the _____ portion. A. Membranous B. Prostatic C. Cavernous D. Vas deferens Correct answer- Prostatic When teaching about sodium reabsorption, which information should the nurse include? The majority of sodium reabsorption takes place in the: A. Proximal tubule B. Loop of Henle C. Distal tubule D. Collecting duct Correct answer- Proximal tubule When the nurse discusses the glomerulus and Bowman capsule together, it is referred to as the renal: A. Corpuscle B. Capsule C. Medulla D. Pyramid Correct answer- Corpuscle When the nurse is discussing the functional unit of the kidney, what other term should the nurse use? A. Calyx B. Nephron C. Collecting duct D. Pyramid Correct answer- Nephron While planning care for a patient with urinary problems, the nurse recalls that the renin-angiotensin system will be activated by: A. Increased blood volume B. Elevated sodium concentrations C. Decreased blood pressure in the afferent arterioles D. Renal hypertension Correct answer- Decreased blood pressure in the afferent arterioles While reviewing urine lab results, the nurse remembers the glomerular filtration rate (GFR) is directly related to the: A. Perfusion pressure in the glomerular capillaries B. Oncotic pressure in the glomerular capillaries C. Vascular resistance in the glomerular arterioles D. Hydrostatic pressure in the Bowman capsule Correct answer- Perfusion pressure in the glomerular capillaries K+ deficit decrease Correct answer- Loss via the kidneys Liver Correct answer- ICF When the nurse is discussing the sodium-sensing cells of the glomerulus, what term should the nurse use? Correct answer- Macula densa A nurse is describing the trigone. Which information should be included? The trigone is defined as: Correct answer- A triangular area between the openings of the two ureters and the urethra A nurse is reviewing urinalysis results and notices glucose is present in the urine. A nurse realizes glucose will be excreted in the urine when: Correct answer- The carrier molecules have reached their maximum A patient has searched the Internet for hormones. The patient has a good understanding when she knows that the hormone _____ is synthesized and secreted by the kidneys to stimulate bone marrow production of red blood cells. Correct answer- Erythropoietin Components of the nephron Correct answer- Loop of Henle Renal corpuscle Proximal tubule Convoluted tubule When a staff member asks how the urine gets from the nephrons to the calyces, what is the nurse's best response? The renal structure that drains directly into the calyces is (are) the (select all that apply): Correct answer- Distal tubules and collecting ducts A nurse recalls the superficial cortical nephrons account for ____% of all nephrons. Correct answer- 85% On average _____% of renal plasma flow to glomerulus is filtered from Bowman's capsule Correct answer- 20% A nurse would chart a patient is experiencing oliguria when a 24-hour urine output is less than ________. Correct answer- 400 ml/d