Pathophysiology Exam 3
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 answersB, 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.)
F. Aspartate aminotransferase (AST)
G. Blood urea nitrogen
H. Creatinine
I. Glomerular filtration rate
J. White blood cell count correct answersB, 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:
K. 30-40 mL/min
L. 40-50 mL/min
M. 70-90 mL/min
N. 90-120 mL/min correct answersD
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?
O. Increased GFR
P. Decreased GFR
Q. Same GFR
,D. No GFR correct answersB
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 answersD
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 answersA
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.)
E. Female gender
F. Smoking
G. Obesity
H. Diabetes
I. Hypertension correct answersB, 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?
J. Creatinine 3.5 mg/dL
K. Sodium 122 mEq/L
L. Albumin 3.5 g/dL
, D. BUN 10 mg/dL correct answersA
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 answersB
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 answersC
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
C. Glomerulonephritis
D. Increased bladder compliance correct answersB
urine stasis occurs with urinary tract obstruction and can lead to the
formation of renal calculi and UTI
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 answersB, 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.)
F. Aspartate aminotransferase (AST)
G. Blood urea nitrogen
H. Creatinine
I. Glomerular filtration rate
J. White blood cell count correct answersB, 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:
K. 30-40 mL/min
L. 40-50 mL/min
M. 70-90 mL/min
N. 90-120 mL/min correct answersD
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?
O. Increased GFR
P. Decreased GFR
Q. Same GFR
,D. No GFR correct answersB
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 answersD
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 answersA
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.)
E. Female gender
F. Smoking
G. Obesity
H. Diabetes
I. Hypertension correct answersB, 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?
J. Creatinine 3.5 mg/dL
K. Sodium 122 mEq/L
L. Albumin 3.5 g/dL
, D. BUN 10 mg/dL correct answersA
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 answersB
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 answersC
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
C. Glomerulonephritis
D. Increased bladder compliance correct answersB
urine stasis occurs with urinary tract obstruction and can lead to the
formation of renal calculi and UTI
