Question 1

At his most recent clinic visit,a patient with end-stage renal disease is noted to have edema,congestive signs in the pulmonary system,and a pericardial friction rub.Appropriate therapy at this time would include

Accepted Answer

A)   initiation of dialysis.
B)   fluid restriction.
C)   antibiotics.
D)   phlebotomy.

Question 2

The defining characteristic of severe acute kidney injury is

Accepted Answer

A)   proteinuria.
B)   oliguria.
C)   hematuria.
D)   diuresis.

Question 3

Osteoporosis commonly occurs in patients with end-stage renal disease because of

Accepted Answer

A)   hyperparathyroidism.
B)   hypercalcemia.
C)   excess active vitamin D.
D)   phosphorous deficiency. A

Question 4

A patient with renal disease is at risk for developing uremia as the nephrons progressively deteriorate,because

Accepted Answer

A)   the basement membrane becomes increasingly permeable.
B)   filtration exceeds secretory and reabsorptive capacity.
C)   excessive solute and water are lost in the urine.
D)   GFR declines.

Question 5

The most common cause of intrinsic kidney injury is _____ injury.

Accepted Answer

A)   glomerular
B)   tubular
C)   interstitial
D)   vascular

Question 6

Hypotension is both a cause of chronic kidney disease and a result of chronic kidney disease.

Accepted Answer

A) True 
 B)False  False

Question 7

Gastrointestinal drainage,perioperative and postoperative hypotension,and hemorrhage may all contribute to renal failure by causing

Accepted Answer

A)   hydronephrosis.
B)   acute tubular necrosis.
C)   nephrosis.
D)   renal inflammation.

Question 8

What problem is a patient likely to experience in end-stage renal disease?

Accepted Answer

A)   Hypokalemia
B)   Polyuria and nocturia
C)   Uremia
D)   Hematuria

Question 9

Postrenal acute kidney injury may be caused by

Accepted Answer

A)   severe hypotension.
B)   glomerulonephritis.
C)   bilateral kidney stones.
D)   acute tubular necrosis.

Question 10

Appropriate management of end-stage renal disease includes

Accepted Answer

A)   potassium supplementation.
B)   a high-protein diet.
C)   erythropoietin administration.
D)   a high-phosphate diet.

Question 11

Renal insufficiency occurs when _____ of the nephrons are not functional.

Accepted Answer

A)   25%
B)   50%
C)   75% to 90%
D)   more than 90%

Question 12

The most likely cause of acidosis in a patient with end-stage renal disease is

Accepted Answer

A)   insufficient filtration of bicarbonate ions at the glomerulus.
B)   excessive production of respiratory and metabolic acids.
C)   insufficient metabolic acid excretion resulting from nephron loss.
D)   hypoventilation secondary to uremic central nervous system depression.

Question 13

A patient being treated for acute tubular necrosis (ATN) develops mild polyuria.The nurse responds to questions about why this occurring by stating

Accepted Answer

A)   "Since he was oliguric for so long, he probably has rebound polyuria. As long as his blood pressure is stable, he is not hypovolemic, so I would not worry."
B)   "I am glad you noticed this change. It happened so gradually that we did not see it. We should call the doctor and get him to measure ADH."
C)   "His renal tubules are recovering, so he is making more urine, but he is not able to concentrate urine well, because he is not fully recovered."
D)   "We had better measure his blood sugar. He may have developed diabetes, and what you see is osmotic diuresis from glucose in the urine."

Question 14

The effect on the renal tubules during the postoliguric phase of acute tubular necrosis involves

Accepted Answer

A)   reconstruction of the basement membrane.
B)   blocking the tubule lumens by dead cells.
C)   making the glomeruli patent again.
D)   regeneration of the renal tubular epithelium.

Question 15

Anemia in people who have end-stage chronic renal disease is caused by

Accepted Answer

A)   chronic loss of blood in the urine.
B)   poor appetite, with lack of iron intake.
C)   decreased secretion of erythropoietin.
D)   increased secretion of aldosterone.

Question 16

One of the most common causes of acute tubular necrosis (ATN) is

Accepted Answer

A)   ischemic conditions.
B)   cytotoxic agents.
C)   immune reaction.
D)   prolonged postrenal kidney injury. A

Question 17

A patient injured severely in a motor vehicle accident is hospitalized with acute kidney injury as well as multiple broken bones and lacerations.When family members ask what is meant by the term 'prerenal,' the nurse responds

Accepted Answer

A)   "The doctors are not sure what caused your husband's acute kidney injury, but they are working to help him recover."
B)   "Your husband's kidney injury did not start in the kidney itself, but rather in the blood flow to the kidney."
C)   "Your husband's kidney injury is only the beginning of the problems that are expected, so they are being vigilant."
D)   "Acute kidney injury is a new term for what people used to call acute renal failure."

Question 18

Individuals with end-stage chronic renal disease are at risk for renal osteodystrophy and spontaneous bone fractures,because

Accepted Answer

A)   excess potassium leaches calcium from bone.
B)   erythropoietin secretion is impaired.
C)   urea causes demineralization of bone.
D)   they are deficient in active vitamin D.

Question 19

The most likely cause of anemia in a patient with end-stage renal disease is

Accepted Answer

A)   insufficient erythropoietin.
B)   blood loss secondary to hematuria.
C)   vitamin B₁₂ deficiency secondary to deficient intrinsic factor.
D)   iron deficiency.

Question 20

In patients with polycystic kidney disease,renal failure is expected to progress over time as the cystic process destroys more nephrons.At what point will a patient reach end-stage renal disease?

Accepted Answer

A)   Greater than 15%
B)   Greater than 25% nephron loss
C)   Greater than 50% nephron loss
D)   Greater than 90% nephron loss

Exam 28: Acute Kidney Injury and Chronic Kidney Disease

At his most recent clinic visit,a patient with end-stage renal disease is noted to have edema,congestive signs in the pulmonary system,and a pericardial friction rub.Appropriate therapy at this time would include

Correct AnswerverifiedShow Answer

The defining characteristic of severe acute kidney injury is

Correct AnswerverifiedShow Answer

Osteoporosis commonly occurs in patients with end-stage renal disease because of

Correct AnswerverifiedA

A patient with renal disease is at risk for developing uremia as the nephrons progressively deteriorate,because

Correct AnswerverifiedShow Answer

The most common cause of intrinsic kidney injury is _____ injury.

Correct AnswerverifiedShow Answer

Hypotension is both a cause of chronic kidney disease and a result of chronic kidney disease.

Correct AnswerverifiedFalse

Gastrointestinal drainage,perioperative and postoperative hypotension,and hemorrhage may all contribute to renal failure by causing

Correct AnswerverifiedShow Answer

What problem is a patient likely to experience in end-stage renal disease?

Correct AnswerverifiedShow Answer

Postrenal acute kidney injury may be caused by

Correct AnswerverifiedShow Answer

Appropriate management of end-stage renal disease includes

Correct AnswerverifiedShow Answer

Renal insufficiency occurs when _____ of the nephrons are not functional.

Correct AnswerverifiedShow Answer

The most likely cause of acidosis in a patient with end-stage renal disease is

Correct AnswerverifiedShow Answer

A patient being treated for acute tubular necrosis (ATN) develops mild polyuria.The nurse responds to questions about why this occurring by stating

Correct AnswerverifiedShow Answer

The effect on the renal tubules during the postoliguric phase of acute tubular necrosis involves

Correct AnswerverifiedShow Answer

Anemia in people who have end-stage chronic renal disease is caused by

Correct AnswerverifiedShow Answer

One of the most common causes of acute tubular necrosis (ATN) is

Correct AnswerverifiedA

A patient injured severely in a motor vehicle accident is hospitalized with acute kidney injury as well as multiple broken bones and lacerations.When family members ask what is meant by the term 'prerenal,' the nurse responds

Correct AnswerverifiedShow Answer

Individuals with end-stage chronic renal disease are at risk for renal osteodystrophy and spontaneous bone fractures,because

Correct AnswerverifiedShow Answer

The most likely cause of anemia in a patient with end-stage renal disease is

Correct AnswerverifiedShow Answer

In patients with polycystic kidney disease,renal failure is expected to progress over time as the cystic process destroys more nephrons.At what point will a patient reach end-stage renal disease?

Correct AnswerverifiedShow Answer

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