Maryville University Nursing 611 Exam 4 Review
questions with correct answers
Calcium oxalate Correct Answer-The most common type of renal stone
kidney stones Correct Answer-Passage of these can be extremely painful
and may produce "referred pain" to umbilicus area - this is due to the
sensory innervation of the upper part of the ureter arising from the 10th
thoracic nerve roots.
Urinary Tract Infection Correct Answer-Clinical manifestations of this
condition in an older adult are Confusion and poorly localized
abdominal discomfort. Can be very difficult diagnose due to vague
symptoms.
Pyelonephritis Correct Answer-an infection of one or both upper urinary
tracts (ureter, renal pelvis, and kidney interstitium). Urinary obstruction
and reflux of urine from the bladder (vesicoureteral reflux) are the most
common underlying risk factors. Microorganisms usually associated
with acute pyelonephritis include E. coli, Proteus, or Pseudomonas.
These microorganisms also split urea into ammonia, making alkaline
urine that increases the risk of stone formation.
Painful bladder syndrome/interstitial cystitis Correct Answer-a condition
that includes nonbacterial infectious cystitis (viral, mycobacterial,
chlamydial, fungal) and noninfectious cystitis (radiation, chemical,
autoimmune, hypersensitivity). The cause is unknown, but an
autoimmune reaction may be responsible for the inflammatory response,
,which includes mast cell activation, altered epithelial permeability,
neuroinflammation, and increased sensory nerve sensitivity.
Acute unilateral renal obstruction and hypertension Correct Answer-The
reduced perfusion (kidneys require at least 20-25% cardiac output -
MAP) of the affected kidney activates the renin-angiotensin-aldosterone
system (RAAS), which causes constriction of peripheral arterioles.
Acute glomerulonephritis Correct Answer-includes renal diseases in
which glomerular inflammation is caused by immune mechanisms that
damage the glomerular capillary filtration membrane including the
endothelium, basement membrane, and epithelium (podocytes). The
classic symptoms include 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.
Nephrotic syndrome Correct Answer-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. This is characteristic of
glomerular injury. Primary causes of this condition include minimal
change disease (lipoid nephrosis), membranous glomerulonephritis, and
focal segmental glomerulosclerosis. Secondary forms of this condition
occur in systemic diseases including diabetes mellitus, amyloidosis, and
systemic lupus erythematosus. This condition also is seen with certain
drugs, infections, malignancies, and vascular disorders.
acute kidney injury Correct Answer-this condition may be acute and
rapidly progressive (within hours), and the process may be reversible.
, Kidney failure Correct Answer-this condition can be chronic,
progressing to end-stage kidney failure over a period of months or years.
Renal insufficiency Correct Answer-this condition refers to a decline in
renal function to about 25% of normal or a GFR of 25 to 30 ml/minute.
Levels of serum creatinine and urea are mildly elevated. However,
changes in serum creatinine level occur only if more than 50% of
glomerular filtration is lost and are often delayed by more than 24 hours.
Such diagnostic delays make the implementation of early therapy very
difficult, contributing to disease progression and mortality.
Obesity Correct Answer-this condition is defined as a body mass index
(BMI) that exceeds 30 kg/m2 and generally develops when caloric
intake exceeds caloric expenditure in genetically susceptible individuals.
This condition is a major risk factor for morbidity, death, and high
healthcare cost in the United States and worldwide. Three leading causes
of death in the United States are associated with this condition:
cardiovascular disease, type 2 diabetes mellitus, and cancer.
Visceral obesity Correct Answer-also known as intra-abdominal, central,
or masculine obesity) occurs when the distribution of body fat is
localized around the abdomen and upper body, resulting in an apple
shape. This condition is associated with accelerated lipolysis and has an
increased risk for inflammation, metabolic syndrome
(hypertriglyceridemia, reduced high-density lipoprotein, increased low-
density lipoproteins, hypertension, and insulin resistance), type 2
diabetes mellitus, cardiovascular complications, and cancer.