NRS236 FINAL EXAM STUDY SET EXAM QUESTIONS AND
ANSWERS
Chronic kidney disease (CKD) - CORRECT ANSWER✅✅Progressive, irreversible nephron loss that causes
surviving nephrons to hyperfilter, leading to proteinuria, fibrosis, decreased GFR, and uremia.
CKD main pathophysiology - CORRECT ANSWER✅✅Remaining nephrons compensate by working
harder, but this increased workload causes more injury and speeds up kidney damage.
CKD and proteinuria - CORRECT ANSWER✅✅Protein leaking into the urine damages tubules and causes
tubulointerstitial inflammation and fibrosis.
CKD and angiotensin II - CORRECT ANSWER✅✅Angiotensin II increases glomerular pressure and
contributes to scarring and progression of kidney disease.
CKD stages - CORRECT ANSWER✅✅Kidney function declines from renal insufficiency to end-stage renal
disease when function is less than 10%.
CKD electrolyte problem - CORRECT ANSWER✅✅Sodium, water, and potassium retention occur;
hyperkalemia is especially dangerous because it can cause lethal cardiac dysrhythmias.
CKD acid-base problem - CORRECT ANSWER✅✅Metabolic acidosis occurs because damaged kidneys
cannot excrete hydrogen ions properly.
CKD bone and mineral changes - CORRECT ANSWER✅✅Decreased calcium, increased phosphate,
secondary hyperparathyroidism, and renal osteodystrophy can occur.
CKD anemia - CORRECT ANSWER✅✅Anemia occurs because the kidneys produce less erythropoietin,
causing decreased red blood cell production.
CKD cardiovascular effects - CORRECT ANSWER✅✅Hypertension, dyslipidemia, and accelerated
cardiovascular disease are common; cardiovascular disease is a major cause of death.
, CKD neurologic effects - CORRECT ANSWER✅✅Uremia can cause impaired concentration, memory
problems, seizures, and motor or sensory dysfunction.
CKD skin symptoms - CORRECT ANSWER✅✅Pallor, sallow skin, and pruritus occur due to anemia and
buildup of uremic waste products.
CKD GI symptoms - CORRECT ANSWER✅✅Uremic fetor, anorexia, nausea, vomiting, and uremic
gastroenteritis can occur.
CKD immune effect - CORRECT ANSWER✅✅Immune suppression increases infection risk and can
reduce vaccine response.
CKD nursing connection - CORRECT ANSWER✅✅Fatigue may point to anemia, bone pain may point to
renal osteodystrophy, and altered mental status may point to uremic encephalopathy.
Urinary incontinence - CORRECT ANSWER✅✅Any involuntary loss of urine; it is not a normal part of
aging.
Stress urinary incontinence - CORRECT ANSWER✅✅Urine leakage with coughing, sneezing, laughing, or
increased intra-abdominal pressure due to pelvic floor weakness.
Urgency urinary incontinence - CORRECT ANSWER✅✅Leakage caused by an overactive detrusor muscle
and a sudden strong urge to void.
Overflow urinary incontinence - CORRECT ANSWER✅✅Leakage caused by an overfull bladder due to
obstruction or poor detrusor contraction.
Mixed urinary incontinence - CORRECT ANSWER✅✅A combination of stress and urgency incontinence.
Renal calculi - CORRECT ANSWER✅✅Kidney stones form when urine becomes supersaturated with
minerals that precipitate into crystals.
ANSWERS
Chronic kidney disease (CKD) - CORRECT ANSWER✅✅Progressive, irreversible nephron loss that causes
surviving nephrons to hyperfilter, leading to proteinuria, fibrosis, decreased GFR, and uremia.
CKD main pathophysiology - CORRECT ANSWER✅✅Remaining nephrons compensate by working
harder, but this increased workload causes more injury and speeds up kidney damage.
CKD and proteinuria - CORRECT ANSWER✅✅Protein leaking into the urine damages tubules and causes
tubulointerstitial inflammation and fibrosis.
CKD and angiotensin II - CORRECT ANSWER✅✅Angiotensin II increases glomerular pressure and
contributes to scarring and progression of kidney disease.
CKD stages - CORRECT ANSWER✅✅Kidney function declines from renal insufficiency to end-stage renal
disease when function is less than 10%.
CKD electrolyte problem - CORRECT ANSWER✅✅Sodium, water, and potassium retention occur;
hyperkalemia is especially dangerous because it can cause lethal cardiac dysrhythmias.
CKD acid-base problem - CORRECT ANSWER✅✅Metabolic acidosis occurs because damaged kidneys
cannot excrete hydrogen ions properly.
CKD bone and mineral changes - CORRECT ANSWER✅✅Decreased calcium, increased phosphate,
secondary hyperparathyroidism, and renal osteodystrophy can occur.
CKD anemia - CORRECT ANSWER✅✅Anemia occurs because the kidneys produce less erythropoietin,
causing decreased red blood cell production.
CKD cardiovascular effects - CORRECT ANSWER✅✅Hypertension, dyslipidemia, and accelerated
cardiovascular disease are common; cardiovascular disease is a major cause of death.
, CKD neurologic effects - CORRECT ANSWER✅✅Uremia can cause impaired concentration, memory
problems, seizures, and motor or sensory dysfunction.
CKD skin symptoms - CORRECT ANSWER✅✅Pallor, sallow skin, and pruritus occur due to anemia and
buildup of uremic waste products.
CKD GI symptoms - CORRECT ANSWER✅✅Uremic fetor, anorexia, nausea, vomiting, and uremic
gastroenteritis can occur.
CKD immune effect - CORRECT ANSWER✅✅Immune suppression increases infection risk and can
reduce vaccine response.
CKD nursing connection - CORRECT ANSWER✅✅Fatigue may point to anemia, bone pain may point to
renal osteodystrophy, and altered mental status may point to uremic encephalopathy.
Urinary incontinence - CORRECT ANSWER✅✅Any involuntary loss of urine; it is not a normal part of
aging.
Stress urinary incontinence - CORRECT ANSWER✅✅Urine leakage with coughing, sneezing, laughing, or
increased intra-abdominal pressure due to pelvic floor weakness.
Urgency urinary incontinence - CORRECT ANSWER✅✅Leakage caused by an overactive detrusor muscle
and a sudden strong urge to void.
Overflow urinary incontinence - CORRECT ANSWER✅✅Leakage caused by an overfull bladder due to
obstruction or poor detrusor contraction.
Mixed urinary incontinence - CORRECT ANSWER✅✅A combination of stress and urgency incontinence.
Renal calculi - CORRECT ANSWER✅✅Kidney stones form when urine becomes supersaturated with
minerals that precipitate into crystals.
