MARYVILLE UNIVERSITY NURSING
611 EXAM 4 REVIEW QUESTIONS &
VERIFIED CORRECT ANSWERS
Urinary Tract Infection - correct answer ✔✔Clinical manifestations of this condition in an older
adult are Confusion and poorly localized abdominal discomfort. Can be very difficult diagnose
due to vague symptoms.
Calcium oxalate - correct answer ✔✔The most common type of renal stone
kidney stones - correct answer ✔✔Passage of these can be extremely painful and may produce
"referred pain" to umbilicus area - this is due to the sensory innervation of the upper part of the
ureter arising from the 10th thoracic nerve roots.
Pyelonephritis - correct answer ✔✔an infection of one or both upper urinary tracts (ureter,
renal pelvis, and kidney interstitium). Urinary obstruction and reflux of urine from the bladder
(vesicoureteral reflux) are the most common underlying risk factors. Microorganisms usually
associated with acute pyelonephritis include E. coli, Proteus, or Pseudomonas. These
microorganisms also split urea into ammonia, making alkaline urine that increases the risk of
stone formation.
Painful bladder syndrome/interstitial cystitis - correct answer ✔✔a condition that includes
nonbacterial infectious cystitis (viral, mycobacterial, chlamydial, fungal) and noninfectious
cystitis (radiation, chemical, autoimmune, hypersensitivity). The cause is unknown, but an
autoimmune reaction may be responsible for the inflammatory response, which includes mast
cell activation, altered epithelial permeability, neuroinflammation, and increased sensory nerve
sensitivity.
, Acute unilateral renal obstruction and hypertension - correct answer ✔✔The reduced perfusion
(kidneys require at least 20-25% cardiac output - MAP) of the affected kidney activates the
renin-angiotensin-aldosterone system (RAAS), which causes constriction of peripheral arterioles.
Acute glomerulonephritis - correct answer ✔✔includes renal diseases in which glomerular
inflammation is caused by immune mechanisms that damage the glomerular capillary filtration
membrane including the endothelium, basement membrane, and epithelium (podocytes). The
classic symptoms include sudden onset of hematuria including red blood cell casts and
proteinuria (milder than nephrotic syndrome), and in more severe cases, these symptoms are
also accompanied by edema, hypertension, and impaired renal function.
Nephrotic syndrome - correct answer ✔✔the excretion of 3.0 g or more of protein (massive
proteinuria) in the urine per day, hypoalbuminemia (less than 3.0 g/dl), and peripheral edema.
This is characteristic of glomerular injury. Primary causes of this condition include minimal
change disease (lipoid nephrosis), membranous glomerulonephritis, and focal segmental
glomerulosclerosis. Secondary forms of this condition occur in systemic diseases including
diabetes mellitus, amyloidosis, and systemic lupus erythematosus. This condition also is seen
with certain drugs, infections, malignancies, and vascular disorders.
acute kidney injury - correct answer ✔✔this condition may be acute and rapidly progressive
(within hours), and the process may be reversible.
Kidney failure - correct answer ✔✔this condition can be chronic, progressing to end-stage
kidney failure over a period of months or years.
Renal insufficiency - correct answer ✔✔this condition refers to a decline in renal function to
about 25% of normal or a GFR of 25 to 30 ml/minute. Levels of serum creatinine and urea are
mildly elevated. However, changes in serum creatinine level occur only if more than 50% of
glomerular filtration is lost and are often delayed by more than 24 hours. Such diagnostic delays
make the implementation of early therapy very difficult, contributing to disease progression and
mortality.
611 EXAM 4 REVIEW QUESTIONS &
VERIFIED CORRECT ANSWERS
Urinary Tract Infection - correct answer ✔✔Clinical manifestations of this condition in an older
adult are Confusion and poorly localized abdominal discomfort. Can be very difficult diagnose
due to vague symptoms.
Calcium oxalate - correct answer ✔✔The most common type of renal stone
kidney stones - correct answer ✔✔Passage of these can be extremely painful and may produce
"referred pain" to umbilicus area - this is due to the sensory innervation of the upper part of the
ureter arising from the 10th thoracic nerve roots.
Pyelonephritis - correct answer ✔✔an infection of one or both upper urinary tracts (ureter,
renal pelvis, and kidney interstitium). Urinary obstruction and reflux of urine from the bladder
(vesicoureteral reflux) are the most common underlying risk factors. Microorganisms usually
associated with acute pyelonephritis include E. coli, Proteus, or Pseudomonas. These
microorganisms also split urea into ammonia, making alkaline urine that increases the risk of
stone formation.
Painful bladder syndrome/interstitial cystitis - correct answer ✔✔a condition that includes
nonbacterial infectious cystitis (viral, mycobacterial, chlamydial, fungal) and noninfectious
cystitis (radiation, chemical, autoimmune, hypersensitivity). The cause is unknown, but an
autoimmune reaction may be responsible for the inflammatory response, which includes mast
cell activation, altered epithelial permeability, neuroinflammation, and increased sensory nerve
sensitivity.
, Acute unilateral renal obstruction and hypertension - correct answer ✔✔The reduced perfusion
(kidneys require at least 20-25% cardiac output - MAP) of the affected kidney activates the
renin-angiotensin-aldosterone system (RAAS), which causes constriction of peripheral arterioles.
Acute glomerulonephritis - correct answer ✔✔includes renal diseases in which glomerular
inflammation is caused by immune mechanisms that damage the glomerular capillary filtration
membrane including the endothelium, basement membrane, and epithelium (podocytes). The
classic symptoms include sudden onset of hematuria including red blood cell casts and
proteinuria (milder than nephrotic syndrome), and in more severe cases, these symptoms are
also accompanied by edema, hypertension, and impaired renal function.
Nephrotic syndrome - correct answer ✔✔the excretion of 3.0 g or more of protein (massive
proteinuria) in the urine per day, hypoalbuminemia (less than 3.0 g/dl), and peripheral edema.
This is characteristic of glomerular injury. Primary causes of this condition include minimal
change disease (lipoid nephrosis), membranous glomerulonephritis, and focal segmental
glomerulosclerosis. Secondary forms of this condition occur in systemic diseases including
diabetes mellitus, amyloidosis, and systemic lupus erythematosus. This condition also is seen
with certain drugs, infections, malignancies, and vascular disorders.
acute kidney injury - correct answer ✔✔this condition may be acute and rapidly progressive
(within hours), and the process may be reversible.
Kidney failure - correct answer ✔✔this condition can be chronic, progressing to end-stage
kidney failure over a period of months or years.
Renal insufficiency - correct answer ✔✔this condition refers to a decline in renal function to
about 25% of normal or a GFR of 25 to 30 ml/minute. Levels of serum creatinine and urea are
mildly elevated. However, changes in serum creatinine level occur only if more than 50% of
glomerular filtration is lost and are often delayed by more than 24 hours. Such diagnostic delays
make the implementation of early therapy very difficult, contributing to disease progression and
mortality.
