MN 551 Midterm Exam 1 – Structure and Function of the Kidney

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Science-forums.com A 77 year old female hospital patient has contracted Clostridium difficile during her stay and is experiencing severe diarrhea. Which of the following statements best conveys a ris... k that this woman faces? She is susceptible to isotonic fluid volume deficit. ---This woman is at risk of isotonic fluid volume deficit and sodium imbalances as a result of her diarrhea. She is not likely to develop fluid volume excess or third spacing as consequences of diarrhea. Which diuretic acts by inhibiting sodium chloride reabsorption in the thick ascending limb of the loop of Henle? (Points : 0.4) Bumetanide (Bumex) Mannitol (Osmitrol) Hydrochlorothiazide (Hydrodiuril) hydrochlorothiazide act on the distal convoluted tubule and inhibit the sodium-chloride symporter leading to a retention of water in the urine, as water normally follows penetrating solutes. Acetazolamide (Diamox) A 77 year old female with a diagnosis of copd is experiencing impaired gas exchange and CO2 retention, despite a rapid respiratory rate. Which of the following phenomena would her care team most realistically anticipate? Her kidneys will adapt with an increase in plasma HCO3- and her pH will decrease. Respiratory acidosis is accompanied by renal adaptation with a more marked increase in plasma HCO3- and a lesser decrease in pH. Her pH is likely below 7.35, and the likely renal response involves the reabsorption of HCO3- and secretion of H+. Excess CO2 production is not a common manifestation of obstructive lung disease. A 68 year old woman with a new onset a vascular dementia has recently begun retaining urine. Which of the following physiological phenomena would her care providers most realistically expect to be currently occurring as a result of her urinary retention? Hypertrophy of the bladder muscle and increased bladder wall thickness. Early accompaniments to urinary retention include hypertrophy of the bladder muscle and increased thickness of the bladder wall. Renal effects are unlikely, and decompensation and loss of contraction power are most often later rather than early effects. An 87 year old male resident has been consistenly continent of urine until the last several weeks. Which of the following action by the care providers at the facility is the most likely priority? Physical exam The priority in the treatment of incontinence in the elderly is an acknowledgement that it is not an inevitability and that the exact causes should and most often can be identified. This identification by way of history-taking and examination would supersede teaching about protective devices or exercis Question 2.2. At which of the following locations in the nephron would a nurse practitioner first expect blood to be largely free of plasma proteins? (Points : 0.4) Proximal convoluted tubule Bowman space Active filtration occurs when the whole blood enters via the afferent arteriole in to the glomerular capillaries, and the blood is then filtered into the Bowman space, removing plasma proteins. The filtrate that enters the proximal convoluted tubule and the loop of Henle is already free of plasma proteins Loop of Henle Afferent arteriole Question 3.3. A 14-year-old boy who appears to be intoxicated is brought to the emergency department by ambulance. The EMTs report that the boy has denied consuming anything out of the ordinary, but an open antifreeze container was found in the boy's room. Which of the following is likely to be used to treat the patient's symptoms? (Points : 0.4) Gastric lavage Syrup of ipecac Fomepizole - Ethylene glycol is found in products ranging from antifreeze and deicing solutions to carpet and fabric cleaners. It tastes sweet and is intoxicating—the factors that contribute to its abuse potential. A lethal dose is approximately 100 mL. It is rapidly absorbed from the intestine, making treatment with either gastric lavage or syrup of ipecac ineffective. Fomepizole, with specific indications for ethylene glycol poisoning, was recently approved by the U.S. Food and Drug Administration. Sodium bicarbonate Question 4.4. A 4-year-old boy who has been deaf since birth and has bilateral cataracts has been brought to the emergency department by his mother because she noticed blood in the toilet after he last voided. Urinalysis confirms heavy microscopic hematuria as well as proteinuria. What will the care team's initial differential diagnosis most likely be? (Points : 0.4) Alport syndrome-Heavy microscopic hematuria, proteinuria, and sensorineural deafness and eye disorders are characteristic of Alport syndrome. This symptomatology is less characteristic of systemic lupus erythematosus glomerulonephritis, Henoch-Schönlein purpura nephritis, or immunoglobulin A nephropathy. Systemic lupus erythematosus glomerulonephritis Henoch-Schonlein purpura nephritis Immunoglobulin A nephropathy Question 5.5. A patient is brought to the emergency department with complaints of shortness of breath. Assessment reveals a full, bounding pulse, severe edema, and audible crackles in the lower lung fields bilaterally. What is the patient's most likely diagnosis? (Points : 0.4) Hyponatremia Fluid volume excess - Peripheral and pulmonary edema as well as a bounding pulse and dyspnea are indicators of fluid volume overload. Hypocalcemia Hyperkalemia [Show More]

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