Pathophysiology Exam 3 Practice Questions and Answers Latest 2023 Update(Complete test bank)

Pathophysiology Exam 3 Practice

Questions and Answers

The nurse working in an outpatient nephrology clinic knows that which of the

following are primary functions of the kidneys? (Select all that apply.)

A. Production of clotting factors

B. Homeostasis

C. Excretion of metabolic wastes

D. Regulation of acid-base balance

E. Metabolism of fats Correct answer- B, C, D

The kidneys do not metabolize fats.

Production of clotting factors is a primary function of the liver.

The kidneys maintain blood pressure using the RAAS and also produce

erythropoietin to stimulate RBC production.

In caring for a patient diagnosed with acute kidney injury, the nephrology

nurse knows that which of the following tests are specific for renal function?

(Select all that apply.)

A. Aspartate aminotransferase (AST)

B. Blood urea nitrogen

C. Creatinine

D. Glomerular filtration rate

E. White blood cell count Correct answer- B, C, D

AST related to LIVER function

In caring for a patient with acute kidney injury the nurse knows that the

patient's renal function has returned to normal range when the patient's GFR

measures:

A. 30-40 mL/min

B. 40-50 mL/min

C. 70-90 mL/min

D. 90-120 mL/min Correct answer- D

Normal GFR is 90-120 mL/min

Normal Creatinine 0.6-1.1 for females and 0.6-1.2 for males

Normal BUN is 10-20 mg/dL

*Be sure to know these normal values, you will use them daily as a nurse

The nursing working in a geriatric living facility understands that as patients

age, which change in glomerular filtration rate is expected?

A. Increased GFR

B. Decreased GFR

C. Same GFR

D. No GFR Correct answer- B

Aging and renal function:

Decrease in renal blood flow and GFR → altered sodium and water balance

Number of nephrons decrease due to renal vascular and perfusion changes

Response to acid-base changes is delayed

Increased risk for drug toxicity

Alterations in thirst and water intake

Get dehydrated very easily; do not recognize thirst and heat

Decreased muscle mass may lead to decreased creatinine values

An older patient is experiencing urinary stasis. The registered nurse knows

that urinary stasis may lead to which of the following?

A. Increased GFR

B. Hypocoagulation

C. Hypertension

D. Infection Correct answer- D

Urinary stasis is a risk factor for developing UTI

Which of the following is classified as the most common primary mineral salt

composition of kidney stones?

A. Calcium

B. Struvite

C. Uric Acid

D. Cysteine Correct answer- A

A - calcium (i.e. oxalate or phosphate) is most common

*Note that a change in urine pH may lead to precipitation of stones

Which of the following are risk factors for developing renal tumors? (Select

all that apply.)

A. Female gender

B. Smoking

C. Obesity

D. Diabetes

E. Hypertension Correct answer- B, C, E

risk factors are male gender, smoking, obesity, uncontrolled hypertension

The registered nurse would expect which of the following lab values for a

patient experiencing acute kidney failure?

A. Creatinine 3.5 mg/dL

B. Sodium 122 mEq/L

C. Albumin 3.5 g/dL

D. BUN 10 mg/dL Correct answer- A

the normal creatinine level is 0.6 - 1.2

This BUN is within normal range (BUN would be elevated in acute kidney

failure)

In caring for a patient experiencing acute kidney injury who has these lab

values: urinary output 15 mL/hr, BUN 30 mg/dL, and creatinine 3.5, the nurse

knows that the patient is experiencing which phase of acute kidney injury?

A. Initiation phase

B. Oliguric phase

C. Recovery (polyuric) phase

D. I don't remember the normal lab values Correct answer- B

Remember that there are phases of acute kidney injury -

Initiation phase is when the injury is just beginning and prevention is still

possible

Next is the oliguric phase where urinary output is decreased and nitrogenous

waste products are maintained (BUN and Creatinine)

There is also the recovery or polyuric/diuretic phase - diuresis is common

and BUN and creatinine decline

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 renal pelvis and calyces proximal to blockage

D. Stimulation of antidiuretic hormone Correct answer- C

Hydroureter; dilation of ureter

Hydronephrosis: dilation/enlargement of renal pelvis and calyces

Ureterohydronephrosis: dilation of ureter AND renal pelvis and calyces

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