NSG 6320 AGNP Board Exam – Urology Assessment Exam In renal adaptation of the newborn, which one of the following statements is correct?
The
... [Show More] kidneys have an inability to concentrate urine and adapt to fluid and electrolyte
stress. Correct
In the nephrons of the kidneys long tubules enhance the effectiveness of tubular
reabsorption.
The kidneys are fully capable of concentrating urine and maintaining fluid and
electrolyte balance.
The kidneys have the ability to increase the production of antidiuretic hormone
(ADH) effectively.
Explanation:
In the neonate the kidneys are structurally complete but physiologically immature. The
glomeruli have an inability to filter and concentrate urine, therefore glucose and amino
acids escape and there is decreased ability to remove uric acid crystals which give the
reddish appearance to the urine. There is an inability to adapt to fluid and electrolyte
stress leading to loss of bicarbonate and poor reabsorption. This puts the neonate at
increased risk of metabolic acidosis. The tubules are short/narrow which causes a
problem with reabsorption. The nephrons function well within a month. ADH inhibits
diuresis and the immature kidney causes an increased risk for dehydration.
2. Question:
What is the most common non-skin cancer in America?
Uterine cancer
Bladder cancer
Cervical cancer
Prostate cancer Correct
Explanation:
Prostate cancer is the most common non-skin cancer in America; 1 in 8 men will be
diagnosed with it at some point in their lives. In fact, nearly 60% of all prostate cancers
are diagnosed in men older than 65.
3. Question:
Patients with prior hypospadias surgery who develop slow and painful urination as
well as prostatitis are experiencing symptoms of:
neurogenic bladder.
urethral stricture. Correct
benign prostatic hyperplasia (BPH).
prostate cancer.
Explanation:
A urethral stricture may occur in patients who have undergone hypospadias surgery
and experience voiding symptoms such as urinary retention and straining to void.
Neurogenic bladder symptoms include urinary retention and/or incontinence
associated with other underlying chronic neurologic conditions (e.g., multiple sclerosis)
or after spinal cord injury. Patients with BPH experience an increase in daytime
frequency, nocturia, urinary incontinence, and terminal dribbling. Prostate cancer is
usually asymptomatic but can sometimes present with storage, voiding, or irritative
symptoms.
4. Question:
What is the average urine pH level?
4.5
6 Correct
7
8
Explanation:
The average urine pH level is 5-6, acid pH is 4.5-5.5, and alkaline pH is 6.5-8.
5. Question:
Symptoms of proctitis may include all of the following except:
left-sided abdominal pain.
rectal pain.
suprapubic pain. Correct
tenesmus.
Explanation:
Proctitis is inflammation of the lining of the rectum leading to rectal pain, bleeding, and
a continuous sensation to defecate (tenesmus). Additional symptoms may also include
left-sided abdominal pain, diarrhea, pain with bowel movements, and a feeling of
fullness in the rectum. Suprapubic pain is not generally associated with proctitis.
6. Question:
A useful mnemonic for elucidating causes of incontinence in the older adult is:
STOOL.
DIAPERS. Correct
DRIP.
URINE.
Explanation:
For elucidating causes of incontinence, two mnemonics may be helpful: DIAPERS,
(Delirium, Infection, Atrophic urethritis/vaginitis, Pharmaceuticals, Excess urine
output from conditions like hyperglycemia or heart failure, Restricted mobility, and
Stool impaction) and DDRRIIPP (Delirium, Drug side effects, Retention of feces,
Restricted mobility, Infection of urine, Inflammation, Polyuria, and Psychogenic).
7. Question:
Which of the following symptoms is NOT associated with nephrotic syndrome?
Proteinuria
Hyperlipidemia
Lower leg edema
Hyperalbuminosa Correct
Explanation:
Nephrotic syndrome is diagnosed by the presence of proteinuria, hyperlipidemia,
edema, or swelling (usually in the legs, feet, or ankles and less often in the hands or
face), and hypoalbuminemia.
8. Question:
In afebrile patients who experience intermittent sharp flank pain in addition to gross
hematuria, further testing would be indicated for:
pelvic inflammatory disease (PID).
pyelonephritis.
nephrolithiasis. Correct
urethritis.
Explanation:
The majority of patients with symptomatic nephrolithiasis have intermittent flank
pain/renal colic in addition to gross or microscopic hematuria. In the absence of
infection, fever is unusual in patients with nephrolithiasis. Abdominal or pelvic pain
and fever are the most common clinical findings in patients with pelvic inflammatory
disease (PID), although dysuria may also be present. Pyelonephritis often presents with
flank pain, fever, and pyuria. Symptoms of urethritis include dysuria, pyuria, or
burning with urination. Flank pain or hematuria is not present in urethritis.
9. Question:
After running a 5K race, a 35-year-old man presents with complaints of muscle pain in
the shoulders, weakness in both legs, and dark brown urine. These findings are
consistent with:
a urinary tract infection (UTI).
rhabdomyolysis. Correct
acute renal failure.
renal calculi.
Explanation:
Rhabdomyolysis is a serious syndrome resulting from a direct or indirect muscle injury.
It results from death of muscle fibers and release of their contents into the bloodstream,
leading to renal failure. Exertional activity such as running a marathon or participating
in strenuous exercises can cause rhabdomyolysis. Creatinine kinase (CK) is the most
reliable and sensitive marker to indicate rhabdomyolysis or severe muscle breakdown [Show Less]