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:

Accepted Answer

Acute poststreptococcal glomerulonephritis is caused by an antigen-antibody complex.
Acute poststreptococcal glomerulonephritis is not due to swelling of the Bowman space.
Acute poststreptococcal glomerulonephritis is caused by an antigen-antibody complex.It is not an inflammatory process.
Acute poststreptococcal glomerulonephritis is caused by an antigen-antibody complex.

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?

Accepted Answer

The most common infecting microorganisms are uropathic strains of Escherichia coli.
The most common infecting microorganisms are uropathic strains of Escherichia coli.Streptococcus in not a factor.
The most common infecting microorganisms are uropathic strains of Escherichia coli,not Candida albicans.
The most common infecting microorganisms are uropathic strains of Escherichia coli,not Chlamydia.

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?

Accepted Answer

Urine stasis occurs with urinary tract obstruction and can lead to the formation of renal calculi.
Reflux and pyelonephritis would not lead to calculi as much as stasis.
Glomerulonephritis would not lead to calculi formation.
Increased compliance would not lead to 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?

Accepted Answer

Because the bladder neck consists of circular smooth muscle with adrenergic innervation,detrusor sphincter dyssynergia may be managed by alpha-adrenergic blocking (antimuscarinic)medications.
Because the bladder neck consists of circular smooth muscle with adrenergic innervation,detrusor sphincter dyssynergia may be managed by alpha-adrenergic blocking (antimuscarinic)medications,not beta blockers.
Because the bladder neck consists of circular smooth muscle with adrenergic innervation,detrusor sphincter dyssynergia may be managed by alpha-adrenergic blocking (antimuscarinic)medications,not a vasodilator.
Because the bladder neck consists of circular smooth muscle with adrenergic innervation,detrusor sphincter dyssynergia may be managed by alpha-adrenergic blocking (antimuscarinic)medications,not a 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?

Accepted Answer

The remaining kidney would hypertrophy to compensate for the increased workload of the loss of the affected kidney.
The remaining kidney would enlarge,not atrophy.
The remaining kidney would hypertrophy,not change cell structure.
The remaining kidney would hypertrophy; the patient would not go into 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:

Accepted Answer

Pyelonephritis is an infection of one or both upper urinary tracts (ureter,renal pelvis,and interstitium).
Pyelonephritis is an infection of one or both upper urinary tracts (ureter,renal pelvis,and interstitium).It does not affect the bladder.
Pyelonephritis is an infection of one or both upper urinary tracts (ureter,renal pelvis,and interstitium).It does not affect the tubules.
Pyelonephritis is an infection of one or both upper urinary tracts (ureter,renal pelvis,and interstitium).It does not involve the glomerulus.

Question 7

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

Accepted Answer

The most important factor in renal calculus formation is urine pH.
The most important factor in renal calculus formation is urine pH,not body temperature.
The most important factor in renal calculus formation is urine pH,not gender,although calculi form more often in men.
The most important factor in renal calculus formation is urine pH,not serum mineral concentrations.

Question 8

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

Accepted Answer

A complicated UTI develops when there is an abnormality in the urinary system or a health problem that compromises host defenses or response to treatment.UTI may occur alone or in association with pyelonephritis,prostatitis,or kidney stones.
A complicated UTI develops when there is an abnormality in the urinary system or a health problem that compromises host defenses or response to treatment.UTI may occur alone or in association with pyelonephritis,prostatitis,or kidney stones.It is not due to the involvement of several species of bacteria.
A complicated UTI develops when there is an abnormality in the urinary system or a health problem that compromises host defenses or response to treatment.UTI may occur alone or in association with pyelonephritis,prostatitis,or kidney stones.It does not always cause urosepsis.
A complicated UTI develops when there is an abnormality in the urinary system or a health problem that compromises host defenses or response to treatment.UTI may occur alone or in association with pyelonephritis,prostatitis,or kidney stones.It does not always result in obstruction.

Question 9

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

Accepted Answer

Changes in the glomerulus are characterized by progressive thickening and fibrosis of the glomerular basement membrane.
Changes in the glomerulus are characterized by progressive thickening and fibrosis of the glomerular basement membrane; there is not tubular obstruction.
The renin-angiotensin system is not activated in glomerulonephritis.
The efferent arterioles are not affected in glomerulonephritis.

Question 10

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

Accepted Answer

Nephrotic syndrome is manifested by proteinuria.Nephrotic syndrome is diagnosed when the protein level in a 24-hour urine collection is greater than 3.5 g.
Proteinuria is the diagnostic criteria for nephrotic syndrome.
The patient with nephrotic syndrome does not experience dysuria.
The patient with nephrotic syndrome does not experience oliguria.

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?

Accepted Answer

Neurologic disorders that develop above the pontine micturition center result in detrusor hyperreflexia,also known as an uninhibited or reflex bladder.
Lesions that develop in upper motor neurons of the brain and spinal cord result in dyssynergia.
Lesions that involve the sacral micturition center (below S1; may also be termed cauda equina syndrome)or peripheral nerve lesions result in detrusor areflexia (acontractile detrusor),a lower motor neuron disorder.
Neurologic lesions that occur below the pontine micturition center but above the sacral micturition center (between C2 and S1)are also upper motor neuron lesions and result in detrusor hyperreflexia with vescico-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?

Accepted Answer

Reduced resistance is associated with the symptom of stress incontinence,which is incontinence with coughing or sneezing.
Urge incontinence is the inability to hold the urine when the urge is felt.
There is coordination between the contracting bladder and the external sphincter,but the detrusor is too weak to empty the bladder,resulting in urinary retention with overflow or stress incontinence.
Functional incontinence is similar to overflow and is not associated with coughing.

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:

Accepted Answer

Urinary obstruction and reflux of urine from the bladder are the most common underlying risk factors.
Urinary obstruction and reflux of urine from the bladder are the most common underlying risk factors.Cystitis is not a common risk factor.
Urinary obstruction and reflux of urine from the bladder are the most common underlying risk factors.Renal cancer is not a common risk factor.
Urinary obstruction and reflux of urine from the bladder are the most common underlying risk factors.Nephrotic syndrome is not a common risk factor.

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:

Accepted Answer

The most common composition of a renal stone is calcium,accounting for 70% to 80%.
The most common composition of a renal stone is calcium,accounting for 70% to 80%.Only a limited number of stones are composed of magnesium.
The most common composition of a renal stone is calcium,accounting for 70% to 80%.Struvite accounts for less than 10% to 15%.
The most common composition of a renal stone is calcium,accounting for 70% to 80%.The percentage of phosphate is very low.

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?

Accepted Answer

Significant flank pain is the most common manifestation.
Anuria does not occur.
Hematuria does occur,but it is not the most common manifestation.
Flank pain is the most common symptom; pyuria does not occur.

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?

Accepted Answer

Antiglomerular basement membrane disease (Goodpasture syndrome)is associated with antibody formation against both pulmonary capillary and glomerular basement membranes.
Antiglomerular basement membrane disease (Goodpasture syndrome)is associated with antibody formation against both pulmonary capillary and glomerular basement membranes.It is not due to a viral infection.
Antiglomerular basement membrane disease (Goodpasture syndrome)is associated with antibody formation against both pulmonary capillary and glomerular basement membranes.It is not an antigen-antibody complex.
Antiglomerular basement membrane disease (Goodpasture syndrome)is associated with antibody formation against both pulmonary capillary and glomerular basement membranes.It is not due to abnormal clotting.

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?

Accepted Answer

Group A ß-hemolytic streptococcus is the primary cause of glomerulonephritis associated with a pharyngeal infection.
Group A ß-hemolytic streptococcus is the primary cause of glomerulonephritis associated with a pharyngeal infection.Klebsiella is not associated with pharyngitis.
Group A ß-hemolytic streptococcus is the primary cause of glomerulonephritis associated with a pharyngeal infection.HIV is not associated with pharyngitis.
Group A ß-hemolytic streptococcus is the primary cause of glomerulonephritis associated with a pharyngeal infection.Genital herpes is not associated with pharyngitis.

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:

Accepted Answer

Hydronephrosis occurs due to dilation of the renal pelvis and calyces proximal to a blockage.
Hydronephrosis is not the result of decreased renal blood flow.
Hydronephrosis is not the result of decreased peritubular capillary pressure,but due to dilation of the renal pelvis.
Hydronephrosis occurs due to dilation of the renal pelvis and calyces proximal to a blockage,not to stimulation of the 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?

Accepted Answer

The patient is demonstrating symptoms of acute cystitis.
Although renal calculi can cause pain and hematuria,it is not manifested by fever and cloudy urine.
Chronic renal failure is not manifested by cloudy urine.
Postrenal renal failure is not manifested by hematuria and cloudy urine.

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:

Accepted Answer

Two major symptoms distinctive of more severe glomerulonephritis are: (1)hematuria with red blood cell casts and (2)proteinuria exceeding 3 to 5 g/day with albumin (macroalbuminuria)as the major protein.
Cystitis is not a symptom of glomerulonephritis.
Chronic pyelonephritis is manifested by dysuria,not proteinuria.
Proteinuria is not seen with renal calculi.

Quiz 29: Alterations of Renal and Urinary Tract Function