Maryville NURS 611 Exam 2 UPDATE COMPREHENSIVE QUESTIONS AND VERIFIED SOLUTIONS CORRECT ANSWERS 2025

How much of the cardiac output do the kidneys require? - Correct Ans-20-25% What causes the umbilical referred pain with kidney stones? - Correct Ans-sensory innervation of the upper part of the ureter arising from the 10th thoracic nerve root. What are the clinical manifestations of a UTI in older adults? - Correct Ans-confusion and poorly localized abdominal discomfort (symptoms are vague). What is pyelonephritis? - Correct Ans-it is an infection of one or both upper urinary tracts(ureter, renal pelvis, and kidney interstitium). What are the underlying risk factors for the development of pyelonephritis? - Correct Ans-urinary obstruction and reflux of urine from the bladder (vesicoureteral reflux). What microorganisms are associated with acute pyelonephritis? - Correct Ans-e. coli, proteus, or pseudomonas. What do the microorganisms that cause pyelonephritis do to increase the risk of stone formation? - Correct Ans-the microorganisms split urea into ammonia, making alkaline urine that increases the risk. Define painful bladder syndrome (interstitial cystitis). - Correct Ans-it is a condition that includes nonbacterial infectious cystitis and noninfectious cystitis. It is possible that noninfectious cystitis is caused by an autoimmune response. What happens during an autoimmune reaction? - Correct Ans-it may be responsible for inflammatory response, which includes mast cell activation, altered epithelial permeability, neuroinflammation, and increased sensory nerve stimulation. How is a diagnosis of IC differentiated from a diagnosis of pyelonephritis? - Correct Ans-urine culture, urinalysis, and clinical signs and symptoms. White blood cell casts indicate pyelonephritis, but they are not always present in the urine. What lab values point to a reduced GFR? - Correct Ans-elevated plasma urea, creatinine concentration, or reduced renal creatinine clearance. NURS 611 WGU D440 What is acute glomerulonephritis? - Correct Ans-it is a term that includes renal diseases that cause glomerular inflammation through immune mechanisms. What happens to the GFR during an inflammatory response? - Correct Ans-the glomerular capillary filtration membrane including the endothelium, basement membrane, and epithelium (podocytes) are damaged by inflammation causing immune mechanisms. What are the classic symptoms of acute glomerulonephritis? - Correct Ans-sudden onset of hematuria including red blood cell casts and proteinuria (milder than nephrotic syndrome), and in more severe cases, these symptoms are also accompanied by edema, hypertension, and impaired renal function. What is nephrotic syndrome? - Correct Ans-It is the excretion of 3.0 g or more of protein (massive proteinuria) in the urine per day, hypoalbuminemia (less than 3.0 g/dl), and peripheral edema. What is nephrotic syndrome characteristic of? - Correct Ans-glomerular injury. What are the primary causes of nephrotic syndrome? - Correct Ans-minimal change disease (lipoid nephrosis), membranous glomerulonephritis, and focal segmental glomerulosclerosis. What are the secondary forms of nephrotic syndrome? - Correct Ans-they occur in systemic diseases including DM, amyloidosis, and SLE. It is also seen with certain drugs, infections, malignancies, and vascular disorders. Acute kidney injury is also known as renal failure. Explain chronic and acute kidney injuries. - Correct Ans-kidney failure can be chronic and progressive. Acute occurs rapidly within hours, and may be reversible. What is renal insufficiency? - Correct Ans-it is a decline in renal function to about 25% of normal or a GFR of 25 to 35 ml/minute. What lab values are elevated with renal insufficiency? - Correct Ans-serum creatinine and urea. serum creatinine changes only occur if more than 50% of GFRis lost and are often delayed by more than 24 hours. What are patients with renal insufficiency prone to? - Correct Ans-hyperkalemia and metabolic acidosis. Renal phosphate excretion is decreased, causing hyperphosphatemia. Fluid retention may cause edema. Symptoms of HF develop in person with CVD. N/V, fatigue accompany uremia and electrolyte imbalances. Wound healing is delayed, and the risk of infection, particularly pneumonia, is greater. NURS 611 WGU D440 What is visceral obesity associated with? - Correct Ans-accelerated lipolysis, increased inflammation, metabolic syndrome, type II DM, CV complications, and cancer. What are the components of metabolic syndrome? - Correct Ans-hypertriglyceridemia, reduced HDL, increased LDL, HTN, and insulin resistance. Peripheral and subcutaneous fat is less... - Correct Ans-metabolically active and less lipolytic and releases fewer adipocytokines (particularly adiponectin) than visceral fat. What is GERD? - Correct Ans-it is the reflux of acid and pepsin from the stomach to the esophagus that cuases esophagitis. What chemicals can relax the lower esophageal sphincter? - Correct Ans anticholinergics, nitrates, CCBs, and nicotine. How do bowel obstructions present in the early stage? - Correct Ans-with abdominal distention. What happens metabolically if the bowel obstruction is at the pylorus or high in the small intestine? - Correct Ans-metabolic alkalosis develops initially as a result of excessive loss of hydrogen ions that normally would be reabsorbed from the gastric juice. What occurs with prolonged intestinal obstruction? - Correct Ans-the lack of circulation produces lactic acid (decreased tissue perfusion) thus metabolic acidosis. What are the risk factors for PUD? - Correct Ans-genetic predisposition, H. pylori, and habitual use of NSAIDs. Other risk factors include alcohol abuse, smoking acute pancreatitis, COPD, obesity, cirrhosis, and age 65. What does the chronic use of NSAIDs do to the stomach lining? - Correct Ans suppresses mucosal prostagladin synthesis, resulting in decreased bicarbonate secretion and mucin production and increased secretion of HCL. What are the clinical manifestations of dumping syndrome? - Correct Ans-increased pulse, hypotension, weakness, pallor, sweating, and dizziness following a partial gastrectomy or pyloroplasty. Occurs about 20 minutes after eating. What happens during dumping syndrome? - Correct Ans-occurs about 20 minutes after eating. Rapid gastric emptying and creation of a high osmotic gradient within the small intestine causes a shift from vascular compartment to the intestinal lumen. How do you manage dumping syndrome? - Correct Ans-dietary management with frequent small meals, no fluids during meals, high protein, low carb diet. Sugar really activates the response. Age of onset for UC? - Correct Ans-any age, 10-40 years most common NURS 611 WGU D440 Age of onset for CD? - Correct Ans-any age, 10-30 years most common Family hx predisposition for UC? - Correct Ans-less common. Family hx predisposition for CD? - Correct Ans-more common. Gender prevalance for UC and CD. - Correct Ans-equal in men and women for UC about equal in CD. Location of lesions for UC. - Correct Ans-colon and rectum. Location of lesions for CD. - Correct Ans-all of the GI tract, mouth to anus, "skip" lesions common. Inflammation and ulceration in UC. - Correct Ans-mucosal layer involved. Inflammation and ulceration with CD. - Correct Ans-entire intestinal wall involved. What are common manifestations of CD? - Correct Ans-fistulae and abscess, strictures and possible obstructions are common. Abdominal pain, diarrhea, small intestinal malabsorption, and steatorrhea are common. What are the common manifestations of UC? - Correct Ans-occassional abdominal pain, diarrhea, bloody stools are common. What is one of the main functions of the liver? - Correct Ans-the deamination of amino acids. Any condition that disrupts the normal functioning of the liver (hepatocyte dysfunction) can cause what? - Correct Ans-hypoalbuminemia. What are the pathologic lesions of hepatitis similar to? - Correct Ans-lesions caused by other viral infections. What is some of the damage caused by hepatitis? - Correct Ans-hepatic cell necrosis, scarring, Kupffer cell hyperplasia, and infiltration by mononuclear phagocytes. What is hepatitis B associated with? - Correct Ans-acute fulminating hepatitis, a rare form of the disease that is characterized by massive hepatic necrosis. Damage tends to be most severe in which cases of hepatitis? - Correct Ans-hepatitis B and C. When does the prodromal (preicteric) phase of hepatitis occur? - Correct Ans-it begins about 2 weeks after exposure and ends with the appearance of jaundice. NURS 611 WGU D440 What are the prodromal symptoms that precede the onset of jaundice? - Correct Ans fatigue, anorexia, malaise, N/V, headache, hyperalgia, cough, and low-grade fever. Steatorrhea is what? - Correct Ans-fat in the stool. It is bulky stool that floats and is oily and smells foul. Explain the icteric phase of hepatitis. - Correct Ans-it begins about 1 to 2 weeks after the prodromal phase and last two to six weeks. What are the characteristics of the icteric phase? - Correct Ans-urine is dark, stools are clay coloredbefore the onset of jaundice from conjugated hyperbilirubinemia. GI and respiratory symptoms subside, but fatigue and abdominal pain persist or become more sever. Mild and transient itching often accompanies jaundice. What is the posticteric or recovery phase of hepatitis? - Correct Ans-it begins with the resolution of jaundice, about 6 to 8 weeks after exposure. Although the liver may still be enlarged and tender, symtpoms diminish. When do liver function test results turn to normal after the onset of jaundice? - Correct Ans-two to 12 weeks. What is cirrhosis? - Correct Ans-an irreversible inflammatory, fibrotic liver disea