Pathophysiology Exam 3 Practice
toughest Questions and correct answers
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 ANSWER-B, 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.)
A. Aspartate aminotransferase (AST)
B. Blood urea nitrogen
C. Creatinine
D. Glomerular filtration rate
E. White blood cell count - CORRECT ANSWER-B, 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:
A. 30-40 mL/min
,B. 40-50 mL/min
C. 70-90 mL/min
D. 90-120 mL/min - CORRECT ANSWER-D
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?
A. Increased GFR
B. Decreased GFR
C. Same GFR
D. No GFR - CORRECT ANSWER-B
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 ANSWER-D
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 ANSWER-A
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.)
A. Female gender
B. Smoking
C. Obesity
D. Diabetes
E. Hypertension - CORRECT ANSWER-B, 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?
A. Creatinine 3.5 mg/dL
, B. Sodium 122 mEq/L
C. Albumin 3.5 g/dL
D. BUN 10 mg/dL - CORRECT ANSWER-A
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 ANSWER-B
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 ANSWER-C
toughest Questions and correct answers
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 ANSWER-B, 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.)
A. Aspartate aminotransferase (AST)
B. Blood urea nitrogen
C. Creatinine
D. Glomerular filtration rate
E. White blood cell count - CORRECT ANSWER-B, 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:
A. 30-40 mL/min
,B. 40-50 mL/min
C. 70-90 mL/min
D. 90-120 mL/min - CORRECT ANSWER-D
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?
A. Increased GFR
B. Decreased GFR
C. Same GFR
D. No GFR - CORRECT ANSWER-B
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 ANSWER-D
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 ANSWER-A
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.)
A. Female gender
B. Smoking
C. Obesity
D. Diabetes
E. Hypertension - CORRECT ANSWER-B, 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?
A. Creatinine 3.5 mg/dL
, B. Sodium 122 mEq/L
C. Albumin 3.5 g/dL
D. BUN 10 mg/dL - CORRECT ANSWER-A
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 ANSWER-B
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 ANSWER-C
