Patho Test 4- Ch.38
A dialysis technician is providing care for a client with chronic renal failure. The technician would recognize which of the following characteristics of healthy kidneys? Select all that apply.
The kidneys are contained within the peritoneal cavity.
Blood vessels, nerves, and ureters all connect with the kidney at the hilus.
The medulla of the kidney contains the glomeruli.
Each kidney consists of lobes, with each lobe comprised of nephrons.
Each nephron contains several hundred glomeruli that perform filtration
A patient in the ICU has been diagnosed with hypovolemic shock. His BP is 88/53, heart rate 122, and respiratory rate 26. Given these vital signs, the nurse should expect the urine output to be
Maintained between 30 and 50 mL/hour with no sediment in the bag.
Increased to 60+ mL/hour with dilute urine.
Decreased below 30 mL/hour with decreased GFR.
The patient's normal amount with dark, concentrated urine.
At which of the following locations in the nephron would a health care professional first expect blood to be largely free of plasma proteins?
Proximal convoluted tubule
Bowman space
Loop of Henle
Afferent arteriole
Which of the following statements about mesangial cells within the glomerulus is accurate? Select all that apply. Mesangial cells
Cover the entire amount of endothelial cells contained within the capillaries.
Have phagocytic properties that remove macromolecular materials.
Exhibit vasodilator properties to assist with increase in blood flow in times of stress
Enlarge (hyperplasia) in response to glomerular diseases.
Are coiled and drain Bowman capsule.
A nurse educator is orientating new nurses to a renal unit of the hospital. Which of the following teaching points should the nurse include as part of a review of normal glomerular function?
Nephrons are delicate structures that cannot endure the high pressure that exists in capillary beds elsewhere in the body.”
Glomerular filtrate is very similar in composition to blood plasma found elsewhere in circulation.”
Dilation of the afferent arteriole allows more blood into the nephron and increases the glomerular filtration rate.”
The glomerulus is located between an arteriole and a venule that work together to regulate blood flow.”
While assessing a patient with urosepsis, the ICU nurse notes the patient's BP is 80/54; HR 132; RR 24; and pulse oximetry 89% on 6 lpm O2. Over the last hour, the patient's urine output is 15 mL. When explaining to a new graduate nurse, the nurse will emphasize that the patient's status may relate to that
The infection is deep inside the kidney, and it will take a long time for the antibiotics to kill the bacteria.
He patient's sympathetic nervous system has been stimulated that has resulted in vasoconstriction of the afferent arteriole, which causes a decrease in renal blood flow.
The glomerular filtration system gets overwhelmed in times of stress (like infections) and can become clogged with waste material from the bacteria.
The ability to transport substances from the tubular fluid into the peritubular capillaries becomes impaired, which results in fluid being forced out of capillaries into the glomerulus.
Which of the following substances is most likely to be reabsorbed in the tubular segments of the nephron using passive transport mechanisms?
Water
Sodium
Phosphate
Calcium
When explaining to a class of nursing students enrolled in pathophysiology, the instructor states, “the majority of energy used by the kidney is for
Filtration of drugs out of the body.”
Secretion of erythropoietin for production of RBCs.”
Active sodium transport mechanisms.”
Removal of excess glucose from the blood.”
Damage to which of the following areas of a nephron would most likely result in impaired secretion and reabsorption?
Distal tubule
Loop of Henle
Proximal tubule
Collecting tubule
When explaining the role of the proximal tubule in terms of medication administration, the nursing instructor will emphasize that which of the following medications are bound to plasma proteins and require the proximal tubule secretion of exogenous organic compounds to help with filtration? Select all that apply.
Penicillin
Aspirin
Morphine sulfate
Potassium chloride
Sodium chloride
Which of the following statements most accurately captures the function of the ascending loop of Henle?
Urine is concentrated by the selective absorption of free water in the ascending limb.
Sodium and water are reabsorbed in equal amounts, reducing filtrate quantity but maintaining osmolality.
The majority of solute and water reabsorption occurs in the ascending loop of Henle.
Impermeability to water and absorption of solutes yields a highly dilute filtrate.
To treat enuresis in a young girl, her pediatrician prescribes desmopressin, an antidiuretic hormone (ADH) nasal spray, before bedtime. What is the most likely rationale for this treatment?
It removes water from the filtrate and returns it to the vascular compartment.
It lessens the amount of fluid entering the glomerulus.
It leads to the production of dilute urine.
It causes tubular cells to lose their water permeability.
Following an automobile accident where the patient had a traumatic amputation of his lower leg and lost greater than 40% of his blood volume, he is currently not producing any urine output. The nurse bases this phenomena on which of the following humoral substances responsible for causing severe vasoconstriction of the renal vessels?
Aquaproin-2 channels
Angiotensin II and ADH
Renin and potassium ions
Albumin and norepinephrine
A physician who is providing care for a 71-year-old male client with a recent diagnosis of renal failure and an acid–base imbalance is explaining some of the underlying etiology of the man's diagnoses to him and his family. Which of the following phenomena would most accurately underlie the teaching that the physician provides?
The kidneys are integral to the reabsorption of hydrogen ions and maintenance of a low pH.
Blood buffer systems and respiratory control can compensate for inadequate renal control of pH.
The kidneys have the primary responsibility for eliminating excess hydrogen ions from the body.
PH is kept at an optimal level through the renal secretion of bicarbonate ions in blood filtrate
While living and hiking in the Rocky Mountains, a gentleman slipped and fell. He goes to an urgent care where an x-ray was done, and some blood was drawn for a CBC. The clinic informs him that he is anemic. What may contribute to this person's anemia? Select all that apply.
Living in a high altitude
Tissue hypoxia
Inability to manufacture erythropoietin
Destruction of RBCs caused by natural killer cells
Dehydration
Which of the following patients on a geriatric medical unit is most likely to require slow-release potassium supplements on a regular basis?
A 90-year-old female who is taking an aldosterone antagonist to treat pulmonary edema
An 81-year-old male who takes a thiazide diuretic to control his hypertension
A 79-year-old male with heart failure who is receiving a loop diuretic
An 83-year-old female who is taking an osmotic diuretic to address severe peripheral edema
A 62-year-old woman with high blood pressure is to begin long-term treatment with a thiazide diuretic that she thinks she will need to take for some time. What should the nurse expect to happen to her potassium and calcium levels?
Her potassium and calcium levels will not change.
Her potassium and calcium levels will both go down.
Her potassium level will drop, but her calcium level may rise.
Her potassium level will rise, but her calcium level may drop.
A patient in a hospital is frustrated at the inconvenience of having to collect his urine for an entire day and night as part of an ordered 24-hour urine collection test. He asks the nurse why the test is necessary since he provided a single urine sample 2 days ago. How could the nurse best respond to the patient's question?
A single urine sample lets your care team determine if there are bacteria in your urine, but other tests of urine chemistry need a longer-term view.”
Current lab tests aren't able to detect the small quantities of most substances contained in a single urine sample.
Only a longer-term test is able to show whether your kidneys are letting sugar spill out into your urine.”
Often why an abnormal substance shows up in urine test, a 24-hour urine collection is needed to determine exactly how much it is present in your urine.”
Which of the following lab results would be associated with abnormalities in kidney function? Select all that apply.
An absence of protein in a urine sample
Increased creatinine levels
Urine gravity of 1.038 and normal serum creatinine levels
Decreased blood urea nitrogen (BUN) level
Detectable levels of glucose in a urine sample
Elevated cystatin-C level.
{"name":"Patho Test 4- Ch.38", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"A dialysis technician is providing care for a client with chronic renal failure. The technician would recognize which of the following characteristics of healthy kidneys? Select all that apply., A patient in the ICU has been diagnosed with hypovolemic shock. His BP is 88\/53, heart rate 122, and respiratory rate 26. Given these vital signs, the nurse should expect the urine output to be, At which of the following locations in the nephron would a health care professional first expect blood to be largely free of plasma proteins?","img":"https://www.quiz-maker.com/3012/images/ogquiz.png"}