NSG 4100 EXAM 1 MOST TESTED QUESTIONS AND
ANSWERS GRADED A+ WITH RATIONALES
More than 90% of nephrons are nonfunctional — this clinical stage is called:
A. Acute kidney injury
B. End-stage renal disease (ESRD)
C. Chronic glomerulonephritis
D. Nephrotic syndrome
Rationale: ESRD denotes kidney failure with <10% functioning nephrons.
In ESRD, because the kidneys cannot filter proteins effectively, where do those proteins
accumulate?
A. In the urine
B. In the blood (leading to hypoalbuminemia effects)
C. In the lungs
D. In the GI tract
Rationale: Proteinuria and impaired filtration disturb serum protein levels and distribution.
When GFR decreases, which laboratory values typically increase?
A. Serum albumin and calcium
B. BUN and creatinine
C. Hemoglobin and hematocrit
D. Serum bicarbonate and pH
Rationale: Reduced GFR causes accumulation of nitrogenous wastes (BUN, creatinine).
What acid-base disturbance commonly occurs in ESRD?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Rationale: Kidneys fail to excrete H⁺ and reabsorb bicarbonate → metabolic acidosis.
Why does anemia develop in ESRD?
A. Excess iron loss in urine
B. Chronic blood loss only
C. Decreased erythropoietin (EPO) production by diseased kidneys
D. Increased RBC destruction by spleen
Rationale: Kidney failure reduces EPO synthesis → decreased RBC production.
,ESTUDYR
Uremic waste buildup can precipitate which cardiac complication?
A. Myocardial infarction only
B. Uremic pericarditis
C. Aortic stenosis
D. Endocarditis
Rationale: Uremia causes inflammation of serous membranes including the pericardium.
Which statement best describes uremia in ESRD?
A. Minor and asymptomatic
B. Central cause of many systemic complications in ESRD
C. Only affects urine color
D. Only causes hypertension
Rationale: Uremia (accumulated toxins) underlies many ESRD manifestations.
Ultimate complications of ESRD include all EXCEPT:
A. Anemia
B. Bone disease
C. Hyperkalemia
D. Acute appendicitis
Rationale: Appendicitis is unrelated; ESRD leads to anemia, bone mineral disorders,
hyperkalemia, HTN, pericarditis.
Common signs of anemia in ESRD patients include:
A. Jaundice and pruritus
B. Pallor, fatigue, and shortness of breath
C. Hypertension and polyuria
D. Tremor and hyperreflexia
Rationale: Reduced oxygen delivery produces pallor, fatigue, dyspnea.
Which of the following is an intervention for anemia in ESRD?
A. High-dose vitamin D only
B. Blood transfusion, EPO therapy, dietary modification, volume replacement, oxygen
C. Immediate dialysis only
D. Hemorrhagic shock induction
Rationale: Management includes RBC replacement, stimulating erythropoiesis and supportive
care.
Post-operative complications after renal surgery include all EXCEPT:
A. Paralytic ileus
B. Hemorrhage and shock
, ESTUDYR
C. Infection
D. Increased nephron number
Rationale: Surgical complications include ileus, bleeding, infection—not nephron gain.
Risk factors for renal cancer include which of the following?
A. Female gender only
B. Male gender, obesity, tobacco, petrochemical/heavy metal exposure, asbestos, unopposed
estrogen, polycystic kidney disease, long-term dialysis
C. Type O blood only
D. Low BMI only
Rationale: Multiple environmental, hormonal, and genetic factors increase renal cancer risk.
Which race has a higher reported incidence of renal cancer?
A. Asian Americans
B. Hispanics
C. African Americans
D. Native Alaskans
Rationale: Epidemiology notes higher incidence rates in certain populations, including African
Americans.
Is renal cancer frequently found incidentally on imaging?
A. No, always symptomatic
B. Yes—many renal cancers are incidental findings
C. Only during biopsy
D. Only after metastasis
Rationale: Small renal masses are often asymptomatic and discovered incidentally.
Classic triad of renal cancer signs includes:
A. Fever, rash, and hoarseness
B. Hematuria, flank pain, and palpable flank mass
C. Diarrhea, constipation, vomiting
D. Night sweats and cough only
Rationale: Hematuria, pain, and flank mass are hallmark signs though all may be absent.
Which diagnostic tools are commonly used for renal cancer?
A. EKG and chest x-ray only
B. Intravenous urography, ultrasound, CT, MRI
C. Colonoscopy only
D. Skin biopsy only
Rationale: Imaging (US, CT, MRI, urography) defines renal masses.