Deck 29: Alterations of Renal and Urinary Tract Function

Question 1

When a nurse observes poststreptococcal glomerulonephritis as a diagnosis on a patient,which principle will the nurse remember? Acute poststreptococcal glomerulonephritis is primarily caused by:

A) Swelling of mesangial cells in the Bowman space in response to the presence of bacteria
B) Antigen-antibody complex deposition in the glomerular capillaries and inflammatory damage
C) Inflammatory factors that stimulate cellular proliferation of epithelial cells
D) Accumulation of antiglomerular basement membrane antibodies

Answer 1

Antigen-antibody complex deposition in the glomerular capillaries and inflammatory damage

Question 2

A 25-year-old female presents with burning urination.She was diagnosed with a urinary tract infection.When the nurse checks the culture results,which of the following organisms is most likely infecting her urinary tract?

A) Streptococcus
B) Candida albicans
C) Chlamydia
D) Escherichia coli

Answer 2

Escherichia coli

Question 3

A 55-year-old male presents reporting urinary retention.Tests reveal that he has a lower urinary tract obstruction.Which of the following is of most concern to the nurse?

A) Vesicoureteral reflux and pyelonephritis
B) Formation of renal calculi
C) Glomerulonephritis
D) Increased bladder compliance

Answer 3

Formation of renal calculi

Question 4

A 19-year-old female was involved in a motor vehicle accident during which she sustained a closed head injury.She is now experiencing detrusor sphincter dyssynergia.Which of the following is the most beneficial medication treatment?

A) Alpha blocker
B) Beta blocker
C) Vasodilator
D) Diuretic

Question 5

A 27-year-old male has a severe kidney obstruction leading to removal of the affected kidney.Which of the following would the nurse expect to occur?

A) Atrophy of the remaining kidney
B) Compensatory hypertrophy of the remaining kidney
C) Dysplasia in the remaining kidney
D) Renal failure

Question 6

A 28-year-old female presents with fever,chills,and flank pain.She is diagnosed with pyelonephritis.A nurse recalls the patient's infection is located in the:

A) Bladder
B) Renal pelvis
C) Renal tubules
D) Glomerulus

Question 7

While planning care for a patient with renal calculi,the nurse remembers the most important factor in renal calculus formation is:

A) urine pH.
B) body temperature.
C) gender.
D) serum mineral concentrations.

Question 8

A nurse assesses a patient with a complicated urinary tract infection (UTI)for:

A) Several species of bacteria
B) Other health problems
C) Urosepsis
D) Rrethral obstruction

Question 9

A 45-year-old male presents with oliguria.He is diagnosed with chronic glomerulonephritis.The nurse knows oliguria is related to:

A) Thickening of the glomerular membrane and decreased renal blood flow
B) Increased glomerular capillary oncotic pressure and tubular obstruction
C) Activation of renin-angiotensin from decreased blood volume
D) Vasoconstriction of the efferent arterioles

Question 10

A 54-year-old female is diagnosed with nephrotic syndrome.Which of the following is a common symptom of this disease?

A) Hematuria
B) Dysuria
C) Oliguria
D) Proteinuria

Question 11

A 35-year-old male received a traumatic brain injury in a motor vehicle accident.CT scan revealed a lesion above the pontine micturition center.Which of the following would the nurse expect?

A) Dyssynergia
B) Detrusor hyperreflexia
C) Detrusor areflexia
D) Detrusor sphincter dyssynergia

Question 12

A 75-year-old male reports to his primary care provider loss of urine with cough,sneezing,or laughing.Which of the following is the most likely diagnosis the nurse will observe on the chart?

A) Urge incontinence
B) Stress incontinence
C) Overflow incontinence
D) Functional incontinence

Question 13

While planning care for a patient who has acute pyelonephritis.A nurse recalls the most common condition associated with the development of acute pyelonephritis is:

A) Cystitis
B) Renal cancer
C) Urinary tract obstruction
D) Nephrotic syndrome

Question 14

When a patient asks what the most common type of renal stones is composed of,how should the nurse respond? The most common type of renal stone is composed of:

A) magnesium.
B) struvite.
C) calcium.
D) phosphate.

Question 15

A 24-year-old female is diagnosed with renal calculus that is causing obstruction.Which of the following symptoms would she most likely experience?

A) Anuria
B) Hematuria
C) Pyuria
D) Flank pain

Question 16

A 25-year-old male was diagnosed with Goodpasture syndrome.While planning care for this patient,which of the following mechanisms would cause tissue injury?

A) Viral infection of the Bowman capsule
B) Production of antibodies against the glomerular basement membrane
C) Antigen-antibody complex deposition with complement activation
D) Abnormal activation of clotting factors and microclotting in the glomerulus

Question 17

A 15-year-old male was diagnosed with pharyngitis.Eight days later he developed acute glomerulonephritis.While reviewing the culture results,which of the following is the most likely cause of this disease?

A) Klebsiella
B) Human immunodeficiency virus (HIV)
C) Genital herpes virus
D) Group A ß-hemolytic streptococcus

Question 18

A 25-year-old female is diagnosed with urinary tract obstruction.While planning care,the nurse realizes that the patient is expected to have hydronephrosis and a decreased glomerular filtration rate caused by:

A) decreased renal blood flow.
B) decreased peritubular capillary pressure.
C) dilation of the renal pelvis and calyces proximal to a blockage.
D) stimulation of antidiuretic hormone.

Question 19

A 29-year-old female presents with cloudy urine,flank pain,hematuria,and fever.Which of the following does the nurse suspect the patient is most likely experiencing?

A) Acute cystitis
B) Renal calculi
C) Chronic renal failure
D) Postrenal renal failure

Question 20

A 30-year-old male is demonstrating hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day,with albumin being the major protein.The most probable diagnosis the nurse will see documented on the chart is:

A) Cystitis
B) Chronic pyelonephritis
C) Acute glomerulonephritis
D) Renal calculi

Question 21

A 42-year-old female is diagnosed with chronic renal failure,and the nurse is discussing dietary treatment.Which information indicates the nurse understands dietary regimen? Treatment includes restricting:

A) Fats
B) Complex carbohydrates
C) Proteins
D) Sugars

Question 22

A 42-year-old male is involved in a motor vehicle accident during which he loses a lot of blood.The nurse realizes he is in acute renal failure caused by:

A) Kidney stones
B) Immune complex deposition in the glomerulus
C) Inadequate renal blood flow
D) Obstruction of the proximal tubule

Question 23

A 35-year-old female was severely burned and is hospitalized.She is now suffering from acute tubular necrosis (ATN).Which of the following is the most likely diagnosis the nurse will observe on the chart?

A) Prerenal
B) Intrarenal
C) Extrarenal
D) Postrenal

Question 24

While turning a patient with chronic renal failure,which principle should the nurse recall? Bone fractures are a risk factor in chronic renal failure because:

A) Calcium is lost in the urine.
B) Osteoblast activity is excessive.
C) The kidneys fail to activate vitamin D.
D) Autoantibodies to calcium molecules develop.

Question 25

A 45-year-old female presents with hypertension,anorexia,nausea and vomiting,and anemia.She is diagnosed with chronic renal failure.When the patient asks what caused this anemia,how should the nurse respond? Your anemia is caused by:

A) Red blood cells being lost in the urine
B) Inadequate production of erythropoietin
C) Inadequate iron absorption in the gut
D) Red blood cells being injured as they pass through the glomerulus

Question 26

A 56-year-old male presents with flank pain and polyuria.Tests reveal that he has an enlarged prostate.Which of the following types of renal failure should the nurse monitor for as it is the most likely to occur?

A) Prerenal
B) Intrarenal
C) Extrarenal
D) Postrenal

Question 27

Anemia accompanies chronic renal failure because of:

A) Blood loss via the urine
B) Renal insensitivity to vitamin D
C) Inadequate production of erythropoietin
D) Inadequate retention of serum iron

Question 28

A patient with end-stage renal disease has pruritus.When the patient asks what causes this,what is the nurse's best response? Pruritus,seen in patients with end-stage renal disease,is caused by high levels of:

A) Potassium
B) Calcium
C) Sodium
D) Magnesium

Question 29

A 60-year-old male is diagnosed with renal failure.While the nurse is reviewing lab results,which of the following lab values would be most consistent with this diagnosis?

A) Elevated plasma creatinine level
B) Decreased plasma potassium level
C) Metabolic alkalosis
D) Increased urea clearance

Question 30

When a nurse is teaching about urinary pathogens in men.Which information should the nurse include? Mechanisms for defense against urinary pathogens in men include (select all that apply):

A) The long length of the urethra
B) Alkaline pH of urine
C) Secretion of mucus that traps bacteria
D) Antimicrobial secretions from the prostate
E) Implantation of the ureters in the bladder