NR507 FINAL REVIEW TEST
QUESTIONS AND ANSWERS
Tonic-clonic phase is due to __________________ - Answer-the excessive discharge
of neurons in the motor nerves
Underlying cause of BPH - Answer-5delta-reductace activity increases with age
-increases dihydrotestosterone levels
-normal prostate cells respond to the increase in dihydrotestosterone levels by living
longer and multiplying
acute kidney injury/acute renal failure - Answer-sudden loss of kidney function
Reversible
S/S:
-oliguria (<30mL/hr)
-increased BUN & creatinine
-fluid & electrolyte abnormalities
Prerenal - Answer-Most common type of Acute Renal Failure
Sudden & severe drop in BP (shock) or interruption of blood flow to the kidneys from
severe injury or illness
-causes: hypotension, decreased CO, decreased blood volume
Intrarenal (intrinsic) - Answer-Direct damage to the kidneys by inflammation, toxins,
drugs, infection, or decreased blood supply.
-Causes: acute tubular necrosis (ATN), acute glomerulonephritis, and other
glomerulopathies
Postrenal - Answer-Sudden obstruction of urine flow due to enlarged prostate, kidney
stones, bladder tumors, or injury.
Prerenal labs - Answer--increased creatinine
-increased BUN
-increased BUN/creatinine ratio 20:1
-concentrated urine (high osmolarity)
Intrinsic renal failure labs - Answer--increased creatining
-increased BUN
-BUN/creatinine ratio <15:1
-dilute urine
Best way to differentiate between prerenal and intrinsic renal failure -
Answer-BUN/creatinine ratio
,Most common damage to the kidneys in intrinsic (intrinsic) renal disease is
___________ - Answer-tubular (85%)
others are:
glomerular (5%)
interstitial (8%)
vascular (<2%)
Chronic Kidney Disease (CKD) - Answer-Progressive loss of renal function that can
develop as a complication of unresolved AKI or systemic diseases, including HTN, DM
(most significant risk factor), SLE or intrinsic kidney disease.
Risk factor for development of UTI - Answer-Pregnancy
Help prevent a UTI - Answer-Increase water consumption
Complicated UTI can be caused by ____ - Answer-a structural urinary tract disorder
a symptom of a lower urinary tract infection - Answer-urgency
UTI's are more common for ______ - Answer-women, especially when:
-sexually active
-pregnant
-during post-menopause with estrogen deficiency
-being treated with antibiotics (normal flora diminished)
Lower UTI - Answer-Cystitis
Lower UTI s/s - Answer-urgency
burning
frequency
dysuria
suprapubic pain
cloudy urine
odorous urine
acute pyelonephritis - Answer-Upper UTI
•Specific diagnosis is established by:
-Urine culture
-Urinalysis (WBC casts indicates pyelonephritis, but may not always be present)
-Complicated pyelonephritis requires blood cultures and urinary tract imaging
Upper UTI s/s - Answer-symptoms associated with cystitis
fever
flank pain
costovertebral angle (CVA) tenderness
N&V
,malaise
signs of shock if infection entered circulation
classic triad (vomiting, flank pain, fever)
pyelonephritis classic triad - Answer-vomiting, flank pain, fever
Urine sample to determine lower vs. upper UTI - Answer-Lower (cystitis)
-WBC > 5,000/hpf
-hematuria
Upper (Pyelonephritis)
-WBC > 100,000/hpf
-WBC Casts
uncomplicated UTI - Answer--occurs in the normal urinary tract
-simple cystitis in non-pregnant women without any urologic abnormalities
-respond well to a short course of antibiotic therapy
Complicated UTI - Answer--a UTI that extends beyond the bladder
- caused by structural or functional urinary tract abnormalities or untreated UTI
-infants and older adults affected
-associated with: indwelling catheters, renal calculi, diabetes, pregnancy
Cystitis identified, red excoriated skin, frequency, dribbling, catheter inserted. 2 days
later: fever, chills, odor, flank pain, nitrites, RBCs, WBC >100,000, and casts.
Diagnosed with Pyelonephritis. What is the major risk factor associated with this? -
Answer-Indwelling foley catheter
21 year old with urinary urgency, frequency, burning, small amount of vaginal discharge
that has an odor. Will the NP perform a vaginal exam? - Answer-Yes
Urinalysis of patient with complicated UTI will show ____________ - Answer-WBCs and
casts
Upon examination of urinalysis, the NP can highly suspect the causative bacteria are
gram negative because of the presence of ______ - Answer-nitrites
Patient most likely has uncomplicated UTI if ________ - Answer-UTI responds well to
short course of antibiotics
Digital rectal exam to assess quality of prostate. The NP would be concerned with
________ - Answer-A hard nodule
-can indicate prostate cancer
Patients most often develop symptoms of BPH when ________ - Answer-the prostatic
urethra becomes obstructed
, the _________ zone of the prostate is the largest zone - Answer-peripheral
Zones of prostate - Answer-Central zone - 25%
Peripheral zone - 70%
Transitional zone - 5%
BPH cause of symptoms - irritative - Answer-urinary frequency
nocturia
urgency that results from bladder hypertrophy and dysfunction
BPH cause of symptoms - obstructive - Answer-incomplete emptying
postvoid dribbling
the action of 5-alpha-reductase inhibitor causes ________ - Answer-shrinks prostate
gland
men who have BPH are prone to UTI because ________ - Answer-stagnate urine in
bladder promotes bacterial growth
Underlying cause of BPH - Answer-normal prostate cells respond to increase in
dihydrotestosterone that causes them to live longer and multiply
location of the characteristic hyperplastic nodules of BPH - Answer-periurethral zone
prostate specific antigen (PSA) helps to ________ - Answer-liquify semen post-
ejaculation
type of stone that forms due to a UTI - Answer-struvite stone
gold standard for diagnosing a renal stone - Answer-CT scan
renal stones are formed when ________________ - Answer-calcium and oxalate in the
urine combine
renal calculi can be found ________ - Answer-in the ureter or bladder
most common type of stone - Answer-calcium stone
most common sites of stone obstruction - Answer-ureteropelvic junction
intersection of ureter and iliac vessels
ureterovesicular junction
QUESTIONS AND ANSWERS
Tonic-clonic phase is due to __________________ - Answer-the excessive discharge
of neurons in the motor nerves
Underlying cause of BPH - Answer-5delta-reductace activity increases with age
-increases dihydrotestosterone levels
-normal prostate cells respond to the increase in dihydrotestosterone levels by living
longer and multiplying
acute kidney injury/acute renal failure - Answer-sudden loss of kidney function
Reversible
S/S:
-oliguria (<30mL/hr)
-increased BUN & creatinine
-fluid & electrolyte abnormalities
Prerenal - Answer-Most common type of Acute Renal Failure
Sudden & severe drop in BP (shock) or interruption of blood flow to the kidneys from
severe injury or illness
-causes: hypotension, decreased CO, decreased blood volume
Intrarenal (intrinsic) - Answer-Direct damage to the kidneys by inflammation, toxins,
drugs, infection, or decreased blood supply.
-Causes: acute tubular necrosis (ATN), acute glomerulonephritis, and other
glomerulopathies
Postrenal - Answer-Sudden obstruction of urine flow due to enlarged prostate, kidney
stones, bladder tumors, or injury.
Prerenal labs - Answer--increased creatinine
-increased BUN
-increased BUN/creatinine ratio 20:1
-concentrated urine (high osmolarity)
Intrinsic renal failure labs - Answer--increased creatining
-increased BUN
-BUN/creatinine ratio <15:1
-dilute urine
Best way to differentiate between prerenal and intrinsic renal failure -
Answer-BUN/creatinine ratio
,Most common damage to the kidneys in intrinsic (intrinsic) renal disease is
___________ - Answer-tubular (85%)
others are:
glomerular (5%)
interstitial (8%)
vascular (<2%)
Chronic Kidney Disease (CKD) - Answer-Progressive loss of renal function that can
develop as a complication of unresolved AKI or systemic diseases, including HTN, DM
(most significant risk factor), SLE or intrinsic kidney disease.
Risk factor for development of UTI - Answer-Pregnancy
Help prevent a UTI - Answer-Increase water consumption
Complicated UTI can be caused by ____ - Answer-a structural urinary tract disorder
a symptom of a lower urinary tract infection - Answer-urgency
UTI's are more common for ______ - Answer-women, especially when:
-sexually active
-pregnant
-during post-menopause with estrogen deficiency
-being treated with antibiotics (normal flora diminished)
Lower UTI - Answer-Cystitis
Lower UTI s/s - Answer-urgency
burning
frequency
dysuria
suprapubic pain
cloudy urine
odorous urine
acute pyelonephritis - Answer-Upper UTI
•Specific diagnosis is established by:
-Urine culture
-Urinalysis (WBC casts indicates pyelonephritis, but may not always be present)
-Complicated pyelonephritis requires blood cultures and urinary tract imaging
Upper UTI s/s - Answer-symptoms associated with cystitis
fever
flank pain
costovertebral angle (CVA) tenderness
N&V
,malaise
signs of shock if infection entered circulation
classic triad (vomiting, flank pain, fever)
pyelonephritis classic triad - Answer-vomiting, flank pain, fever
Urine sample to determine lower vs. upper UTI - Answer-Lower (cystitis)
-WBC > 5,000/hpf
-hematuria
Upper (Pyelonephritis)
-WBC > 100,000/hpf
-WBC Casts
uncomplicated UTI - Answer--occurs in the normal urinary tract
-simple cystitis in non-pregnant women without any urologic abnormalities
-respond well to a short course of antibiotic therapy
Complicated UTI - Answer--a UTI that extends beyond the bladder
- caused by structural or functional urinary tract abnormalities or untreated UTI
-infants and older adults affected
-associated with: indwelling catheters, renal calculi, diabetes, pregnancy
Cystitis identified, red excoriated skin, frequency, dribbling, catheter inserted. 2 days
later: fever, chills, odor, flank pain, nitrites, RBCs, WBC >100,000, and casts.
Diagnosed with Pyelonephritis. What is the major risk factor associated with this? -
Answer-Indwelling foley catheter
21 year old with urinary urgency, frequency, burning, small amount of vaginal discharge
that has an odor. Will the NP perform a vaginal exam? - Answer-Yes
Urinalysis of patient with complicated UTI will show ____________ - Answer-WBCs and
casts
Upon examination of urinalysis, the NP can highly suspect the causative bacteria are
gram negative because of the presence of ______ - Answer-nitrites
Patient most likely has uncomplicated UTI if ________ - Answer-UTI responds well to
short course of antibiotics
Digital rectal exam to assess quality of prostate. The NP would be concerned with
________ - Answer-A hard nodule
-can indicate prostate cancer
Patients most often develop symptoms of BPH when ________ - Answer-the prostatic
urethra becomes obstructed
, the _________ zone of the prostate is the largest zone - Answer-peripheral
Zones of prostate - Answer-Central zone - 25%
Peripheral zone - 70%
Transitional zone - 5%
BPH cause of symptoms - irritative - Answer-urinary frequency
nocturia
urgency that results from bladder hypertrophy and dysfunction
BPH cause of symptoms - obstructive - Answer-incomplete emptying
postvoid dribbling
the action of 5-alpha-reductase inhibitor causes ________ - Answer-shrinks prostate
gland
men who have BPH are prone to UTI because ________ - Answer-stagnate urine in
bladder promotes bacterial growth
Underlying cause of BPH - Answer-normal prostate cells respond to increase in
dihydrotestosterone that causes them to live longer and multiply
location of the characteristic hyperplastic nodules of BPH - Answer-periurethral zone
prostate specific antigen (PSA) helps to ________ - Answer-liquify semen post-
ejaculation
type of stone that forms due to a UTI - Answer-struvite stone
gold standard for diagnosing a renal stone - Answer-CT scan
renal stones are formed when ________________ - Answer-calcium and oxalate in the
urine combine
renal calculi can be found ________ - Answer-in the ureter or bladder
most common type of stone - Answer-calcium stone
most common sites of stone obstruction - Answer-ureteropelvic junction
intersection of ureter and iliac vessels
ureterovesicular junction
