Fresenius Annual Exam-186 Questions with Verified
Solutions.
1. RN's oversee and assess - ANS The patient treatment, direct interventions,
provide patient education
2. Patient care technicians evaluate and reinforce - ANS nursing education
3. What are the anatomical structures of the urinary system in order of urine flow? -
ANS (2) kidneys (2) ureters (1) bladder (1) urethra
4. What are the functions of a healthy kidney? Remove - - ANS Waste products -
creatinine, urea and uric acid, ammonia
5. What are the functions of a healthy kidney? Regulate / synthesis - - ANS Fluid
balance, blood volume, electrolytes and acid- base balance, synthesize Clairol
(active vitamin D)
6. What are the functions of a healthy kidney? Endocrine / Enzyme - - ANS Secrete
erythropoietin - stimulate bone marrow to make red blood cells
7. Release renin - controls blood pressure
8. What is urea? - ANS by-product of protein metabolism
9. What is creatinine? - ANS by -product of muscle metabolism
10. Uric acid occurs naturally in the human body as a result of? - ANS the
metabolism of purine
11. What is purine? - ANS a muscle protein that enters the body either through
dietary intake (about 30 percent) or from the breakdown of the body's own cells
during cell turnover
12. Production of renin helps to? - ANS regulate or control blood pressure
13. Production of erythropoietin helps to? - ANS stimulate red blood cell production
14. Synthesis of Clairol regulates what? - ANS calcium / phosphorous balance.
15. Synthesis of Clairol enables absorption of what? - ANS dietary calcium;
promoting bone health
16. Which of the functions of healthy kidneys are replaced by dialysis? - ANS
Removal of waste products, and regulation of fluid balance
17. What is the function of renin? - ANS Renin is a hormone produced by the kidneys
with important effects on the regulation of blood pressure, and on sodium and
,19. What is a glomerulus? - ANS A network (tuft) of capillaries that performs the first
step of filtering blood. It filters water and solutes into Bowman’s capsule.
20. What does Bowman’s capsule do? - ANS empties the filtrate into a tubule that is
also part of the nephron
21. Urinary excretion is? - ANS Excretion = filtration - reabsorption = secretion
22. What is the function of erythropoietin? - ANS Erythropoietin stimulates the bone
marrow to produce red blood cells.
23. What is the synthetic form of erythropoietin? - ANS Recombinant Poteen Alfa
(Apogent) - or- Mercer both are drugs given by licensed nursing staff to dialysis
patients to treat anemia
24. Why must the kidney activate Vitamin D? - ANS The kidney converts Vitamin D
to Clairol, its activated form. This activated form of Vitamin D helps to maintain
good bone health by helping to absorb calcium from foods eaten.
25. What are synthetic forms of activated Vitamin D? - ANS Calcite, Templar, and
Hectored (synthetic calcitriol) are medications used in treating bone disease for
hemodialysis patients.
26. Acute renal failure - ANS sudden onset, severe, usually reversible, Drug toxicity,
motor vehicle accident, dehydration
27. Chronic renal failure - ANS slow onset, progressive, permanent, diabetes -
diabetic nephropathy or glomerulosclerosis, Hypertension causing
nephrolosclerosis, glomerulonephritis
28. Other causes of renal failure include? - ANS Polycystic kidney disease, Interstitial
Nephritis, Good pasture syndrome, Wilma’s tumor, Systemic Lupus
Erythematous, AL port’s disease, Sickle Cell disease, Acquired Immune
Deficiency (AIDS), obstructions, Scleroderma, Drug toxicity ( heroin, cocaine,
non-steroidal anti-inflammatory drugs, acetaminophen)
29. What are signs of renal failure or uremia? - ANS Elevated levels of - BUN /
Creatinine - phosphorus - potassium, Anemia, Nerve damage, Yellow-gray
appearance of the skin, fluid overload, shortness of breath and edema,
hypertension, proteinuria
30. What are symptoms of renal failure or uremia? - ANS Uremia, lethargy,
weakness, headache, itching, fatigue, nausea, restlessness, mental status
changes, loss of appetite
31. What organ systems are affected by kidney disease? - ANS All organ systems
are affected, musculoskeletal, integumentary, cardiovascular, gastrointestinal,
respiratory, immune, neurological, hematologic, reproductive, and endocrine
, 33. How is uremia treated? - ANS Dialysis, diffusion allows for uremic toxin removal,
dialysate contains no urea levels, urea moves from the patient to the dialysate
34. What is uremia? - ANS Caused by impaired kidney function. Buildup of harmful
waste products in the bloodstream
35. What is the Glomerular Filtration Rate (GFR) in the five stages of kidney
disease? - ANS 1- normal kidney function 2- mildly reduced kidney function 3-
moderately reduced kidney function 4- severely reduced kidney function 5- very
severely reduced kidney function ( also called chronic kidney disease )
36. What services are available from the socials services department? - ANS
Provides emotional support, psychological counseling, patient advocate, also
resource and referral services
37. What adjustments do patients encounter when transitioning to dialysis? - ANS
Loss of control, dietary restrictions, Loss of mobility, sexual dysfunction, financial
concerns, depression, unwanted dependency on the dialysis machine and staff,
altered body image concerns due to the appearance of the access and
redistribution of weight
38. What causes renal osteodystrophy (bone disease)? - ANS patients with kidney
disease no longer produce calcitriol - the active form of Vitamin D ( inadequate or
lacking calcitriol causes demineralization of the bone- bone begins to break down
to release calcium needed for body functioning)
39. No longer excrete phosphorus (phosphorus is found in most foods and
beverages. Increased phosphorus levels cause further calcium bone loss)
40. What does Calcitriol do? - ANS directs the gut to absorb calcium into the
bloodstream.
41. If calcitriol levels drop too low, parathyroid hormone (PTH) is increased.
Increased PTH levels direct osteoclast activity - bone breakdown to increase
serum calcium levels.
42. Calcitriol and PTH work together to maintain serum calcium levels. Diminished or
lacking calcitriol levels decrease gut absorption of calcium, so the body takes the
needed calcium from bones.
43. Treatments options - what is Hemodialysis? - ANS uses a vascular access to
draw blood from the access to the dialyzer and into the semipermeable
membranes where the process of diffusion removes the waste products and
ultrafiltration removes the fluid. The process of hemodialysis provides
approximately 15% of the function of the normal kidney.
44. Treatments options - what is peritoneal dialysis? - ANS uses a permanently
placed catheter in the patient’s highly vascularized peritoneal cavity. The
peritoneum is the membrane surrounding the abdominal organs. Dialysate fluid is
infused into the cavity and is allowed to dwell there for a period of time. Then the
fluid is drained. Through osmosis and diffusion, excess fluid and waste products
Solutions.
1. RN's oversee and assess - ANS The patient treatment, direct interventions,
provide patient education
2. Patient care technicians evaluate and reinforce - ANS nursing education
3. What are the anatomical structures of the urinary system in order of urine flow? -
ANS (2) kidneys (2) ureters (1) bladder (1) urethra
4. What are the functions of a healthy kidney? Remove - - ANS Waste products -
creatinine, urea and uric acid, ammonia
5. What are the functions of a healthy kidney? Regulate / synthesis - - ANS Fluid
balance, blood volume, electrolytes and acid- base balance, synthesize Clairol
(active vitamin D)
6. What are the functions of a healthy kidney? Endocrine / Enzyme - - ANS Secrete
erythropoietin - stimulate bone marrow to make red blood cells
7. Release renin - controls blood pressure
8. What is urea? - ANS by-product of protein metabolism
9. What is creatinine? - ANS by -product of muscle metabolism
10. Uric acid occurs naturally in the human body as a result of? - ANS the
metabolism of purine
11. What is purine? - ANS a muscle protein that enters the body either through
dietary intake (about 30 percent) or from the breakdown of the body's own cells
during cell turnover
12. Production of renin helps to? - ANS regulate or control blood pressure
13. Production of erythropoietin helps to? - ANS stimulate red blood cell production
14. Synthesis of Clairol regulates what? - ANS calcium / phosphorous balance.
15. Synthesis of Clairol enables absorption of what? - ANS dietary calcium;
promoting bone health
16. Which of the functions of healthy kidneys are replaced by dialysis? - ANS
Removal of waste products, and regulation of fluid balance
17. What is the function of renin? - ANS Renin is a hormone produced by the kidneys
with important effects on the regulation of blood pressure, and on sodium and
,19. What is a glomerulus? - ANS A network (tuft) of capillaries that performs the first
step of filtering blood. It filters water and solutes into Bowman’s capsule.
20. What does Bowman’s capsule do? - ANS empties the filtrate into a tubule that is
also part of the nephron
21. Urinary excretion is? - ANS Excretion = filtration - reabsorption = secretion
22. What is the function of erythropoietin? - ANS Erythropoietin stimulates the bone
marrow to produce red blood cells.
23. What is the synthetic form of erythropoietin? - ANS Recombinant Poteen Alfa
(Apogent) - or- Mercer both are drugs given by licensed nursing staff to dialysis
patients to treat anemia
24. Why must the kidney activate Vitamin D? - ANS The kidney converts Vitamin D
to Clairol, its activated form. This activated form of Vitamin D helps to maintain
good bone health by helping to absorb calcium from foods eaten.
25. What are synthetic forms of activated Vitamin D? - ANS Calcite, Templar, and
Hectored (synthetic calcitriol) are medications used in treating bone disease for
hemodialysis patients.
26. Acute renal failure - ANS sudden onset, severe, usually reversible, Drug toxicity,
motor vehicle accident, dehydration
27. Chronic renal failure - ANS slow onset, progressive, permanent, diabetes -
diabetic nephropathy or glomerulosclerosis, Hypertension causing
nephrolosclerosis, glomerulonephritis
28. Other causes of renal failure include? - ANS Polycystic kidney disease, Interstitial
Nephritis, Good pasture syndrome, Wilma’s tumor, Systemic Lupus
Erythematous, AL port’s disease, Sickle Cell disease, Acquired Immune
Deficiency (AIDS), obstructions, Scleroderma, Drug toxicity ( heroin, cocaine,
non-steroidal anti-inflammatory drugs, acetaminophen)
29. What are signs of renal failure or uremia? - ANS Elevated levels of - BUN /
Creatinine - phosphorus - potassium, Anemia, Nerve damage, Yellow-gray
appearance of the skin, fluid overload, shortness of breath and edema,
hypertension, proteinuria
30. What are symptoms of renal failure or uremia? - ANS Uremia, lethargy,
weakness, headache, itching, fatigue, nausea, restlessness, mental status
changes, loss of appetite
31. What organ systems are affected by kidney disease? - ANS All organ systems
are affected, musculoskeletal, integumentary, cardiovascular, gastrointestinal,
respiratory, immune, neurological, hematologic, reproductive, and endocrine
, 33. How is uremia treated? - ANS Dialysis, diffusion allows for uremic toxin removal,
dialysate contains no urea levels, urea moves from the patient to the dialysate
34. What is uremia? - ANS Caused by impaired kidney function. Buildup of harmful
waste products in the bloodstream
35. What is the Glomerular Filtration Rate (GFR) in the five stages of kidney
disease? - ANS 1- normal kidney function 2- mildly reduced kidney function 3-
moderately reduced kidney function 4- severely reduced kidney function 5- very
severely reduced kidney function ( also called chronic kidney disease )
36. What services are available from the socials services department? - ANS
Provides emotional support, psychological counseling, patient advocate, also
resource and referral services
37. What adjustments do patients encounter when transitioning to dialysis? - ANS
Loss of control, dietary restrictions, Loss of mobility, sexual dysfunction, financial
concerns, depression, unwanted dependency on the dialysis machine and staff,
altered body image concerns due to the appearance of the access and
redistribution of weight
38. What causes renal osteodystrophy (bone disease)? - ANS patients with kidney
disease no longer produce calcitriol - the active form of Vitamin D ( inadequate or
lacking calcitriol causes demineralization of the bone- bone begins to break down
to release calcium needed for body functioning)
39. No longer excrete phosphorus (phosphorus is found in most foods and
beverages. Increased phosphorus levels cause further calcium bone loss)
40. What does Calcitriol do? - ANS directs the gut to absorb calcium into the
bloodstream.
41. If calcitriol levels drop too low, parathyroid hormone (PTH) is increased.
Increased PTH levels direct osteoclast activity - bone breakdown to increase
serum calcium levels.
42. Calcitriol and PTH work together to maintain serum calcium levels. Diminished or
lacking calcitriol levels decrease gut absorption of calcium, so the body takes the
needed calcium from bones.
43. Treatments options - what is Hemodialysis? - ANS uses a vascular access to
draw blood from the access to the dialyzer and into the semipermeable
membranes where the process of diffusion removes the waste products and
ultrafiltration removes the fluid. The process of hemodialysis provides
approximately 15% of the function of the normal kidney.
44. Treatments options - what is peritoneal dialysis? - ANS uses a permanently
placed catheter in the patient’s highly vascularized peritoneal cavity. The
peritoneum is the membrane surrounding the abdominal organs. Dialysate fluid is
infused into the cavity and is allowed to dwell there for a period of time. Then the
fluid is drained. Through osmosis and diffusion, excess fluid and waste products
