Deck 28: Acute Renal Failure and Chronic Kidney Disease

Question 1

The stage of "renal insufficiency" of chronic kidney disease is associated with

A) destruction of more than 90% of total nephrons.
B) uremic syndrome.
C) polyuria and nocturia.
D) proteinuria and hypoproteinemia.

Answer 1

polyuria and nocturia.

Question 2

The best indicator of renal function is the glomerular filtration rate (GFR).

Answer 2

True

Question 3

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

A) hypoparathyroidism.
B) hypercalcemia.
C) insufficient active vitamin D.
D) phosphate deficiency.

Answer 3

insufficient active vitamin D.

Question 4

Renal artery stenosis, hypertension, and nephrosclerosis may all contribute to renal failure by causing

A) hydronephrosis.
B) renal ischemia.
C) nephrosis.
D) renal inflammation.

Question 5

Prerenal acute renal failure occurs when kidney perfusion is impaired.

Question 6

The most helpful laboratory value in monitoring the progression of declining renal function is

A) serum creatinine.
B) serum potassium.
C) blood urea nitrogen.
D) mental status changes.

Question 7

A high urine sodium and a fractional sodium excretion greater than 1 is associated with

A) hypovolemia.
B) acute tubular necrosis.
C) prerenal oliguria.
D) activation of the renin-angiotensin-aldosterone cascade.

Question 8

The primary risk factor for the development of chronic kidney disease is hypertension.

Question 9

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

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

Question 10

The presence of tubular epithelial cell casts in the urine is indicative of prerenal oliguria.

Question 11

A patient who develops acute renal failure after receiving nephrotoxic antibiotics most likely has postrenal acute renal failure.

Question 12

Patients with acute renal failure commonly develop metabolic acidosis because of impaired kidney secretion of H⁺.

Question 13

Patients with end-stage renal disease are at a high risk of developing hypocalcemia.

Question 14

Prerenal oliguria is a reversible stage of acute renal failure.

Question 15

Prerenal oliguria is characterized by low urine osmolality and high urine sodium concentration.

Question 16

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

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 17

Signs and symptoms of end-stage renal disease begin to appear when approximately 75% of nephrons have been lost.

Question 18

The oliguric phase of acute tubular necrosis is characterized by

A) polyuria and nocturia.
B) rapidly developing uremia.
C) inability to concentrate urine.
D) enhanced glomerular filtration.

Question 19

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

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

Question 20

Appropriate therapy for prerenal oliguria includes

A) fluid administration.
B) potassium supplementation.
C) fluid restriction.
D) protein restriction.

Question 21

Appropriate management of end-stage renal disease includes

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

Question 22

Match the following predisposing factors with the types of acute renal failure below.
Intrarenal

A)Nephrotoxic antibiotic
B)Shock
C)Prostatic hyperplasia

Question 23

Match the following predisposing factors with the types of acute renal failure below.
Prerenal

A)Nephrotoxic antibiotic
B)Shock
C)Prostatic hyperplasia

Question 24

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

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

Question 25

Which of the following interventions has been found to retard the advancement of chronic kidney disease?

A) Calcium supplementation
B) Erythropoietin
C) Insulin
D) ACE inhibitors or A-II receptor blockers

Question 26

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

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

Question 27

Match the following predisposing factors with the types of acute renal failure below.
Postrenal

A)Nephrotoxic antibiotic
B)Shock
C)Prostatic hyperplasia

Question 28

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?

A) Not possible to predict based on nephron loss
B) Greater than 50% nephron loss
C) Greater than 75% nephron loss
D) Greater than 90% nephron loss