Deck 22: Renal Disorders

Question 1

Which is the most common condition associated with the formation of renal calculi?
1) Hyperabsorption of calcium and oxalate from the gastrointestinal tract
2) Chronic urinary tract infection
3) Gout
4) Failure of renal tubular reabsorption of cystine

Answer 1

1

Question 2

Which is a likely cause of elevated blood urea nitrogen (BUN) in a client?
1) An increase in the glomerular filtration rate
2) Dehydration
3) Low protein diet
4) Very frail body structure

Answer 2

2

Question 3

A client presents with a specific type of renal calculi that is not widely prevalent. The nurse knows that this client has been undergoing chemotherapy as part of his or her treatment for cancer. Which is an associated characteristic of the type of renal calculi that is most likely to be present in this client?
1) Urine supersaturated with cystine
2) High purine levels in the bloodstream
3) Alkaline pH of urine
4) Pseudomonas infection in the urinary tract

Answer 3

2

Question 4

A health-care provider is evaluating the urine and blood test reports of a client with a muscular body structure. Which observations are most likely to indicate that the client is suffering from renal impairment?
1) High amount of leukocyte esterase
2) A blood urea nitrogen (BUN) of 25 mg/dL
3) Increased creatinine clearance
4) Decreased creatinine clearance
5) High specific gravity of dilute urine

Question 5

A nurse is teaching student nurses about the epidemiology of renal calculi. Which statement made by a student nurse indicates the need for further training?
1) "The lifetime risk of developing nephrolithiasis is around 7% for men in the United States."
2) "Renal calculi develop most commonly in adults aged 20 to 49 years."
3) "The risk of developing renal calculi doubles if there is a family history."
4) "Renal calculi can recur, with a chance of 52% recurrence within 10 years."

Question 6

What percentage of the body's cardiac output is received by the kidneys?
1) 5% to 10%
2) 20% to 25%
3) 30% to 35%
4) 45% to 50%

Question 7

A nurse is teaching student nurses about the treatment of nephrolithiasis. Which statements made by a student nurse indicate the need for further learning?
1) "A low-sodium diet is recommended to limit fluid overload."
2) "Pain management is the major part of treatment."
3) "Clients are instructed to drink at least 3 liters of fluid a day."
4) "Most renal stones are treated with lithotripsy."
5) "Drinking cranberry juice is beneficial in certain types of renal calculi."

Question 8

Which urinalysis finding indicates that the client could be suffering from renal dysfunction?
001)
1) Urine is odorless and slightly hazy.
2) Urine is clear and amber-colored.
3) Urine is yellow, with a specific gravity of 1.
4) Urine contains crystals.

Question 9

A nurse notices that the glomerular filtration rate of a client has decreased. What are the possible reasons for this?
1) A disease process has decreased the client's blood pressure.
2) A disease process has increased the client's blood pressure.
3) A disease process has decreased the client's renal perfusion.
4) A disease process has increased the client's renal perfusion.
5) The normal aging process

Question 10

What percentage of clients suffering from Goodpasture's syndrome has clinically apparent manifestations of pulmonary and renal disease?
1) 60% to 80%
2) 20% to 40%
3) Fewer than 10%
4) More than 90%

Question 11

At what age does the peak function of the kidneys occur in a healthy adult?
1) 20 years
2) 25 years
3) 30 years
4) 35 years

Question 12

Which statements does the nurse identify as correct after contrasting peritoneal dialysis (PD) with hemodialysis and continuous renal replacement therapy (CRRT)?
1) In CRRT, the dialysis solution pulls wastes and extra fluid from the blood into the abdominal cavity.
2) The dwell time in PD is 4 hours.
3) In hemodialysis, the entire blood volume circulates through the dialyzer in 30 to 40 minutes.
4) PD is a slower process used for clients who are hemodynamically unstable.
5) The process of draining and filling in PD takes about 30 to 40 minutes.

Question 13

What percentage of filtered electrolytes is reabsorbed at the loop of Henle?
1) 15%
2) 25%
3) 40%
4) 60%

Question 14

Which statement made by a student nurse demonstrates understanding of the basic pathology of renal disorders?
1) "Postrenal dysfunction can be accompanied by an increased risk of infection."
2) "Prerenal dysfunction can be caused by excessive consumption of nonsteroidal anti-inflammatory drugs (NSAIDs)."
3) "Intrarenal dysfunction can lead to hydronephrosis."
4) "Postrenal dysfunction can result from severe hypovolemia."

Question 15

Individuals with which tissue types are at high risk for developing Goodpasture's syndrome in the kidney and lungs?
1) HLA-DR2
2) HLA-DR3
3) Both A and B
4) None of the above

Question 16

Which statement made by a student nurse demonstrates understanding about the secretory functions of the kidney?
1) "Clients with renal failure have higher hemoglobin levels because of constant secretion of erythropoietin."
2) "Kidneys create glucose from amino acids in case of excessive consumption of animal proteins."
3) "The juxtaglomerular apparatus secretes renin in response to high sodium levels in the blood."
4) "Clients with impaired renal function have disrupted calcium balance in the bloodstream due to inactive vitamin D."

Question 17

The nurse is assessing the urinalysis report of a client of average build. Which observation definitely indicates an illness state in the client?
1) A serum creatinine level of 10 mg/dL
2) A blood urea nitrogen (BUN) level of 15 mg/dL
3) Casts in the urine
4) Slightly hazy urine

Question 18

The nurse is assessing a client with suspected nephrolithiasis. Which factors would the nurse identify as possible causes for the disease?
1) The client excretes excess uric acid in the urine.
2) The client drinks over 3 liters of water every day.
3) The client has a family history of renal calculi.
4) The client does not take calcium supplements.
5) The client suffers from hyperparathyroidism.

Question 19

Which statement made by a student nurse pertains to the theory of protein deficiency as a possible cause of formation of renal calculi?
1) "A kidney stone is formed when crystalline constituents settle on uropontin."
2) "Calcium phosphate deposition in the renal papilla leads to formation of a kidney stone."
3) "A Randall plaque is formed when a calcium phosphate compound settles in the renal papilla."
4) "Nephrocalcin inhibits kidney stone formation."

Question 20

The nurse assesses a client for the presence of proteinuria. What observations indicate that the client is suffering from this condition?
1) Protein excretion in urine of 130 mg/day
2) Protein excretion in urine of 200 mg/day
3) Foamy urine
4) Tea-colored urine
5) Presence of crystals in the urine

Question 21

Arrange in order the steps that lead to the formation of a kidney stone according to the second theory of the formation of renal calculi (A-E). (Enter the letter of each step in the proper sequence; do not use commas or spaces.)
A. The calculus erodes through the urothelium of the renal pelvis.
B. Calcium phosphate compound collects layers of collagenous material and cellular debris.
C. Calcium phosphate deposits in the renal papilla.
D. The plaque collects layers of crystalline elements to become a calculus.
E. Randall plaque forms within the subepithelial membrane.

Question 22

A client presents a colicky type of flank pain that radiates into the groin. On assessment, the nurse finds edema and distention of the renal pelvis in the client, caused by the build-up of urine. Which conditions is the client at a risk of developing if he or she continues to suffer from edema and distention of the renal pelvis for a prolonged period of time?
1) Compression of the kidney tissue
2) Ischemia
3) Hematuria
4) Crystalluria
5) Pleural effusion
Other

Question 23

Arrange in order the mechanism of the occurrence of edema in a client suffering from acute glomerulonephritis (A-F). (Enter the letter of each step in the proper sequence; do not use commas or spaces.)
A. The low colloid oncotic pressure (COP) is overcome by hydrostatic pressure.
B. Loss of albumin and RBCs in the urine takes place.
C. The antigen-antibody complexes damage the structure of the glomeruli.
D. Hyperpermeability of the capillaries occurs.
E. Diminished COP occurs throughout the body.
F. Antigen enters the body and stimulates antibody synthesis.

Question 24

What constitutes the net effects of the renin-angiotensin-aldosterone system (RAAS) of the kidneys?
1) Sodium reabsorption
2) Water reabsorption
3) Potassium reabsorption
4) Potassium excretion
5) Arterial vasodilation

Question 25

Arrange in order the changes that occur in the kidneys during polycystic kidney disease (A-G). (Enter the letter of each step in the proper sequence; do not use commas or spaces.)
A. Blood leaks into the cysts.
B. An outpocketing of the nephron tubule walls takes place.
C. The cysts develop blood vessels.
D. Hyperplasia of renal epithelial cells occurs.
E. The cystic walls stretch causing excruciating pain.
F. Gross hematuria occurs.
G. Glomerular filtrate accumulates in cysts.