Chapter 20: Kidney Disorders and Therapeutic Management

Chapter 20: Kidney Disorders and Therapeutic Management

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. An elderly patient is in a motor vehicle accident and sustains a significant internal hemorrhage. Which category of renal failure is the patient at the greatest risk of developing?

ANS:  C

Any condition that decreases blood flow, blood pressure, or kidney perfusion before arterial blood reaches the renal artery that supplies the kidney may be anatomically described as prerenal acute kidney injury (AKI). When arterial hypoperfusion caused by low cardiac output, hemorrhage, vasodilation, thrombosis, or other cause reduces the blood flow to the kidney, glomerular filtration decreases, and consequently urine output decreases. Any condition that produces an ischemic or toxic insult directly at parenchymal nephron tissue places the patient at risk for development of intrarenal AKI. Any obstruction that hinders the flow of urine from beyond the kidney through the remainder of the urinary tract may lead to postrenal AKI. When the internal filtering structures are pathologically affected, the condition was previously known as acute tubular necrosis.

2. Which of the following laboratory values is the most help in evaluating a patient for acute renal failure?

ANS:  B

Serum creatinine is the most reliable predictor of kidney function. In the acutely ill patient, small changes in the serum creatinine level and urine output may signal important declines in the glomerular filtration rate and kidney function.

3. Which of the following IV solutions is recommended for treatment of prerenal failure?

ANS:  B

Prerenal failure is caused by decreased perfusion and flow to the kidney. It is often associated with trauma, hemorrhage, hypotension, and major fluid losses. If contrast dye is used, aggressive fluid resuscitation with normal saline (NaCl) is recommended.

4. One therapeutic measure for treating hyperkalemia is the administration of dextrose and regular insulin. How do these agents lower potassium?

ANS:  D

Acute hyperkalemia can be treated temporarily by intravenous administration of insulin and glucose. An infusion of 50 mL of 50% dextrose accompanied by 10 units of regular insulin forces potassium out of the serum and into the cells.

5. Which of the following IV solutions is contraindicated for patients with kidney or liver disease or in lactic acidosis?

ANS:  C

Lactated Ringer solution is contraindicated for patients with kidney or liver diseases or in lactic acidosis.