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

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EoT Exam Module 5 & 6
Kathleen Jackson
Quiz by Kathleen Jackson, updated more than 1 year ago
Kathleen Jackson
Created by Kathleen Jackson over 5 years ago
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Question 1

Question
The tendency to involuntarily pass urine, usually in small amounts, when abdominal pressure is raised during coughing, for example, is termed:
Answer
  • urge incontinence
  • neurological incontinence
  • stress incontinence
  • overflow incontinence

Question 2

Question
Which diuretics promote the greatest diuresis?
Answer
  • Thiazides.
  • Potassium-sparing diuretics.
  • Aldosterone inhibitors.
  • Loop diurectics.

Question 3

Question
Turbid urine normally indicates:
Answer
  • kidney stones
  • diabetes
  • infection
  • dehydration

Question 4

Question
Which is most likely to contribute to overflow incontinence?
Answer
  • kidney stones lodged in the renal calyxes
  • glomerulonephritis
  • prostate enlargement
  • urethritis

Question 5

Question
Azotaemia describes increased concentrations of:
Answer
  • nitrogen waste compounds in blood
  • urea in urine
  • potassium and sodium levels in blood
  • azotaemia is, in fact, an alternative term for uraemic frost

Question 6

Question
From the following, choose the substance likely to appear in the urine when the glomerulus is inflamed.
Answer
  • Creatinine
  • Urea
  • Sodium
  • Albumin

Question 7

Question
When comparing normal kidney function with dialysis, which of the following mechanisms is not possible in dialysis?
Answer
  • Diffusion
  • Active transport
  • Ultrafiltration
  • Osmosis

Question 8

Question
Which of the following should be present in the filtrate in the proximal convoluted tubule?
Answer
  • Erythrocytes
  • Leukocytes
  • Glucose molecules
  • Plasma proteins

Question 9

Question
Common causes of urolithiasis include all of the following EXCEPT:
Answer
  • hypercalcemia.
  • hyperlipidemia.
  • inadequate fluid intake.
  • hyperuricemia.

Question 10

Question
Which of the following increases glomerular filtration rate?
Answer
  • Constriction of the afferent arteriole
  • Increased hydrostatic pressure in the glomerular capillaries
  • Dilation of the efferent arteriole
  • Increased plasma osmotic pressure

Question 11

Question
Reducing fluid intake is non-pharmacological advice designed to decrease the incidence of urinary tract infections.
Answer
  • True
  • False

Question 12

Question
Infection and inflammation of the bladder is termed:
Answer
  • cystitis
  • urethritis
  • pyelonephritis
  • any of the above, depending on the origin of the infection

Question 13

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

Question 14

Question
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.
Answer
  • True
  • False

Question 15

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

Question 16

Question
What is the cause of most cases of pyelonephritis?
Answer
  • Severe pH imbalance of urine
  • Dialysis or other invasive procedure
  • An ascending infection by E. coli
  • Abnormal immune response, causing inflammation

Question 17

Question
What is the first indicator in the arterial blood gases of acidosis caused by glomerulonephritis?
Answer
  • Increased carbonic acid
  • Increased bicarbonate ion
  • Decreased bicarbonate ion
  • A pH less than 7.35

Question 18

Question
Which of the following would be considered normal serum pH?
Answer
  • 7.0
  • 7.4
  • 8
  • 4.5 - 8

Question 19

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

Question 20

Question
Pyelonephritis may be distinguished from cystitis by the presence in pyelonephritis of:
Answer
  • urinary casts and flank pain.
  • painful micturition.
  • microbes, leukocytes, and pus in the urine.
  • urgency and frequency.

Question 21

Question
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?
Answer
  • Postrenal oliguric
  • Prerenal anuric
  • Postrenal anuric
  • Intrinsic nonoliguric

Question 22

Question
Which one of the following electrolytes usually must be restricted in patients with acute renal failure?
Answer
  • Potassium
  • Bicarbonate
  • Calcium
  • Chloride

Question 23

Question
Intrinsic acute kidney injury can be identified/caused by?
Answer
  • decreased creatinine
  • a blockage of the renal artery
  • glomerulonephritis
  • haemorrhage

Question 24

Question
What is the definition of acute kidney injury?
Answer
  • 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.

Question 25

Question
Which of the following indicates the early stage of acute renal failure?
Answer
  • 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

Question 26

Question
What is/are a cause(s) of acute tubule necrosis and acute renal failure?
Answer
  • Sudden significant exposure to nephrotoxins
  • Prolonged circulatory shock
  • Crush injuries or burns
  • All of the above

Question 27

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

Question 28

Question
Which of the following would likely cause chronic renal failure?
Answer
  • Circulatory shock
  • Diabetes mellitus
  • Cystitis with pyelonephritis in the right kidney
  • Obstruction of a ureter by a renal calculus

Question 29

Question
What causes polyuria during the stage of renal insufficiency?
Answer
  • Loss of tubule function
  • Increased GFR
  • Increased blood pressure
  • Decreased aldosterone secretion

Question 30

Question
Insensible water loss occurs from ________, and ________.
Answer
  • 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

Question 31

Question
Fluid load in patients may be increased, inadvertently or purposely, by:
Answer
  • rectal solutions
  • enteral feeding
  • peritoneal dialysis
  • all of the above

Question 32

Question
Which condition will induce cell shrinking?
Answer
  • when interstitial fluid is hypertonic
  • when interstitial fluid is hypotonic
  • when interstitial fluid is isotonic
  • all of the above

Question 33

Question
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:
Answer
  • 5.8 mOsmols
  • 90 mOsmols
  • 280 mOsmols
  • 560 mOsmols

Question 34

Question
A clinical use of a hypertonic solution is:
Answer
  • To correct whole blood loss with mild hypvolaemia
  • Dehydrated patients with severe hypernatremia
  • Treat severe intracellular dehydration
  • Treating cerebral oedema and intracranial hypertension

Question 35

Question
Which of the following is an example of an isotonic solution?
Answer
  • 0.45% sodium chloride.
  • 4% glucose with 0.18% sodium chloride.
  • 10% glucose.
  • 25% mannitol.

Question 36

Question
Which of the following is an example of an hypotonic solution?
Answer
  • 0.9% sodium chloride
  • 25% mannitol
  • Water
  • Whole blood

Question 37

Question
A 70-year-old male with chronic renal failure presents with oedema. Which of the following is the most likely cause of this condition?
Answer
  • increased interstitial oncotic pressure
  • decreased capillary oncotic pressure
  • increased capillary oncotic pressure
  • decreased capillary hydrostatic pressure

Question 38

Question
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:
Answer
  • pitting oedema
  • localised oedema
  • generalised oedema
  • pulmonary oedema

Question 39

Question
Insensible fluid loss refers to water lost through:
Answer
  • faeces only
  • perspiration only
  • urine and faeces
  • perspiration and expiration

Question 40

Question
A 35-year-old male weighs 70 kg. Approximately how much of this weight is intracellular fluid?
Answer
  • 5 L
  • 10 L
  • 28 L
  • 42 L

Question 41

Question
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?
Answer
  • his symptoms would subside quickly
  • decreased extracellular fluid volume
  • intracellular dehydration
  • increased intracellular fluid volume

Question 42

Question
Which of the following is a common cause of hyponatraemia?
Answer
  • Prolonged period of rapid, deep respirations
  • Excessive sweating
  • Loss of the thirst mechanism
  • Excessive aldosterone secretion

Question 43

Question
Which of the following ions is most closely related to water movement?
Answer
  • Potassium
  • Sodium
  • Chloride
  • Calcium

Question 44

Question
Which of the following is the primary cation in the extracellular fluid?
Answer
  • Bicarbonate
  • Potassium
  • Chloride
  • Sodium

Question 45

Question
Which compartment contains the greatest amount of body water
Answer
  • Intracellular
  • Interstital
  • Plasma
  • Transcellular

Question 46

Question
When a patient is being treated with thiazide diuretics, there is a danger of ________, an unwanted and potentially dangerous side effect.
Answer
  • hypocalcaemia
  • hypokalaemia
  • hypophosphataemia
  • hyponatraemia

Question 47

Question
Hyperkalaemia causes:
Answer
  • 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.

Question 48

Question
Which of the following would most likely cause hypochloraemia?
Answer
  • hypokalaemia
  • hypernataemia
  • elevated bicarbonate
  • hypercalcaemia

Question 49

Question
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?
Answer
  • hypoglycaemia
  • respiratory acidosis
  • constipation
  • frusemide therapy

Question 50

Question
Secretion of aldosterone results in:
Answer
  • decreased plasma osmolality.
  • increased blood volume.
  • increased serum potassium levels.
  • localised oedema.

Question 51

Question
Metabolic acidosis may be associated with
Answer
  • Increased chloride levels
  • Decreased bicarbonate
  • Increased metabolic acids
  • All answers are correct

Question 52

Question
Chronic compensation for respiratory acidosis includes:
Answer
  • kidney excretion of HCO3-
  • kidney excretion of H+
  • protein buffering
  • prolonged exhalations to blow off CO2

Question 53

Question
Which of the following is a strong acid?
Answer
  • Phosphorus
  • Albumin
  • Sodium chloride
  • Lactate

Question 54

Question
Long-term regulation of acid-base balance through removal or retention of acids is accomplished by the:
Answer
  • lungs
  • kidneys
  • liver
  • protein buffer systems

Question 55

Question
Which of the following buffer pairs is considered the major plasma buffering system?
Answer
  • NH3/NH4
  • NaCl/KPO4
  • HCO3-/H2CO3
  • HPO4/H2PO4

Question 56

Question
Autoregulation in the kidneys refers to:
Answer
  • 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.

Question 57

Question
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
Answer
  • 7, 6, 5, 3, 6
  • 2, 6, 5, 3, 7
  • 7, 6, 4, 3, 1
  • 2, 1, 5, 3, 6

Question 58

Question
Which condition is likely to cause metabolic acidosis?
Answer
  • Slow, shallow respirations
  • Excessive fluid in the body
  • Prolonged diarrhoea
  • Mild vomiting

Question 59

Question
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?
Answer
  • respiratory alkalosis with renal compensation
  • respiratory acidosis with renal compensation
  • metabolic alkalosis with respiratory compensation
  • metabolic acidosis with respiratory compensation

Question 60

Question
Which serum value indicates decompensated metabolic acidosis?
Answer
  • Bicarbonate level increases
  • Bicarbonate level decreases
  • pH is above normal range
  • pH is below normal range

Question 61

Question
Acute compensation for metabolic acidosis includes:
Answer
  • CO2 retention.
  • kidney excretion of H+.
  • hyperventilation.
  • hypoventilation.

Question 62

Question
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?
Answer
  • diabetes insipidus
  • decreased extracellular fluid osmolality
  • hyponatraemia
  • decreased urine formation

Question 63

Question
Uncontrolled essential hypertension may cause chronic renal failure because of:
Answer
  • 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.

Question 64

Question
In chronic renal failure, which of the following is the most immediately dangerous?
Answer
  • acidosis
  • phosphataemia
  • haematuria
  • anaemia

Question 65

Question
Which of the following causes acute renal failure?
Answer
  • Nephrosclerosis
  • Bilateral acute glomerulonephritis
  • Polycystic kidney disease
  • Pyelonephritis in the right kidney

Question 66

Question
Which of the following is a typical sign of dehydration?
Answer
  • Rapid, strong pulse
  • Low haematocrit
  • Increased urine output
  • Decreased tissue turgor

Question 67

Question
The normal pH of urine is:
Answer
  • 1.5-5.5.
  • 4.5- 8.0.
  • 7.35-7.45.
  • 7.0-10.

Question 68

Question
Which of the following conditions would decrease oncotic pressure in the capillaries?
Answer
  • low blood pressure
  • high-protein diet
  • liver failure
  • high blood-glucose

Question 69

Question
Chronic renal failure adversely affects which body system?
Answer
  • the cardiovascular system
  • the respiratory system
  • the CNS
  • All answers are correct

Question 70

Question
Infants are at a higher risk for developing dehydration because they have:
Answer
  • a lower total body water volume.
  • a decreased intravascular volume.
  • a greater body surface area.
  • an increased tendency towards developing oedema.

Question 71

Question
Which of the following would result in hyperkalaemia?
Answer
  • insulin
  • excess aldosterone
  • acute acidosis
  • alkalosis

Question 72

Question
Which of the following results from decreased blood flow into the kidneys?
Answer
  • Systemic blood pressure drop
  • Dilation of the afferent arterioles
  • Increased angiotensin and systemic vasoconstriction
  • Decreased aldosterone secretion

Question 73

Question
Which of the following alterations would result in fluid movement into the interstitial space?
Answer
  • increased interstitial hydrostatic pressure
  • decreased capillary hydrostatic pressure
  • increased capillary oncotic pressure
  • decreased capillary oncotic pressure

Question 74

Question
Causes of respiratory acidosis include:
Answer
  • hyperventilation.
  • an increase in noncarbonic acids.
  • pneumonia.
  • vomiting.

Question 75

Question
Crush injuries associated with a massive degree of cell rupture are likely to increase levels of extracellular:
Answer
  • potassium
  • calcium
  • sodium
  • phosphate

Question 76

Question
Choose the basic cause of bone remodelling disorders associated with chronic renal failure.
Answer
  • Excessive loss of phosphate ion
  • Deficit of parathyroid hormone
  • Failure of the kidney to activate vitamin D
  • Development of hypercalcemia
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