NSG 3850 Exam 3
Comprehensive Renal Disorders Examination 2026
1. A nurse is educating a patient about polycystic kidney disease (PKD). Which statement by the patient
indicates understanding of the genetic transmission of autosomal dominant PKD?
A. "This condition only affects men in my family."
B. "My children have a 50% chance of inheriting this condition."
C. "This disease will skip generations in my family."
D. "Only my male children are at risk for developing this."
ANSWER: B
Rationale:
Option A is incorrect: PKD affects both men and women equally; it is not gender-specific. The notes
indicate it is "common in men & increase w/aging" but this refers to prevalence, not exclusive
transmission.
Option B is correct: Autosomal dominant PKD follows a dominant inheritance pattern, meaning each
child has a 50% chance of inheriting the affected gene from an affected parent. This is a key teaching
point for genetic counseling.
Option C is incorrect: Autosomal dominant conditions do not skip generations; they appear in every
generation where the gene is present.
Option D is incorrect: Both male and female children have equal risk of inheriting autosomal dominant
PKD as it is not sex-linked.
2. A newborn is diagnosed with autosomal recessive polycystic kidney disease. The nurse should
prioritize assessment for which life-threatening complication?
A. Hypertension
B. Pulmonary hypoplasia
C. Liver dysfunction
D. Urinary tract infection
ANSWER: B
,Rationale:
Option A is incorrect: While hypertension (systemic HTN) is a manifestation of autosomal recessive PKD,
it is not immediately life-threatening in the neonatal period compared to respiratory complications.
Option B is correct: According to the notes, when autosomal recessive PKD is "accompanied by
pulmonary hypoplasia (lungs not developed) may result in death." This is identified in the neonatal
period "at birth" and is the most critical immediate threat to life.
Option C is incorrect: Liver dysfunction is a concern "if survives to adulthood" when patients "will
decline in liver function." It is not the primary neonatal concern.
Option D is incorrect: While UTIs can occur, they are not the most immediately life-threatening
complication in the neonatal period with this condition.
3. A 45-year-old patient with autosomal dominant polycystic kidney disease asks why they are
experiencing pain. What is the nurse's best response?
A. "The pain is likely from kidney stones that are common with your condition."
B. "Pain is a frequent complaint in adults with PKD, often from bleeding cysts."
C. "The pain indicates your kidney function is rapidly declining."
D. "This pain is probably unrelated to your kidney disease."
ANSWER: B
Rationale:
Option A is incorrect: While patients with PKD do have a history of kidney stones, the notes specifically
state "Pain from bleeding" and "Adults: PAIN is a freq complaint," indicating that bleeding cysts are a
more direct cause.
Option B is correct: The notes clearly indicate "Pain from bleeding" as a manifestation and emphasize
that "Adults: PAIN is a freq complaint." Cysts can multiply, expand, and bleed, causing significant pain.
Option C is incorrect: While pain can occur with declining function, it is not necessarily an indicator of
rapid decline. Pain is common even in earlier stages due to cyst expansion and bleeding.
Option D is incorrect: Pain is directly related to PKD and is one of the most common complaints in adults
with this condition.
4. Which laboratory value would the nurse expect to see decrease as polycystic kidney disease
progresses?
A. Potassium
B. Hemoglobin
C. Glomerular filtration rate (GFR)
D. Blood urea nitrogen (BUN)
,ANSWER: C
Rationale:
Option A is incorrect: Potassium typically increases (hyperkalemia), not decreases, as kidney disease
progresses due to the kidneys' inability to excrete potassium. Normal range is 3.5-5.
Option B is incorrect: While anemia can occur in chronic kidney disease, hemoglobin is not the primary
indicator of PKD progression mentioned in the notes.
Option C is correct: The notes indicate that as "cysts can multiply & expand, kidney size ↑ & ↓, seen in
↓ GFR." GFR normally is 90-120 mL/min and decreases as kidney function declines, eventually resulting
in end-stage kidney disease.
Option D is incorrect: BUN increases (not decreases) as kidney function declines. Normal BUN is 10-20,
and it elevates when kidneys cannot effectively filter waste products.
5. A patient with autosomal dominant PKD is being discharged. Which organ, other than the kidneys,
should the nurse include in patient education about potential cyst development?
A. Pancreas
B. Spleen
C. Liver
D. Gallbladder
ANSWER: C
Rationale:
Option A is incorrect: While cysts can theoretically develop in various organs, the pancreas is not
mentioned as the most common extrarenal site in the provided notes.
Option B is incorrect: The spleen is not identified as a common site for cyst development in PKD
patients.
Option C is correct: The notes explicitly state "Cysts can move to other organs → most common Liver"
and include "LIVER biopsy" in the diagnostic considerations. Hepatic cysts are the most common
extrarenal manifestation.
Option D is incorrect: The gallbladder is not mentioned as a common site for cyst development in PKD.
6. Which genetic chromosome abnormality is associated with the more severe form of autosomal
dominant PKD?
A. Chromosome 4 - PKD2
B. Chromosome 16 - PKD1
C. Chromosome 6 - PKD3
D. Chromosome 12 - PKD4
, ANSWER: B
Rationale:
Option A is incorrect: Chromosome 4 (PKD2) is associated with a less common and typically milder form
of ADPKD that presents later in life.
Option B is correct: The notes specify "2 Types: Chromosome 16 - PKD1" and "Chromosome 4 - PKD2."
PKD1 on chromosome 16 accounts for approximately 85% of cases and typically presents earlier with
more severe disease progression.
Option C is incorrect: There is no PKD3 on chromosome 6 mentioned in the notes or standard PKD
classification.
Option D is incorrect: There is no PKD4 on chromosome 12 in standard PKD classification.
7. A nurse is reviewing laboratory results for a patient. Which finding would indicate the need for further
evaluation of kidney function?
A. Creatinine 0.8 mg/dL in a male patient
B. GFR of 95 mL/min
C. Creatinine 1.5 mg/dL in a female patient
D. Albumin 4.0 g/dL
ANSWER: C
Rationale:
Option A is incorrect: Creatinine of 0.8 mg/dL is within normal range for males (0.6-1.2 according to the
notes).
Option B is incorrect: GFR of 95 mL/min is within normal range (90-120 mL/min per the notes).
Option C is correct: Creatinine of 1.5 mg/dL in a female is elevated above the normal range of 0.5-1.1
mg/dL, indicating impaired kidney function and requiring further evaluation.
Option D is incorrect: Albumin of 4.0 g/dL is within normal range (3.5-5 g/dL).
8. A patient with PKD asks about when symptoms typically appear. What is the nurse's best response
regarding autosomal dominant PKD?
A. "Symptoms are usually present at birth."
B. "Most people develop symptoms in their 40s to 60s."
C. "Symptoms don't appear until after age 70."
D. "You would have known since childhood if you had this."
ANSWER: B
Rationale:
Comprehensive Renal Disorders Examination 2026
1. A nurse is educating a patient about polycystic kidney disease (PKD). Which statement by the patient
indicates understanding of the genetic transmission of autosomal dominant PKD?
A. "This condition only affects men in my family."
B. "My children have a 50% chance of inheriting this condition."
C. "This disease will skip generations in my family."
D. "Only my male children are at risk for developing this."
ANSWER: B
Rationale:
Option A is incorrect: PKD affects both men and women equally; it is not gender-specific. The notes
indicate it is "common in men & increase w/aging" but this refers to prevalence, not exclusive
transmission.
Option B is correct: Autosomal dominant PKD follows a dominant inheritance pattern, meaning each
child has a 50% chance of inheriting the affected gene from an affected parent. This is a key teaching
point for genetic counseling.
Option C is incorrect: Autosomal dominant conditions do not skip generations; they appear in every
generation where the gene is present.
Option D is incorrect: Both male and female children have equal risk of inheriting autosomal dominant
PKD as it is not sex-linked.
2. A newborn is diagnosed with autosomal recessive polycystic kidney disease. The nurse should
prioritize assessment for which life-threatening complication?
A. Hypertension
B. Pulmonary hypoplasia
C. Liver dysfunction
D. Urinary tract infection
ANSWER: B
,Rationale:
Option A is incorrect: While hypertension (systemic HTN) is a manifestation of autosomal recessive PKD,
it is not immediately life-threatening in the neonatal period compared to respiratory complications.
Option B is correct: According to the notes, when autosomal recessive PKD is "accompanied by
pulmonary hypoplasia (lungs not developed) may result in death." This is identified in the neonatal
period "at birth" and is the most critical immediate threat to life.
Option C is incorrect: Liver dysfunction is a concern "if survives to adulthood" when patients "will
decline in liver function." It is not the primary neonatal concern.
Option D is incorrect: While UTIs can occur, they are not the most immediately life-threatening
complication in the neonatal period with this condition.
3. A 45-year-old patient with autosomal dominant polycystic kidney disease asks why they are
experiencing pain. What is the nurse's best response?
A. "The pain is likely from kidney stones that are common with your condition."
B. "Pain is a frequent complaint in adults with PKD, often from bleeding cysts."
C. "The pain indicates your kidney function is rapidly declining."
D. "This pain is probably unrelated to your kidney disease."
ANSWER: B
Rationale:
Option A is incorrect: While patients with PKD do have a history of kidney stones, the notes specifically
state "Pain from bleeding" and "Adults: PAIN is a freq complaint," indicating that bleeding cysts are a
more direct cause.
Option B is correct: The notes clearly indicate "Pain from bleeding" as a manifestation and emphasize
that "Adults: PAIN is a freq complaint." Cysts can multiply, expand, and bleed, causing significant pain.
Option C is incorrect: While pain can occur with declining function, it is not necessarily an indicator of
rapid decline. Pain is common even in earlier stages due to cyst expansion and bleeding.
Option D is incorrect: Pain is directly related to PKD and is one of the most common complaints in adults
with this condition.
4. Which laboratory value would the nurse expect to see decrease as polycystic kidney disease
progresses?
A. Potassium
B. Hemoglobin
C. Glomerular filtration rate (GFR)
D. Blood urea nitrogen (BUN)
,ANSWER: C
Rationale:
Option A is incorrect: Potassium typically increases (hyperkalemia), not decreases, as kidney disease
progresses due to the kidneys' inability to excrete potassium. Normal range is 3.5-5.
Option B is incorrect: While anemia can occur in chronic kidney disease, hemoglobin is not the primary
indicator of PKD progression mentioned in the notes.
Option C is correct: The notes indicate that as "cysts can multiply & expand, kidney size ↑ & ↓, seen in
↓ GFR." GFR normally is 90-120 mL/min and decreases as kidney function declines, eventually resulting
in end-stage kidney disease.
Option D is incorrect: BUN increases (not decreases) as kidney function declines. Normal BUN is 10-20,
and it elevates when kidneys cannot effectively filter waste products.
5. A patient with autosomal dominant PKD is being discharged. Which organ, other than the kidneys,
should the nurse include in patient education about potential cyst development?
A. Pancreas
B. Spleen
C. Liver
D. Gallbladder
ANSWER: C
Rationale:
Option A is incorrect: While cysts can theoretically develop in various organs, the pancreas is not
mentioned as the most common extrarenal site in the provided notes.
Option B is incorrect: The spleen is not identified as a common site for cyst development in PKD
patients.
Option C is correct: The notes explicitly state "Cysts can move to other organs → most common Liver"
and include "LIVER biopsy" in the diagnostic considerations. Hepatic cysts are the most common
extrarenal manifestation.
Option D is incorrect: The gallbladder is not mentioned as a common site for cyst development in PKD.
6. Which genetic chromosome abnormality is associated with the more severe form of autosomal
dominant PKD?
A. Chromosome 4 - PKD2
B. Chromosome 16 - PKD1
C. Chromosome 6 - PKD3
D. Chromosome 12 - PKD4
, ANSWER: B
Rationale:
Option A is incorrect: Chromosome 4 (PKD2) is associated with a less common and typically milder form
of ADPKD that presents later in life.
Option B is correct: The notes specify "2 Types: Chromosome 16 - PKD1" and "Chromosome 4 - PKD2."
PKD1 on chromosome 16 accounts for approximately 85% of cases and typically presents earlier with
more severe disease progression.
Option C is incorrect: There is no PKD3 on chromosome 6 mentioned in the notes or standard PKD
classification.
Option D is incorrect: There is no PKD4 on chromosome 12 in standard PKD classification.
7. A nurse is reviewing laboratory results for a patient. Which finding would indicate the need for further
evaluation of kidney function?
A. Creatinine 0.8 mg/dL in a male patient
B. GFR of 95 mL/min
C. Creatinine 1.5 mg/dL in a female patient
D. Albumin 4.0 g/dL
ANSWER: C
Rationale:
Option A is incorrect: Creatinine of 0.8 mg/dL is within normal range for males (0.6-1.2 according to the
notes).
Option B is incorrect: GFR of 95 mL/min is within normal range (90-120 mL/min per the notes).
Option C is correct: Creatinine of 1.5 mg/dL in a female is elevated above the normal range of 0.5-1.1
mg/dL, indicating impaired kidney function and requiring further evaluation.
Option D is incorrect: Albumin of 4.0 g/dL is within normal range (3.5-5 g/dL).
8. A patient with PKD asks about when symptoms typically appear. What is the nurse's best response
regarding autosomal dominant PKD?
A. "Symptoms are usually present at birth."
B. "Most people develop symptoms in their 40s to 60s."
C. "Symptoms don't appear until after age 70."
D. "You would have known since childhood if you had this."
ANSWER: B
Rationale:
