Exam 3 Flashcards

Front 1

Both prehepatic and posthepatic causes of portal hypertension include the formation of:

Back 1

venous thromboses or obstructions.

Front 2

A client who was exposed to hepatitis A at a local restaurant has recovered from the disease. At her annual physical, the client asks the health care provider if she should go to her health department and get the hepatitis A shot. The best response, based on the concepts of adaptive immunity, by the health care provider would be:

Back 2

No, since having an active case, you have already developed antigens against hepatitis A.

Front 3

A common symptom of cholestasis/ intrahepatic bile obstruction is

Back 3

pruritus (itching)

Front 4

A patient had his left lobe of his liver removed due to a hepatocellular carcinoma. His blood test will show persistent elevations of bilirubin for the rest of his life.

Back 4

False

Front 5

Kernicterus is an avoidable complication of

Back 5

physiologic neonatal jaundice

Front 6

Liver failure is characterized by:

Back 6

A, B and C (pale feces, dark urine, hemorrhoids)

Front 7

Manifestations of acohol liver disease include

Back 7

A, B and C (fatty liver, cirrhosis, hepatitis)

Front 8

Portal circulation involves blood draining from the following, among other sources:

Back 8

pancreas

Front 9

Pre-hepatic causes of jaundice are primarily due to

Back 9

breakdown of red blood cells

Front 10

The important function of bilirubin deconjugation is accomplished by actions of the:

Back 10

gut bacteria

Front 11

The liver can be distinguished from the other visceral organs due to its ability to

Back 11

regenerate

Front 12

The majorityof bilirubin is derived from:

Back 12

breakdown of red blood cells

Front 13

Cerebral dysfunction in end-stage liver disease can be attributed to the accumulation of:

Back 13

ammonia

Front 14

Alcoholic liver disease manifests in three stages. The intermediate stage, alcoholic hepatitis, is characterized by liver cell:

Back 14

necrosis

Front 15

An early sign of acute symptomatic viral hepatitis may include:

Back 15

A, B, and C (distaste for coffee, severe anorexia, inability to smoke cigarettes)

Front 16

Individuals with liver disease often experience the effects of excess serum ammonia as a result of impairment of the liver's ability to process ammonia. How does the liver process ammonia in healthy individuals?

Back 16

By processing it into urea and releasing it into the circulation.

Front 17

Kupffer cells function as ______ to remove harmful substances or cells from the portal blood as it moves through the venous sinusoids.

Back 17

phagocytes

Front 18

The late manifestations of cirrhosis are related to liver failure and:

Back 18

portal hypertension.

Front 19

The patient has right upper quadrant pain caused by acute “choledocholithiasis” (a gallstone in the common bile duct). If the common bile duct becomes obstructed, manifestations will also include:

Back 19

bilirubinuria

Front 20

Which of the following factors accounts for the poor prognosis that typically accompanies a diagnosis of primary hepatocellular cancer?

Back 20

The nonspecific symptomatology of liver cancer means that diagnosis often happens at a late stage.

Front 21

A 16-year-old girl has been admitted to the emergency department after ingesting 20 g of acetaminophen (Tylenol) in a suicide attempt. The care team would recognize that this patient faces a severe risk of:

Back 21

acute fulminant hepatitis.

Front 22

A liver failure client asks, How does the liver process ammonia in healthy individuals? The health care provider explains that ammonia is toxic to tissues, especially neurons, so this ammonia is removed from the blood by the liver, which:

Back 22

Processes it into urea, releasing it into the circulation

Front 23

A newborn is admitted to the hospital with a high bilirubin level of 13 mg/dL. The assessment data related to this lab value includes:

Back 23

Yellowish discoloration of the skin

Front 24

A decrease in the serum level of which of the following substances is suggestive of liver injury?

Back 24

Albumin

Front 25

Antibody testing has confirmed that a man is positive for hepatitis A virus (HAV). Which of the client's statements suggests that he understands his new diagnosis?

Back 25

I don't know why I didn't bother to get vaccinated against this.

Front 26

A client with hepatitis B asks the nurse, How did I get this hepatitis? The nurse responds that the mode of transmission is predominantly by:

Back 26

Unprotected sexual intercourse

Front 27

A client is suspected of having the onset of alcoholic liver disease. The nurse should be assessing for which of the following manifestations related to the necrosis of liver cells?

Back 27

Rapid onset of jaundice

Front 28

The highest risk for chronic hepatitis outcomes in infants < 1 year of age is due to which viral infection?

Back 28

Hepatitis B

Front 29

The risk of chronic hepatitis in patients with acute Hepatitis C is:

Back 29

75%

Front 30

An employee in your health department has had their Hepatitis profile drawn as part of their clearance to work in the clinic. Their HepBsAntigen is negative, HepB core Antibody (anti-HepBc) is negative and the HepBsAntibody (antiHepBs) is positive. You determine that he is:

Back 30

Immune due to previous Hep B vaccination

Front 31

The chief reason for liver transplantation in the US is:

Back 31

chronic viral hepatitis

Front 32

Hepatitis A has a high case fatality rate.

Back 32

False

Front 33

Esophageal varices result from portal hypertension.

Back 33

True

Front 34

Autosomal dominant polycystic kidney disease (ADPKD) is a systemic disorder that primarily affects the kidneys, resulting in the formation of fluid-filled __________ in both kidneys with the threat of progression to chronic renal failure.

Back 34

cysts

Front 35

Diabetes mellitus and hypertension are two major causes of glomerular injury.

Back 35

True

Front 36

How many nephrons are in a normal human body?

Back 36

2 million

Front 37

In the adult, the kidneys are perfused with 20% to 25% of the cardiac output.

Back 37

True

Front 38

Large molecules, such as protein, easily cross the glomerular wall.

Back 38

False

Front 39

Most causes of renal obstruction are neoplastic in etiology.

Back 39

False

Front 40

Most kidney stones are composed of_________.

Back 40

calcium

Front 41

One of the strongest vasoconstrictors in the body is aldosterone.

Back 41

False

Front 42

The functional unit of the kidney is the ____________.

Back 42

the nephron

Front 43

The loop of _____________ plays an important role in controlling the concentration of the urine and is divided into three segments.

Back 43

Henle

Front 44

What determines the permeability of the glomerular capillary membrane?

Back 44

The basement membrane

Front 45

Which arteriole exits the nephron?

Back 45

Efferent

Front 46

_____________ failure, the most common form of acute renal failure, is characterized by a marked decrease in renal blood flow.

Back 46

Pre-renal

Front 47

_______________ tumor (nephroblastoma) usually presents between 3 and 5 years of age and is the most common malignant abdominal tumor in children.

Back 47

Wilm's

Front 48

Acute renal failure is not a reversible process.

Back 48

False

Front 49

An accumulation of nitrogenous waste products in the blood is called _____________.

Back 49

azotemia

Front 50

Obstructive nephropathy is often inherited as a Mendelian trait.

Back 50

False

Front 51

One of the first renal manifestations of diabetic nephropathy is hypertension.

Back 51

False

Front 52

A glycopeptide hormone produced by kidney fibroblasts and stimulates red blood cell production in the bone marrow is_______________________.

Back 52

erythropoetin

Front 53

Nephrotic syndrome is associated with increased glomerular permeability to plasma ____________, resulting in generalized edema.

Back 53

protein

Front 54

Serum _____________ reflects the GFR (glomerular filtration rate) and can be used as an estimate of renal function.

Back 54

creatinine

Front 55

A client had excessive blood loss and prolonged hypotension during surgery. His postoperative urine output is sharply decreased, and his blood urea nitrogen (BUN) is elevated. The most likely cause for the change is acute:

Back 55

Acute tubular necrosis

Front 56

A drug abuser was found unconscious after shooting up heroin 2 days prior. Because of the pressure placed on the hip and arm, the client has developed rhabdomyolysis. The nurse knows this can:

Back 56

Obstruct the renal tubules with myoglobin and damage tubular cells

Front 57

Which of the following individuals likely faces the greatest risk for the development of chronic kidney disease?

Back 57

A client with a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or control his diet

Front 58

The nurse is providing care for a client who has a diagnosis of kidney failure. Which of the following laboratory findings is consistent with this client's diagnosis?

Back 58

Hypocalcemia

Front 59

Reduced glomerular filtration rate (GFR), with a serum creatinine level that remains in the normal range, is associated with aging because elderly persons tend to have reduced:

Back 59

Muscle mass

Front 60

Which of the following aspects of kidney function is performed by the juxtaglomerular apparatus?

Back 60

Matching changes in GFR with renal blood flow

Front 61

What is the best screen for early kidney damage due to diabetes?

Back 61

urine microalbumin

Front 62

Which of the following factors is likely to result in decreased renal blood flow?

Back 62

Sympathetic nervous system stimulation

Front 63

Which of the following aspects of kidney function is performed by the juxtaglomerular apparatus?

Back 63

Matching changes in GFR with renal blood flow