NURS620 EXAM 2 RENAL DISORDERS
VERIFIED STUDY QUESTIONS AND
ANSWERS
The most common cause of sepsis in older adults is: - ANSWER-UTI
What is the usual clinical presentation of an adult patient with cystitis? -
ANSWER-c/o dysuria, urgency, frequency, nocturia, and suprapubic
heaviness
Which statement characterizes functional incontinence? - ANSWER-Mainly
caused by factors outside the urinary tract, especially immobility, that
prohibit proper toileting habits.
What are the two most common pathogens in community acquired UTIs? -
ANSWER-Staphylococcus saprophyticus and Escherichia coli
When prescribing oxybutinin (Ditropan) for the patient with overactive
bladder symptoms, the nurse practitioner must consider which disorder in
the medical history before prescribing? - ANSWER-Narrow-angle glaucoma
The clinical presentation of a client with urolithiasis would include: -
ANSWER-Pain starting in the flank and localizing in the costovertebral angle
What is the most common cause of chronic renal failure (CRF)? - ANSWER-
Diabetic nephropathy
The most frequent sign of bladder cancer is: - ANSWER-hematuria
The inability to empty the bladder, resulting in overdistention and frequent
loss of small amounts of urine, describes which type of urine incontinence? -
ANSWER-Overflow incontinence
A factor contributing to stress incontinence is: - ANSWER-A decreased
estrogen level
The aging process begins to affect the kidneys with a progressive loss of
nephron units by age? - ANSWER-40 years old
The kidneys lose about 20% of their mass between ages 40 and 80.
The most common cause of sepsis in older adults is? - ANSWER-a urinary
tract infection.
,An older adult who is ill with:
-hypothermia or high fever,
-change in mental status and a documented UTI
-has a suspected UTI and sepsis
**TREAT VIGOROUSLY POTENT ANTIBIOTICS + ADEQUATE HYDRATION TO
SUPPORT BP**
Urinary stasis may precipitate a UTI, and kidney stones may accompany one,
along with genitourinary problems, but a UTI alone is the most common
cause of sepsis in the older adult.
Approximately 80-90% of uncomplicated UTI cases are a result of? -
ANSWER-Gram-Negative Rod Bacteria E. coli
2nd cause Gram-Positive coccus Staphylococcus saprophyticus
Other causes: Proteus mirabilis, Klebsiella, Enterobacter, Serratia, and
Pseudomonas
UTI antibiotic treatment - ANSWER-Sulfonamides
trimethoprim and sulfamethoxazole (Bactrim, Septra 80mg/400mg Bactrim
DS 160mg/800mg) 1 tab Q12 hours x 7-14 days
Fluoroquinolones
cipofloxacin (Cipro) uncomplicated 250mg BID x 3 days; complicated 500mg
x 7-14day
levofloxacin (Levaquin) uncomplicated 250mg daily x3 days; complicated
250mg daily x 10days or 750mg x 5days.
Cloudy urine is usually indicative of which of the following conditions? -
ANSWER-UTI, hematuria, bilirubin, and mucus.
,The appearance of urine may indicate ingestion of certain products and/or
lead to possible common differential diagnoses.
For colorless urine, the differential diagnoses would be diabetes insipidus,
diuretic agents, and fluid overload.
For dark urine, they are hematuria, malignancy, stones, and acidic urine.
For pink/red urine, they are hematuria, hemoglobin, myoglobin, beets, and
food coloring.
For orange/yellow urine, the differentials are phenazopyridine, rifampin, and
bile pigments.
For brown/black urine, they are myoglobin, bile pigments, melanin, cascara,
and iron preparations.
For green urine, they are bile pigments, methylene blue, indigo, carmine.
For foamy urine, they are bile salts and proteinuria.
Rita, age 16, has a 3-day history of red urine. You want her to go home for a
few days and then return for some lab work. In teaching her what to avoid,
you know she has misunderstood the directions when she tells you she
shouldn't ingest any? - ANSWER-Watermelon
Eating watermelon will not cause the urine to change color.
Ingesting blackberries or beets, taking ibuprofen or phenazopyridine
(Pyridium),
and eating foods with red food color all may cause the urine to be pink, red,
burgundy, or cola colored.
Urine specific gravity is increased in clients with? - ANSWER-Dehydration
, Urine specific gravity is increased in those with:
-dehydrated;
-pituitary tumor that causes the release of excessive amounts of antidiuretic
hormone;
-decreased renal blood flow, glycosuria, or proteinuria.
The specific gravity of urine is decreased in clients who are over-hydrated
and in those who have diabetes insipidus or chronic renal failure
Cardiovascular failure is a major cause of which type of acute renal failure? -
ANSWER-*Prerenal* acute renal failure
Cardiovascular failure and hypovolemia are the two major causes of prerenal
acute renal failure.
Vascular disease, glomerulonephritis, interstitial nephritis, and acute tubular
necrosis are causes of intrarenal acute renal failure.
Extrarenal obstruction, intrarenal obstruction, and bladder rupture are
causes of postrenal acute renal failure.
Jessica, age 79, has been on dialysis for 6 years due to chronic kidney
disease. She has been on an oral iron preparation and now asks you if she
should think about switching to the intravenous (IV) iron preparation. How do
you respond? - ANSWER-"Let's try it. It corrects iron deficiency faster, more
safely, and better than oral iron."
Ferumoxytol, a semisynthetic iron oxide formulated with mannitol and
administered IV, corrects iron deficiency anemia in clients with CKD more
quickly and more safely than do oral iron preparations. Oral iron does not
raise hemoglobin that much because clients with CKD, whether or not
they're on dialysis, don ' t absorb iron well. About 25% - 50% of clients with
CKD taking oral iron do not tolerate it well in the doses needed and have
resulting gastrointestinal (GI) side effects. In one study, twice the number of
VERIFIED STUDY QUESTIONS AND
ANSWERS
The most common cause of sepsis in older adults is: - ANSWER-UTI
What is the usual clinical presentation of an adult patient with cystitis? -
ANSWER-c/o dysuria, urgency, frequency, nocturia, and suprapubic
heaviness
Which statement characterizes functional incontinence? - ANSWER-Mainly
caused by factors outside the urinary tract, especially immobility, that
prohibit proper toileting habits.
What are the two most common pathogens in community acquired UTIs? -
ANSWER-Staphylococcus saprophyticus and Escherichia coli
When prescribing oxybutinin (Ditropan) for the patient with overactive
bladder symptoms, the nurse practitioner must consider which disorder in
the medical history before prescribing? - ANSWER-Narrow-angle glaucoma
The clinical presentation of a client with urolithiasis would include: -
ANSWER-Pain starting in the flank and localizing in the costovertebral angle
What is the most common cause of chronic renal failure (CRF)? - ANSWER-
Diabetic nephropathy
The most frequent sign of bladder cancer is: - ANSWER-hematuria
The inability to empty the bladder, resulting in overdistention and frequent
loss of small amounts of urine, describes which type of urine incontinence? -
ANSWER-Overflow incontinence
A factor contributing to stress incontinence is: - ANSWER-A decreased
estrogen level
The aging process begins to affect the kidneys with a progressive loss of
nephron units by age? - ANSWER-40 years old
The kidneys lose about 20% of their mass between ages 40 and 80.
The most common cause of sepsis in older adults is? - ANSWER-a urinary
tract infection.
,An older adult who is ill with:
-hypothermia or high fever,
-change in mental status and a documented UTI
-has a suspected UTI and sepsis
**TREAT VIGOROUSLY POTENT ANTIBIOTICS + ADEQUATE HYDRATION TO
SUPPORT BP**
Urinary stasis may precipitate a UTI, and kidney stones may accompany one,
along with genitourinary problems, but a UTI alone is the most common
cause of sepsis in the older adult.
Approximately 80-90% of uncomplicated UTI cases are a result of? -
ANSWER-Gram-Negative Rod Bacteria E. coli
2nd cause Gram-Positive coccus Staphylococcus saprophyticus
Other causes: Proteus mirabilis, Klebsiella, Enterobacter, Serratia, and
Pseudomonas
UTI antibiotic treatment - ANSWER-Sulfonamides
trimethoprim and sulfamethoxazole (Bactrim, Septra 80mg/400mg Bactrim
DS 160mg/800mg) 1 tab Q12 hours x 7-14 days
Fluoroquinolones
cipofloxacin (Cipro) uncomplicated 250mg BID x 3 days; complicated 500mg
x 7-14day
levofloxacin (Levaquin) uncomplicated 250mg daily x3 days; complicated
250mg daily x 10days or 750mg x 5days.
Cloudy urine is usually indicative of which of the following conditions? -
ANSWER-UTI, hematuria, bilirubin, and mucus.
,The appearance of urine may indicate ingestion of certain products and/or
lead to possible common differential diagnoses.
For colorless urine, the differential diagnoses would be diabetes insipidus,
diuretic agents, and fluid overload.
For dark urine, they are hematuria, malignancy, stones, and acidic urine.
For pink/red urine, they are hematuria, hemoglobin, myoglobin, beets, and
food coloring.
For orange/yellow urine, the differentials are phenazopyridine, rifampin, and
bile pigments.
For brown/black urine, they are myoglobin, bile pigments, melanin, cascara,
and iron preparations.
For green urine, they are bile pigments, methylene blue, indigo, carmine.
For foamy urine, they are bile salts and proteinuria.
Rita, age 16, has a 3-day history of red urine. You want her to go home for a
few days and then return for some lab work. In teaching her what to avoid,
you know she has misunderstood the directions when she tells you she
shouldn't ingest any? - ANSWER-Watermelon
Eating watermelon will not cause the urine to change color.
Ingesting blackberries or beets, taking ibuprofen or phenazopyridine
(Pyridium),
and eating foods with red food color all may cause the urine to be pink, red,
burgundy, or cola colored.
Urine specific gravity is increased in clients with? - ANSWER-Dehydration
, Urine specific gravity is increased in those with:
-dehydrated;
-pituitary tumor that causes the release of excessive amounts of antidiuretic
hormone;
-decreased renal blood flow, glycosuria, or proteinuria.
The specific gravity of urine is decreased in clients who are over-hydrated
and in those who have diabetes insipidus or chronic renal failure
Cardiovascular failure is a major cause of which type of acute renal failure? -
ANSWER-*Prerenal* acute renal failure
Cardiovascular failure and hypovolemia are the two major causes of prerenal
acute renal failure.
Vascular disease, glomerulonephritis, interstitial nephritis, and acute tubular
necrosis are causes of intrarenal acute renal failure.
Extrarenal obstruction, intrarenal obstruction, and bladder rupture are
causes of postrenal acute renal failure.
Jessica, age 79, has been on dialysis for 6 years due to chronic kidney
disease. She has been on an oral iron preparation and now asks you if she
should think about switching to the intravenous (IV) iron preparation. How do
you respond? - ANSWER-"Let's try it. It corrects iron deficiency faster, more
safely, and better than oral iron."
Ferumoxytol, a semisynthetic iron oxide formulated with mannitol and
administered IV, corrects iron deficiency anemia in clients with CKD more
quickly and more safely than do oral iron preparations. Oral iron does not
raise hemoglobin that much because clients with CKD, whether or not
they're on dialysis, don ' t absorb iron well. About 25% - 50% of clients with
CKD taking oral iron do not tolerate it well in the doses needed and have
resulting gastrointestinal (GI) side effects. In one study, twice the number of
