MN551 MIDTERM EXAM - COMPLETE QUESTIONS
AND
DETAILED SOLUTIONS LATEST UPDATE THIS YEAR
JUST RELEASED
Question 1: A 55-year-old man has made an appointment to see his
nurse practitioner because he has been awakening three to four
times nightly to void and often has a sudden need to void with little
warning during the day. What is the man's most likely diagnosis
and possible underlying pathophysiologic problem?
Answer:
Overactive bladder that may result from both neurogenic and myogenic
sources
Question 2: Which of the following patients would be considered to
have a significant risk of developing the prerenal form of acute
renal failure?
Answer:
A 22-year-old male who has lost a large amount of blood following a workplace
injury
Question 3: A 77-year-old female with a diagnosis of chronic
obstructive pulmonary disease is experiencing impaired gas
exchange and CO2 retention, despite a rapid respiratory rate.
Which of the following phenomena would her care team most
realistically anticipate?
Answer:
, Her kidneys will adapt with an increase in plasma HCO3- and her pH will
decrease.
Question 4: A 34-year-old male patient has diagnoses of liver
failure, ascites, and hepatic encephalopathy secondary to alcohol
abuse. The patient's family is questioning the care team about why
his abdomen is so large even though he is undernourished and
emaciated. Which of the following statements most accurately
underlies the explanation that a member of the care team would
provide to the family?
Answer:
The normally small transcellular fluid compartment, or third space, is becoming
enlarged.
Question 5: Which of the following data would a clinician consider
to be most indicative of acute renal failure?
Answer:
Increased nitrogenous waste levels, decreased glomerular filtration rate (GFR)
Question 6: A 51-year-old woman diagnosed with multiple sclerosis
(MS) five months prior is distressed that she has had several recent
episodes of urinary incontinence. She has asked her nurse
practitioner why this is the case. Which of the following statements
best captures the facts that would underlie the nurse's response to
the patient?
Answer:
She may be unable to sense her bladder filling as a result of her MS.
,Question 7: A 77-year-old female hospital patient has contracted
Clostridium difficile during her stay and is experiencing severe
diarrhea. Which of the following statements best conveys a risk
that this woman faces?
Answer:
She is susceptible to isotonic fluid volume deficit and hypernatremia as a result
of water losses.
Question 8: An 87-year-old male resident of an assisted living
facility has been consistently continent of urine until the last
several weeks. Which of the following actions by the care providers
at the facility is the most likely priority?
Answer:
Performing a physical examination and history to determine the exact cause
and character of the incontinence
Question 9: A pediatric unit will be receiving from a rural medical
outpost a patient transfer of an 8-day-old infant with a suspected
congenital renal disorder. Which of the following possibilities is the
care team most likely to be able to rule out early?
Answer:
Renal cell carcinoma may be present.
Question 10: May have upper and lower poles of the two kidneys
may be fused, kidneys may be misshapen and have cysts, one of
the infant's kidneys may have failed to develop to a normal size.
Which of the following substances is most likely to be reabsorbed
in the tubular segments of the nephron using passive transport
mechanisms?
, Answer:
Water
Question 11: A 60-year-old man has been diagnosed with renal
calculi after repeated episodes of excruciating flank pain in recent
weeks. The man states, "I don't know how this could happen to me,
since I'm so careful about eating a healthy diet." What is the most
appropriate response to the man's statement?
Answer:
What you eat can influence your risk of stone formation, but many other factors
like hormones and your metabolism are involved.
Question 12: A patient with poorly controlled diabetes mellitus
presents to the emergency department with suspected
ketoacidosis. Which of the following diagnostic results would be
most likely to confirm this diagnosis?
Answer:
Increased CO2, increased anion gap, base deficit
Question 13: Which diuretic acts by inhibiting sodium chloride
reabsorption in the thick ascending limb of the loop of Henle?
Answer:
Bumetanide (Bumex)
Question 14: An 82-year-old resident of a long-term care facility
with a recent history of repeated urinary tract infections and
restlessness is suspected of having urinary retention. Which of the
following actions by the care team is most appropriate?
AND
DETAILED SOLUTIONS LATEST UPDATE THIS YEAR
JUST RELEASED
Question 1: A 55-year-old man has made an appointment to see his
nurse practitioner because he has been awakening three to four
times nightly to void and often has a sudden need to void with little
warning during the day. What is the man's most likely diagnosis
and possible underlying pathophysiologic problem?
Answer:
Overactive bladder that may result from both neurogenic and myogenic
sources
Question 2: Which of the following patients would be considered to
have a significant risk of developing the prerenal form of acute
renal failure?
Answer:
A 22-year-old male who has lost a large amount of blood following a workplace
injury
Question 3: A 77-year-old female with a diagnosis of chronic
obstructive pulmonary disease is experiencing impaired gas
exchange and CO2 retention, despite a rapid respiratory rate.
Which of the following phenomena would her care team most
realistically anticipate?
Answer:
, Her kidneys will adapt with an increase in plasma HCO3- and her pH will
decrease.
Question 4: A 34-year-old male patient has diagnoses of liver
failure, ascites, and hepatic encephalopathy secondary to alcohol
abuse. The patient's family is questioning the care team about why
his abdomen is so large even though he is undernourished and
emaciated. Which of the following statements most accurately
underlies the explanation that a member of the care team would
provide to the family?
Answer:
The normally small transcellular fluid compartment, or third space, is becoming
enlarged.
Question 5: Which of the following data would a clinician consider
to be most indicative of acute renal failure?
Answer:
Increased nitrogenous waste levels, decreased glomerular filtration rate (GFR)
Question 6: A 51-year-old woman diagnosed with multiple sclerosis
(MS) five months prior is distressed that she has had several recent
episodes of urinary incontinence. She has asked her nurse
practitioner why this is the case. Which of the following statements
best captures the facts that would underlie the nurse's response to
the patient?
Answer:
She may be unable to sense her bladder filling as a result of her MS.
,Question 7: A 77-year-old female hospital patient has contracted
Clostridium difficile during her stay and is experiencing severe
diarrhea. Which of the following statements best conveys a risk
that this woman faces?
Answer:
She is susceptible to isotonic fluid volume deficit and hypernatremia as a result
of water losses.
Question 8: An 87-year-old male resident of an assisted living
facility has been consistently continent of urine until the last
several weeks. Which of the following actions by the care providers
at the facility is the most likely priority?
Answer:
Performing a physical examination and history to determine the exact cause
and character of the incontinence
Question 9: A pediatric unit will be receiving from a rural medical
outpost a patient transfer of an 8-day-old infant with a suspected
congenital renal disorder. Which of the following possibilities is the
care team most likely to be able to rule out early?
Answer:
Renal cell carcinoma may be present.
Question 10: May have upper and lower poles of the two kidneys
may be fused, kidneys may be misshapen and have cysts, one of
the infant's kidneys may have failed to develop to a normal size.
Which of the following substances is most likely to be reabsorbed
in the tubular segments of the nephron using passive transport
mechanisms?
, Answer:
Water
Question 11: A 60-year-old man has been diagnosed with renal
calculi after repeated episodes of excruciating flank pain in recent
weeks. The man states, "I don't know how this could happen to me,
since I'm so careful about eating a healthy diet." What is the most
appropriate response to the man's statement?
Answer:
What you eat can influence your risk of stone formation, but many other factors
like hormones and your metabolism are involved.
Question 12: A patient with poorly controlled diabetes mellitus
presents to the emergency department with suspected
ketoacidosis. Which of the following diagnostic results would be
most likely to confirm this diagnosis?
Answer:
Increased CO2, increased anion gap, base deficit
Question 13: Which diuretic acts by inhibiting sodium chloride
reabsorption in the thick ascending limb of the loop of Henle?
Answer:
Bumetanide (Bumex)
Question 14: An 82-year-old resident of a long-term care facility
with a recent history of repeated urinary tract infections and
restlessness is suspected of having urinary retention. Which of the
following actions by the care team is most appropriate?
