PORTAGE LEARNING NURS 231: Pathophysiology 2022 MODULE 8

PORTAGE LEARNING NURS 231: Pathophysiology 2022 MODULE 8 Question 1 2.5 / 2.5 pts Each of the following statements are true regarding control over the GFR except: The kidney can maintain a constant GFR despite variations in the arterial blood pressure of the rest of the body. The sympathetic nervous system can supersede the renal autoregulatory system. Correct! The RAA responds when blood pressure rises above normal limits. The RAA responds when blood pressure drops below normal limits. Question 2 2.5 / 2.5 pts Which of the following statements is false regarding ADH? Elevated levels of ADH will lead to a small volume of concentrated urine. Correct! Elevated levels of ADH will lead to dilute urine. decreased levels of ADH will lead to dilute urine. Alcohol inhibits ADH. Question 3 2.5 / 2.5 pts Which of the following statements is true regarding nephrons? It is divided into an outer medulla and an inner cortex It has 1 source of blood supply Correct! The glomerulus filters the blood while the tubule reabsorbs needed nutrients Question 4 0 / 2.5 pts Low Na+ levels in the plasma and interstitial compartment is characteristic of which of the following fluid imbalances? You Answered Dehydration Correct Answer Water intoxication Edema Question 5 2.5 / 2.5 pts Reabsorption in the PCT is characterized by the following except: Na+ and water are reabsorbed in equal proportions Correct! Glucose and amino acids are minimally reabsorbed in the PCT glucose and amino acids are almost completely reabsorbed in the PCT Sodium, chloride, potassium, and bicarbonate are 65%-80% reabsorbed from the filtrate Question 6 2.5 / 2.5 pts Which of the following is/are true regarding acid-base balance? (mark all that apply) Correct! Acid-base balance refers to the balance of the concentration of hydrogen ions (H+) in the blood Acid-base balance refers to the balance of the concentration of bicarbonate ions (OH-) in the blood Venous blood is characterized by a more alkaline pH Correct! A higher concentration of H+ ions will decrease the pH of the blood Question 7 2.5 / 2.5 pts Acute postinfectious glomerulonephritis is characterized by the following except: Typically caused by a streptococcal infection Correct! Associated with a poor prognosis as it often leads to CKD the prognosis is good when underlying cause is treated Accompanied by glomerular enlargement and hypercellularity Oliguria is often the first symptom Question 8 2.5 / 2.5 pts Which of the following is characteristic of acute transplant rejection? Occurs months to years after transplant Correct! Involves increased T lymphocytes It does not respond well to immunosuppressive therapy Question 9 0 / 2.5 pts Which of the following is true of 25-hydroxycholecalciferol? You Answered It is the inactive form of vitamin D taken in through the skin via UV rays It is the inactive form of synthetic vitamin D Correct Answer It is the active form of vitamin D, converted in the liver It is the active form of vitamin D, converted in the kidney Question 10 2.5 / 2.5 pts A patient is said to be in stage 4 kidney disease. What would you expect their GFR to be? A. 25 mL/min/1.73m2 B. 42 mL/min/1.73m2 C. 70 mL/min/1.73m2 D. 14 mL/min/1.73m2 Correct! A. B. C. D. Question 11 2.5 / 2.5 pts The following are true regarding tubular secretion except: Correct! K+ is secreted in the intercalated cells K+ is secreted in the principal cells H+ along with organic acids and bases are secreted from the proximal tubule Involves the elimination of urea from the filtrate Question 12 2.5 / 2.5 pts Dilation of the afferent arterioles is achieved through the action of which of the following? Correct! Cardiovascular baroreceptors Aldosterone Diuretics Question 13 Not yet graded / 2 pts Fill in the blank: The outer portion of the kidney that houses the glomeruli and convoluted tubules is called the . Your Answer: outer cortex Answer: renal cortex Question 14 Not yet graded / 2 pts Fill in the blank: The formation of erythropoietin is preceded by low levels of . Your Answer: oxygen in the tissues Answer: oxygen Question 15 Not yet graded / 2 pts Fill in the blank: The has the largest impact on pH control. Your Answer: kidney Answer: renal control mechanism Question 16 Not yet graded / 2 pts Fill in the blank: A person who has a blood Mg2+ concentration of 3.3 mg/dL. Is considered to have . Your Answer: hypermagnesemia Answer: hypermagnesemia Question 17 Not yet graded / 2 pts Fill in the blank: failure is caused by conditions that damage the structures within the kidney. Your Answer: renal Answer: Intrarenal Question 18 Not yet graded / 5 pts T/F, if False make the statement True Angiotensin I is converted to angiotensin II in the kidneys. Your Answer: False. Angiotensin I is converted to angiotensin II in the lungs Answer: False, angiotensin I is converted to angiotensin II in the lungs. Question 19 Not yet graded / 5 pts T/F, if False make the statement True Hyperkalemia can be caused by movement of K+ from the ECF to the ICF compartment. Your Answer: False. Caused by the movement of K+ from the ICF to ECF compartment. Answer: False, hyperkalemia can be cause by the movement of K+ from the ICF to the ECF compartment. Question 20 Not yet graded / 5 pts Short Answer: Explain why renal flow is decreased with sympathetic activity. Your Answer: Renal flow is decreased when there is an increase sympathetic activity. This is due to the afferent vasocontriction. Answer: Sympathetic activity diverts blood to the heart, brain, and skeletal muscles. During these times the renal autoregulatory system may be superseded by nervous system control. In this event, a narrowing of the afferent arteriole is caused by sympathetic nerve fibers followed by a release of epinephrine from the adrenal medulla which leads to a subsequent decrease in renal flow and the GFR. Question 21 Not yet graded / 5 pts Short Answer: A patient’s plasma Ca2+ levels are 11.0 mg/dL. Given these levels, list a symptom affecting the GI tract they may experience and explain why it would be occurring. Your Answer: A GI symptom is constipation. This would occur due to the decrease in neural excitability and decrease in smooth muscle activity. Answer: The patient has hypercalcemia. Constipation, nausea, and/or vomiting may result secondary to a decrease in smooth muscle activity. Question 22 Not yet graded / 5 pts Short Answer: A patient has a diagnosis of glomerular disease. Given what you know about the structural framework of the glomerular capillaries, what would be detected in this patient’s urine, and explain why this would happen. Your Answer: Protein and blood will be detected in the the urine. This happens due to the increased permeability of the glomerular capillary wall. Answer: Blood and protein may be present in the urine. Spaces within the basement membrane of the glomerular capillaries, under normal circumstances prevent red blood cells and plasma proteins from passing through the glomerular membrane into the filtrate. The disease process would compromise this. Question 23 3 3 Not yet graded / 5 pts Short Answer: A patient with chronic kidney disease must undergo dialysis treatments as they wait for transplantation. Give 1 reason peritoneal dialysis would be preferable to the patient over hemodialysis and 1 concern in choosing peritoneal dialysis over hemodialysis. Your Answer: Peritoneal dialysis can be prefered because it can be done at the patient's home. A concern of choosing peritoneal dialysis is the risk for infection at the catheter exit site. Answer: Peritoneal dialysis can be done in the patient’s home as opposed to going to a dialysis clinic multiple times per week. A major concern of the utilization of peritoneal dialysis is the risk for infection at the catheter site. Question 24 Not yet graded / 10 pts A patient presents to the emergency department with complaints of sharp pain that comes in waves in the upper lateral quadrant of the abdomen. Their skin is clammy, and they have been experiencing nausea and vomiting all day long. They have a past medical history of hyperparathyroidism. Urinalysis reveals calcium in their urine. A CT scan is ordered, and it reveals a stone 6 mm in diameter. What type of renal calculi do you suspect? What treatment is needed? Explain your reasoning for both answers. Your Answer: Calcium stones is suspected because of increased calcium levels in urine and history of hyperparathyroidism. Since the stone is 6mm, it may not pass on its own. Ureteroscopic removal may be required. This allows the ureter to be dilated, giving the physician ability to remove the stone. Answer: The patient has a calcium stone given their past medical history and the findings of calcium in their urine. The stone will be unable to pass on its own given the diameter greater than 5 mm. It can be removed through ureteroscopic removal or extracorporeal shockwave lithotripsy. The patient may also be put on medication for pain management. Question 25 Not yet graded / 10 pts A patient presents in the emergency department with severe dehydration secondary to vomiting. The following are the results of their blood work: pH = 8.2, PCO2 = 39 mm, and HCO - = 33 mEq/L. Based upon these results, what type of acid-base disorder are they experiencing? Is compensation occurring? Describe a treatment intervention for this disorder. Normal values are as follows: pH = 7.35-7.45, PCO2 = 35-45 mm, HCO - = 22-26 mEq/L. Your Answer: Metabolic alkalosis. Respiratory compensation is occuring. Treatment is fluid replacement with normal saline solution. Answer: The patient is in metabolic alkalosis. The respiratory system is not compensating as PCO2 compensation falls within normal limits. Fluids are replaced with normal saline solution. Question 26 Not yet graded / 10 pts A patient is in the ICU following open heart surgery. The patient was feeling well earlier in the day, but suddenly began to demonstrate signs of confusion and disorientation. Blood results reveal Na+ = 100 mEq/L. Based upon these symptoms and results of blood work, what electrolyte imbalance is this patient experiencing? What treatment is indicated for this imbalance? Your Answer: Patient is experiencing euvolemic hypotonic hyponatremia. Treatment is administering saline solution. Answer: This patient is experiencing euvolemic hypotonic hyponatremia. The administration of intravenous saline solution would be indicated to correct the sodium deficiency.