Renal Pathophysiology: Causes, Symptoms, and Treatment

Question 1

Which of the following is a primary function of the proximal tubule in the kidney's nephrons?

Accepted Answer

Reabsorbing glucose, amino acids, and other essential nutrients

Answer

Filtering waste products and toxins from the blood

Answer

Secreting hydrogen ions to regulate blood pH

Answer

Concentrating urine to conserve water

Question 2

What is the main function of the proximal convoluted tubule (PCT) in the kidney?

Accepted Answer

Reabsorbs water and electrolytes

Answer

Secretes hydrogen ions

Answer

Filters waste products

Answer

Concentrates urine

Question 3

What is the main function of the loop of Henle in the nephron?

Accepted Answer

Create a concentration gradient in the renal medulla

Answer

Filter waste products from the blood

Answer

Reabsorb glucose from the filtrate

Answer

Secrete hydrogen ions into the filtrate

Question 4

In acute renal failure, which lab findings align with the disease's pathophysiology?

Accepted Answer

Elevated blood urea and creatinine

Accepted Answer

Decreased urine output (oliguria)

Answer

Normal glomerular filtration rate (GFR)

Answer

Elevated white blood cell (WBC) count

Question 5

Which of the following is NOT a primary function of the kidneys?

Accepted Answer

Producing insulin to regulate blood sugar levels

Answer

Filtering waste products from the blood

Answer

Producing urine to eliminate waste

Answer

Regulating blood pressure through fluid and electrolyte balance

Question 6

In glomerular filtration, which process is primarily responsible for the majority of filtrate clearance in the kidney?

Accepted Answer

Capillary ultrafiltration

Answer

Active transport

Answer

Osmosis

Answer

Diffusion

Question 7

Which of the following is NOT a primary function of the kidneys?

Accepted Answer

Production of hormones

Answer

Excretion of waste products from the blood

Answer

Regulation of blood pH

Answer

Regulation of fluid and electrolyte balance

Question 8

What mechanism accounts for most fluid reabsorption in the kidney's proximal tubule?

Accepted Answer

Active transport of sodium ions

Answer

Passive diffusion of water

Answer

Facilitated diffusion of glucose

Answer

Pinocytosis

Question 9

What is the primary function of the juxtaglomerular apparatus (JGA) in regulating blood pressure?

Accepted Answer

Releases renin

Answer

Filters waste

Answer

Produces hormones

Answer

Reabsorbs water

Question 10

Which of the following is NOT a primary function of the kidneys in maintaining homeostasis?

Accepted Answer

Maintaining glucose homeostasis

Answer

Regulating fluid balance and electrolyte concentrations

Answer

Excreting waste products from the bloodstream

Answer

Controlling blood pressure

Question 11

In the process of urine formation, which function is primarily performed by the kidney tubules?

Accepted Answer

Adjusting the volume and composition of urine to maintain homeostasis

Answer

Filtering waste products and toxins from the blood

Answer

Maintaining blood pH within a narrow range

Answer

Producing hormones that regulate blood pressure and electrolytes

Question 12

Which hormone is NOT directly involved in blood pressure regulation by the kidneys?

Accepted Answer

Antidiuretic hormone (ADH)

Answer

Renin

Answer

Angiotensin II

Question 13

Which of the following is a primary function of the kidneys in regulating fluid and electrolyte balance?

Accepted Answer

Reabsorbing water and electrolytes from the filtrate

Answer

Filtering waste products from the blood

Answer

Secreting hormones to regulate blood pressure

Answer

Producing red blood cells

Question 14

Beyond eliminating waste, what is another crucial function of the kidneys?

Accepted Answer

Blood pressure regulation

Answer

Insulin production

Answer

Digestive enzyme production

Answer

Infection defense

Question 15

What is the primary function of the kidneys?

Accepted Answer

Filter blood and remove waste

Answer

Produce hormones for calcium regulation

Answer

Store and release urine

Answer

Control blood pressure by regulating fluids

Question 16

What is the main function of the kidneys?

Accepted Answer

To filter blood and remove waste products and excess fluid

Answer

To produce red blood cells

Answer

To regulate body temperature

Answer

To store urine

Question 17

Which of the following processes is NOT a primary function of the kidneys?

Accepted Answer

Producing digestive enzymes

Answer

Eliminating waste products from the body

Answer

Regulating blood pressure

Question 18

In acute renal failure, which condition is most frequently observed?

Accepted Answer

Pre-renal azotemia

Answer

Intrinsic renal disease

Answer

Post-renal obstruction

Answer

Nephrotic syndrome

Question 19

Which mechanism is NOT directly involved in regulating renal blood flow?

Accepted Answer

Renin-angiotensin-aldosterone system

Answer

Autoregulation

Answer

Sympathetic nervous system

Answer

Tubuloglomerular feedback

Question 20

Which of the following functions is NOT performed by the proximal tubule of the nephron?

Accepted Answer

Secretion of hydrogen ions

Answer

Reabsorption of glucose

Answer

Reabsorption of sodium and chloride

Question 21

A patient with acute renal failure is admitted to the hospital. Which lab finding is a priority nursing concern?

Accepted Answer

Hyperkalemia

Answer

Hyponatremia

Answer

Hypocalcemia

Answer

Hyperphosphatemia

Question 22

How do the kidneys primarily regulate electrolyte levels in the body?

Accepted Answer

Tubular reabsorption and secretion

Answer

Glomerular filtration

Answer

Hormonal regulation

Answer

Sympathetic nervous system activation

Question 23

Which laboratory test is primarily used to estimate glomerular filtration rate (GFR) in assessing renal function?

Accepted Answer

Creatinine clearance

Answer

Cystatin C

Answer

Blood urea nitrogen (BUN)

Answer

Urinary protein excretion

Question 24

Which component is NOT part of the renal corpuscle?

Accepted Answer

Proximal convoluted tubule

Answer

Glomerulus

Answer

Bowman's capsule

Question 25

Which mechanism in the proximal tubule is responsible for actively transporting sodium ions from the tubular lumen into the bloodstream?

Accepted Answer

Sodium-potassium ATPase pump

Answer

Passive diffusion

Answer

Facilitated diffusion with a carrier protein

Question 26

Which mechanism is primarily responsible for the formation of filtrate in the kidneys?

Accepted Answer

Glomerular filtration

Answer

Simple diffusion

Answer

Active secretion

Answer

Tubular reabsorption

Question 27

A patient with uncontrolled hypertension has swelling throughout their body, foamy urine, and low blood albumin. What is the most likely diagnosis?

Accepted Answer

Nephrotic syndrome

Answer

Acute kidney injury

Answer

Chronic kidney disease

Answer

Pyelonephritis

Question 28

Which laboratory test is primarily used to estimate glomerular filtration rate (GFR) during a clinical assessment of renal function?

Accepted Answer

Creatinine clearance test

Answer

Blood urea nitrogen (BUN) alone

Answer

Urine specific gravity alone

Question 29

Which laboratory test is primarily used to assess the kidneys' ability to concentrate urine?

Accepted Answer

Urine specific gravity

Answer

Serum creatinine

Answer

Glomerular filtration rate (GFR)

Answer

Blood urea nitrogen (BUN)

Question 30

What is a defining clinical manifestation of nephrotic syndrome?

Accepted Answer

Proteinuria

Answer

Hematuria

Answer

Leukocyturia

Answer

Oliguria

Question 31

Which bacterial species is the primary cause of pyelonephritis, an infection of the kidneys?

Accepted Answer

Escherichia coli

Answer

Streptococcus pneumoniae

Answer

Staphylococcus aureus

Answer

Pseudomonas aeruginosa

Question 32

Which of the following is a primary concern among the potential complications of renal transplantation?

Accepted Answer

Rejection of the transplanted kidney

Answer

Urinary tract infection

Answer

Rapid weight gain

Question 33

Which clinical manifestation is commonly associated with renal calculi?

Accepted Answer

Flank pain radiating to the groin

Answer

Frequent urination and burning sensation during urination

Answer

Blood and protein in the urine

Question 34

Which immunosuppressant drug is commonly used to prevent rejection after a kidney transplant?

Accepted Answer

Tacrolimus

Answer

Metformin

Answer

Ibuprofen

Answer

Vancomycin

Question 35

What is the primary function of the kidneys in regulating fluid and electrolyte balance?

Accepted Answer

Regulating the concentration of sodium and potassium in the blood

Answer

Filtering waste products from the blood

Answer

Producing red blood cells

Answer

Storing glucose for energy

Question 36

Which electrolyte imbalances may arise during hemodialysis, and what interventions can be taken to prevent or address them?

Accepted Answer

Hypokalemia; Administer potassium supplements or increase dietary potassium intake.

Accepted Answer

Metabolic acidosis; Administer sodium bicarbonate or acetate.

Answer

Hypernatremia; Restrict fluid intake.

Question 37

In chronic kidney disease, what happens to erythropoietin production?

Accepted Answer

Decreases

Answer

Increases

Question 38

Explain the pathophysiology of ischemic acute kidney injury (AKI), including the mechanisms of renal ischemia, tubular damage, and potential complications.

Accepted Answer

Renal ischemia causes reduced production of nitric oxide (NO) and prostacyclins, leading to vasoconstriction and decreased renal blood flow.

Accepted Answer

Tubular damage in ischemic AKI is mainly caused by the release of inflammatory cytokines and reactive oxygen species.

Accepted Answer

Potential complications of ischemic AKI include electrolyte imbalances and metabolic acidosis.

Answer

Ischemic AKI primarily affects the tubules, causing decreased glomerular filtration rate (GFR).

Question 39

How does an angiotensin-converting enzyme (ACE) inhibitor primarily exert its antihypertensive effect?

Accepted Answer

Vasodilation by reducing angiotensin II levels

Answer

Natriuresis by inhibiting aldosterone secretion

Answer

Reduction of sympathetic tone by decreasing norepinephrine release

Answer

Blockade of calcium channels in the vascular smooth muscle

Question 40

Which among the following is **NOT** a common clinical presentation of hyperkalemia?

Accepted Answer

Oliguria

Answer

Muscle weakness

Answer

Cardiac arrhythmias

Answer

Nausea and vomiting

Question 41

Which of the following describes the technique used in continuous ambulatory peritoneal dialysis (CAPD)?

Accepted Answer

Continuous infusion and drainage of dialysate into the peritoneal cavity

Answer

Use of the patient's blood vessels for filtration

Answer

Exclusively used for end-stage renal disease patients

Answer

Requires constant monitoring in a hospital setting

Question 42

Which factor does NOT contribute to the development and progression of diabetic nephropathy?

Accepted Answer

Nephrotic syndrome

Answer

Hyperglycemia

Answer

Oxidative stress

Answer

Inflammation

Question 43

Which ethical principle prioritizes maximizing societal benefit in deceased donor kidney allocation?

Accepted Answer

Utility

Answer

Justice

Answer

Equity

Answer

Beneficence

Question 44

Which type of urinary tract infection is caused by bacteria ascending from the urethra and typically affects the bladder?

Accepted Answer

Cystitis

Answer

Pyelonephritis

Answer

Urethritis

Answer

Nephritis

Question 45

What is the most common clinical manifestation of acute glomerulonephritis?

Accepted Answer

Hematuria, or the presence of blood in the urine

Answer

Edema, particularly in the face and lower extremities

Answer

Proteinuria, or the presence of excess protein in the urine

Answer

Oliguria, or decreased urine output

Question 46

What is the primary function of the renin-angiotensin-aldosterone system in regulating blood pressure?

Accepted Answer

Maintain blood pressure by constricting blood vessels and promoting sodium and water reabsorption

Answer

Regulate sodium balance by increasing sodium excretion in the kidneys

Answer

Promote erythropoiesis by stimulating the production of red blood cells

Answer

Enhance renal blood flow by dilating renal blood vessels

Question 47

Which laboratory finding is a key indicator of acute tubular necrosis?

Accepted Answer

Elevated serum creatinine levels

Answer

Decreased urine output

Answer

Presence of red blood cells in the urine (hematuria)

Answer

Presence of white blood cells in the urine (pyuria)

Question 48

Which of the following is a characteristic symptom experienced by patients with urinary tract infection (UTI)?

Accepted Answer

Dysuria

Answer

Hematuria

Answer

Oliguria

Answer

Nausea

Question 49

The process by which the kidneys help regulate blood pH is referred to as:

Accepted Answer

Secretion

Answer

Reabsorption

Answer

Excretion

Answer

Filtration

Question 50

The primary nursing intervention for a patient with acute renal failure is to:

Accepted Answer

Monitor fluid balance closely

Answer

Administer antibiotics

Answer

Provide pain relief

Answer

Insert a Foley catheter

Question 51

Identify the primary mechanism responsible for acute kidney injury (AKI) in patients with sepsis.

Accepted Answer

Ischemia

Answer

Glomerulonephritis

Answer

Tubular necrosis

Answer

Pyelonephritis

Question 52

The glomerular filtration rate (GFR) is a measurement of which physiological parameter?

Accepted Answer

Volume of blood filtered by the kidneys per minute

Answer

Volume of urine produced per minute

Answer

Concentration of creatinine in the blood

Answer

Number of functional nephrons

Question 53

Identify the most prevalent type of urinary tract infection (UTI).

Accepted Answer

Cystitis

Answer

Pyelonephritis

Answer

Urethritis

Answer

Prostatitis

Question 54

What is the primary function of the proximal tubules in the kidneys?

Accepted Answer

Reabsorption of glucose and amino acids

Answer

Secretion of hydrogen ions

Answer

Production of urine

Answer

Filtration of blood

Question 55

Identify the hormone that stimulates the kidneys to conserve water.

Accepted Answer

Antidiuretic hormone (ADH)

Answer

Aldosterone

Answer

Parathyroid hormone (PTH)

Answer

Calcitonin

Question 56

In ethical animal research for renal pathophysiology, which factor is of paramount importance?

Accepted Answer

Animal Welfare

Answer

Cost-Effectiveness

Answer

Translatability of Findings

Answer

Researcher's Convenience

Question 57

Acute interstitial nephritis (AIN) is characterized by inflammation of the renal interstitium. Describe its key features, including the primary cause, mechanism of tubular damage, clinical manifestations, and potential complications.

Accepted Answer

AIN primarily results from drug hypersensitivity reactions, leading to immune complex deposition and subsequent tubular damage.

Answer

AIN predominantly affects the glomeruli, causing inflammation and impaired filtration.

Answer

Tubular damage in AIN is solely attributed to direct toxic effects of drugs or toxins on tubular cells.

Answer

AIN often presents with subtle symptoms and rarely leads to severe complications.

Question 58

Which nursing intervention is crucial for preventing the recurrence of kidney stones?

Accepted Answer

Encouraging sufficient fluid intake

Answer

Administering pain medication

Answer

Restricting dietary calcium

Answer

Prescribing antibiotics

Question 59

In chronic kidney disease, how does inflammation contribute to fibrosis, and what is the overall effect on the kidneys?

Accepted Answer

Inflammation causes fibrosis, leading to scarring and reduced kidney function.

Answer

Fibrosis is the main cause of inflammation in chronic kidney disease.

Answer

Inflammation and fibrosis are separate processes that don't affect each other.

Question 60

Discuss the ethical considerations involved in allocating deceased donor kidneys, with particular emphasis on the principles of justice, equity, and utility.

Accepted Answer

The principles of justice, equity, and utility should be carefully balanced and considered together in kidney allocation decisions.

Answer

Kidney allocation should be based solely on the principles of justice, equity, and utility.

Answer

Equity should be the predominant factor in kidney allocation, ensuring that all patients have an equal opportunity to receive a kidney.

Answer

Utility, or maximizing the overall benefit to society, should be the primary consideration in kidney allocation.

Question 61

Which molecular mechanisms play a primary role in the development of diabetic nephropathy?

Accepted Answer

Increased formation of AGEs, activation of PKC, and oxidative stress

Answer

Activation of the RAAS

Answer

Increased production of inflammatory cytokines

Answer

Impaired sodium reabsorption in the proximal tubule

Question 62

Which of the following consequences is most likely to occur with a significantly decreased glomerular filtration rate (GFR)?

Accepted Answer

Retention of waste products in the blood

Answer

Excessive loss of potassium in the urine

Answer

Increased levels of calcium in the blood

Answer

Elevated blood pressure

Question 63

Which of the following is a modifiable risk factor for developing chronic kidney disease?

Accepted Answer

Smoking

Answer

Hereditary factors

Answer

Advanced age

Answer

Race

Question 64

Which of the following is a common symptom of urinary tract infection in men, but not typically seen in women?

Accepted Answer

Discharge from the urethra

Answer

Burning sensation during urination

Answer

Increased frequency of urination

Answer

Lower abdominal pain