Fresenius RN Exam 353 Questions with Verified
Answers for 2024.
What are the anatomical structures of the urinary system? - ANS 2 Kidneys
2 Ureters
Bladder
Urethra
Anatomical structure of kidneys, order of urine flow? - ANS kidneys, ureters, urinary
bladder, urethra
Kidneys produce urine which is transported by the ureters to the bladder where it is
stored and eventually excreted from the body via the urethra.
What is a nephron? - ANS Nephrons are the functional units of the kidney. They are a
tubular structure that filter blood to form urine.
What are nephrons composed of? - ANS Glomerulus and Tubules
What is a glomerulus composed of? - ANS Tangled cluster of capillaries surrounded by
the Bowman's capsule.
How does blood enter the kidney? - ANS Through the renal artery
What is the acronym for the 7 functions of the kidneys? - ANS A Wet Bed
What does A Wet Bed stand for? - ANS A - acid base balance maintenance
W - Water balance maintenance
E - Electrolyte balance
T - Toxin removal
B - Blood pressure regulation
E - Erythropoietin production
D - Vitamin d metabolism
What is Glomerular Filtration Rate (GFR) in the 5 stages of kidney disease? - ANS GFR
describes the flow rate of filtered fluid through the kidney.
GFR of the 5 stages of kidney disease? - ANS 1. 90 or greater
2. 60-89
3. 30-59
4. 15-29
5. Less than 15
Descriptions of the 5 stages of kidney disease? - ANS 1. Normal kidney function but
urine or other abnormalities point to kidney disease.
2. Mildly reduced kidney function, urine or other abnormalities point to kidney disease.
3. Moderately reduced kidney function.
4. Severely reduced kidney function.
5. Very severely reduced kidney function (also called CKD)
What are the types of kidney failure? - ANS Acute and chronic
,What can cause chronic renal failure? - ANS Diabetes
Hypertension
Glomerulonephritis
What are some characteristics of chronic renal failure? - ANS Slow onset
Progressive
Permanent
Other causes of Renal Failure can include: - ANS Polycystic Kidney Disease
Interstitial Nephritis
Good pasture Syndrome
Wilma’s Tumor
Systemic Lupus Erythematous
AL port’s Disease
Sickle Cell Disease
Drug Toxicity (Heroin, cocaine, NSAIDs, acetaminophen)
AIDS
Obstructions
Scleroderma
Classic signs of renal failure? - ANS Elevated serum BUN/creatinine, phosphorus,
potassium
Anemia
Nerve damage
Yellow-gray appearance of the skin
Fluid overload
SOA
Edema
Hypertension
Proteinuria
Classic symptoms of renal failure? - ANS Uremia
Lethargy
Weakness
Headache
Itching
Fatigue
Nausea
Restlessness
Mental Status changes
Loss of appetite
What is anemia? - ANS Lack of Red Blood Cells RBC's
What causes anemia? - ANS Decreased of lacking erythropoietin production
Shortened RBC lifespan
Decreased iron absorption
Blood loss during dialysis
How is anemia treated? - ANS Erythropoietin stimulating agents (ESA's) are
administered. ESAs stimulate RBC production in the bone marrow. Examples of ESA's
include Apogent, Arranges, and Mercer.
Signs and symptoms of anemia? - ANS Fatigue
, Allows RBC to transport oxygen
Examples include Veneer, Ferrlicit
RN administration is usually 50 mg IVP every other week.
Given IV due to absorption and constipation properties seen with oral preparations.
Which functions of healthy kidneys are replaced by dialysis? - ANS Removal of waste
products
Regulation of fluid balance
What are 3 modalities of treatment for ESRD? - ANS Hemodialysis
Peritoneal dialysis
Transplantation
Describe hemodialysis - ANS Uses a vascular access to draw blood from the patient
and send to the dialyzer and into the semi permeable membrane where diffusion
removes the waste products and ultrafiltration removes the fluid.
Describe peritoneal dialysis - ANS There are 2 types: Continuous cycle peritoneal
dialysis (CCPD) and continuous ambulatory peritoneal dialysis (CAPD)
Both types use a permanently placed catheter in the patient’s highly vascularized
peritoneal cavity. The peritoneum is the membrane surrounding the organs in the
abdomen During CAPD, dialysate is infused into the peritoneal space, allowed to "dwell"
for a period of time as ordered by the physician and then drained.
Through osmosis and diffusion, excess fluid and waste products are removed.
Describe Transplantation - ANS A working kidney is surgically implanted
Kidney is from a living or cadaveric donor
Patient must take anti-rejection medications for the life of the kidney
Where HD vs. PD is done? - ANS HD is done usually outpatient or home HD is done in
home.
PD is done in the patient's home.
What filters waste in HD vs. PD? - ANS A dialyzer (artificial kidney) filters the waste
from blood in HD.
The patient's peritoneal membrane acts as the semi-permeable membrane and filters
waste in PD.
How long does HD vs. PD take? - ANS HD usually lasts 3-4 hours, 3 times a week.
PD is performed daily with several exchanges during the day, or done during sleeping
hours with a cycler.
How is fluid removed in HD vs. PD? - ANS Fluid removal is done through ultrafiltration
in HD.
Fluid removal occurs via osmotic pressure and concentration gradients caused by
dextrose solution and dwell times in PD.
What are the body fluid compartments? - ANS Intracellular - inside the cells.
Extracellular - outside the cells.
Intravascular - inside the blood vessels.
Interstitial - between the cells.
What is diffusion? - ANS Movement of solutes across a semi-permeable membrane
from higher to lower concentration.
Answers for 2024.
What are the anatomical structures of the urinary system? - ANS 2 Kidneys
2 Ureters
Bladder
Urethra
Anatomical structure of kidneys, order of urine flow? - ANS kidneys, ureters, urinary
bladder, urethra
Kidneys produce urine which is transported by the ureters to the bladder where it is
stored and eventually excreted from the body via the urethra.
What is a nephron? - ANS Nephrons are the functional units of the kidney. They are a
tubular structure that filter blood to form urine.
What are nephrons composed of? - ANS Glomerulus and Tubules
What is a glomerulus composed of? - ANS Tangled cluster of capillaries surrounded by
the Bowman's capsule.
How does blood enter the kidney? - ANS Through the renal artery
What is the acronym for the 7 functions of the kidneys? - ANS A Wet Bed
What does A Wet Bed stand for? - ANS A - acid base balance maintenance
W - Water balance maintenance
E - Electrolyte balance
T - Toxin removal
B - Blood pressure regulation
E - Erythropoietin production
D - Vitamin d metabolism
What is Glomerular Filtration Rate (GFR) in the 5 stages of kidney disease? - ANS GFR
describes the flow rate of filtered fluid through the kidney.
GFR of the 5 stages of kidney disease? - ANS 1. 90 or greater
2. 60-89
3. 30-59
4. 15-29
5. Less than 15
Descriptions of the 5 stages of kidney disease? - ANS 1. Normal kidney function but
urine or other abnormalities point to kidney disease.
2. Mildly reduced kidney function, urine or other abnormalities point to kidney disease.
3. Moderately reduced kidney function.
4. Severely reduced kidney function.
5. Very severely reduced kidney function (also called CKD)
What are the types of kidney failure? - ANS Acute and chronic
,What can cause chronic renal failure? - ANS Diabetes
Hypertension
Glomerulonephritis
What are some characteristics of chronic renal failure? - ANS Slow onset
Progressive
Permanent
Other causes of Renal Failure can include: - ANS Polycystic Kidney Disease
Interstitial Nephritis
Good pasture Syndrome
Wilma’s Tumor
Systemic Lupus Erythematous
AL port’s Disease
Sickle Cell Disease
Drug Toxicity (Heroin, cocaine, NSAIDs, acetaminophen)
AIDS
Obstructions
Scleroderma
Classic signs of renal failure? - ANS Elevated serum BUN/creatinine, phosphorus,
potassium
Anemia
Nerve damage
Yellow-gray appearance of the skin
Fluid overload
SOA
Edema
Hypertension
Proteinuria
Classic symptoms of renal failure? - ANS Uremia
Lethargy
Weakness
Headache
Itching
Fatigue
Nausea
Restlessness
Mental Status changes
Loss of appetite
What is anemia? - ANS Lack of Red Blood Cells RBC's
What causes anemia? - ANS Decreased of lacking erythropoietin production
Shortened RBC lifespan
Decreased iron absorption
Blood loss during dialysis
How is anemia treated? - ANS Erythropoietin stimulating agents (ESA's) are
administered. ESAs stimulate RBC production in the bone marrow. Examples of ESA's
include Apogent, Arranges, and Mercer.
Signs and symptoms of anemia? - ANS Fatigue
, Allows RBC to transport oxygen
Examples include Veneer, Ferrlicit
RN administration is usually 50 mg IVP every other week.
Given IV due to absorption and constipation properties seen with oral preparations.
Which functions of healthy kidneys are replaced by dialysis? - ANS Removal of waste
products
Regulation of fluid balance
What are 3 modalities of treatment for ESRD? - ANS Hemodialysis
Peritoneal dialysis
Transplantation
Describe hemodialysis - ANS Uses a vascular access to draw blood from the patient
and send to the dialyzer and into the semi permeable membrane where diffusion
removes the waste products and ultrafiltration removes the fluid.
Describe peritoneal dialysis - ANS There are 2 types: Continuous cycle peritoneal
dialysis (CCPD) and continuous ambulatory peritoneal dialysis (CAPD)
Both types use a permanently placed catheter in the patient’s highly vascularized
peritoneal cavity. The peritoneum is the membrane surrounding the organs in the
abdomen During CAPD, dialysate is infused into the peritoneal space, allowed to "dwell"
for a period of time as ordered by the physician and then drained.
Through osmosis and diffusion, excess fluid and waste products are removed.
Describe Transplantation - ANS A working kidney is surgically implanted
Kidney is from a living or cadaveric donor
Patient must take anti-rejection medications for the life of the kidney
Where HD vs. PD is done? - ANS HD is done usually outpatient or home HD is done in
home.
PD is done in the patient's home.
What filters waste in HD vs. PD? - ANS A dialyzer (artificial kidney) filters the waste
from blood in HD.
The patient's peritoneal membrane acts as the semi-permeable membrane and filters
waste in PD.
How long does HD vs. PD take? - ANS HD usually lasts 3-4 hours, 3 times a week.
PD is performed daily with several exchanges during the day, or done during sleeping
hours with a cycler.
How is fluid removed in HD vs. PD? - ANS Fluid removal is done through ultrafiltration
in HD.
Fluid removal occurs via osmotic pressure and concentration gradients caused by
dextrose solution and dwell times in PD.
What are the body fluid compartments? - ANS Intracellular - inside the cells.
Extracellular - outside the cells.
Intravascular - inside the blood vessels.
Interstitial - between the cells.
What is diffusion? - ANS Movement of solutes across a semi-permeable membrane
from higher to lower concentration.
