Emily Doyle
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Pathophysiology: The Biologic Basis for Disease in Adults and Children 8th Edition

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Emily Doyle
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Chapter 39: Alterations of Renal and Urinary Function

Question 1 of 24

1

How does progressive nephron injury affect angiotensin II activity?

Select one of the following:

  • Angiotensin II activity is decreased.

  • Angiotensin II activity is elevated.

  • Angiotensin II activity is totally suppressed.

  • Angiotensin II activity is not affected.

Explanation

Question 2 of 24

1

A patient has been diagnosed with a renal stone. Based on knowledge of common stone types,
what self-care measure does the healthcare professional plan to teach the patient when stone
analysis has returned?

Select one of the following:

  • Increase water intake

  • Decrease soda intake

  • Restrict animal protein in the diet.

  • Ingest 1000 mg of calcium a day

Explanation

Question 3 of 24

1

The student asks the professor to explain the role of pyrophosphate, potassium citrate, and
magnesium in the formation of kidney stones. What response by the professor is best?

Select one of the following:

  • They inhibit crystal growth

  • They stimulate the supersaturation of salt.

  • They facilitate the precipitation of salts.

  • They enhance crystallization of salt crystals

Explanation

Question 4 of 24

1

Hypercalciuria is primarily attributable to which alteration?

Select one of the following:

  • Defective renal calcium reabsorption

  • Intestinal hyperabsorption of dietary calcium

  • Bone demineralization caused by prolonged immobilization

  • Hyperparathyroidism

Explanation

Question 5 of 24

1

Detrusor hyperreflexia develops from neurologic disorders that originate where?

Select one of the following:

  • Spinal cord between C2 and C4

  • Spinal cord between S2 and S4

  • Above the pontine micturition center

  • Below the cauda equina

Explanation

Question 6 of 24

1

A patient has overactive bladder syndrome. Which classification of drug does the healthcare
professional plan to teach the patient about?

Select one of the following:

  • β-Adrenergic blocking medications

  • α-Adrenergic blocking medications

  • Parasympathomimetic medications

  • Anticholinesterase medications

Explanation

Question 7 of 24

1

Bladder cancer is associated with the gene mutation of which gene?

Select one of the following:

  • c-erbB2

  • Human epidermal growth factor receptor 2 (HER2)

  • TP53

  • myc

Explanation

Question 8 of 24

1

A female patient has been diagnosed with an uncomplicated urinary tract infection. What
self-care measure does the healthcare provider teach the patient that is specific to this type of
infection?

Select one of the following:

  • Drink at least eight glasses of water a day.

  • Take medication if you have a fever

  • Rest as much as you can in the next few days.

  • After using the bathroom, wipe from front to back.

Explanation

Question 9 of 24

1

A healthcare professional is assessing a patient who could have either pyelonephritis or
cystitis. Which differentiating sign would assist the professional in making this diagnosis?

Select one of the following:

  • Difficulty starting the stream of urine

  • Spasmodic pain that radiates to the groin

  • Increased glomerular filtration rate

  • Urinalysis confirmation of white blood cell casts

Explanation

Question 10 of 24

1

An 85-year-old person has a urinary tract infection. What clinical manifestation does the
healthcare professional expect to see in this person?

Select one of the following:

  • Confusion and poorly localized abdominal discomfort

  • Dysuria, frequency, and suprapubic pain

  • Hematuria and flank pain

  • Pyuria, urgency, and frequency

Explanation

Question 11 of 24

1

Pyelonephritis is usually caused by which type of organism?

Select one of the following:

  • Bacteria

  • Fungi

  • Viruses

  • Parasites

Explanation

Question 12 of 24

1

Which abnormal laboratory value is found in glomerular disorders?

Select one of the following:

  • Elevated creatinine concentration

  • Low blood urea nitrogen (BUN)

  • Elevated immunoglobulin A (IgA)

  • Low serum complement

Explanation

Question 13 of 24

1

Which glomerular lesion is characterized by thickening of the glomerular capillary wall with
immune deposition of immunoglobulin G (IgG) and C3?

Select one of the following:

  • Proliferative

  • Membranous

  • Mesangial

  • Crescentic

Explanation

Question 14 of 24

1

Goodpasture syndrome is an example of which of these?

Select one of the following:

  • Antiglomerular basement membrane disease

  • Acute glomerulonephritis

  • Chronic glomerulonephritis

  • Immunoglobulin A (IgA) nephropathy

Explanation

Question 15 of 24

1

A patient exhibits symptoms including hematuria with red blood cell casts and proteinuria
exceeding 3 to 5 g/day, with albumin as the major protein. What diagnostic test or treatment
regime does the healthcare professional educate the patient on?

Select one of the following:

  • Intravenous pyelogram

  • Oral antibiotics

  • Renal biopsy

  • Cyclophosphamide

Explanation

Question 16 of 24

1

Hypothyroidism, edema, hyperlipidemia, and lipiduria characterize which kidney disorder?

Select one of the following:

  • Nephrotic syndrome

  • Acute glomerulonephritis

  • Chronic glomerulonephritis

  • Pyelonephritis

Explanation

Question 17 of 24

1

A patient who has a history of mildly decreased renal function is admitted to the hospital for
IV antibiotics. Which antibiotics would the healthcare professional avoid in this patient?

Select one of the following:

  • Penicillin and ampicillin

  • Vancomycin and bacitracin

  • Gentamicin and tobramycin

  • Cefazolin and cefepime

Explanation

Question 18 of 24

1

Which urine characteristics are indicative of acute tubular necrosis (ATN) caused by intrinsic
(intrarenal) failure?

Select one of the following:

  • Urine sodium >30 mEq/L

  • Urine osmolality >500 mOsm

  • Fractional excretion of sodium (FENa) <1%

  • Urine sediment has no cells, some hyaline casts

Explanation

Question 19 of 24

1

How are glucose and insulin used to treat hyperkalemia associated with acute renal failure?

Select one of the following:

  • Glucose has an osmotic effect, which attracts water and sodium, resulting in more dilute blood and a lower potassium concentration.

  • When insulin transports glucose into the cell, it also carries potassium with it.

  • Potassium attaches to receptors on the cell membrane of glucose and is carried into the cell.

  • Increasing insulin causes ketoacidosis, which causes potassium to move into the cell in exchange for hydrogen.

Explanation

Question 20 of 24

1

Creatinine is primarily excreted by glomerular filtration after being constantly released from
what type of tissue?

Select one of the following:

  • Nervous system

  • Kidneys

  • Muscle

  • Liver

Explanation

Question 21 of 24

1

A professor has taught a student about skeletal alterations seen in chronic kidney disease.
Which statement by the student indicates the professor needs to give more information?

Select one of the following:

  • Parathyroid hormone is no longer effective in maintaining serum phosphate levels.

  • The parathyroid gland is no longer able to secrete sufficient parathyroid hormone

  • The synthesis of 1,25-vitamin D3, which reduces intestinal absorption of calcium, is impaired.

  • The effectiveness of calcium and phosphate resorption from bone is impaired.

Explanation

Question 22 of 24

1

A patient who has chronic kidney disease has hemoglobin of 7.2 mg/dL. What treatment does
the healthcare professional prepare the patient for?

Select one of the following:

  • Intrinsic factor

  • Vitamin B12

  • Vitamin D

  • Erythropoietin

Explanation

Question 23 of 24

1

When the right kidney is obstructed, how will the glomeruli and tubules in the left kidney
compensate?

Select one of the following:

  • Increase in number

  • Increase in size

  • Develop collateral circulation

  • Increase speed of production

Explanation

Question 24 of 24

1

What medical term is used to identify a functional urinary tract obstruction caused by an
interruption of the nerve supply to the bladder?

Select one of the following:

  • Neurogenic bladder

  • Obstructed bladder

  • Necrotic bladder

  • Retrograde bladder

Explanation

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