NR 507 Advanced Pathophysiology Study
Guide | NP Exam Questions & Review with
Detailed Answers |100% Verifed and Updated
Acute renal failure
Correct Answer:
Reversible
Determining prognosis- kidneys respond to diuretic with good output; this indicates that
kidneys are functioning well
Acute Pyelonephritis
Correct Answer:
Diagnosing by clinical symptoms alone can be difficult; can be similar to cystitis
Diagnosis established by:
-Urine culture
-Urinalysis (WBC casts indicates pyelonephritis, but may not always be present)
-Signs/Symptoms
-Complicated pyelonephritis requires blood cultures and urinary tract imaging
Renal Calculi (Renal Stones)
Correct Answer:
Goals of Treatment:
Manage acute pain
Promote passage of stone
Reduce size of stone
Prevent new stone formation
Chronic Renal Failure
Correct Answer:
,Chronic Kidney Disease (CKD) is a progressive loss of renal function associated with systemic
disease such as hypertension, diabetes mellitus (most significant risk factor), systemic lupus
erythematosus or intrinsic kidney disease
CKD stage is determined by estimates of GFR and albuminuria
Who is a candidate for dialysis?
Correct Answer:
End-stage renal disease (ESRD) is the final stage of CKD with the number one cause being
diabetes mellitus combined with hypertension. At this point, the patient is completely
dependent on dialysis to survive.
CKD is classified into five stages and is based on the patient's GFR rather than symptoms.
Patients will need dialysis when the following symptoms are present:
--Metabolic acidosis.
--Hyperkalemia: Hyperkalemia in the presence of EKG changes (peaked T-waves) is an indication
for dialysis. --Hyperkalemia by itself is not an indication for dialysis.
--Drug toxicity: Drug toxicity due to the following drugs is an indication for dialysis and include
salicylates, Lithium, Isopropanol, Methanol and Ethylene glycol).
--Fluid volume overload that is not responsive to diuretics.
--Uremic symptoms due to nitrogenous wastes in the blood stream.
Stage I CKD
Correct Answer:
There is kidney damage with normal or elevated GFR
90-120
Stage II CKD
Correct Answer:
There is kidney damage with mild decrease in GFR
60-89
Stage III CKD
Correct Answer:
There is a moderate decrease in GFR
30-59
Stage IV CKD
,Correct Answer:
There is a severe decrease in GFR
15-29
Stage V CKD
Correct Answer:
Kidney failure- End-stage renal disease
<15 (dialysis) Once Stage IV is reached, progression to Stage V is inevitable as well as dialysis or
kidney transplant
Complications of Decreased GFR
Correct Answer:
Anemia
Hypertension
Decreased calcium absorption
Hyperlipidemia
Heart failure
Left ventricular hypertrophy
Fluid volume overload
Hyperkalemia
Hyperparathyroidism
Hyperphosphatemia
Metabolic acidosis
Malnutrition (late complication)
GERD
Correct Answer:
Warning signs include: Symptoms over age of 50:
-Dysphagia (difficulty swallowing)
-Odynophagia (pain on swallowing)
-Nausea and vomiting
-Weight loss
-Melena
-Early satiety (feeling full after eating very little food
Hiatal Hernia
, Correct Answer:
Often asymptomatic
Generally, a wide variety of symptoms develop later in life and are associated with other GI
disorders, primarily GERD
--Sliding hiatal hernia: treatment usually conservative. Individuals can diminish reflux by eating
small, frequent meals and avoiding the recumbent position after eating. Abdominal supports
and tight clothing are avoided and weight control recommended for obese individuals.
Duodenal Ulcer
Correct Answer:
Characteristic manifestation = chronic intermittent pain in epigastric area
Pain begins 30 minutes to 2 hours after eating when stomach is empty
Not unusual for pain to occur in middle of the night and disappear by morning
Peptic Ulcer Disease
Correct Answer:
Peptic ulcer is a break or ulceration in the protective mucosal lining of the lower esophagus,
stomach or duodenum
Least likely to occur in the large intestine
Major Depressive Disorder
Correct Answer:
SSRIs are the standard first-line treatment for major depression
Initial selection of an antidepressant includes:
-Assessment of symptoms
-Age
-Side effects
-Safety
-Cost
Social Anxiety Disorder
Guide | NP Exam Questions & Review with
Detailed Answers |100% Verifed and Updated
Acute renal failure
Correct Answer:
Reversible
Determining prognosis- kidneys respond to diuretic with good output; this indicates that
kidneys are functioning well
Acute Pyelonephritis
Correct Answer:
Diagnosing by clinical symptoms alone can be difficult; can be similar to cystitis
Diagnosis established by:
-Urine culture
-Urinalysis (WBC casts indicates pyelonephritis, but may not always be present)
-Signs/Symptoms
-Complicated pyelonephritis requires blood cultures and urinary tract imaging
Renal Calculi (Renal Stones)
Correct Answer:
Goals of Treatment:
Manage acute pain
Promote passage of stone
Reduce size of stone
Prevent new stone formation
Chronic Renal Failure
Correct Answer:
,Chronic Kidney Disease (CKD) is a progressive loss of renal function associated with systemic
disease such as hypertension, diabetes mellitus (most significant risk factor), systemic lupus
erythematosus or intrinsic kidney disease
CKD stage is determined by estimates of GFR and albuminuria
Who is a candidate for dialysis?
Correct Answer:
End-stage renal disease (ESRD) is the final stage of CKD with the number one cause being
diabetes mellitus combined with hypertension. At this point, the patient is completely
dependent on dialysis to survive.
CKD is classified into five stages and is based on the patient's GFR rather than symptoms.
Patients will need dialysis when the following symptoms are present:
--Metabolic acidosis.
--Hyperkalemia: Hyperkalemia in the presence of EKG changes (peaked T-waves) is an indication
for dialysis. --Hyperkalemia by itself is not an indication for dialysis.
--Drug toxicity: Drug toxicity due to the following drugs is an indication for dialysis and include
salicylates, Lithium, Isopropanol, Methanol and Ethylene glycol).
--Fluid volume overload that is not responsive to diuretics.
--Uremic symptoms due to nitrogenous wastes in the blood stream.
Stage I CKD
Correct Answer:
There is kidney damage with normal or elevated GFR
90-120
Stage II CKD
Correct Answer:
There is kidney damage with mild decrease in GFR
60-89
Stage III CKD
Correct Answer:
There is a moderate decrease in GFR
30-59
Stage IV CKD
,Correct Answer:
There is a severe decrease in GFR
15-29
Stage V CKD
Correct Answer:
Kidney failure- End-stage renal disease
<15 (dialysis) Once Stage IV is reached, progression to Stage V is inevitable as well as dialysis or
kidney transplant
Complications of Decreased GFR
Correct Answer:
Anemia
Hypertension
Decreased calcium absorption
Hyperlipidemia
Heart failure
Left ventricular hypertrophy
Fluid volume overload
Hyperkalemia
Hyperparathyroidism
Hyperphosphatemia
Metabolic acidosis
Malnutrition (late complication)
GERD
Correct Answer:
Warning signs include: Symptoms over age of 50:
-Dysphagia (difficulty swallowing)
-Odynophagia (pain on swallowing)
-Nausea and vomiting
-Weight loss
-Melena
-Early satiety (feeling full after eating very little food
Hiatal Hernia
, Correct Answer:
Often asymptomatic
Generally, a wide variety of symptoms develop later in life and are associated with other GI
disorders, primarily GERD
--Sliding hiatal hernia: treatment usually conservative. Individuals can diminish reflux by eating
small, frequent meals and avoiding the recumbent position after eating. Abdominal supports
and tight clothing are avoided and weight control recommended for obese individuals.
Duodenal Ulcer
Correct Answer:
Characteristic manifestation = chronic intermittent pain in epigastric area
Pain begins 30 minutes to 2 hours after eating when stomach is empty
Not unusual for pain to occur in middle of the night and disappear by morning
Peptic Ulcer Disease
Correct Answer:
Peptic ulcer is a break or ulceration in the protective mucosal lining of the lower esophagus,
stomach or duodenum
Least likely to occur in the large intestine
Major Depressive Disorder
Correct Answer:
SSRIs are the standard first-line treatment for major depression
Initial selection of an antidepressant includes:
-Assessment of symptoms
-Age
-Side effects
-Safety
-Cost
Social Anxiety Disorder
