NURS 332 MIDTERM #2 – 2025 NURSING THEORY AND
CLINICAL APPLICATION REVIEW QUESTIONS WITH VERIFIED
ANSWERS, MOST TESTED QUESTIONS
How is acute kidney injury identified? - CORRECT ANSWER-oliguria and elevated serum BUN
(3.0-6.5=N) and creatinine (60-110=N)
Together, elevation of BUN and creatinine= azotemia
What are some of the risk factors for acute kidney infection? - CORRECT ANSWER--proteinuria
-history of renal problems
-use of nephrotoxic agents
-exposure to heavy metals or organic solvents
-recent hypotensive episode
-tumor or vascular obstruction
What are some drugs that alter renal perfusion? - CORRECT ANSWER--ACE inhibitors
-ARB's
-NSAIDs
-cyclosporine
What is prerenal injury caused by? - CORRECT ANSWER--inadequate blood flow resulting in
renal hypoperfusion/ischemia
-often reversible
What are some of the causes of prerenal injury? - CORRECT ANSWER--increased vascular
capacity
-drugs that alter renal hemodynamics
-decreased cardiac output
What is an intrinsic renal injury? - CORRECT ANSWER--destruction of renal tubular epithelial
cells
,What causes intrinsic renal injury? - CORRECT ANSWER--drug allergies
-vascular problems
-acute glomerulonephritis, other infections
What is rhabdomyolysis? - CORRECT ANSWER-the breakdown of skeletal muscle---release of
myoglobin
-dark urine
-myoglobin plugs glomeruli
What are the two types of acute tubular necrosis? - CORRECT ANSWER--ischemic
-toxic
What is ischemic ATN? - CORRECT ANSWER--prolonged hypoperfusion
-Example: surgical procedure
What is toxic ATN? - CORRECT ANSWER--from aminoglycoside anti-infectives
-CT dyes
-only way to reduce risk is to provide aggressive volume expansion---crystalloid administration
What is oliguric ATN? - CORRECT ANSWER--less likely to recover renal function--have a high
mortality rate
What is non-oliguric ATN? - CORRECT ANSWER--renal concentrating defect
-hyperkalemia common complication
What is postrenal injury? - CORRECT ANSWER--caused by an obstruction to the outflow of urine
from the kidneys (bladder, uterers, urethra)
-obstruction to one kidney does not likely lead to renal failure unless the other kidney is not
functioning or absent
, What GFR tells you that you are at risk for kidney problems? - CORRECT ANSWER-GFR decrease
>25%
What GFR tells you that your kidneys are injured? - CORRECT ANSWER-GFR decrease >50%
What GFR tells you that your kidneys are failing? - CORRECT ANSWER-GFR decrease >75%
What are some of the multisystem effects of uremia? - CORRECT ANSWER--GI
-Renal osteodystrophy
-metabolic acidosis
What happens to the BUN as the GFR decreases? - CORRECT ANSWER--increases
-BUN is affected by hydration status, level of catabolism, protein intake, and GI bleeding and is not a
reliable measure of GFR
what is creatinine? - CORRECT ANSWER--end product of muscle metabolism and is released
into the blood at a constant rate
-creatinine is eliminated at a rate=to renal function
what is diminished renal reserve? - CORRECT ANSWER--output normal (remaining nephrons are
able to compensate)
what is renal insufficency? - CORRECT ANSWER-inability to concentrate urine may result in
polyuria
what happens in renal failure? - CORRECT ANSWER-oliguria
What happens in ESRD? - CORRECT ANSWER-anuria
What is the normal BUN and creatinine ratio? - CORRECT ANSWER-10:1 or 15:1
CLINICAL APPLICATION REVIEW QUESTIONS WITH VERIFIED
ANSWERS, MOST TESTED QUESTIONS
How is acute kidney injury identified? - CORRECT ANSWER-oliguria and elevated serum BUN
(3.0-6.5=N) and creatinine (60-110=N)
Together, elevation of BUN and creatinine= azotemia
What are some of the risk factors for acute kidney infection? - CORRECT ANSWER--proteinuria
-history of renal problems
-use of nephrotoxic agents
-exposure to heavy metals or organic solvents
-recent hypotensive episode
-tumor or vascular obstruction
What are some drugs that alter renal perfusion? - CORRECT ANSWER--ACE inhibitors
-ARB's
-NSAIDs
-cyclosporine
What is prerenal injury caused by? - CORRECT ANSWER--inadequate blood flow resulting in
renal hypoperfusion/ischemia
-often reversible
What are some of the causes of prerenal injury? - CORRECT ANSWER--increased vascular
capacity
-drugs that alter renal hemodynamics
-decreased cardiac output
What is an intrinsic renal injury? - CORRECT ANSWER--destruction of renal tubular epithelial
cells
,What causes intrinsic renal injury? - CORRECT ANSWER--drug allergies
-vascular problems
-acute glomerulonephritis, other infections
What is rhabdomyolysis? - CORRECT ANSWER-the breakdown of skeletal muscle---release of
myoglobin
-dark urine
-myoglobin plugs glomeruli
What are the two types of acute tubular necrosis? - CORRECT ANSWER--ischemic
-toxic
What is ischemic ATN? - CORRECT ANSWER--prolonged hypoperfusion
-Example: surgical procedure
What is toxic ATN? - CORRECT ANSWER--from aminoglycoside anti-infectives
-CT dyes
-only way to reduce risk is to provide aggressive volume expansion---crystalloid administration
What is oliguric ATN? - CORRECT ANSWER--less likely to recover renal function--have a high
mortality rate
What is non-oliguric ATN? - CORRECT ANSWER--renal concentrating defect
-hyperkalemia common complication
What is postrenal injury? - CORRECT ANSWER--caused by an obstruction to the outflow of urine
from the kidneys (bladder, uterers, urethra)
-obstruction to one kidney does not likely lead to renal failure unless the other kidney is not
functioning or absent
, What GFR tells you that you are at risk for kidney problems? - CORRECT ANSWER-GFR decrease
>25%
What GFR tells you that your kidneys are injured? - CORRECT ANSWER-GFR decrease >50%
What GFR tells you that your kidneys are failing? - CORRECT ANSWER-GFR decrease >75%
What are some of the multisystem effects of uremia? - CORRECT ANSWER--GI
-Renal osteodystrophy
-metabolic acidosis
What happens to the BUN as the GFR decreases? - CORRECT ANSWER--increases
-BUN is affected by hydration status, level of catabolism, protein intake, and GI bleeding and is not a
reliable measure of GFR
what is creatinine? - CORRECT ANSWER--end product of muscle metabolism and is released
into the blood at a constant rate
-creatinine is eliminated at a rate=to renal function
what is diminished renal reserve? - CORRECT ANSWER--output normal (remaining nephrons are
able to compensate)
what is renal insufficency? - CORRECT ANSWER-inability to concentrate urine may result in
polyuria
what happens in renal failure? - CORRECT ANSWER-oliguria
What happens in ESRD? - CORRECT ANSWER-anuria
What is the normal BUN and creatinine ratio? - CORRECT ANSWER-10:1 or 15:1
