Pathophysiology Exam 3 Practice
Questions
The nurse working in an outpatient nephrology clinic knows that which of the following are
primary functions of the kidneys? (Select all that apply.)
A. Production of clotting factors
B. Homeostasis
C. Excretion of metabolic wastes
D. Regulation of acid-base balance
E. Metabolism of fats - ANSB, C, D
The kidneys do not metabolize fats.
Production of clotting factors is a primary function of the liver.
The kidneys maintain blood pressure using the RAAS and also produce erythropoietin to
stimulate RBC production.
In caring for a patient diagnosed with acute kidney injury, the nephrology nurse knows that
which of the following tests are specific for renal function? (Select all that apply.)
A. Aspartate aminotransferase (AST)
B. Blood urea nitrogen
C. Creatinine
D. Glomerular filtration rate
E. White blood cell count - ANSB, C, D
AST related to LIVER function
In caring for a patient with acute kidney injury the nurse knows that the patient's renal function
has returned to normal range when the patient's GFR measures:
A. 30-40 mL/min
B. 40-50 mL/min
C. 70-90 mL/min
D. 90-120 mL/min - ANSD
Normal GFR is 90-120 mL/min
Normal Creatinine 0.6-1.1 for females and 0.6-1.2 for males
Normal BUN is 10-20 mg/dL
*Be sure to know these normal values, you will use them daily as a nurse
The nursing working in a geriatric living facility understands that as patients age, which change
in glomerular filtration rate is expected?
,A. Increased GFR
B. Decreased GFR
C. Same GFR
D. No GFR - ANSB
Aging and renal function:
Decrease in renal blood flow and GFR → altered sodium and water balance
Number of nephrons decrease due to renal vascular and perfusion changes
Response to acid-base changes is delayed
Increased risk for drug toxicity
Alterations in thirst and water intake
Get dehydrated very easily; do not recognize thirst and heat
Decreased muscle mass may lead to decreased creatinine values
An older patient is experiencing urinary stasis. The registered nurse knows that urinary stasis
may lead to which of the following?
A. Increased GFR
B. Hypocoagulation
C. Hypertension
D. Infection - ANSD
Urinary stasis is a risk factor for developing UTI
Which of the following is classified as the most common primary mineral salt composition of
kidney stones?
A. Calcium
B. Struvite
C. Uric Acid
D. Cysteine - ANSA
A - calcium (i.e. oxalate or phosphate) is most common
*Note that a change in urine pH may lead to precipitation of stones
Which of the following are risk factors for developing renal tumors? (Select all that apply.)
A. Female gender
B. Smoking
C. Obesity
D. Diabetes
E. Hypertension - ANSB, C, E
risk factors are male gender, smoking, obesity, uncontrolled hypertension
, The registered nurse would expect which of the following lab values for a patient experiencing
acute kidney failure?
A. Creatinine 3.5 mg/dL
B. Sodium 122 mEq/L
C. Albumin 3.5 g/dL
D. BUN 10 mg/dL - ANSA
the normal creatinine level is 0.6 - 1.2
This BUN is within normal range (BUN would be elevated in acute kidney failure)
In caring for a patient experiencing acute kidney injury who has these lab values: urinary output
15 mL/hr, BUN 30 mg/dL, and creatinine 3.5, the nurse knows that the patient is experiencing
which phase of acute kidney injury?
A. Initiation phase
B. Oliguric phase
C. Recovery (polyuric) phase
D. I don't remember the normal lab values - ANSB
Remember that there are phases of acute kidney injury -
Initiation phase is when the injury is just beginning and prevention is still possible
Next is the oliguric phase where urinary output is decreased and nitrogenous waste products
are maintained (BUN and Creatinine)
There is also the recovery or polyuric/diuretic phase - diuresis is common and BUN and
creatinine decline
A 25-year-old female is diagnosed with urinary tract obstruction. While planning care, the nurse
realizes that the patient is expected to have hydronephrosis and a decreased glomerular
filtration rate caused by:
A. Decreased renal blood flow
B. Decreased peritubular capillary pressure
C. Dilation of renal pelvis and calyces proximal to blockage
D. Stimulation of antidiuretic hormone - ANSC
Hydroureter; dilation of ureter
Hydronephrosis: dilation/enlargement of renal pelvis and calyces
Ureterohydronephrosis: dilation of ureter AND renal pelvis and calyces
A 55-year-old male presents reporting urinary retention. Tests reveal that he has a lower urinary
tract obstruction. Which of the following is of most concern to the nurse?
A. Vesicoureteral reflux and pyelonephritis
B. Formation of renal calculi
C. Glomerulonephritis
Questions
The nurse working in an outpatient nephrology clinic knows that which of the following are
primary functions of the kidneys? (Select all that apply.)
A. Production of clotting factors
B. Homeostasis
C. Excretion of metabolic wastes
D. Regulation of acid-base balance
E. Metabolism of fats - ANSB, C, D
The kidneys do not metabolize fats.
Production of clotting factors is a primary function of the liver.
The kidneys maintain blood pressure using the RAAS and also produce erythropoietin to
stimulate RBC production.
In caring for a patient diagnosed with acute kidney injury, the nephrology nurse knows that
which of the following tests are specific for renal function? (Select all that apply.)
A. Aspartate aminotransferase (AST)
B. Blood urea nitrogen
C. Creatinine
D. Glomerular filtration rate
E. White blood cell count - ANSB, C, D
AST related to LIVER function
In caring for a patient with acute kidney injury the nurse knows that the patient's renal function
has returned to normal range when the patient's GFR measures:
A. 30-40 mL/min
B. 40-50 mL/min
C. 70-90 mL/min
D. 90-120 mL/min - ANSD
Normal GFR is 90-120 mL/min
Normal Creatinine 0.6-1.1 for females and 0.6-1.2 for males
Normal BUN is 10-20 mg/dL
*Be sure to know these normal values, you will use them daily as a nurse
The nursing working in a geriatric living facility understands that as patients age, which change
in glomerular filtration rate is expected?
,A. Increased GFR
B. Decreased GFR
C. Same GFR
D. No GFR - ANSB
Aging and renal function:
Decrease in renal blood flow and GFR → altered sodium and water balance
Number of nephrons decrease due to renal vascular and perfusion changes
Response to acid-base changes is delayed
Increased risk for drug toxicity
Alterations in thirst and water intake
Get dehydrated very easily; do not recognize thirst and heat
Decreased muscle mass may lead to decreased creatinine values
An older patient is experiencing urinary stasis. The registered nurse knows that urinary stasis
may lead to which of the following?
A. Increased GFR
B. Hypocoagulation
C. Hypertension
D. Infection - ANSD
Urinary stasis is a risk factor for developing UTI
Which of the following is classified as the most common primary mineral salt composition of
kidney stones?
A. Calcium
B. Struvite
C. Uric Acid
D. Cysteine - ANSA
A - calcium (i.e. oxalate or phosphate) is most common
*Note that a change in urine pH may lead to precipitation of stones
Which of the following are risk factors for developing renal tumors? (Select all that apply.)
A. Female gender
B. Smoking
C. Obesity
D. Diabetes
E. Hypertension - ANSB, C, E
risk factors are male gender, smoking, obesity, uncontrolled hypertension
, The registered nurse would expect which of the following lab values for a patient experiencing
acute kidney failure?
A. Creatinine 3.5 mg/dL
B. Sodium 122 mEq/L
C. Albumin 3.5 g/dL
D. BUN 10 mg/dL - ANSA
the normal creatinine level is 0.6 - 1.2
This BUN is within normal range (BUN would be elevated in acute kidney failure)
In caring for a patient experiencing acute kidney injury who has these lab values: urinary output
15 mL/hr, BUN 30 mg/dL, and creatinine 3.5, the nurse knows that the patient is experiencing
which phase of acute kidney injury?
A. Initiation phase
B. Oliguric phase
C. Recovery (polyuric) phase
D. I don't remember the normal lab values - ANSB
Remember that there are phases of acute kidney injury -
Initiation phase is when the injury is just beginning and prevention is still possible
Next is the oliguric phase where urinary output is decreased and nitrogenous waste products
are maintained (BUN and Creatinine)
There is also the recovery or polyuric/diuretic phase - diuresis is common and BUN and
creatinine decline
A 25-year-old female is diagnosed with urinary tract obstruction. While planning care, the nurse
realizes that the patient is expected to have hydronephrosis and a decreased glomerular
filtration rate caused by:
A. Decreased renal blood flow
B. Decreased peritubular capillary pressure
C. Dilation of renal pelvis and calyces proximal to blockage
D. Stimulation of antidiuretic hormone - ANSC
Hydroureter; dilation of ureter
Hydronephrosis: dilation/enlargement of renal pelvis and calyces
Ureterohydronephrosis: dilation of ureter AND renal pelvis and calyces
A 55-year-old male presents reporting urinary retention. Tests reveal that he has a lower urinary
tract obstruction. Which of the following is of most concern to the nurse?
A. Vesicoureteral reflux and pyelonephritis
B. Formation of renal calculi
C. Glomerulonephritis
