Kathleen Jackson
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EoT Exam Module 5 & 6

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2808NRS Human Pathophysiology and Pharmacology 2 (Module 5 & 6)

Question 1 of 76

1

The tendency to involuntarily pass urine, usually in small amounts, when abdominal pressure is raised during coughing, for example, is termed:

Select one of the following:

  • urge incontinence

  • neurological incontinence

  • stress incontinence

  • overflow incontinence

Explanation

Question 2 of 76

1

Which diuretics promote the greatest diuresis?

Select one of the following:

  • Thiazides.

  • Potassium-sparing diuretics.

  • Aldosterone inhibitors.

  • Loop diurectics.

Explanation

Question 3 of 76

1

Turbid urine normally indicates:

Select one of the following:

  • kidney stones

  • diabetes

  • infection

  • dehydration

Explanation

Question 4 of 76

1

Which is most likely to contribute to overflow incontinence?

Select one of the following:

  • kidney stones lodged in the renal calyxes

  • glomerulonephritis

  • prostate enlargement

  • urethritis

Explanation

Question 5 of 76

1

Azotaemia describes increased concentrations of:

Select one of the following:

  • nitrogen waste compounds in blood

  • urea in urine

  • potassium and sodium levels in blood

  • azotaemia is, in fact, an alternative term for uraemic frost

Explanation

Question 6 of 76

1

From the following, choose the substance likely to appear in the urine when the glomerulus is inflamed.

Select one of the following:

  • Creatinine

  • Urea

  • Sodium

  • Albumin

Explanation

Question 7 of 76

1

When comparing normal kidney function with dialysis, which of the following mechanisms is not possible in dialysis?

Select one of the following:

  • Diffusion

  • Active transport

  • Ultrafiltration

  • Osmosis

Explanation

Question 8 of 76

1

Which of the following should be present in the filtrate in the proximal convoluted tubule?

Select one of the following:

  • Erythrocytes

  • Leukocytes

  • Glucose molecules

  • Plasma proteins

Explanation

Question 9 of 76

1

Common causes of urolithiasis include all of the following EXCEPT:

Select one of the following:

  • hypercalcemia.

  • hyperlipidemia.

  • inadequate fluid intake.

  • hyperuricemia.

Explanation

Question 10 of 76

1

Which of the following increases glomerular filtration rate?

Select one of the following:

  • Constriction of the afferent arteriole

  • Increased hydrostatic pressure in the glomerular capillaries

  • Dilation of the efferent arteriole

  • Increased plasma osmotic pressure

Explanation

Question 11 of 76

1

Reducing fluid intake is non-pharmacological advice designed to decrease the incidence of urinary tract infections.

Select one of the following:

  • True
  • False

Explanation

Question 12 of 76

1

Infection and inflammation of the bladder is termed:

Select one of the following:

  • cystitis

  • urethritis

  • pyelonephritis

  • any of the above, depending on the origin of the infection

Explanation

Question 13 of 76

1

The incidence of urinary tract infections is about the same in women and in men, but treatment is more frequently sought by women.

Select one of the following:

  • True
  • False

Explanation

Question 14 of 76

1

Requesting patients to produce a mid-stream urine sample is designed to ensure the sample is not diluted by urine that has accumulated at the base of the bladder and in the urethra.

Select one of the following:

  • True
  • False

Explanation

Question 15 of 76

1

Under normal circumstances urine in the bladder is sterile, but it may be contaminated with bacteria upon exiting the urethra.

Select one of the following:

  • True
  • False

Explanation

Question 16 of 76

1

What is the cause of most cases of pyelonephritis?

Select one of the following:

  • Severe pH imbalance of urine

  • Dialysis or other invasive procedure

  • An ascending infection by E. coli

  • Abnormal immune response, causing inflammation

Explanation

Question 17 of 76

1

What is the first indicator in the arterial blood gases of acidosis caused by glomerulonephritis?

Select one of the following:

  • Increased carbonic acid

  • Increased bicarbonate ion

  • Decreased bicarbonate ion

  • A pH less than 7.35

Explanation

Question 18 of 76

1

Which of the following would be considered normal serum pH?

Select one of the following:

  • 7.0

  • 7.4

  • 8

  • 4.5 - 8

Explanation

Question 19 of 76

1

In a case of acute pyelonephritis, what is the cause of flank pain?

Select one of the following:

  • Increasing glomerular permeability, creating an increased volume of filtrate in the kidney

  • Inflammation, causing ischemia in the tubules

  • Inflammation, stretching the renal capsule

  • Microbes irritating the tissues

Explanation

Question 20 of 76

1

Pyelonephritis may be distinguished from cystitis by the presence in pyelonephritis of:

Select one of the following:

  • urinary casts and flank pain.

  • painful micturition.

  • microbes, leukocytes, and pus in the urine.

  • urgency and frequency.

Explanation

Question 21 of 76

1

An elderly male patient produced only 25 mL of urine in the past 24 hours. The urologist discovers that prostatic hypertrophy is the cause. Which one of the following best describes this patient's acute renal failure?

Select one of the following:

  • Postrenal oliguric

  • Prerenal anuric

  • Postrenal anuric

  • Intrinsic nonoliguric

Explanation

Question 22 of 76

1

Which one of the following electrolytes usually must be restricted in patients with acute renal failure?

Select one of the following:

  • Potassium

  • Bicarbonate

  • Calcium

  • Chloride

Explanation

Question 23 of 76

1

Intrinsic acute kidney injury can be identified/caused by?

Select one of the following:

  • decreased creatinine

  • a blockage of the renal artery

  • glomerulonephritis

  • haemorrhage

Explanation

Question 24 of 76

1

What is the definition of acute kidney injury?

Select one of the following:

  • A drop in serum creatinine to less than or equal to 26 umol/L within 48 hours.

  • An increase in urine output to greater than 0.5 mL/kg/hr for 6 consecutive hours.

  • A rise in serum creatinine to greater than or equal to 26 umol/L within 48 hours.

  • An decrease in urine output to greater than 0.5 mL/kg/hr for 6 consecutive hours.

Explanation

Question 25 of 76

1

Which of the following indicates the early stage of acute renal failure?

Select one of the following:

  • Very low GFR and increased serum urea

  • Hypotension and increased urine output

  • Development of decompensated acidosis

  • Polyuria with urine of fixed and low specific gravity

Explanation

Question 26 of 76

1

What is/are a cause(s) of acute tubule necrosis and acute renal failure?

Select one of the following:

  • Sudden significant exposure to nephrotoxins

  • Prolonged circulatory shock

  • Crush injuries or burns

  • All of the above

Explanation

Question 27 of 76

1

What is the primary reason for hypocalcemia developing during end-stage renal failure or uremia?

Select one of the following:

  • Insufficient calcium in the diet

  • A deficit of activated vitamin D and hyperphosphatemia

  • Excessive excretion of calcium ions in the urine

  • Decreased parathyroid hormone secretion

Explanation

Question 28 of 76

1

Which of the following would likely cause chronic renal failure?

Select one of the following:

  • Circulatory shock

  • Diabetes mellitus

  • Cystitis with pyelonephritis in the right kidney

  • Obstruction of a ureter by a renal calculus

Explanation

Question 29 of 76

1

What causes polyuria during the stage of renal insufficiency?

Select one of the following:

  • Loss of tubule function

  • Increased GFR

  • Increased blood pressure

  • Decreased aldosterone secretion

Explanation

Question 30 of 76

1

Insensible water loss occurs from ________, and ________.

Select one of the following:

  • irregular incidents, such as vomiting as output can vary greatly

  • faeces; accounts for approximately 15% of normal daily output

  • kidneys; accounts for approximately 35% of normal daily output

  • lungs and skin; accounts for approximately 30% of normal daily output

Explanation

Question 31 of 76

1

Fluid load in patients may be increased, inadvertently or purposely, by:

Select one of the following:

  • rectal solutions

  • enteral feeding

  • peritoneal dialysis

  • all of the above

Explanation

Question 32 of 76

1

Which condition will induce cell shrinking?

Select one of the following:

  • when interstitial fluid is hypertonic

  • when interstitial fluid is hypotonic

  • when interstitial fluid is isotonic

  • all of the above

Explanation

Question 33 of 76

1

An athlete who has lost a litre or more of fluid via sweating is best advised to replace this with a solution that contains both salts and water, and a total osmolarity of approximately:

Select one of the following:

  • 5.8 mOsmols

  • 90 mOsmols

  • 280 mOsmols

  • 560 mOsmols

Explanation

Question 34 of 76

1

A clinical use of a hypertonic solution is:

Select one of the following:

  • To correct whole blood loss with mild hypvolaemia

  • Dehydrated patients with severe hypernatremia

  • Treat severe intracellular dehydration

  • Treating cerebral oedema and intracranial hypertension

Explanation

Question 35 of 76

1

Which of the following is an example of an isotonic solution?

Select one of the following:

  • 0.45% sodium chloride.

  • 4% glucose with 0.18% sodium chloride.

  • 10% glucose.

  • 25% mannitol.

Explanation

Question 36 of 76

1

Which of the following is an example of an hypotonic solution?

Select one of the following:

  • 0.9% sodium chloride

  • 25% mannitol

  • Water

  • Whole blood

Explanation

Question 37 of 76

1

A 70-year-old male with chronic renal failure presents with oedema. Which of the following is the most likely cause of this condition?

Select one of the following:

  • increased interstitial oncotic pressure

  • decreased capillary oncotic pressure

  • increased capillary oncotic pressure

  • decreased capillary hydrostatic pressure

Explanation

Question 38 of 76

1

A 10-year-old male is brought to the ED because he is incoherent and semiconscious. CT scan reveals he is suffering from cerebral oedema. This type of oedema is referred to as:

Select one of the following:

  • pitting oedema

  • localised oedema

  • generalised oedema

  • pulmonary oedema

Explanation

Question 39 of 76

1

Insensible fluid loss refers to water lost through:

Select one of the following:

  • faeces only

  • perspiration only

  • urine and faeces

  • perspiration and expiration

Explanation

Question 40 of 76

1

A 35-year-old male weighs 70 kg. Approximately how much of this weight is intracellular fluid?

Select one of the following:

  • 5 L

  • 10 L

  • 28 L

  • 42 L

Explanation

Question 41 of 76

1

A 5-year-old male presents to the ED with delirium and sunken eyes. After diagnosing him with severe dehydration, the doctor orders fluid replacement. The nurse administers a hypertonic IV solution. Which of the following would be expected?

Select one of the following:

  • his symptoms would subside quickly

  • decreased extracellular fluid volume

  • intracellular dehydration

  • increased intracellular fluid volume

Explanation

Question 42 of 76

1

Which of the following is a common cause of hyponatraemia?

Select one of the following:

  • Prolonged period of rapid, deep respirations

  • Excessive sweating

  • Loss of the thirst mechanism

  • Excessive aldosterone secretion

Explanation

Question 43 of 76

1

Which of the following ions is most closely related to water movement?

Select one of the following:

  • Potassium

  • Sodium

  • Chloride

  • Calcium

Explanation

Question 44 of 76

1

Which of the following is the primary cation in the extracellular fluid?

Select one of the following:

  • Bicarbonate

  • Potassium

  • Chloride

  • Sodium

Explanation

Question 45 of 76

1

Which compartment contains the greatest amount of body water

Select one of the following:

  • Intracellular

  • Interstital

  • Plasma

  • Transcellular

Explanation

Question 46 of 76

1

When a patient is being treated with thiazide diuretics, there is a danger of ________, an unwanted and potentially dangerous side effect.

Select one of the following:

  • hypocalcaemia

  • hypokalaemia

  • hypophosphataemia

  • hyponatraemia

Explanation

Question 47 of 76

1

Hyperkalaemia causes:

Select one of the following:

  • a decrease in resting membrane potential with increased excitability of cardiac muscle.

  • a decrease in resting membrane potential with decreased excitability of cardiac muscle.

  • an increase in resting membrane potential with decreased excitability of cardiac muscle.

  • an increase in resting membrane potential with increased excitability of cardiac muscle.

Explanation

Question 48 of 76

1

Which of the following would most likely cause hypochloraemia?

Select one of the following:

  • hypokalaemia

  • hypernataemia

  • elevated bicarbonate

  • hypercalcaemia

Explanation

Question 49 of 76

1

A 42-year-old female presents to her GP complaining of muscle weakness and cardiac abnormalities. Laboratory tests indicate that she is hypokalaemic. Which of the following could be the cause of her condition?

Select one of the following:

  • hypoglycaemia

  • respiratory acidosis

  • constipation

  • frusemide therapy

Explanation

Question 50 of 76

1

Secretion of aldosterone results in:

Select one of the following:

  • decreased plasma osmolality.

  • increased blood volume.

  • increased serum potassium levels.

  • localised oedema.

Explanation

Question 51 of 76

1

Metabolic acidosis may be associated with

Select one of the following:

  • Increased chloride levels

  • Decreased bicarbonate

  • Increased metabolic acids

  • All answers are correct

Explanation

Question 52 of 76

1

Chronic compensation for respiratory acidosis includes:

Select one of the following:

  • kidney excretion of HCO3-

  • kidney excretion of H+

  • protein buffering

  • prolonged exhalations to blow off CO2

Explanation

Question 53 of 76

1

Which of the following is a strong acid?

Select one of the following:

  • Phosphorus

  • Albumin

  • Sodium chloride

  • Lactate

Explanation

Question 54 of 76

1

Long-term regulation of acid-base balance through removal or retention of acids is accomplished by the:

Select one of the following:

  • lungs

  • kidneys

  • liver

  • protein buffer systems

Explanation

Question 55 of 76

1

Which of the following buffer pairs is considered the major plasma buffering system?

Select one of the following:

  • NH3/NH4

  • NaCl/KPO4

  • HCO3-/H2CO3

  • HPO4/H2PO4

Explanation

Question 56 of 76

1

Autoregulation in the kidneys refers to:

Select one of the following:

  • the control of systemic blood pressure by the kidneys.

  • control of blood flow by the SNS.

  • the secretion of renin and activation of angiotensin.

  • local minor reflex adjustments in the arterioles to maintain normal blood flow.

Explanation

Question 57 of 76

1

Place the following events in the correct sequence of events when ketoacids increase in the blood of a diabetic patient.
Not all options are used in the answers.
1. Serum pH decreases
2. Serum bicarbonate decreases
3. PCO2 decreases
4. Respiration decreases
5. Respiration increases
6. Serum pH increases
7. Serum bicarbonate increases

Select one of the following:

  • 7, 6, 5, 3, 6

  • 2, 6, 5, 3, 7

  • 7, 6, 4, 3, 1

  • 2, 1, 5, 3, 6

Explanation

Question 58 of 76

1

Which condition is likely to cause metabolic acidosis?

Select one of the following:

  • Slow, shallow respirations

  • Excessive fluid in the body

  • Prolonged diarrhoea

  • Mild vomiting

Explanation

Question 59 of 76

1

A 55-year-old female presents to her GP complaining of dizziness, confusion and tingling in the extremities. Blood tests reveal an elevated pH, decreased PCO2 and slightly decreased HCO3-. Which of the following is the most likely diagnosis?

Select one of the following:

  • respiratory alkalosis with renal compensation

  • respiratory acidosis with renal compensation

  • metabolic alkalosis with respiratory compensation

  • metabolic acidosis with respiratory compensation

Explanation

Question 60 of 76

1

Which serum value indicates decompensated metabolic acidosis?

Select one of the following:

  • Bicarbonate level increases

  • Bicarbonate level decreases

  • pH is above normal range

  • pH is below normal range

Explanation

Question 61 of 76

1

Acute compensation for metabolic acidosis includes:

Select one of the following:

  • CO2 retention.

  • kidney excretion of H+.

  • hyperventilation.

  • hypoventilation.

Explanation

Question 62 of 76

1

A 52-year-old male with diabetes presents to the ED with lethargy, confusion and depressed reflexes. His wife indicates that he does not follow the prescribed diet and takes his medication sporadically. Which of the following is most likely to occur?

Select one of the following:

  • diabetes insipidus

  • decreased extracellular fluid osmolality

  • hyponatraemia

  • decreased urine formation

Explanation

Question 63 of 76

1

Uncontrolled essential hypertension may cause chronic renal failure because of:

Select one of the following:

  • damage to afferent arterioles and renal ischemia.

  • failure of tubules to respond to hormonal controls.

  • glomerular congestion causes damaged capillaries.

  • predisposition to recurrent urinary tract infections.

Explanation

Question 64 of 76

1

In chronic renal failure, which of the following is the most immediately dangerous?

Select one of the following:

  • acidosis

  • phosphataemia

  • haematuria

  • anaemia

Explanation

Question 65 of 76

1

Which of the following causes acute renal failure?

Select one of the following:

  • Nephrosclerosis

  • Bilateral acute glomerulonephritis

  • Polycystic kidney disease

  • Pyelonephritis in the right kidney

Explanation

Question 66 of 76

1

Which of the following is a typical sign of dehydration?

Select one of the following:

  • Rapid, strong pulse

  • Low haematocrit

  • Increased urine output

  • Decreased tissue turgor

Explanation

Question 67 of 76

1

The normal pH of urine is:

Select one of the following:

  • 1.5-5.5.

  • 4.5- 8.0.

  • 7.35-7.45.

  • 7.0-10.

Explanation

Question 68 of 76

1

Which of the following conditions would decrease oncotic pressure in the capillaries?

Select one of the following:

  • low blood pressure

  • high-protein diet

  • liver failure

  • high blood-glucose

Explanation

Question 69 of 76

1

Chronic renal failure adversely affects which body system?

Select one of the following:

  • the cardiovascular system

  • the respiratory system

  • the CNS

  • All answers are correct

Explanation

Question 70 of 76

1

Infants are at a higher risk for developing dehydration because they have:

Select one of the following:

  • a lower total body water volume.

  • a decreased intravascular volume.

  • a greater body surface area.

  • an increased tendency towards developing oedema.

Explanation

Question 71 of 76

1

Which of the following would result in hyperkalaemia?

Select one of the following:

  • insulin

  • excess aldosterone

  • acute acidosis

  • alkalosis

Explanation

Question 72 of 76

1

Which of the following results from decreased blood flow into the kidneys?

Select one of the following:

  • Systemic blood pressure drop

  • Dilation of the afferent arterioles

  • Increased angiotensin and systemic vasoconstriction

  • Decreased aldosterone secretion

Explanation

Question 73 of 76

1

Which of the following alterations would result in fluid movement into the interstitial space?

Select one of the following:

  • increased interstitial hydrostatic pressure

  • decreased capillary hydrostatic pressure

  • increased capillary oncotic pressure

  • decreased capillary oncotic pressure

Explanation

Question 74 of 76

1

Causes of respiratory acidosis include:

Select one of the following:

  • hyperventilation.

  • an increase in noncarbonic acids.

  • pneumonia.

  • vomiting.

Explanation

Question 75 of 76

1

Crush injuries associated with a massive degree of cell rupture are likely to increase levels of extracellular:

Select one of the following:

  • potassium

  • calcium

  • sodium

  • phosphate

Explanation

Question 76 of 76

1

Choose the basic cause of bone remodelling disorders associated with chronic renal failure.

Select one of the following:

  • Excessive loss of phosphate ion

  • Deficit of parathyroid hormone

  • Failure of the kidney to activate vitamin D

  • Development of hypercalcemia

Explanation

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