Bioscience I - Exam 3

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Bioscience I - Exam 3 - Quiz

Review for exam 3 in bioscience, covering the renal lectures.


Questions and Answers
  • 1. 

                                What is the major product of metabolism excreted by the kidneys?

    • A.

      Urea

    • B.

      Water

    • C.

      Creatinine

    • D.

      Renin

    Correct Answer
    A. Urea
    Explanation
    Urea is the major product of metabolism excreted by the kidneys. It is formed in the liver through the breakdown of proteins and amino acids. Urea is then transported to the kidneys where it is filtered out of the bloodstream and excreted in urine. This process helps to remove waste products from the body and maintain the balance of nitrogen in the blood. Water, creatinine, and renin are also involved in kidney function, but they are not the major product of metabolism excreted by the kidneys.

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  • 2. 

    Which of the following hormones is secreted by the kidneys?

    • A.

      Insulin

    • B.

      Erythropoetin

    • C.

      Glucose

    • D.

      Uric Acid

    Correct Answer
    B. Erythropoetin
    Explanation
    Erythropoietin is a hormone that is secreted by the kidneys. It plays a crucial role in the production of red blood cells. When the kidneys detect low oxygen levels in the blood, they release erythropoietin, which stimulates the bone marrow to produce more red blood cells. This hormone helps to maintain the oxygen-carrying capacity of the blood and is essential for proper functioning of the body. Insulin, glucose, and uric acid are not hormones secreted by the kidneys.

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  • 3. 

    Which of the following is characterized by movement of substances from the blood to the filtrate?

    • A.

      Tubular reabsorption

    • B.

      Glomerular filtration

    • C.

      Tubular Secretion

    • D.

      Juxtamedullary absorption

    Correct Answer
    C. Tubular Secretion
    Explanation
    Tubular secretion is characterized by the movement of substances from the blood to the filtrate. This process occurs in the renal tubules of the kidney, where certain substances that were not filtered out during glomerular filtration are actively transported from the blood into the filtrate. This allows for the elimination of waste products, such as drugs, excess ions, and metabolic byproducts, from the body. Tubular secretion plays a crucial role in maintaining the body's fluid and electrolyte balance.

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  • 4. 

    Which of the following is characterized by movement of filtrate back into the blood from renal tubule?

    • A.

      Glomerular filtration

    • B.

      Tubular Secretion

    • C.

      Juxtamedullary absorption

    • D.

      Tubular reabsorption

    Correct Answer
    D. Tubular reabsorption
    Explanation
    Tubular reabsorption is characterized by the movement of filtrate back into the blood from the renal tubule. This process occurs in the kidney's nephrons, where substances such as water, glucose, electrolytes, and amino acids are reabsorbed from the renal tubules into the bloodstream. This helps to maintain the body's balance of water and electrolytes, as well as reabsorb important nutrients. Tubular reabsorption is a crucial step in urine formation and plays a vital role in maintaining homeostasis within the body.

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  • 5. 

    Which of the following is responsible to adhering the kidneys to the abdominal wall and other internal structures?

    • A.

      Renal Fascia

    • B.

      Renal Capsule

    • C.

      Adipose Capsule

    • D.

      Perinephrium

    Correct Answer
    A. Renal Fascia
    Explanation
    The renal fascia is responsible for adhering the kidneys to the abdominal wall and other internal structures. It is a layer of connective tissue that surrounds and supports the kidneys, helping to keep them in place within the abdominal cavity. The renal fascia also provides protection to the kidneys and helps to maintain their position, preventing excessive movement or displacement.

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  • 6. 

    What is the purpose of the tufts of capillaries which compose the glomerulus? 

    • A.

      This is the site where filtered fluid is converted to urine

    • B.

      Provide a large surface area

    • C.

      Provide multiple arteriole sites for blood flow

    • D.

      They support the MAP

    Correct Answer
    B. Provide a large surface area
    Explanation
    The tufts of capillaries in the glomerulus provide a large surface area. This is important because it allows for efficient filtration of blood and the removal of waste products and excess water from the body. By having a large surface area, more blood can be filtered at a time, increasing the efficiency of the filtration process.

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  • 7. 

    Which of the following is likely to have the greatest blood loss?

    • A.

      Total nephrectomy

    • B.

      Renal Biopsy

    • C.

      Partial Nephrectomy

    • D.

      All above have equal blood loss potential

    Correct Answer
    C. Partial Nephrectomy
    Explanation
    Partial nephrectomy is likely to have the greatest blood loss compared to total nephrectomy and renal biopsy. During a partial nephrectomy, only a portion of the kidney is removed, while in total nephrectomy, the entire kidney is removed. Renal biopsy involves taking a small sample of kidney tissue for examination. Since partial nephrectomy involves removing a part of the kidney, it is expected to have a higher potential for blood loss compared to the other options.

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  • 8. 

    How is blood supplied to the glomerulus?

    • A.

      Via a single efferent arteriole

    • B.

      Through multiple renal arterioles

    • C.

      Through hundreds of renal capillaries

    • D.

      Through a single afferent renal arteriole

    Correct Answer
    D. Through a single afferent renal arteriole
    Explanation
    Blood is supplied to the glomerulus through a single afferent renal arteriole. The afferent arteriole brings blood into the glomerulus, where it then enters a network of capillaries known as the glomerular capillaries. These capillaries are responsible for filtration of waste products and excess fluid from the blood. After filtration, the blood exits the glomerulus through the efferent arteriole. So, the correct answer is that blood is supplied to the glomerulus through a single afferent renal arteriole.

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  • 9. 

    What is the major function of the proximal tubule?

    • A.

      Reabsoption of sodium

    • B.

      Reabsorption of water

    • C.

      Concentration of urine

    • D.

      Reabsorption of Chloride

    Correct Answer
    A. Reabsoption of sodium
    Explanation
    The major function of the proximal tubule is to reabsorb sodium. This is an important process in the kidneys where sodium is actively transported from the tubule back into the bloodstream. This helps maintain the body's fluid and electrolyte balance. Sodium reabsorption in the proximal tubule is also coupled with the reabsorption of other substances such as glucose, amino acids, and water.

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  • 10. 

    Which portion of the tubular system is responsible for maintaining a hypertonic medullary interstitium?

    • A.

      Proximal Tubule

    • B.

      Loop of Henle

    • C.

      Collecting Tubule

    • D.

      Distal Tubule

    Correct Answer
    B. Loop of Henle
    Explanation
    The Loop of Henle is responsible for maintaining a hypertonic medullary interstitium. This is achieved through the countercurrent mechanism, where the descending limb of the loop allows for passive reabsorption of water, while the ascending limb actively pumps out sodium and chloride ions. This creates a concentration gradient in the medullary interstitium, which helps in the reabsorption of water in the collecting duct. The proximal tubule, collecting tubule, and distal tubule also play important roles in renal function, but they are not specifically responsible for maintaining a hypertonic medullary interstitium.

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  • 11. 

    What effect will an increase in ADH secretion have on the kidneys?

    • A.

      Urine output will decrease

    • B.

      Urine output will increase

    • C.

      No effect on kidneys

    Correct Answer
    A. Urine output will decrease
    Explanation
    An increase in ADH secretion will cause the kidneys to reabsorb more water from the urine, resulting in a decrease in urine output. ADH, or antidiuretic hormone, acts on the kidneys to increase their permeability to water, allowing more water to be reabsorbed back into the bloodstream. This leads to a decrease in the volume of urine produced, as more water is conserved by the body.

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  • 12. 

    In what portion of the tubular system does concentration of urine occur?

    • A.

      Proximal Tubule

    • B.

      Loop of Henle

    • C.

      Collecting Tubule

    • D.

      Distal Tubule

    Correct Answer
    C. Collecting Tubule
    Explanation
    The concentration of urine occurs in the collecting tubule. This is where water is reabsorbed from the urine, resulting in a more concentrated final product. The proximal tubule is responsible for the reabsorption of most of the water and solutes, but it does not specifically concentrate the urine. The loop of Henle is involved in creating a concentration gradient in the medulla of the kidney, but it does not directly concentrate the urine. The distal tubule is responsible for fine-tuning the reabsorption and secretion of specific ions, but it does not concentrate the urine either. Therefore, the correct answer is the collecting tubule.

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  • 13. 

    Which of the following is not true regarding juxtaglomerular cells?

    • A.

      They contain renin

    • B.

      Innervated by sympathetic nervous system

    • C.

      Responsible for secretion of ADH

    • D.

      All above are true

    Correct Answer
    C. Responsible for secretion of ADH
    Explanation
    The statement "Responsible for secretion of ADH" is not true regarding juxtaglomerular cells. Juxtaglomerular cells are specialized cells located in the kidney that produce and secrete the enzyme renin, which plays a role in regulating blood pressure. These cells are also innervated by the sympathetic nervous system. However, the secretion of antidiuretic hormone (ADH) is primarily regulated by the hypothalamus and released by the posterior pituitary gland.

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  • 14. 

    Which of the following will not affect release of renin?

    • A.

      Administration of epinephrine

    • B.

      Decrease in MAP

    • C.

      A patient diagnosed with diabetes insipidus

    • D.

      Change in sodium flow past macula densa

    Correct Answer
    D. Change in sodium flow past macula densa
    Explanation
    A change in sodium flow past the macula densa will not affect the release of renin. The macula densa is a group of specialized cells in the kidney that detect changes in sodium concentration in the tubular fluid. When sodium flow past the macula densa decreases, it signals the juxtaglomerular cells to release renin, which is an enzyme involved in the regulation of blood pressure. However, if there is a change in sodium flow past the macula densa, it means that the concentration of sodium is not changing, so there is no need for renin release. Therefore, a change in sodium flow past the macula densa will not affect the release of renin.

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  • 15. 

    Renal blood flow is determined by oxygen consumption. 

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The statement "Renal blood flow is determined by oxygen consumption" is false. Renal blood flow is actually determined by factors such as blood pressure, vascular resistance, and autoregulation. Oxygen consumption is important for the overall functioning of the kidneys, but it does not directly determine renal blood flow.

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  • 16. 

    What would be considered the lowest normal hourly urinary output for a pt weighing 80 kg?

    • A.

      40 ml/hr

    • B.

      80 ml/hr

    • C.

      160 ml/hr

    • D.

      30 ml/hr

    Correct Answer
    A. 40 ml/hr
    Explanation
    The lowest normal hourly urinary output for a patient weighing 80 kg would be 40 ml/hr. This means that the patient should be producing at least 40 milliliters of urine every hour. This is considered the minimum acceptable amount of urine output for a patient of this weight, indicating that their kidneys are functioning properly and adequately removing waste and excess fluid from the body.

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  • 17. 

    Renal blood flow is approximately how many mL’s per minute?

    • A.

      125

    • B.

      1200

    • C.

      500

    • D.

      2500

    Correct Answer
    B. 1200
    Explanation
    Renal blood flow refers to the amount of blood that passes through the kidneys in a minute. The correct answer of 1200 mL per minute suggests that this is the approximate amount of blood that flows through the kidneys in a minute. This value is within the normal range for renal blood flow, indicating that it is a reasonable estimate.

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  • 18. 

    You are the SRNA for Mr. Recher who is coming in for emergent surgery to fix internal bleeding following a MVA.  He is currently hypotensive (MAP of 60) in spite of fluid administration and continues to lose blood. What effect will these injuries have on renal blood flow and urine output?

    • A.

      Glomerular filtration will cease due to his low MAP

    • B.

      Urine output will increase due to fluid administration

    • C.

      Renal blood flow will decrease due to decrease in MAP

    • D.

      Effect on kidneys dependent upon whether renal arteries or aorta were damaged in accident

    Correct Answer
    C. Renal blood flow will decrease due to decrease in MAP
    Explanation
    The correct answer is that renal blood flow will decrease due to a decrease in MAP. In this scenario, the patient is hypotensive with a MAP of 60, which indicates low blood pressure. The kidneys rely on an adequate blood pressure to maintain renal blood flow. When the MAP decreases, it leads to a decrease in perfusion pressure in the kidneys, resulting in reduced renal blood flow. This decrease in renal blood flow can subsequently affect urine output.

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  • 19. 

    What is the mechanism of action of loop diuretic such as furosemide?

    • A.

      Limits passive water reabsoption in the thin descending limb

    • B.

      Antagonizes aldosterone in the collecting duct

    • C.

      Inhibit carbonic anhydrase in the proximal tubule

    • D.

      Inhibit sodium reabsoption in the ascending limb

    Correct Answer
    D. Inhibit sodium reabsoption in the ascending limb
    Explanation
    Loop diuretics such as furosemide work by inhibiting the reabsorption of sodium in the ascending limb of the loop of Henle in the kidney. This prevents the reabsorption of sodium, leading to increased excretion of sodium in the urine. By blocking sodium reabsorption, loop diuretics also cause increased excretion of water, chloride, and other electrolytes. This mechanism of action is what allows loop diuretics to have a potent diuretic effect and help in the treatment of conditions such as edema and hypertension.

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  • 20. 

    Which of the following would be inappropriate to use for an edematous CHF patient in the ICU?

    • A.

      Mannitol

    • B.

      Diamox

    • C.

      Furosemide

    • D.

      Hydrochlorothiazide

    Correct Answer
    A. Mannitol
    Explanation
    Mannitol would be inappropriate to use for an edematous CHF patient in the ICU because it is an osmotic diuretic that can increase fluid volume and worsen edema. It works by drawing water into the renal tubules, which can lead to increased intravascular volume and strain on the heart. Therefore, it is not recommended for patients with congestive heart failure and edema.

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  • 21. 

    Which of the following would be a poor choice for a pt with HTN who is also taking an ACE inhibitor?

    • A.

      Furosemide

    • B.

      Aldactone

    • C.

      Hydrochlorothiazide

    • D.

      Diamox

    Correct Answer
    B. Aldactone
    Explanation
    Aldactone would be a poor choice for a patient with hypertension (HTN) who is also taking an ACE inhibitor because both medications can increase potassium levels in the body. Aldactone is a potassium-sparing diuretic, which means it helps the body retain potassium. When combined with an ACE inhibitor, which can also increase potassium levels, there is a higher risk of developing hyperkalemia (high potassium levels), which can be dangerous. Therefore, Aldactone should be avoided in this scenario to prevent potential complications.

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  • 22. 

    What is the site of action of Acetazolamide, a carbonic anhydrase inhibitor?

    • A.

      Thick ascending Limb

    • B.

      Thin descending limb

    • C.

      Proximal Tubule

    • D.

      Distal Tubule

    Correct Answer
    C. Proximal Tubule
    Explanation
    Acetazolamide is a carbonic anhydrase inhibitor, meaning it blocks the action of the enzyme carbonic anhydrase. This enzyme is responsible for the conversion of carbon dioxide and water into bicarbonate and hydrogen ions in the proximal tubule of the kidney. By inhibiting carbonic anhydrase in the proximal tubule, acetazolamide reduces the reabsorption of bicarbonate, leading to increased excretion of bicarbonate and consequently increased excretion of sodium, water, and potassium. Therefore, the site of action of acetazolamide is the proximal tubule.

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  • 23. 

    Which of the following diuretic exerts its action in the Distal Tubule?

    • A.

      Mannitol

    • B.

      Acetazolamide

    • C.

      Spironolactone

    • D.

      Hydrochlorothiazide

    Correct Answer
    D. Hydrochlorothiazide
    Explanation
    Hydrochlorothiazide is a diuretic that exerts its action in the distal tubule. It works by inhibiting the reabsorption of sodium and chloride ions, leading to increased excretion of water and electrolytes. This diuretic is commonly used to treat conditions such as hypertension and edema. Mannitol is an osmotic diuretic that acts on the proximal tubule, while acetazolamide is a carbonic anhydrase inhibitor that primarily affects the proximal convoluted tubule. Spironolactone is a potassium-sparing diuretic that acts on the collecting duct.

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  • 24. 

    Which of the following is not a risk factor for renal failure post op?

    • A.

      Prolonged surgery >4 hours

    • B.

      Pre-existing renal disease

    • C.

      History of CHF

    • D.

      Advanced Age

    Correct Answer
    A. Prolonged surgery >4 hours
    Explanation
    Prolonged surgery >4 hours is not a risk factor for renal failure post-op. While prolonged surgery can increase the risk of complications, such as infection or blood loss, it is not directly associated with renal failure. Pre-existing renal disease, history of CHF, and advanced age are all known risk factors for renal failure post-op due to the increased strain on the kidneys during surgery and anesthesia.

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  • 25. 

    The greatest renal derangements are caused by abnormalities of _________ and are readily detectable.

    • A.

      Obstruction

    • B.

      Glomerular function

    • C.

      Tubular function

    • D.

      Renal tumors

    Correct Answer
    B. Glomerular function
    Explanation
    Renal derangements refer to abnormalities or dysfunctions in the kidneys. The question asks for the cause of the greatest renal derangements that are readily detectable. The correct answer is "Glomerular function." The glomerulus is a part of the kidney responsible for filtering waste products and excess fluids from the blood. Any abnormalities or dysfunction in the glomerular function can lead to significant renal derangements, such as proteinuria, hematuria, or decreased renal function, which can be easily detected through various tests like urine analysis or blood tests.

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  • 26. 

    What is the most accurate lab test for assessing overall renal function and GFR?

    • A.

      BUN

    • B.

      Serum Creatinine

    • C.

      24 hour creatinine clearance

    • D.

      Renal ultrasound

    Correct Answer
    C. 24 hour creatinine clearance
    Explanation
    The 24 hour creatinine clearance test is the most accurate lab test for assessing overall renal function and glomerular filtration rate (GFR). This test measures the amount of creatinine cleared from the blood by the kidneys over a 24 hour period. Creatinine is a waste product produced by the muscles that is filtered out of the blood by the kidneys. By measuring the amount of creatinine cleared, the test can provide an accurate assessment of how well the kidneys are functioning and the GFR. BUN (blood urea nitrogen) and serum creatinine levels can also provide some information about renal function, but the 24 hour creatinine clearance test is considered more accurate. A renal ultrasound, while useful for evaluating the structure of the kidneys, does not directly assess renal function or GFR.

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  • 27. 

    Ammonia is produced from deamination of amino acids.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Ammonia is produced from the deamination of amino acids. Deamination is the process by which the amino group (-NH2) is removed from an amino acid, resulting in the production of ammonia (NH3) as a byproduct. This process occurs primarily in the liver and kidneys. Therefore, the statement "Ammonia is produced from deamination of amino acids" is true.

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  • 28. 

    An increase in protein catabolism due to sepsis would likely cause…

    • A.

      A decrease in BUN

    • B.

      An increase in creatinine

    • C.

      A decrease in creatinine

    • D.

      An increase in BUN

    Correct Answer
    D. An increase in BUN
    Explanation
    An increase in protein catabolism due to sepsis would likely cause an increase in BUN (blood urea nitrogen) levels. BUN is a waste product of protein breakdown in the liver. When protein catabolism increases, more protein is broken down, leading to higher levels of BUN in the bloodstream. This can indicate impaired kidney function, as the kidneys are responsible for filtering and excreting BUN from the body. Therefore, an increase in BUN is a common finding in sepsis, reflecting the increased breakdown of proteins and potential kidney dysfunction.

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  • 29. 

    An increase in GFR would likely cause...

    • A.

      A decrease in BUN

    • B.

      An increase in creatinine

    • C.

      An increase in BUN

    • D.

      None of above

    Correct Answer
    A. A decrease in BUN
    Explanation
    An increase in GFR (glomerular filtration rate) indicates an increase in the amount of blood being filtered by the kidneys per unit of time. This increased filtration rate would result in a more efficient removal of waste products from the blood, including urea nitrogen (BUN). As a result, there would be a decrease in BUN levels. Creatinine, on the other hand, is a waste product that is not reabsorbed by the kidneys, so an increase in GFR would lead to an increase in creatinine levels. Therefore, the correct answer is a decrease in BUN.

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  • 30. 

    Mr. Jud is a body builder who has come to the OR today for repair rotator cuff. What might you expect to see on his labs?

    • A.

      A decrease in BUN

    • B.

      An increase in creatinine

    • C.

      A decrease in creatinine

    • D.

      An increase in BUN

    Correct Answer
    B. An increase in creatinine
    Explanation
    When a person undergoes surgery, especially in the case of a rotator cuff repair, there is a risk of kidney damage due to the use of anesthesia and the stress on the body. Creatinine is a waste product that is normally filtered out by the kidneys. An increase in creatinine levels in the lab results would indicate impaired kidney function, which is a potential complication of surgery. Therefore, it is expected to see an increase in creatinine levels in Mr. Jud's labs.

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  • 31. 

    Which would be the ideal anesthetic agent for a patient with renal disease?

    • A.

      Sevoflurane

    • B.

      Enflurane

    • C.

      Isoflurane

    • D.

      Desflurane

    Correct Answer
    C. Isoflurane
    Explanation
    Isoflurane would be the ideal anesthetic agent for a patient with renal disease. This is because isoflurane has a low potential for renal toxicity compared to other volatile anesthetic agents. It undergoes minimal metabolism in the liver and is primarily eliminated through the lungs, making it a safer option for patients with impaired renal function. Additionally, isoflurane provides good anesthesia depth and rapid onset and recovery, making it suitable for various surgical procedures.

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  • 32. 

    A sudden inability of the kidneys to vary urine volume and content appropriately in response to homeostatic needs is known as what?

    • A.

      Yo’ momma

    • B.

      Chronic Renal Failure

    • C.

      Glomerulonephritis

    • D.

      Acute Renal Failure

    Correct Answer
    D. Acute Renal Failure
    Explanation
    Acute Renal Failure refers to a sudden inability of the kidneys to adjust urine volume and composition according to the body's homeostatic requirements. This condition can occur due to various factors such as kidney damage, decreased blood flow to the kidneys, or blockage in the urinary tract. It is characterized by a rapid decline in kidney function, leading to an accumulation of waste products and electrolyte imbalances in the body.

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  • 33. 

    Acute Renal failure is irreversible and generally leads to chronic renal failure.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The given statement is false. Acute renal failure is a sudden and temporary loss of kidney function, which can be caused by various factors such as dehydration, medication side effects, or kidney injury. Unlike chronic renal failure, which is a long-term and progressive loss of kidney function, acute renal failure can be reversible with proper treatment and management. Therefore, acute renal failure does not necessarily lead to chronic renal failure.

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  • 34. 

    What is Azotemia?

    • A.

      Retention of nitrogenous waste products

    • B.

      Decreased urine production,

    • C.

      The presence of protein in the urine

    • D.

      Inflammation of the small blood vessels within the kidney

    Correct Answer
    A. Retention of nitrogenous waste products
    Explanation
    Azotemia refers to the retention of nitrogenous waste products in the bloodstream. These waste products, such as urea and creatinine, are normally filtered out by the kidneys and excreted in urine. However, in cases of azotemia, the kidneys are unable to properly filter and eliminate these waste products, leading to their buildup in the blood. This can occur due to kidney dysfunction or damage, and it is often a sign of underlying kidney disease or other medical conditions. Symptoms of azotemia may include decreased urine production and the presence of protein in the urine.

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  • 35. 

    Acute renal failure is usually due to ______ or _______ factors which will impair renal function.

    • A.

      Infectious, Hypertensive

    • B.

      Hemodynamic, Endocrine

    • C.

      Cardiovascular, Obstructive

    • D.

      Congenital defects, Diabetic

    Correct Answer
    B. Hemodynamic, Endocrine
    Explanation
    Acute renal failure is a condition characterized by a sudden loss of kidney function. Hemodynamic factors refer to changes in blood flow to the kidneys, such as decreased blood volume or low blood pressure, which can impair renal function. Endocrine factors, on the other hand, involve hormonal imbalances that can affect kidney function. Both hemodynamic and endocrine factors can contribute to the development of acute renal failure by impairing the normal functioning of the kidneys.

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  • 36. 

    Acute renal failure will likely cause a decreased ________ and an increase in _______.

    • A.

      Renal vascular resistance, renal perfusion pressure

    • B.

      Renal reserve, urinary output

    • C.

      Renal perfusion pressure, renal vascular resistance

    • D.

      Urinary output, Renal Reserve

    Correct Answer
    C. Renal perfusion pressure, renal vascular resistance
    Explanation
    Acute renal failure is a condition characterized by a sudden loss of kidney function. In this scenario, there is likely to be a decrease in renal perfusion pressure, which refers to the pressure at which blood is delivered to the kidneys. This decrease in pressure can be caused by various factors such as low blood volume or constriction of blood vessels supplying the kidneys. Additionally, there is likely to be an increase in renal vascular resistance, which refers to the resistance encountered by blood flow within the renal blood vessels. This increase in resistance can be a result of the kidneys attempting to compensate for the decreased perfusion pressure by constricting their blood vessels.

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  • 37. 

    Which of the following is not a pre-renal cause of acute renal failure?

    • A.

      Renal vein Thrombosis

    • B.

      Liver Failure

    • C.

      Sepsis

    • D.

      Prostatic Hypertrophy

    Correct Answer
    D. Prostatic Hypertrophy
    Explanation
    Prostatic hypertrophy is not a pre-renal cause of acute renal failure. Pre-renal causes refer to conditions that affect blood flow to the kidneys, leading to kidney dysfunction. Renal vein thrombosis, liver failure, and sepsis can all cause decreased blood flow to the kidneys, resulting in acute renal failure. However, prostatic hypertrophy, which is the enlargement of the prostate gland, does not directly affect blood flow to the kidneys and therefore is not considered a pre-renal cause of acute renal failure.

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  • 38. 

    Which type of acute renal failure pt will maintain urine output greater than 400 ml/day?

    • A.

      Nonoliguric

    • B.

      Anuric

    • C.

      Oliguric

    • D.

      This pt would not have renal failure

    Correct Answer
    A. Nonoliguric
    Explanation
    Nonoliguric acute renal failure refers to a condition where there is a normal or increased urine output of greater than 400 ml/day. This means that the kidneys are still able to produce and excrete a sufficient amount of urine, indicating that there is some level of functioning in the renal system. In contrast, anuric acute renal failure is characterized by a complete absence of urine output, while oliguric acute renal failure is characterized by a significantly reduced urine output. Therefore, the correct answer is nonoliguric, as this type of patient will maintain a urine output greater than 400 ml/day.

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  • 39. 

    Which type of acute renal failure pt will have no urine output?

    • A.

      Nonoliguric

    • B.

      Anuric

    • C.

      Oliguric

    • D.

      All of above

    Correct Answer
    B. Anuric
    Explanation
    Anuric acute renal failure refers to a condition where the patient has no urine output. This means that the kidneys are not producing any urine, leading to a complete absence of urine flow. This can be caused by various factors such as severe damage to the kidneys, obstruction in the urinary tract, or decreased blood flow to the kidneys. Anuric acute renal failure is a serious condition that requires immediate medical attention and intervention to prevent further complications.

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  • 40. 

    A patient with acute Oliguric renal failure will have how much urine output per day?

    • A.

      No urine output

    • B.

      Greater than 3L/day

    • C.

      Less than 400 ml/day

    • D.

      None of above

    Correct Answer
    C. Less than 400 ml/day
    Explanation
    In acute Oliguric renal failure, the kidneys are not able to adequately filter waste and excess fluid from the blood, resulting in a significant decrease in urine output. A normal urine output is typically around 1-2 liters per day. Therefore, a patient with acute Oliguric renal failure will have less than 400 ml of urine output per day.

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  • 41. 

    Which of the following would not be considered an Intrarenal cause of acute renal failure?

    • A.

      Rhabdomyolosis

    • B.

      Aminoglycoside antibiotic use

    • C.

      Glomerulonephritis

    • D.

      Urinary tract infection

    Correct Answer
    D. Urinary tract infection
    Explanation
    A urinary tract infection (UTI) would not be considered an intrarenal cause of acute renal failure. Intrarenal causes refer to conditions that originate within the kidney itself, such as glomerulonephritis or rhabdomyolysis. UTIs primarily affect the urinary tract, including the bladder and urethra, and can potentially spread to the kidneys, causing a condition known as pyelonephritis. However, UTIs are not typically considered a direct intrarenal cause of acute renal failure.

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  • 42. 

    During which phase of acute intrarenal renal failure is the process able to corrected if prompt action is taken?

    • A.

      Initiation period

    • B.

      Maintenance period

    • C.

      Recovery period

    • D.

      All the above, acute renal failure is reversible

    Correct Answer
    A. Initiation period
    Explanation
    During the initiation period of acute intrarenal renal failure, the process is able to be corrected if prompt action is taken. This is because during this phase, the underlying cause of the renal failure can still be addressed and potentially resolved. Prompt intervention can help prevent further damage to the kidneys and allow for the restoration of normal kidney function. In contrast, the maintenance and recovery periods may involve more irreversible damage to the kidneys and may require supportive care rather than corrective measures.

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  • 43. 

    What are two most common causes of acute intrarenal renal failure in a healthy kidney? (two answers)

    • A.

      Severe infection

    • B.

      Nephrotoxic insult

    • C.

      Hypoperfusion

    • D.

      Parenchymal Disease

    Correct Answer(s)
    B. Nephrotoxic insult
    C. Hypoperfusion
    Explanation
    The two most common causes of acute intrarenal renal failure in a healthy kidney are nephrotoxic insult and hypoperfusion. Nephrotoxic insult refers to the damage caused to the kidney by exposure to certain drugs or toxins. Hypoperfusion, on the other hand, occurs when there is a decrease in blood flow to the kidneys, leading to inadequate oxygen and nutrient supply. Both of these factors can result in acute renal failure, where the kidney is unable to properly filter waste products from the blood.

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  • 44. 

    At which phase of acute intrarenal renal failure will loss of renal function and irreversible damage to kidneys occur?

    • A.

      Never, acute renal failure is always reversible

    • B.

      Recovery period

    • C.

      Initiation period

    • D.

      Maintenance period

    Correct Answer
    D. Maintenance period
    Explanation
    During the maintenance period of acute intrarenal renal failure, there is a sustained loss of renal function and irreversible damage to the kidneys. This phase occurs after the initiation period, where the initial insult to the kidneys takes place, and before the recovery period, where the kidneys start to regain their function. In the maintenance period, the damage to the kidneys worsens, leading to a decline in renal function that cannot be reversed. Therefore, this is the phase where irreversible damage occurs.

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  • 45. 

    What is the most common cause of acute renal failure?

    • A.

      Renal Ischemia

    • B.

      Intrinsic Renal Disease

    • C.

      Nephrotoxins

    • D.

      None of above

    Correct Answer
    A. Renal Ischemia
    Explanation
    Renal ischemia refers to a condition where there is a lack of blood flow to the kidneys, leading to acute renal failure. This can occur due to various reasons such as decreased blood volume, low blood pressure, or blockage in the blood vessels supplying the kidneys. When the kidneys do not receive enough oxygen and nutrients, they are unable to function properly, resulting in acute renal failure. Intrinsic renal disease and nephrotoxins can also cause acute renal failure, but renal ischemia is the most common cause.

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  • 46. 

    The risk for acute renal failure increases with age due to a decreased renal reserve.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    As individuals age, their kidneys may experience a decrease in renal reserve, which refers to the ability of the kidneys to maintain normal function even under stressful conditions. This decreased renal reserve can make older individuals more susceptible to acute renal failure, a condition where the kidneys suddenly lose their ability to filter waste from the blood. Therefore, the statement that the risk for acute renal failure increases with age due to a decreased renal reserve is true.

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  • 47. 

    When trying to prevent acute renal failure following a large surgical procedure it is most important to prevent which of the following?

    • A.

      Electrolyte imbalances

    • B.

      Sustained renal hypoperfusion

    • C.

      Exposure to nephrotoxins

    • D.

      Blockage of foley catheter

    Correct Answer
    B. Sustained renal hypoperfusion
    Explanation
    In order to prevent acute renal failure following a large surgical procedure, it is most important to prevent sustained renal hypoperfusion. This is because sustained renal hypoperfusion, which refers to inadequate blood flow to the kidneys, can lead to ischemia and damage to the renal tissue. Without adequate blood flow, the kidneys are unable to effectively filter waste products and maintain electrolyte balance, leading to renal failure. Therefore, preventing sustained renal hypoperfusion is crucial in preserving kidney function and preventing acute renal failure.

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  • 48. 

    You are the SRNA for Mr. Eobil who is having a spinal laminectomy and fusion today. He has a past history of HTN and DM. Two hours into the procedure you notice your urine output has dropped to 15 ml/hr for this 70 kg pt. What should be your first intervention?

    • A.

      Give a 20mg IV dose of lasix

    • B.

      Start a 2 mcg/kg/min dopamine drip

    • C.

      Give a fluid challenge

    • D.

      Watch the pt, if low output continues for another hour then consider intervention

    Correct Answer
    C. Give a fluid challenge
    Explanation
    The correct answer is to give a fluid challenge. A fluid challenge involves administering a bolus of intravenous fluids to assess the patient's response. In this case, the decreased urine output may indicate inadequate fluid volume, which can be addressed by giving a fluid challenge. This intervention will help determine if the low urine output is due to hypovolemia and if additional fluid resuscitation is needed. Monitoring the patient's response to the fluid challenge will guide further interventions if necessary.

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  • 49. 

    You are in the middle of a long case, and are the SRNA for Ms. Pompador. During the procedure her urine output dropped and you gave her a fluid challenge in an attempt to increase urine output. In spite or adequate hydration her urine output still has not picked up, what should be your next intervention?

    • A.

      Start dopamine drip at 5 mcg/kg/min

    • B.

      Give another fluid challenge

    • C.

      Watch the pt for now, see if urine output picks up later in case.

    • D.

      Give a dose of 20mg Lasix IV

    Correct Answer
    D. Give a dose of 20mg Lasix IV
    Explanation
    If the patient's urine output has not improved despite adequate hydration and a fluid challenge, the next intervention should be to give a dose of 20mg Lasix IV. Lasix, also known as furosemide, is a loop diuretic that can help increase urine output by promoting the excretion of excess fluid and sodium from the body. This intervention may help address the underlying cause of the decreased urine output and improve the patient's condition.

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  • 50. 

    During which phase of Chronic Renal failure is there a loss of nephron function without symptoms?

    • A.

      Decreased Renal reserve

    • B.

      Renal Insufficiency

    • C.

      End stage renal failure

    • D.

      Oliguric phase

    Correct Answer
    A. Decreased Renal reserve
    Explanation
    During the phase of Decreased Renal reserve in Chronic Renal failure, there is a loss of nephron function without any noticeable symptoms. This means that the kidneys are still able to function adequately despite some loss of nephron function. It is in this phase that the kidneys are still able to compensate for the loss of function by increasing their workload. However, as the disease progresses, symptoms may start to appear in the subsequent phases such as Renal Insufficiency, End stage renal failure, and Oliguric phase.

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