NursGuru
    Login/Signup
    Review ModeExam ModePractice Mode

    Exam Review

    1. A patient with heart failure was recently diagnosed with pre-renal acute kidney injury (AKI). The nurse demonstrates an understanding of the new diagnosis from her knowledge that the glomerular filtration rate (GFR) is dependent upon the
      A)
      secretion of erythropoietin.
      B)
      cardiac output (CO).
      C)
      secretion of dihydroxy vitamin D.
      D)
      glomerular capillary wall.
    2. Nephrotoxins, such as antibiotics or snake venom, may be responsible for and lead to intra-renal acute kidney injury (AKI)?
      A)
      cystitis.
      B)
      pyelonephritis.
      C)
      acute tubular necrosis (ATN).
      D)
      hydronephrosis.
    3. A nurse suspects post-renal acute kidney injury (AKI) in a patient who presents with and has a long-standing history of
      A)
      testicular heaviness; cryptorchidism.
      B)
      oliguria; hypertension.
      C)
      oliguria; benign prostatic hyperplasia (BPH).
      D)
      an elevated serum creatinine; polycystic kidney disease.
    4. A patient is diagnosed with acute post-streptococcal glomerulonephritis (GN). The pathophysiology of acute glomerulonephritis usually includes all the following except
      A)
      glomerular filtration rate (GFR) substantially increases.
      B)
      autoantibodies attack and damage the glomeruli of the kidneys.
      C)
      substances such as red blood cells and protein pathologically leak from the capillaries into the urine.
      D)
      inflammatory changes in the glomeruli cause leaky glomerular capillaries.
    Page 1 of 10

    Exam Review

    1. A patient has had chronic kidney disease (CKD) for many years. He is at risk for developing as a result of
      A)
      anemia; a reduced production of erythropoietin.
      B)
      metabolic alkalosis; a reduced production of bicarbonate.
      C)
      hip fracture; hypophosphatemia.
      D)
      nephrolithiasis; hypocalcemia.
    2. A patient with a history of renal failure presents to the emergency department with altered mental status, anorexia, and pruritus. Which laboratory finding correlates with these signs and symptoms?
      A)
      blood urea nitrogen of 6.
      B)
      serum creatinine of 2.4.
      C)
      hypercalcemia.
      D)
      urine specific gravity of 1.028.
    3. The nurse identifies that 40 ml of amber urine with a urine specific gravity of 1.029 is an indication of a patient’s
      A)
      onset of chronic kidney disease (CKD).
      B)
      overhydration.
      C)
      normal specific gravity value.
      D)
      dehydration.
    4. A patient with intra-renal acute kidney injury (AKI) develops chronic kidney disease (CKD) over a period of time. His treatment would likely include
      A)
      a low protein diet to minimize urea production in the liver and thus decrease azotemia.
      B)
      hair plugs to remedy the severe alopecia always seen in renal disease.
      C)
      antacids, because they contain phosphate to remedy the hypophosphatemia typically found in CKD.
      D)
      hydration, because the classic signs and symptoms of a renal patient include poor skin turgor, dry mucous membranes, and a high serum osmolality.
    Page 2 of 10

    Exam Review

    1. A woman is diagnosed with advanced ovarian cancer. She is upset and crying. She asks her nurse how this could have happened. Which response by the nurse indicates an understanding of this illness?
      A)
      Abnormal tissue has formed as a result of retrograde menstruation.
      B)
      Since signs and symptoms are vague, metastasis can occur before a diagnosis is made.
      C)
      A diet high in saturated fat is a risk factor for contracting this condition.
      D)
      Getting an annual Pap smear could have identified the cancer at an earlier stage.
    2. A report of an abnormal vaginal discharge and constant pelvic-area pain by a patient should lead the nurse to suspect
      A)
      a chlamydia infection.
      B)
      benign prostatic hyperplasia (BPH).
      C)
      a kidney stone.
    3. A man presents to the emergency department complaining of sudden onset of one-sided flank pain and hematuria. He is pacing the floor, which he says helps to distract him from the excruciating, colicky pain. Based on his presentation, what is most likely the cause of the pain?
      A)
      kidney stone.
      B)
      pyelonephritis.
      C)
      renal artery occlusion.
      D)
      glomerulonephritis.
    4. Following a house fire, a patient presents to the emergency department. She is coughing up blood-tinged, frothy sputum and complaining of dyspnea. Arterial blood gases are drawn and the results are: pH = 7.44, PCO2 = 43, PO2 = 60, HCO3 = 24, SO2 = 85%. The arterial blood gas results show and the treatment should include
      A)
      hypercapnia; teaching pursed-lip breathing techniques.
      B)
      hyperventilation; breathing into a paper bag.
      C)
      respiratory acidosis; giving oxygen.
      D)
      hypoxemia; giving oxygen.
    Page 3 of 10

    Exam Review

    1. Arterial blood gases are drawn on a patient. The results are: pH = 7.30, PCO2 = 55, PO2 = 80, HCO3 = 25. Which illness state might cause this disturbance?
      A)
      panic attack.
      B)
      extreme vomiting.
      C)
      kidney failure.
      D)
      intracranial bleeding.
    2. Which signs and symptoms would most likely represent a patient with increased work of breathing?
      A)
      temperature of 99°F; green sputum.
      B)
      respiratory rate of 18; pH 7.44.
      C)
      chest pain that radiates down the left arm.
      D)
      accessory muscle use on exhalation; respiratory rate of 36.
    3. A young girl with a history of asthma is brought to her family nurse practitioner. The child is wheezing and has prolonged expirations. The basic etiology of her signs and symptoms includes
      A)
      difficulty with inhalation due to stiff alveoli that have filled with fluid.
      B)
      destruction of elastic recoil properties of the lungs.
      C)
      bronchial-lining swelling that prevents ease of exhalation.
      D)
      use of accessory muscles for breathing.
    4. The nurse taking care of a patient with emphysema notes that he is very thin and barrel-chested, has a respiratory rate of 26, and is using accessory muscles and pursed-lip breathing. The pathological pulmonary characteristics that are most likely causes of his signs and symptoms include
      A)
      pulmonary artery perfusion defects and ventilation/perfusion mismatch.
      B)
      pulmonary edema and hemoptysis.
      C)
      loss of alveolar elastic recoil and resultant air trapping.
      D)
      chronically inflamed bronchi and thick mucus.
    Page 4 of 10

    Exam Review

    1. The nurse taking care of a patient with emphysema notes that he is very thin and barrel-chested, has a respiratory rate of 26, and is using accessory muscles and pursed-lip breathing. In assisting this patient with daily management of his emphysema, which nursing recommendation is best?
      A)
      Suggest that he lean back in a low semi-reclining position.
      B)
      Encourage him to slow down his respiratory rate.
      C)
      Teach him to prolong his inhalations and exhale quickly.
      D)
      Educate the patient about the tripod position breathing technique.
    2. A young girl with a history of asthma is brought to her family nurse practitioner. The family nurse practitioner’s treatment plan for this asthmatic patient will include bronchodilators and a peak flow meter. Which statement by the nurse best explains the rationale for the use of a peak flow meter?
      A)
      Use of this device will counteract the effect of your allergic reaction.
      B)
      Lower peak flows will indicate an improvement in your condition.
      C)
      Inhaling deeply through the meter will improve alveolar compliance.
      D)
      Exhaling out and into the meter will provide a guide for how well you are removing air.
    3. A patient begins experiencing dyspnea. The patient’s healthcare provider orders a ventilation-perfusion lung scan and the results indicate a ventilation-perfusion ratio of 1.0. This abnormal ratio shows that the dyspnea is most likely due to
      A)
      decreased pulmonary perfusion.
      B)
      increased pulmonary perfusion.
      C)
      decreased ventilation.
      D)
      paroxysmal orthopnea.
    4. A patient develops a pneumothorax from the rupture of a weakened alveoli. What physiologic sequela occurs as a result of a closed pneumothorax?
      A)
      Results in the disruption of the normal positive pressure that is present in the lungs.
      B)
      Occurs as a result of inflammation to the trachea and bronchi.
      C)
      Affected lung collapses as air accumulates in the thorax.
      D)
      Extra fluid collects in the space between the visceral and parietal pleura.
    Page 5 of 10

    Exam Review

    1. Following a house fire, a patient presents to the emergency department. She is coughing up blood-tinged, frothy sputum and complaining of dyspnea. Upon auscultation of her lungs, the nurse hears crackles. The pathophysiology of the patient’s signs and symptoms are most likely related to
      A)
      backup of fluid from left ventricle into lungs due to a previous history of heart failure.
      B)
      increase in elastase production and proteolytic activity due to smoke inhalation.
      C)
      overproduction of mucus in bronchi, causing difficulty with exhalation.
      D)
      alveolar inflammation and impaired surfactant function due to smoke inhalation.
    2. Inadequate chest expansion and problems with inhalation are most likely to be caused by
      A)
      emphysema.
      B)
      pneumonia.
      C)
      pulmonary edema.
      D)
      asthma.
    3. A patient complains he has trouble walking. The pain in his leg increases when he walks and decreases when he rests. This pattern is known as
      A)
      intermittent claudication and indicates ischemic pain.
      B)
      intermittent claudication and is caused by leg edema and stasis ulcers.
      C)
      peripheral vascular disease and is caused by venous insufficiency.
      D)
      Claude Vandamme syndrome and is caused by oversecretion of testosterone.
    4. A patient has been diagnosed with an abdominal aortic aneurysm (AAA). Which statement related to the diagnosis is most likely true?
      A)
      Atherosclerosis of the abdominal aorta causes damage to the arterial intima.
      B)
      Streptococcus bacteria weaken arterial walls causing an outpouching of the arterial blood vessel.
      C)
      Arterial valves become floppy allowing backflow and arterial congestion in the abdomen.
      D)
      Hypotension will cause blood to seep from the lumen into the arterial muscle and tissue.
    Page 6 of 10