NURS 4000 final Test 2025 With Questions
With Correct Answers
Cystic Fibrosis Patho
Genetic disease causing thick, sticky secretions
Cystic Fibrosis respiratory s/s
-persistent productive cough with phlegm
-wheezing, SOB, frequent lung infections/pneumonia
-Barrel chest, clubbing, accessory muscle use
Intrarenal
Damage to nephron:
causes: nephrotoxins (aminoglycosides, contrast) prolonged ischemia,
gloerulonephritis, acute tubular necrosis
-Fix= stop toxins, support kidneys
Post-renal
Obstruction
causes: stones, BPH, tumor, strictures
Fix= relieve obstruction
Renal phases
Initiation- happens; few symptoms; hours-days
Oliguric- GFR decreases, oliguria, big problems: azotemia, fluid overload, increase
K+, metabolic acidosis
Diuretic- tubules start recovering
,-massive diuresis (4-5L/day) risk dehydration and electrolyte losses
Recovery- GFR improves to 70-80% weeks-months
AKI assessment priorities
VS (hypotension- then HTN with fluid overload)
I&O, daily weights, edema, lung sounds
labs: increased BUN/Cr, increased K+, decreased NA, metabolic acidosis, anemia
Neuro status (uremia), ECG (hyperkalemia)
Acute glomerulonephritis
Often post-strep immune reaction
immune complexes clog glomeruli- leak RBC's and some protein
S/S: cola/brown urine, edema, HTN, decreased GFR
Concerns: fluid overload, htn, risk for AKI
Chronic glomerulonephritis
Secondary to lupus, diabetic nephropathy--> slow decline over years
Nephrotic syndrome
-Massive protein loss in urine--> proteinuria, hypoalbuminemia, edema,
hyperlipidemia, increased clot risk, increased infection
Nursing focus for glomerular disorders
-Fluid status and BP, daily weight, I&O
-Diet: NA/protein modication
-monitor for clots and infection
Polycystic Kidney Disease patho
Inherited; fluid-filled cysts enlarge both kidneys- compress normal tissue-
decreases blood flow and function --> CKD/ESRD
polycystic kidnehy disease s/s
-HTN often first sign
-Flank pain, heamturia, proteinuria, polyuria, nocturia, recurrent UTIs, stones,
enlarged kidneys/abd gorwth
, Nursing priorities polycystic kidney disease
-Preserve function- HTN (ACE/ARB) avoid nephrotoxins
-manage pain (avoid nsaids)
-treat UTIs quickly
-eventually- dialysis/transplant; genetic counseling
Pyelonephritis (upper UTI) patho
Ascending bacterial infection (often e. coli)- inflamed renal parenchyma and
collecting system
pyelonephritis s/s
Fever, chills, n/v, flank pain, CVA tenderness
-lower UTI: dysuria, frequency, urgency, hematuria
-UA: pyuria & bacteriuria; leukocytosis
Pyelonephritis management
IV-> PO antibiotics, hydration, pain control, antipyretics
-monitor for sepsis and chronic damage
Renal Cancer triad
flank pain, hematuria, flank mass (often late)
Bladder cancer
painless hematuria= classic sign
hemodialysis: what does it do?
acts as artificial kidney to remove waste and fluid
access: av fistula, graft, or central catheter
Hemodialysis priority assessments
Thrill and bruit- must be present
extremity- no bp, sticks, tight clothing on access arm
fluid status: weight, edema lung sounds bp
Pre-dialysis
With Correct Answers
Cystic Fibrosis Patho
Genetic disease causing thick, sticky secretions
Cystic Fibrosis respiratory s/s
-persistent productive cough with phlegm
-wheezing, SOB, frequent lung infections/pneumonia
-Barrel chest, clubbing, accessory muscle use
Intrarenal
Damage to nephron:
causes: nephrotoxins (aminoglycosides, contrast) prolonged ischemia,
gloerulonephritis, acute tubular necrosis
-Fix= stop toxins, support kidneys
Post-renal
Obstruction
causes: stones, BPH, tumor, strictures
Fix= relieve obstruction
Renal phases
Initiation- happens; few symptoms; hours-days
Oliguric- GFR decreases, oliguria, big problems: azotemia, fluid overload, increase
K+, metabolic acidosis
Diuretic- tubules start recovering
,-massive diuresis (4-5L/day) risk dehydration and electrolyte losses
Recovery- GFR improves to 70-80% weeks-months
AKI assessment priorities
VS (hypotension- then HTN with fluid overload)
I&O, daily weights, edema, lung sounds
labs: increased BUN/Cr, increased K+, decreased NA, metabolic acidosis, anemia
Neuro status (uremia), ECG (hyperkalemia)
Acute glomerulonephritis
Often post-strep immune reaction
immune complexes clog glomeruli- leak RBC's and some protein
S/S: cola/brown urine, edema, HTN, decreased GFR
Concerns: fluid overload, htn, risk for AKI
Chronic glomerulonephritis
Secondary to lupus, diabetic nephropathy--> slow decline over years
Nephrotic syndrome
-Massive protein loss in urine--> proteinuria, hypoalbuminemia, edema,
hyperlipidemia, increased clot risk, increased infection
Nursing focus for glomerular disorders
-Fluid status and BP, daily weight, I&O
-Diet: NA/protein modication
-monitor for clots and infection
Polycystic Kidney Disease patho
Inherited; fluid-filled cysts enlarge both kidneys- compress normal tissue-
decreases blood flow and function --> CKD/ESRD
polycystic kidnehy disease s/s
-HTN often first sign
-Flank pain, heamturia, proteinuria, polyuria, nocturia, recurrent UTIs, stones,
enlarged kidneys/abd gorwth
, Nursing priorities polycystic kidney disease
-Preserve function- HTN (ACE/ARB) avoid nephrotoxins
-manage pain (avoid nsaids)
-treat UTIs quickly
-eventually- dialysis/transplant; genetic counseling
Pyelonephritis (upper UTI) patho
Ascending bacterial infection (often e. coli)- inflamed renal parenchyma and
collecting system
pyelonephritis s/s
Fever, chills, n/v, flank pain, CVA tenderness
-lower UTI: dysuria, frequency, urgency, hematuria
-UA: pyuria & bacteriuria; leukocytosis
Pyelonephritis management
IV-> PO antibiotics, hydration, pain control, antipyretics
-monitor for sepsis and chronic damage
Renal Cancer triad
flank pain, hematuria, flank mass (often late)
Bladder cancer
painless hematuria= classic sign
hemodialysis: what does it do?
acts as artificial kidney to remove waste and fluid
access: av fistula, graft, or central catheter
Hemodialysis priority assessments
Thrill and bruit- must be present
extremity- no bp, sticks, tight clothing on access arm
fluid status: weight, edema lung sounds bp
Pre-dialysis
