D115 Renal-Uro Exam Questions and
answers 2025
All .of .the .following .electrolyte .disorders .are .commonly .found .in .a .patient .with
.chronic .renal .failure, .except:
Hypernatremia
Hypocalcemia
Hyperkalemia
Hypophosphatemia .- .ANS✓✓-Hypophosphatemia
Feedback:Electrolyte .disorders .commonly .seen .in .patients .with .chronic .renal
.failure .include .hyperkalemia, .hyperphosphatemia, .hypocalcemia, .and
.bicarbonate .deficiency.
The .advanced .practice .nurse .sees .a .78-year-old .patient .who .has .complaints .of
.fatigue .and .difficulty .emptying .his .bladder. .Examination .reveals .a .distended
.bladder .but .is .otherwise .unremarkable. .The .BUN .is .88mg/dL; .the .creatinine .is
.2.8mg/dL. .This .clinical .assessment .is .most .consistent .with:
prerenal .azotemia
acute .glomerulonephritis
acute .tubular .necrosis
postrenal .azotemia .- .ANS✓✓-postrenal .azotemia
Feedback:Postrenal .azotemia .refers .to .elevations .in .BUN .and .creatinine .levels
.resulting .from .obstruction .of .the .collecting .system. .This .obstruction .to .flow
.leads .to .reversal .of .the .Starling .forces .responsible .for .glomerular .filtration.
The .APN .sees .a .68-year-old .woman .with .heart .failure. .She .has .complaints .of
.tachycardia. .Assessment .reveals .S3 .heart .sound, .basilar .crackles .bilaterally,
.BP .90/68 .mmHg, .BUN .is .58 .mg/dL, .creatinine .is .2.4 .mg/dL. .This .clinical
.presentation .is .most .consistent .with:
prerenal .azotemia
acute .glomerulonephritis
tubular .necrosis
postrenal .azotemia .- .ANS✓✓-prerenal .azotemia
Feedback:Prerenal .azotemia .refers .to .elevations .in .BUN .and .creatinine .levels
.resulting .from .problems .in .the .systemic .circulation .that .decrease .flow .to .the
.kidneys. .This .decreased .renal .flow .stimulates .salt .and .water .retention .to
.restore .volume .and .pressure.
, 6.Which .of .the .following .patient .is .the .most .likely .candidate .to .initiate .dialysis
.due .to .chronic .kidney .disease?
A .46-year-old .man .with .hypertension .and .GFR=42 .mL/min
A .64-year-old .woman .with .type .2 .diabetes .and .GFR=28 .mL/min
A .76-year-old .man .with .anemia .and .GFR=55 .mL/min
A .58-year-old .woman .with .heart .disease .and .GFR=46 .mL/min .- .ANS✓✓-A .64-
year-old .woman .with .type .2 .diabetes .and .GFR=28 .mL/min
Feedback:The .most .common .cause .of .kidney .failure .are .diabetes .and
.hypertension. .In .presence .of .these .risk .factors, .the .lower .the .GFR, .the .higher
.priority .for .dialysis.
7.Which .of .the .following .correctly .explains .the .primary .mechanism .of .damage
.in .diabetic .nephropathy?
The .formation .of .advanced .glycation .end .products .damages .glomeular
.structures
immune .activation .occurs .due .to .hypergylcyemia
elevated .levels .of .transforming .growth .factor .B .cause .inflammation
The .renin-angiotensin-aldosterone .system .(RAAS) .promotes .fibrosis .due .to
.hyperglycemia .- .ANS✓✓-The .formation .of .advanced .glycation .end .products
.damages .glomeular .structures
Feedback:The .primary .mechanism .of .damage .in .diabetic .nephropathy .is .the
.formation .of .advanced .glycation .end .products .and .an .increase .in .oxidative
.stress .due .to .hyperglycemia.
A .patient .involved .in .a .motor .vehicle .accident .is .brought .into .the .ED .with .an
.abdominal .wound .with .acute .blood .loss .and .hypotension. .Which .of .the
.following .mechanisms .best .describes .control .of .renal .blood .flow?
Increased .sympathetic .vasoconstrictor .activity
Afferent .arterioles .vasodilate .due .to .myogenic .mechanism
Afferent .arterioles .vasoconstrict .due .to .tubuloglomerular .feedback
Angiotensin .II .levels .decrease, .promoting .vasodilation .- .ANS✓✓-Increased
.sympathetic .vasoconstrictor .activity
Feedback:Increased .sympathetic .vasoconstrictor .activity .occurs .as .a .result .of
.hypovolemia .and .hypotension, .overriding .renal .autoregulation
The .APN .is .seeing .a .patient .being .treated .for .sepsis. .In .reviewing .the .labs, .the
.APN .discovers .that .the .patient .has .a .large .increase .in .serum .creatinine. .Which
.of .the .following .is .most .likely .true?
The .client .has .developed .chronic .kidney .disease
Postrenal .kidney .damage .has .occurred
Prerenal .kidney .damage .has .occurred
Acute .kidney .injury .has .resolved .- .ANS✓✓-Prerenal .kidney .damage .has
.occurred
Feedback:Prerenal .kidney .damage .is .a .result .of .inadequate .renal .blood .flow
.and .be .due .to .sepsis, .cardiogenic .shock, .hemorrhagic .shock, .or .other .states
.of .low .blood .flow.
The .APN .is .reviewing .patient .records. .Which .of .the .following .patients .is .at .the
.greatest .risk .for .nephrolithiasis?
answers 2025
All .of .the .following .electrolyte .disorders .are .commonly .found .in .a .patient .with
.chronic .renal .failure, .except:
Hypernatremia
Hypocalcemia
Hyperkalemia
Hypophosphatemia .- .ANS✓✓-Hypophosphatemia
Feedback:Electrolyte .disorders .commonly .seen .in .patients .with .chronic .renal
.failure .include .hyperkalemia, .hyperphosphatemia, .hypocalcemia, .and
.bicarbonate .deficiency.
The .advanced .practice .nurse .sees .a .78-year-old .patient .who .has .complaints .of
.fatigue .and .difficulty .emptying .his .bladder. .Examination .reveals .a .distended
.bladder .but .is .otherwise .unremarkable. .The .BUN .is .88mg/dL; .the .creatinine .is
.2.8mg/dL. .This .clinical .assessment .is .most .consistent .with:
prerenal .azotemia
acute .glomerulonephritis
acute .tubular .necrosis
postrenal .azotemia .- .ANS✓✓-postrenal .azotemia
Feedback:Postrenal .azotemia .refers .to .elevations .in .BUN .and .creatinine .levels
.resulting .from .obstruction .of .the .collecting .system. .This .obstruction .to .flow
.leads .to .reversal .of .the .Starling .forces .responsible .for .glomerular .filtration.
The .APN .sees .a .68-year-old .woman .with .heart .failure. .She .has .complaints .of
.tachycardia. .Assessment .reveals .S3 .heart .sound, .basilar .crackles .bilaterally,
.BP .90/68 .mmHg, .BUN .is .58 .mg/dL, .creatinine .is .2.4 .mg/dL. .This .clinical
.presentation .is .most .consistent .with:
prerenal .azotemia
acute .glomerulonephritis
tubular .necrosis
postrenal .azotemia .- .ANS✓✓-prerenal .azotemia
Feedback:Prerenal .azotemia .refers .to .elevations .in .BUN .and .creatinine .levels
.resulting .from .problems .in .the .systemic .circulation .that .decrease .flow .to .the
.kidneys. .This .decreased .renal .flow .stimulates .salt .and .water .retention .to
.restore .volume .and .pressure.
, 6.Which .of .the .following .patient .is .the .most .likely .candidate .to .initiate .dialysis
.due .to .chronic .kidney .disease?
A .46-year-old .man .with .hypertension .and .GFR=42 .mL/min
A .64-year-old .woman .with .type .2 .diabetes .and .GFR=28 .mL/min
A .76-year-old .man .with .anemia .and .GFR=55 .mL/min
A .58-year-old .woman .with .heart .disease .and .GFR=46 .mL/min .- .ANS✓✓-A .64-
year-old .woman .with .type .2 .diabetes .and .GFR=28 .mL/min
Feedback:The .most .common .cause .of .kidney .failure .are .diabetes .and
.hypertension. .In .presence .of .these .risk .factors, .the .lower .the .GFR, .the .higher
.priority .for .dialysis.
7.Which .of .the .following .correctly .explains .the .primary .mechanism .of .damage
.in .diabetic .nephropathy?
The .formation .of .advanced .glycation .end .products .damages .glomeular
.structures
immune .activation .occurs .due .to .hypergylcyemia
elevated .levels .of .transforming .growth .factor .B .cause .inflammation
The .renin-angiotensin-aldosterone .system .(RAAS) .promotes .fibrosis .due .to
.hyperglycemia .- .ANS✓✓-The .formation .of .advanced .glycation .end .products
.damages .glomeular .structures
Feedback:The .primary .mechanism .of .damage .in .diabetic .nephropathy .is .the
.formation .of .advanced .glycation .end .products .and .an .increase .in .oxidative
.stress .due .to .hyperglycemia.
A .patient .involved .in .a .motor .vehicle .accident .is .brought .into .the .ED .with .an
.abdominal .wound .with .acute .blood .loss .and .hypotension. .Which .of .the
.following .mechanisms .best .describes .control .of .renal .blood .flow?
Increased .sympathetic .vasoconstrictor .activity
Afferent .arterioles .vasodilate .due .to .myogenic .mechanism
Afferent .arterioles .vasoconstrict .due .to .tubuloglomerular .feedback
Angiotensin .II .levels .decrease, .promoting .vasodilation .- .ANS✓✓-Increased
.sympathetic .vasoconstrictor .activity
Feedback:Increased .sympathetic .vasoconstrictor .activity .occurs .as .a .result .of
.hypovolemia .and .hypotension, .overriding .renal .autoregulation
The .APN .is .seeing .a .patient .being .treated .for .sepsis. .In .reviewing .the .labs, .the
.APN .discovers .that .the .patient .has .a .large .increase .in .serum .creatinine. .Which
.of .the .following .is .most .likely .true?
The .client .has .developed .chronic .kidney .disease
Postrenal .kidney .damage .has .occurred
Prerenal .kidney .damage .has .occurred
Acute .kidney .injury .has .resolved .- .ANS✓✓-Prerenal .kidney .damage .has
.occurred
Feedback:Prerenal .kidney .damage .is .a .result .of .inadequate .renal .blood .flow
.and .be .due .to .sepsis, .cardiogenic .shock, .hemorrhagic .shock, .or .other .states
.of .low .blood .flow.
The .APN .is .reviewing .patient .records. .Which .of .the .following .patients .is .at .the
.greatest .risk .for .nephrolithiasis?
