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NUR 280 ( LATEST 2024 / 2025 ) RENAL QUIZ | ALL Q&AS BRAND NEW GUARANTEED A++
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NUR 280 ( LATEST 2024 / 2025 ) RENAL QUIZ | ALL Q&AS BRAND NEW GUARANTEED A++
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NUR 280 Renal Quiz1. The most recent assessment of a patient with a diagnosis of type 1 diabetes indicates a
heightened risk of diabetic nephropathy. Which of the following assessment findings is most
suggestive of this increased risk?
A. Orthostatic hypotension
B. Hematuria
C. Microalbuminuria
D. Diabetic retinopathy:
Answer
Microalbuminuria Feedback
The increased glomerular filtration rate (GFR) that occurs in persons with early alterations in
renal function is associated with microalbuminuria, which is an important predictor of future
diabetic nephropathies. Hematuria is not directly suggestive of diabetic nephropathy, although it
is a highly significant assessment finding. Orthostatic hypotension and diabetic retinopathy are
not direct indicators of diabetic retinopathy.
2. As chronic kidney disease progresses, the second stage (renal insufficiency) is identified
by:
A. metabolic acidosis.
B. isotonic polyuria.
C. hyperparathyroidism.
D. diminished renal reserve.:
Answer
isotonic polyuria.
Feedback
Diminished renal reserve is characteristic of renal insufficiency, when labs remain normal and
renal insufficiency. Only the second stage, renal insufficiency, is characterized by polyuria that
is isotonic. Metabolic acidosis develops later as a result of the kidneys being unable to eliminate
hydrogen ions. Hyperparathyroidism occurs in kidney failure, as a compensatory change in
,response to chronically low serum calcium and phosphate retention.
3. 1) A characteristic manifestation of polycystic kidney disease is:
A. hypertension.
B. alkaline urine.
C. renal colic.
D. massive proteinuria.
Answer
A. hypertension.
Feedback
Polycystic kidney disease, which can be inherited as a Mendelian trait, results in the formation
of fluid-filled cysts in kidneys, hypertension, cardiovascular abnormalities, cerebral
aneurysms, and cyst formation in other organs such as the liver and pan- creas. When present,
urinary calculi serve as foreign bodies and contribute to renal infection, often caused by urea-
splitting organisms (e.g., Proteus, staphylococci) that increase ammonia production and cause
the urine to become alkaline. One type of pain associated with kidney stones is renal colic,
described as colicky pain that accompanies stretching of the collecting system or ureter.
Nephrotic syndrome is characterized by massive proteinuria.
4. 2) A patient had excessive blood loss and prolonged hypotension during surgery. His
postoperative urine output is sharply decreased and his blood urea nitrogen (BUN) is elevated.
The most likely cause for the change is acute:
A. prerenal inflammation.
B. ischemic tubular necrosis.
C. intrarenal nephrotoxicity.
D. bladder outlet obstruction.
Answer
B. ischemic tubular necrosis. Feedback
Ischemic acute tubular necrosis (ATN) occurs most frequently in persons who have major
surgery with prolonged renal hypoperfusion—this directly damages the tubules. Nephrotoxic
ATN is caused by toxic agents or drugs. Prerenal vasoconstriction is associated with acute
onset loss of renal output. Bladder (postrenal) obstruction would not affect the BUN, since it
rarely causes renal failure.
5. 3) A patient has a diagnosis of chronic renal failure secondary to diabetic nephropathy.
Which of
the following hematologic changes may result from this patient's kidney disorder?
A. Thrombocytopenia
B. Anemia
C. Leukocytosis
, D. Leukopenia
Answer
B. Anemia Feedback
Because of the central role of the kidneys in the production of erythropoietin, individuals with
kidney disease may be prone to anemia. Changes in platelet or white blood cell levels are not
likely to result directly from renal failure.
6. 4) A patient is beginning to recover from acute tubular necrosis. The recovery phase of
ATN is
characterized by:
A. proteinuria.
B. hypokalemia.
C. diuresis.
D. edema.:
Answer
C. diuresis.
Feedback
The recovery phase is first noticed as increased/excessive output (diuresis) of dilute urine.
Potassium will remain elevated or continue to rise, since the diuresis occurs before renal
function fully returns to normal. Edema/fluid retention is characteristic of the maintenance
phase. Proteinuria is characteristic of glomerular disease and/or chronic kidney disease.
A patient with significant burns on his lower body has developed sepsis on the third day
following his accident. Which of the following developments is most clearly suggestive of
ischemic acute tubular necrosis rather than prerenal failure?
7. A patient with significant burns on his lower body has developed sepsis on the third day
following his accident. Which of the following developments is most clearly suggestive of
ischemic acute tubular necrosis rather than prerenal failure?
A. The patient exhibits pulmonary and peripheral edema.
B. The patient's GFR does not increase after restoration of renal blood flow.
C. Emergency hemodialysis does not result in decreased BUN and creatinine.
D. The patient exhibits oliguria and frank hematuria.:
Answer
The patient's GFR does not increase after restoration of renal blood flow.
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