NATIONAL AND STATE NURSING EXAM- MCQ _MG_0095
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1. The inflammation of the renal pelvis, tubules and interstitium is known as:
a. Raynaud’s disease
b. Wilson disease
c. Pyelonephritis
d. Cystitis
Answer: c. Pyelonephritis
Description:Pyelonephritis is an inflammation of the renal pelvis, tubules, and interstitium. It is a type of kidney infection that can be caused by bacteria, viruses, or fungi. Raynaud's disease is a condition that causes the fingers and toes to turn white, blue, and red in response to cold or stress. Wilson disease is a genetic disorder that causes copper to build up in the body, leading to damage to the liver, brain, and other organs. Cystitis is an inflammation of the bladder. Pyelonephritis is a serious condition that can lead to kidney failure if not treated. Symptoms of pyelonephritis include fever, chills, flank pain, nausea, vomiting, and cloudy or bloody urine. Treatment for pyelonephritis usually includes antibiotics and fluids. In some cases, hospitalization may be necessary.
2. All of the following are the major clinical features of the patient with pyelonephritis; EXCEPT:
a. Dysuria
b. Hematuria and urgency
c. Periumbilical pain
d. Flank pain
Answer: c. Periumbilical pain
Description:The major clinical features of a patient with pyelonephritis typically include dysuria (painful or difficult urination), hematuria (blood in the urine) and urgency, and flank pain (pain in the lower back or side of the abdomen). However, periumbilical pain (pain around the belly button) is not a characteristic symptom of pyelonephritis.
3. Risk/causative factor for nephrotic syndrome is:
a. Amyloidosis
b. Diabetes mellitus
c. Glomerulonephritis
d. All of these
Answer: d. All of these
Description:Nephrotic syndrome is a group of symptoms that occur when the kidneys leak large amounts of protein into the urine. This can lead to a number of health problems, including high blood pressure, low blood protein levels, and edema. There are many different causes of nephrotic syndrome, including: Amyloidosis Diabetes mellitus Glomerulonephritis Infections Medications Systemic diseases, such as lupus erythematosus and HIV/AIDS Some people are more likely to develop nephrotic syndrome than others. These include people with a family history of the condition, people with certain genetic disorders, and people who are overweight or obese. There is no cure for nephrotic syndrome, but it can be treated with medications that help to reduce protein loss in the urine. Treatment also includes managing the underlying cause of the condition.
4. Triad of symptoms in nephrotic syndrome include all; EXCEPT:
a. Proteinuria
b. Hypoalbuminemia
c. Edema
d. Weight loss
Answer: d. Weight loss
Description:Nephrotic syndrome is defined by a triad of clinical features: oedema, substantial proteinuria (>3.5 g/24 hours) and hypoalbuminemia (<30 g/L). it is often associated with hyperlipidemia, thromboembolism and an increased risk of infection. Weight gain occurs due to fluid retention.
5. Causes of nephrotic syndrome include:
a. Diabetes mellitus
b. Idiopathic
c. SLE
d. All of these
Answer: d. All of these
Description:The causes of nephrotic syndrome can include all of the options listed. Nephrotic syndrome is a condition characterized by increased permeability of the glomerular filtration barrier, leading to significant proteinuria (excessive protein in the urine), hypoalbuminemia (low levels of albumin in the blood), edema (swelling), and hyperlipidemia (elevated levels of lipids in the blood). Diabetes mellitus is a common cause of nephrotic syndrome, particularly diabetic nephropathy, which is kidney damage resulting from long-standing diabetes. Idiopathic nephrotic syndrome refers to cases where the underlying cause is unknown. Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple organs, including the kidneys, and is a known cause of nephrotic syndrome.
6. Reason behind edema in nephrotic syndrome:
a. Proteinuria
b. Hypoalbuminemia
c. Hyperlipidemia
d. Hematuria
Answer: b. Hypoalbuminemia
Description:Nephrotic syndrome is a group of symptoms that occur when the kidneys leak large amounts of protein into the urine. This can lead to a number of health problems, including high blood pressure, low blood protein levels, and edema. Edema is the accumulation of fluid in the tissues. It is caused by a decrease in the amount of protein in the blood, which is called hypoalbuminemia. Albumin is a protein that helps to keep fluid in the blood vessels. When albumin levels are low, fluid leaks out of the blood vessels and into the tissues. This is why people with nephrotic syndrome often have edema, especially in their feet and ankles. The other options are not correct. Proteinuria is the presence of protein in the urine, but it does not directly cause edema. Hyperlipidemia is high levels of fat in the blood, and hematuria is the presence of blood in the urine. These conditions are not directly related to edema in nephrotic syndrome.
7. In nephrotic syndrome edema first appear:
a. Around the eyes
b. Lower leg
c. Abdomen
d. All over the body
Answer: a. Around the eyes
Description:In nephrotic syndrome, edema typically first appears around the eyes. This is known as periorbital edema or "puffy eyes." It may then progress to involve other parts of the body, such as the lower legs (pedal edema), abdomen (ascites), and eventually affect the entire body (generalized edema). However, the initial presentation of edema in nephrotic syndrome commonly starts around the eyes.
8. Priority nursing intervention for edema in a client with nephrotic syndrome is:
a. Provide meticulous skin care
b. Maintain intake output
c. Administer diuretics
d. Administer corticosteroids
Answer: a. Provide meticulous skin care
Description:Edema is the accumulation of fluid in the tissues. In nephrotic syndrome, this is caused by a decrease in the amount of protein in the blood, which is called hypoalbuminemia. Albumin is a protein that helps to keep fluid in the blood vessels. When albumin levels are low, fluid leaks out of the blood vessels and into the tissues. This can lead to swelling, especially in the feet and ankles. Swelling can put pressure on the skin, which can lead to skin breakdown. This is why it is important to provide meticulous skin care to people with nephrotic syndrome. The other options are also important, but they are not as important as providing meticulous skin care. Maintaining intake and output is important to prevent dehydration, and administering diuretics and corticosteroids can help to reduce edema. However, these interventions do not directly address the risk of skin breakdown. Here are some tips for providing meticulous skin care to people with nephrotic syndrome: Wash the skin with mild soap and water. Apply a moisturizer to the skin. Keep the skin dry. Avoid scratching the skin. Monitor the skin for any signs of breakdown. If you are caring for someone with nephrotic syndrome, it is important to talk to their doctor about how to provide meticulous skin care. They can help you develop a skin care plan that is right for the individual.
9. Prolonged steroid therapy to treat nephrotic syndrome can leads to:
a. Cushingoid appearance
b. Hypoaldosteronism
c. Cryptorchidism
d. Oliguria
Answer: a. Cushingoid appearance
Description:Prolonged steroid therapy to treat nephrotic syndrome can lead to a Cushingoid appearance. This refers to the development of certain physical characteristics resembling those seen in Cushing's syndrome, which is an excess of cortisol in the body. These features may include weight gain, especially in the face (moon face) and upper back (buffalo hump), thinning of the skin, easy bruising, and stretch marks. It's important to note that the other options listed (hypoaldosteronism, cryptorchidism, and oliguria) are not directly associated with prolonged steroid therapy in nephrotic syndrome.
10. Which of the following characteristic defines nephritic syndrome?
a. Fatty casts in urine
b. Polyuria and hypotension
c. Proteinuria (<3.5 g/dL) and Hematuria
d. RBC casts in urine with a decreased BUN and creatinine
Answer: c. Proteinuria (<3.5 g/dL) and Hematuria
Description:The characteristic that defines nephritic syndrome is proteinuria (<3.5 g/dL) and hematuria. Nephritic syndrome is characterized by inflammation of the glomeruli, which leads to damage and dysfunction of the kidney's filtration system. This results in the presence of red blood cells (hematuria) and protein (proteinuria) in the urine. It is important to note that the other options listed (fatty casts in urine, polyuria and hypotension, RBC casts in urine with decreased BUN and creatinine) are not specific to nephritic syndrome and may be associated with other kidney conditions.
11. Lipid casts are seen in:
a. Cytomegalic inclusion disease
b. Acute tubular necrosis
c. Nephrotic syndrome
d. None of the above
Answer: c. Nephrotic syndrome
Description:Lipid casts are seen in nephrotic syndrome. They are formed when the kidneys leak large amounts of protein into the urine, including lipoproteins. These lipoproteins can then precipitate in the tubules of the kidneys, forming casts. Lipid casts are not seen in acute tubular necrosis or cytomegalovirus infection. Here are some other findings that can be seen in nephrotic syndrome: Proteinuria Hypoalbuminemia Edema Hyperlipidemia Hypertension Hematuria If you are experiencing any of these symptoms, it is important to see a doctor right away. Nephrotic syndrome can be a serious condition, but it can usually be treated effectively.
12. The cause of edema in Nephritic syndrome is:
a. Decreased in plasma protein concentration
b. Reduced plasma osmotic pressure
c. Increased in plasma protein concentration
d. Sodium and water retention
Answer: d. Sodium and water retention
Description:The heavy proteinuria depletes serum albumin levels in patient with nephrotic syndrome. This result in generalized edema as a consequence of ↓ed colloid osmotic pressure. Sodium and water retention is also seen which aggravates the edema However, in Nephritic syndrome damage to glomeruli causes a fall in GFR and eventually produces uremic symptoms with salt and water retention, leading to edema and hypertension
13. Proteinuria is seen is:
a. Nephrotic syndrome
b. Nephritic syndrome
c. Multiple myeloma
d. All of these
Answer: d. All of these
Description:Proteinuria can be seen in all of the conditions mentioned: nephrotic syndrome, nephritic syndrome, and multiple myeloma. In nephrotic syndrome, there is significant protein loss in the urine, typically exceeding 3.5 grams per day. This occurs due to increased permeability of the glomerular filtration barrier, leading to the leakage of proteins into the urine. In nephritic syndrome, proteinuria is also present but is usually less severe compared to nephrotic syndrome. Hematuria (presence of blood in the urine) is another characteristic feature of nephritic syndrome. In multiple myeloma, a type of blood cancer that affects plasma cells, the abnormal plasma cells produce excessive amounts of monoclonal immunoglobulins (M-proteins). These abnormal proteins can be detected in the urine, resulting in proteinuria.
14. The most important cause of kidney failure is:
a. Accidents
b. Nephritic syndrome
c. Multiple myeloma
d. All of these
Answer: b. Nephritic syndrome
Description:Kidney failure is a serious condition that occurs when the kidneys are no longer able to function properly. This can lead to a buildup of toxins in the blood, which can be life-threatening. There are many different causes of kidney failure, but the most common is nephritic syndrome. Nephritic syndrome is a group of symptoms that occur when the kidneys leak large amounts of protein into the urine. This can lead to a number of health problems, including high blood pressure, low blood protein levels, and edema. Other important causes of kidney failure include: Diabetes mellitus Hypertension Glomerulonephritis Polycystic kidney disease Autoimmune diseases, such as lupus erythematosus and rheumatoid arthritis Medications, such as sulfa drugs and nonsteroidal anti-inflammatory drugs (NSAIDs) Infections, such as pyelonephritis Trauma If you are experiencing any of the symptoms of kidney failure, it is important to see a doctor right away. Kidney failure can be a serious condition, but it can usually be treated effectively. Accidents, multiple myeloma, and other conditions can also cause kidney failure, but they are not as common as nephritic syndrome.
15. When the kidneys fail, the body fills with extra fluid and waste products. This condition is called:
a. Uremia
b. Hypertension
c. Anemia
d. Diabetes
Answer: a. Uremia
Description:When the kidneys fail and are unable to effectively filter waste products and excess fluid from the body, the condition is called uremia. Uremia occurs as a result of the buildup of waste products like urea and creatinine in the bloodstream. It can lead to various symptoms and complications, including fluid retention, electrolyte imbalances, fatigue, nausea, vomiting, loss of appetite, altered mental status, and other systemic manifestations. Hypertension (high blood pressure), anemia (low red blood cell count), and diabetes (a metabolic disorder characterized by high blood sugar levels) can be associated with kidney disease or may contribute to its development, but they do not specifically describe the condition of the body filling with extra fluid and waste products, which is characteristic of uremia.
16. Risk factors associated with renal disorder
a. High sodium diet
b. Hypertension
c. Diabetes mellites
d. All of these
Answer: d. All of these
Description:Here are some of the risk factors associated with renal disorders: High sodium diet: A high-sodium diet can cause fluid retention, which can put stress on the kidneys. Hypertension: High blood pressure can damage the kidneys over time. Diabetes mellitus: Diabetes can damage the kidneys by causing blood sugar levels to rise too high. Family history: If you have a family history of kidney disease, you are more likely to develop the condition yourself. Age: Kidney function declines with age, so older adults are at an increased risk of developing kidney disease. Certain medications: Some medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can damage the kidneys. Certain medical conditions: Some medical conditions, such as lupus and HIV/AIDS, can increase the risk of developing kidney disease. If you have any of these risk factors, it is important to talk to your doctor about how to protect your kidneys. They can help you make lifestyle changes and/or prescribe medications to help reduce your risk of developing kidney disease. Here are some tips to help reduce your risk of developing renal disorders: Eat a healthy diet: A healthy diet is low in sodium and high in fruits, vegetables, and whole grains. Maintain a healthy weight: Being overweight or obese can increase your risk of developing kidney disease. Exercise regularly: Exercise helps to keep your blood pressure and blood sugar levels in check, which can help protect your kidneys. Avoid smoking: Smoking can damage the kidneys. Manage your blood pressure: If you have high blood pressure, it is important to manage it with medication and lifestyle changes. Manage your blood sugar: If you have diabetes, it is important to manage your blood sugar with medication and lifestyle changes. Get regular checkups: It is important to get regular checkups with your doctor so they can monitor your kidney function.
17. Acute renal failure is defined as:
a. 15% or greater increase in serum creatine above baseline
b. 20% or greater increase in serum creatine above baseline
c. 30% or greater increase in serum creatine above baseline
d. 50% or greater increase in serum creatine above baseline
Answer: d. 50% or greater increase in serum creatine above baseline
Description:Acute renal failure is defined as a 50% or greater increase in serum creatinine above baseline. Serum creatinine is a commonly used marker to assess kidney function, as it reflects the waste product that the kidneys filter out of the bloodstream. An abrupt and significant increase in serum creatinine indicates a decline in kidney function, which characterizes acute renal failure. The other options mentioned (a 15% or greater increase, a 20% or greater increase, and a 30% or greater increase) are not the thresholds typically used to define acute renal failure.
18. Parameter helpful to assess the renal failure as early as possible:
a. BUN
b. Urine output
c. Creatinine clearance
d. GFR
Answer: c. Creatinine clearance
Description:Creatinine clearance is a measure of how well the kidneys are able to remove creatinine from the blood. Creatinine is a waste product that is produced by muscles. When the kidneys are not functioning properly, creatinine levels in the blood can rise. BUN, or blood urea nitrogen, is another marker of kidney function. However, BUN can be affected by other factors, such as diet and hydration status. Creatinine clearance is a more specific marker of kidney function and is therefore more helpful in assessing renal failure. Urine output is also a helpful measure of kidney function. However, urine output can be affected by factors other than kidney function, such as dehydration. GFR, or glomerular filtration rate, is the gold standard measure of kidney function. However, GFR is not always available and can be difficult to measure. In conclusion, creatinine clearance is the most helpful parameter to assess renal failure as early as possible.
19. In chronic renal failure all the following are noticed; EXCEPT:
a. Anemia
b. Hypocalcemia
c. Metabolic acidosis
d. Hypokalemia
Answer: d. Hypokalemia
Description:In chronic renal failure, all of the following are commonly noticed except for hypokalemia (low potassium levels). Chronic renal failure is a progressive and irreversible decline in kidney function over a period of time. It can lead to various complications and disturbances in the body. The most common abnormalities observed in chronic renal failure include: a. Anemia: Chronic renal failure can cause a decrease in the production of erythropoietin, a hormone involved in red blood cell production, leading to anemia. b. Hypocalcemia: Chronic renal failure can disrupt the balance of calcium and phosphorus in the body, resulting in low calcium levels (hypocalcemia). c. Metabolic acidosis: As kidney function declines, the kidneys may have difficulty regulating acid-base balance, leading to the accumulation of acid in the blood and metabolic acidosis. d. Hypokalemia: Hypokalemia (low potassium levels) is not typically associated with chronic renal failure. In fact, renal failure can often lead to hyperkalemia (high potassium levels) due to impaired potassium excretion by the kidneys.
20. Acute renal failure results in:
a. Hypokalemia acidosis
b. Hyperkalemia alkalosis
c. Hyperkalemic acidosis
d. Hypokalemic acidosis
Answer: c. Hyperkalemic acidosis
Description:Acute renal failure is a sudden loss of kidney function. This can lead to a buildup of toxins in the blood, which can cause acidosis. Acidosis is a condition in which the blood pH is too low. This can lead to a number of health problems, including muscle weakness, confusion, and seizures. Hyperkalemia is a condition in which the potassium levels in the blood are too high. This can also be a complication of acute renal failure. Hyperkalemia can lead to a number of health problems, including heart arrhythmias and cardiac arrest. In acute renal failure, the kidneys are not able to remove potassium from the blood. This can lead to hyperkalemia. Hyperkalemia can also be caused by other factors, such as medications and kidney damage. Acidosis can be caused by a number of factors, including acute renal failure, diabetic ketoacidosis, and lactic acidosis. Acidosis can lead to a number of health problems, including muscle weakness, confusion, and seizures. In acute renal failure, the kidneys are not able to remove acids from the blood. This can lead to acidosis. Acidosis can also be caused by other factors, such as medications and kidney damage. The combination of hyperkalemia and acidosis is called hyperkalemic acidosis. This is a serious condition that can be life-threatening. If you are experiencing any of the symptoms of acute renal failure, it is important to see a doctor right away. Acute renal failure can be a serious condition, but it can usually be treated effectively.
21. CRF is associated with?
a. Respiratory acidosis
b. Metabolic alkalosis
c. Metabolic acidosis
d. Respiratory alkalosis
Answer: c. Metabolic acidosis
Description:Chronic renal failure (CRF) is a progressive loss of kidney function over time. As the kidneys lose function, they are not able to remove acids from the blood as effectively. This can lead to metabolic acidosis, a condition in which the blood pH is too low. Metabolic acidosis can cause a number of symptoms, including fatigue, weakness, shortness of breath, and confusion. It can also lead to more serious complications, such as heart arrhythmias and seizures. There are a number of factors that can contribute to metabolic acidosis in CRF, including: Decreased production of bicarbonate by the kidneys Increased production of acids by the body Loss of bicarbonate in the urine Treatment for metabolic acidosis in CRF typically involves the administration of bicarbonate supplements. In some cases, dialysis may also be necessary. It is important to note that respiratory acidosis and respiratory alkalosis are not typically associated with CRF. Respiratory acidosis is a condition in which the blood pH is too high, and respiratory alkalosis is a condition in which the blood pH is too low. These conditions are typically caused by problems with breathing, not with kidney function.
22. Expected laboratory findings in a person with renal failure is:
a. BUN 35 mg/dL, potassium 4.0 mEq/L
b. Blood pH 7.2, potassium 6.5 mEq/L
c. BUN 15 mg/Dl, increased serum calcium, creatinine 1.0 mg/dL
d. BUN 45 mg/dL, potassium 3.5 mEq/L
Answer: b. Blood pH 7.2, potassium 6.5 mEq/L
Description:Because of accumulation or uremic waste blood ph become acidic and lack of kidney function leads to accumulation of potassium
23. All of the following electrolyte imbalance are seen in patient with chronic renal failure (CRF); EXCEPT:
a. Hypocalcemia
b. Hyperkalemia
c. Hyponatremia
d. Hypophosphatemia
Answer: d. Hypophosphatemia
Description:In patients with chronic renal failure (CRF), all of the following electrolyte imbalances can be seen except for hypophosphatemia. Chronic renal failure is characterized by a progressive and irreversible decline in kidney function, leading to various metabolic and electrolyte disturbances. The commonly observed electrolyte imbalances in CRF include: a. Hypocalcemia: CRF can disrupt the balance of calcium and phosphorus in the body, leading to low calcium levels (hypocalcemia). b. Hyperkalemia: As kidney function declines, the kidneys may have difficulty excreting potassium properly, resulting in high potassium levels (hyperkalemia). c. Hyponatremia: CRF can disrupt the regulation of sodium levels in the body, leading to low sodium levels (hyponatremia). d. Hypophosphatemia: This is not typically associated with chronic renal failure. In fact, CRF often leads to increased phosphorus levels (hyperphosphatemia) due to impaired phosphorus excretion by the kidneys.
24. The cause of pruritus in CKD patients:
a. Hyperkalemia
b. Uremia
c. Hyponatremia
d. Hypernatremia
Answer: b. Uremia
Description:Uremia is a buildup of waste products in the blood that occurs when the kidneys are not functioning properly. These waste products can cause a number of symptoms, including pruritus, or itching. Pruritus is a common symptom in CKD patients. It is often described as a deep, generalized itch that is worse at night. The cause of pruritus in CKD is not fully understood, but it is thought to be due to a combination of factors, including: Buildup of waste products in the blood Changes in skin blood flow Dry skin Medications There is no one-size-fits-all treatment for pruritus in CKD. Treatment options vary depending on the severity of the itching and the underlying cause. Some treatment options include: Topical treatments, such as emollients and antihistamines Systemic medications, such as cholestyramine and gabapentin Phototherapy Dialysis If you are experiencing pruritus, it is important to talk to your doctor. They can help you determine the best treatment option for you. The other options are not correct. Hyperkalemia is a condition in which the potassium levels in the blood are too high. Hyponatremia is a condition in which the sodium levels in the blood are too low. Hypernatremia is a condition in which the sodium levels in the blood are too high. These conditions are not typically associated with pruritus in CKD patients.
25. The cause of acidosis is CKD:
a. Inability of kidney tubules to excrete ammonia
b. Inability to reabsorb sodium bicarbonate
c. Decreased excretion of phosphate and organic acids
d. All of these
Answer: d. All of these
Description:The cause of acidosis in chronic kidney disease (CKD) is attributed to all of the factors mentioned. Chronic kidney disease can lead to metabolic acidosis, which is an accumulation of acid in the body due to the kidneys' reduced ability to maintain acid-base balance. Several factors contribute to acidosis in CKD: a. Inability of kidney tubules to excrete ammonia: In CKD, the impaired kidney function affects the ability of the renal tubules to excrete ammonia, which is an important substance involved in buffering and eliminating acid from the body. The reduced ammonia excretion contributes to the development of acidosis. b. Inability to reabsorb sodium bicarbonate: The kidneys play a crucial role in reabsorbing filtered bicarbonate ions, which helps maintain the body's acid-base balance. In CKD, the kidneys' ability to reabsorb bicarbonate is compromised, leading to a loss of bicarbonate and contributing to metabolic acidosis. c. Decreased excretion of phosphate and organic acids: CKD can result in decreased excretion of phosphate and organic acids, which can contribute to an increase in acid production and acidosis. Therefore, all of the factors mentioned in options a, b, and c play a role in causing acidosis in CKD.
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