NURS 611 PATHOPHYSIOLOGY
REVIEW SHEET TEST 4 2026 FULL
QUESTIONS AND ACCURATE
ANSWERS
◉ kidney stones. Answer: Passage of these can be extremely painful
and may produce "referred pain" to umbilicus area - this is due to the
sensory innervation of the upper part of the ureter arising from the
10th thoracic nerve roots.
◉ Urinary Tract Infection. Answer: Clinical manifestations of this
condition in an older adult are Confusion and poorly localized
abdominal discomfort. Can be very difficult diagnose due to vague
symptoms.
◉ Pyelonephritis. Answer: an infection of one or both upper urinary
tracts (ureter, renal pelvis, and kidney interstitium). Urinary obstruction
and reflux of urine from the bladder (vesicoureteral reflux) are the most
common underlying risk factors. Microorganisms usually associated
with acute pyelonephritis include E. coli, Proteus, or Pseudomonas.
These microorganisms also split urea into ammonia, making alkaline
urine that increases the risk of stone formation.
◉ Painful bladder syndrome/interstitial cystitis. Answer: a condition
that includes nonbacterial infectious cystitis (viral, mycobacterial,
chlamydial, fungal) and noninfectious cystitis (radiation, chemical,
autoimmune, hypersensitivity). The cause is unknown, but an
,autoimmune reaction may be responsible for the inflammatory
response, which includes mast cell activation, altered epithelial
permeability, neuroinflammation, and increased sensory nerve
sensitivity.
◉ Acute unilateral renal obstruction and hypertension. Answer: The
reduced perfusion (kidneys require at least 20-25% cardiac output -
MAP) of the affected kidney activates the renin-angiotensin-
aldosterone system (RAAS), which causes constriction of peripheral
arterioles.
◉ Acute glomerulonephritis. Answer: includes renal diseases in which
glomerular inflammation is caused by immune mechanisms that
damage the glomerular capillary filtration membrane including the
endothelium, basement membrane, and epithelium (podocytes). The
classic symptoms include sudden onset of hematuria including red
blood cell casts and proteinuria (milder than nephrotic syndrome), and
in more severe cases, these symptoms are also accompanied by edema,
hypertension, and impaired renal function.
◉ Nephrotic syndrome. Answer: the excretion of 3.0 g or more of
protein (massive proteinuria) in the urine per day, hypoalbuminemia
(less than 3.0 g/dl), and peripheral edema. This is characteristic of
glomerular injury. Primary causes of this condition include minimal
change disease (lipoid nephrosis), membranous glomerulonephritis,
and focal segmental glomerulosclerosis. Secondary forms of this
condition occur in systemic diseases including diabetes mellitus,
amyloidosis, and systemic lupus erythematosus. This condition also is
, seen with certain drugs, infections, malignancies, and vascular
disorders.
◉ acute kidney injury. Answer: this condition may be acute and rapidly
progressive (within hours), and the process may be reversible.
◉ Kidney failure. Answer: this condition can be chronic, progressing to
end-stage kidney failure over a period of months or years.
◉ Renal insufficiency. Answer: this condition refers to a decline in renal
function to about 25% of normal or a GFR of 25 to 30 ml/minute. Levels
of serum creatinine and urea are mildly elevated. However, changes in
serum creatinine level occur only if more than 50% of glomerular
filtration is lost and are often delayed by more than 24 hours. Such
diagnostic delays make the implementation of early therapy very
difficult, contributing to disease progression and mortality.
◉ Obesity. Answer: this condition is defined as a body mass index (BMI)
that exceeds 30 kg/m2 and generally develops when caloric intake
exceeds caloric expenditure in genetically susceptible individuals. This
condition is a major risk factor for morbidity, death, and high
healthcare cost in the United States and worldwide. Three leading
causes of death in the United States are associated with this condition:
cardiovascular disease, type 2 diabetes mellitus, and cancer.
◉ Visceral obesity. Answer: also known as intra-abdominal, central, or
masculine obesity) occurs when the distribution of body fat is localized
REVIEW SHEET TEST 4 2026 FULL
QUESTIONS AND ACCURATE
ANSWERS
◉ kidney stones. Answer: Passage of these can be extremely painful
and may produce "referred pain" to umbilicus area - this is due to the
sensory innervation of the upper part of the ureter arising from the
10th thoracic nerve roots.
◉ Urinary Tract Infection. Answer: Clinical manifestations of this
condition in an older adult are Confusion and poorly localized
abdominal discomfort. Can be very difficult diagnose due to vague
symptoms.
◉ Pyelonephritis. Answer: an infection of one or both upper urinary
tracts (ureter, renal pelvis, and kidney interstitium). Urinary obstruction
and reflux of urine from the bladder (vesicoureteral reflux) are the most
common underlying risk factors. Microorganisms usually associated
with acute pyelonephritis include E. coli, Proteus, or Pseudomonas.
These microorganisms also split urea into ammonia, making alkaline
urine that increases the risk of stone formation.
◉ Painful bladder syndrome/interstitial cystitis. Answer: a condition
that includes nonbacterial infectious cystitis (viral, mycobacterial,
chlamydial, fungal) and noninfectious cystitis (radiation, chemical,
autoimmune, hypersensitivity). The cause is unknown, but an
,autoimmune reaction may be responsible for the inflammatory
response, which includes mast cell activation, altered epithelial
permeability, neuroinflammation, and increased sensory nerve
sensitivity.
◉ Acute unilateral renal obstruction and hypertension. Answer: The
reduced perfusion (kidneys require at least 20-25% cardiac output -
MAP) of the affected kidney activates the renin-angiotensin-
aldosterone system (RAAS), which causes constriction of peripheral
arterioles.
◉ Acute glomerulonephritis. Answer: includes renal diseases in which
glomerular inflammation is caused by immune mechanisms that
damage the glomerular capillary filtration membrane including the
endothelium, basement membrane, and epithelium (podocytes). The
classic symptoms include sudden onset of hematuria including red
blood cell casts and proteinuria (milder than nephrotic syndrome), and
in more severe cases, these symptoms are also accompanied by edema,
hypertension, and impaired renal function.
◉ Nephrotic syndrome. Answer: the excretion of 3.0 g or more of
protein (massive proteinuria) in the urine per day, hypoalbuminemia
(less than 3.0 g/dl), and peripheral edema. This is characteristic of
glomerular injury. Primary causes of this condition include minimal
change disease (lipoid nephrosis), membranous glomerulonephritis,
and focal segmental glomerulosclerosis. Secondary forms of this
condition occur in systemic diseases including diabetes mellitus,
amyloidosis, and systemic lupus erythematosus. This condition also is
, seen with certain drugs, infections, malignancies, and vascular
disorders.
◉ acute kidney injury. Answer: this condition may be acute and rapidly
progressive (within hours), and the process may be reversible.
◉ Kidney failure. Answer: this condition can be chronic, progressing to
end-stage kidney failure over a period of months or years.
◉ Renal insufficiency. Answer: this condition refers to a decline in renal
function to about 25% of normal or a GFR of 25 to 30 ml/minute. Levels
of serum creatinine and urea are mildly elevated. However, changes in
serum creatinine level occur only if more than 50% of glomerular
filtration is lost and are often delayed by more than 24 hours. Such
diagnostic delays make the implementation of early therapy very
difficult, contributing to disease progression and mortality.
◉ Obesity. Answer: this condition is defined as a body mass index (BMI)
that exceeds 30 kg/m2 and generally develops when caloric intake
exceeds caloric expenditure in genetically susceptible individuals. This
condition is a major risk factor for morbidity, death, and high
healthcare cost in the United States and worldwide. Three leading
causes of death in the United States are associated with this condition:
cardiovascular disease, type 2 diabetes mellitus, and cancer.
◉ Visceral obesity. Answer: also known as intra-abdominal, central, or
masculine obesity) occurs when the distribution of body fat is localized
