NUR 376 Exam 3 V2 | NUR 376 Applied
Pathophysiology | Actual Q&A with
Rationale (NUR376 Exam 3) | Concordia
1. A patient is admitted with acute kidney injury (AKI) following a severe hemorrhage. Which
physiological mechanism best describes the prerenal etiology of this condition?
A. Direct damage to the renal parenchyma from toxins
B. Obstruction of the urinary tract by calculi
C. Inflammation of the glomerular basement membrane
D. Decreased renal perfusion resulting from systemic hypotension
Correct Answer: D
Prerenal AKI occurs when there is a significant decrease in blood flow to the kidneys, such
as in cases of hemorrhage or dehydration. The reduction in systemic blood pressure leads
to decreased glomerular filtration pressure and a subsequent drop in GFR. This form of
injury is characterized by the lack of structural damage to the kidney tissue initially,
making it potentially reversible if perfusion is restored quickly.
2. Which clinical manifestation is a hallmark of Nephrotic Syndrome and distinguishes it from
Nephritic Syndrome?
A. Gross hematuria and hypertension
B. Massive proteinuria exceeding 3.5 grams per day
,C. RBC casts in the urine
D. Oliguria and flank pain
Correct Answer: B
Nephrotic Syndrome is primarily defined by heavy proteinuria, which occurs due to
increased permeability of the glomerular basement membrane. This loss of protein leads to
hypoalbuminemia, which reduces oncotic pressure and results in generalized edema. While
hematuria can occur in some cases, it is the massive protein loss that serves as the
definitive diagnostic feature compared to the inflammatory nature of nephritic syndrome.
3. The nurse notes that a patient with Chronic Kidney Disease (CKD) has a significantly low
hemoglobin level. What is the primary pathophysiological cause of this anemia?
A. Chronic blood loss during hemodialysis
B. Inadequate dietary intake of iron
C. Reduced production of erythropoietin by the kidneys
D. Shortened lifespan of red blood cells due to uremic toxins
Correct Answer: C
In CKD, the kidneys lose their ability to produce erythropoietin, the hormone responsible
for stimulating red blood cell production in the bone marrow. As the renal mass decreases,
the levels of this hormone fall, leading to normocytic, normochromic anemia. Although iron
deficiency and uremic toxins contribute, the lack of erythropoietin remains the
fundamental cause in these patients.
, 4. A patient with a history of recurrent calcium oxalate renal calculi is being educated on
prevention. Which mechanism explains why high sodium intake increases the risk of stone
formation?
A. High sodium intake promotes hypercalciuria
B. Sodium increases the acidity of the urine
C. Sodium prevents the breakdown of uric acid
D. Excess sodium causes the urine to become more alkaline
Correct Answer: A
High sodium intake competes with calcium for reabsorption in the renal tubules, leading
to increased calcium excretion in the urine, known as hypercalciuria. When urine calcium
levels rise, the likelihood of calcium combining with oxalate to form stones increases
significantly. Therefore, reducing dietary salt is a critical intervention to lower the
saturation of stone-forming minerals in the urinary filtrate.
5. A nurse is assessing a patient for clinical signs of Fluid Volume Deficit (Dehydration). Which
of the following findings should the nurse anticipate? (Select all that apply)
A. Postural hypotension
B. Distended neck veins
C. Flat neck veins when supine
D. Increased hematocrit
Pathophysiology | Actual Q&A with
Rationale (NUR376 Exam 3) | Concordia
1. A patient is admitted with acute kidney injury (AKI) following a severe hemorrhage. Which
physiological mechanism best describes the prerenal etiology of this condition?
A. Direct damage to the renal parenchyma from toxins
B. Obstruction of the urinary tract by calculi
C. Inflammation of the glomerular basement membrane
D. Decreased renal perfusion resulting from systemic hypotension
Correct Answer: D
Prerenal AKI occurs when there is a significant decrease in blood flow to the kidneys, such
as in cases of hemorrhage or dehydration. The reduction in systemic blood pressure leads
to decreased glomerular filtration pressure and a subsequent drop in GFR. This form of
injury is characterized by the lack of structural damage to the kidney tissue initially,
making it potentially reversible if perfusion is restored quickly.
2. Which clinical manifestation is a hallmark of Nephrotic Syndrome and distinguishes it from
Nephritic Syndrome?
A. Gross hematuria and hypertension
B. Massive proteinuria exceeding 3.5 grams per day
,C. RBC casts in the urine
D. Oliguria and flank pain
Correct Answer: B
Nephrotic Syndrome is primarily defined by heavy proteinuria, which occurs due to
increased permeability of the glomerular basement membrane. This loss of protein leads to
hypoalbuminemia, which reduces oncotic pressure and results in generalized edema. While
hematuria can occur in some cases, it is the massive protein loss that serves as the
definitive diagnostic feature compared to the inflammatory nature of nephritic syndrome.
3. The nurse notes that a patient with Chronic Kidney Disease (CKD) has a significantly low
hemoglobin level. What is the primary pathophysiological cause of this anemia?
A. Chronic blood loss during hemodialysis
B. Inadequate dietary intake of iron
C. Reduced production of erythropoietin by the kidneys
D. Shortened lifespan of red blood cells due to uremic toxins
Correct Answer: C
In CKD, the kidneys lose their ability to produce erythropoietin, the hormone responsible
for stimulating red blood cell production in the bone marrow. As the renal mass decreases,
the levels of this hormone fall, leading to normocytic, normochromic anemia. Although iron
deficiency and uremic toxins contribute, the lack of erythropoietin remains the
fundamental cause in these patients.
, 4. A patient with a history of recurrent calcium oxalate renal calculi is being educated on
prevention. Which mechanism explains why high sodium intake increases the risk of stone
formation?
A. High sodium intake promotes hypercalciuria
B. Sodium increases the acidity of the urine
C. Sodium prevents the breakdown of uric acid
D. Excess sodium causes the urine to become more alkaline
Correct Answer: A
High sodium intake competes with calcium for reabsorption in the renal tubules, leading
to increased calcium excretion in the urine, known as hypercalciuria. When urine calcium
levels rise, the likelihood of calcium combining with oxalate to form stones increases
significantly. Therefore, reducing dietary salt is a critical intervention to lower the
saturation of stone-forming minerals in the urinary filtrate.
5. A nurse is assessing a patient for clinical signs of Fluid Volume Deficit (Dehydration). Which
of the following findings should the nurse anticipate? (Select all that apply)
A. Postural hypotension
B. Distended neck veins
C. Flat neck veins when supine
D. Increased hematocrit
