MARYVILLE NURS 611 EXAM 4
QUESTIONS AND ANSWERS GRADED A+
2025/2026
Acute unilateral renal obstruction and hypertension are caused by - ANS Renal stones
most common type of kidney stone - ANS Calcium oxalate
Amount of cardiac output that kidneys expect to receive - ANS 20-25%
Passage of kidney stones can be extremely painful and cause referred pain to where? -
ANS Umbilicus area
The kidney stones are often jagged, so what ends up happening is that they get stuck in what? -
ANS The ureters
When that kidney stone gets stuck in the ureter, what does it obstruct? - ANS Urine flow
The kidneys will react due to obstruction, because they expect their 20-25% of cardiac output.
The kidneys do not know why they are not getting their normal share of cardiac output but they
sense the decreased perfusion due to the obstruction, so those kidneys activate what -
ANS The RAAS system
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,With activation of that RAAS system from the kidneys, there is angiotensin, which is a powerful
peripheral constrictor. So, what happens within those kidneys themselves is decreased tissue
perfusion so they activate the RAAS system which contains the angiotensin with powerful
constrictor properties, so it constricts what? - ANS Arterioles
When angiotensin constricts the arterioles, what happens as a result? - ANS Hypertension, so
basically HTN happens due to urinary obstruction
Which population do we think mainly about when we think about UTIs? - ANS The older
populaiton
With older adults it may be harder to determine if they have a UTI because clinically, the main
manifestation that is often seen with the elderly and a UTI is what? - ANS Confusion,
abdominal pain or discomfort, blood in urine.
What can a UTI lead to very quickly, especially with the older population? - ANS sepsis
Infection of one or both upper urinary tracts (ureter, renal pelvis, kidney interstitium) is what? -
ANS Pyelonephritis
most common risk factors for pyelonephritis - ANS Urinary obstruction, and reflux of urine
from the bladder.
most common culprit of pyelonephritis - ANS E. coli, proteus, pseudomonas
Why do we think of E. coli, especially for women with pyelonephritis? - ANS Because of
proximity of the anus to the urinary tract
On urinalysis what would you see with pyelonephritis - ANS WBC casts, because they are only
formed in the renal tubules
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, Urine should always go (----) and when there is an obstruction urine goes (----) - ANS Forward,
backward
When the urine flows backward from an obstruction, where does it flow back into - ANS The
renal pelvis
What is the renal pelvis? - ANS is the funnel-like dilated part of the ureter in the kidney, The
renal pelvis functions as a funnel for urine flowing to the ureter.
When the urine flows backward from an obstruction into the renal pelvis, what happens? -
ANS it causes inflammation, which is caused by bacteria
A condition that includes non bacterial infectious cystitis and noninfectious cystitis is called
what? - ANS Painful bladder syndrome or interstitial cystitis
Painful Bladder Syndrome/Interstitial Cystitis (PBS/IC) mimics - ANS UTI, but is non bacterial.
Patients present with UTI and are treated with multiple rounds of abx and do not improve is the
clue it is PBS/IC
Cause of PBS/IC - ANS Non bacterial infectious cystisis:
- Viral
- Mycobacterial
- Chlamydia
- Fungal
Noninfectious Cystitis:
- Radiation
- Chemical
- Autoimmune
- Hypersensitivity
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
QUESTIONS AND ANSWERS GRADED A+
2025/2026
Acute unilateral renal obstruction and hypertension are caused by - ANS Renal stones
most common type of kidney stone - ANS Calcium oxalate
Amount of cardiac output that kidneys expect to receive - ANS 20-25%
Passage of kidney stones can be extremely painful and cause referred pain to where? -
ANS Umbilicus area
The kidney stones are often jagged, so what ends up happening is that they get stuck in what? -
ANS The ureters
When that kidney stone gets stuck in the ureter, what does it obstruct? - ANS Urine flow
The kidneys will react due to obstruction, because they expect their 20-25% of cardiac output.
The kidneys do not know why they are not getting their normal share of cardiac output but they
sense the decreased perfusion due to the obstruction, so those kidneys activate what -
ANS The RAAS system
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,With activation of that RAAS system from the kidneys, there is angiotensin, which is a powerful
peripheral constrictor. So, what happens within those kidneys themselves is decreased tissue
perfusion so they activate the RAAS system which contains the angiotensin with powerful
constrictor properties, so it constricts what? - ANS Arterioles
When angiotensin constricts the arterioles, what happens as a result? - ANS Hypertension, so
basically HTN happens due to urinary obstruction
Which population do we think mainly about when we think about UTIs? - ANS The older
populaiton
With older adults it may be harder to determine if they have a UTI because clinically, the main
manifestation that is often seen with the elderly and a UTI is what? - ANS Confusion,
abdominal pain or discomfort, blood in urine.
What can a UTI lead to very quickly, especially with the older population? - ANS sepsis
Infection of one or both upper urinary tracts (ureter, renal pelvis, kidney interstitium) is what? -
ANS Pyelonephritis
most common risk factors for pyelonephritis - ANS Urinary obstruction, and reflux of urine
from the bladder.
most common culprit of pyelonephritis - ANS E. coli, proteus, pseudomonas
Why do we think of E. coli, especially for women with pyelonephritis? - ANS Because of
proximity of the anus to the urinary tract
On urinalysis what would you see with pyelonephritis - ANS WBC casts, because they are only
formed in the renal tubules
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, Urine should always go (----) and when there is an obstruction urine goes (----) - ANS Forward,
backward
When the urine flows backward from an obstruction, where does it flow back into - ANS The
renal pelvis
What is the renal pelvis? - ANS is the funnel-like dilated part of the ureter in the kidney, The
renal pelvis functions as a funnel for urine flowing to the ureter.
When the urine flows backward from an obstruction into the renal pelvis, what happens? -
ANS it causes inflammation, which is caused by bacteria
A condition that includes non bacterial infectious cystitis and noninfectious cystitis is called
what? - ANS Painful bladder syndrome or interstitial cystitis
Painful Bladder Syndrome/Interstitial Cystitis (PBS/IC) mimics - ANS UTI, but is non bacterial.
Patients present with UTI and are treated with multiple rounds of abx and do not improve is the
clue it is PBS/IC
Cause of PBS/IC - ANS Non bacterial infectious cystisis:
- Viral
- Mycobacterial
- Chlamydia
- Fungal
Noninfectious Cystitis:
- Radiation
- Chemical
- Autoimmune
- Hypersensitivity
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
