NUR 376 Exam 4 V3 | NUR 376 Applied
Pathophysiology | Actual Q&A with
Rationale (NUR376 Exam 4) | Concordia
1. A patient presents with a sudden decrease in urine output and an elevated serum
creatinine level following a period of severe hypotension. Which phase of acute kidney injury
(AKI) is this patient likely entering?
A. Recovery phase
B. Diuretic phase
C. Oliguric phase
D. Initiation phase
Correct Answer: C
The oliguric phase is characterized by a significant decrease in urine output, often less
than 400 mL/day, due to a drop in the glomerular filtration rate. This phase typically
occurs within 1 to 7 days of the initial kidney injury and is accompanied by rising BUN and
creatinine levels. The AI analysis indicates that identifying this phase early is critical for
managing fluid balance and electrolyte disturbances in the clinical setting.
,2. When assessing a patient with chronic kidney disease (CKD), the nurse notes a glomerular
filtration rate (GFR) of 25 mL/min. According to the stages of CKD, which stage does this
represent?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
Correct Answer: D
Stage 4 CKD is defined by a GFR between 15 and 29 mL/min, indicating severe kidney
damage. At this stage, the patient is often prepared for renal replacement therapy such as
dialysis or transplant. Understanding these stages allows the healthcare team to provide
stage-appropriate interventions and patient education.
3. A patient with end-stage renal disease (ESRD) is experiencing severe anemia. What is the
primary pathophysiological mechanism behind this condition?
A. Increased destruction of red blood cells by the spleen
B. Deficiency in the production of erythropoietin by the kidneys
C. Chronic blood loss during hemodialysis sessions
D. Inadequate dietary intake of iron and B12
Correct Answer: B
, The kidneys are responsible for producing erythropoietin, a hormone that stimulates the
bone marrow to produce red blood cells. In ESRD, the damaged kidneys cannot produce
sufficient erythropoietin, leading to decreased RBC production and subsequent anemia.
This condition is typically treated with synthetic erythropoiesis-stimulating agents to
maintain hemoglobin levels.
4. Which clinical manifestation is a hallmark sign of nephrotic syndrome?
A. Gross hematuria
B. Elevated GFR
C. Hypokalemia
D. Massive proteinuria (>3.5 g/day)
Correct Answer: D
Nephrotic syndrome is characterized by massive proteinuria due to increased
permeability of the glomerular basement membrane. This loss of protein leads to
hypoalbuminemia, which causes significant peripheral edema through decreased oncotic
pressure. Clinicians must monitor for these changes to distinguish nephrotic syndrome
from nephritic syndrome, which is more commonly associated with hematuria.
5. A patient is diagnosed with intrarenal acute kidney injury. Which of the following
conditions are potential causes of this type of injury? (Select all that apply)
A. Renal artery stenosis
B. Acute tubular necrosis (ATN)
Pathophysiology | Actual Q&A with
Rationale (NUR376 Exam 4) | Concordia
1. A patient presents with a sudden decrease in urine output and an elevated serum
creatinine level following a period of severe hypotension. Which phase of acute kidney injury
(AKI) is this patient likely entering?
A. Recovery phase
B. Diuretic phase
C. Oliguric phase
D. Initiation phase
Correct Answer: C
The oliguric phase is characterized by a significant decrease in urine output, often less
than 400 mL/day, due to a drop in the glomerular filtration rate. This phase typically
occurs within 1 to 7 days of the initial kidney injury and is accompanied by rising BUN and
creatinine levels. The AI analysis indicates that identifying this phase early is critical for
managing fluid balance and electrolyte disturbances in the clinical setting.
,2. When assessing a patient with chronic kidney disease (CKD), the nurse notes a glomerular
filtration rate (GFR) of 25 mL/min. According to the stages of CKD, which stage does this
represent?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
Correct Answer: D
Stage 4 CKD is defined by a GFR between 15 and 29 mL/min, indicating severe kidney
damage. At this stage, the patient is often prepared for renal replacement therapy such as
dialysis or transplant. Understanding these stages allows the healthcare team to provide
stage-appropriate interventions and patient education.
3. A patient with end-stage renal disease (ESRD) is experiencing severe anemia. What is the
primary pathophysiological mechanism behind this condition?
A. Increased destruction of red blood cells by the spleen
B. Deficiency in the production of erythropoietin by the kidneys
C. Chronic blood loss during hemodialysis sessions
D. Inadequate dietary intake of iron and B12
Correct Answer: B
, The kidneys are responsible for producing erythropoietin, a hormone that stimulates the
bone marrow to produce red blood cells. In ESRD, the damaged kidneys cannot produce
sufficient erythropoietin, leading to decreased RBC production and subsequent anemia.
This condition is typically treated with synthetic erythropoiesis-stimulating agents to
maintain hemoglobin levels.
4. Which clinical manifestation is a hallmark sign of nephrotic syndrome?
A. Gross hematuria
B. Elevated GFR
C. Hypokalemia
D. Massive proteinuria (>3.5 g/day)
Correct Answer: D
Nephrotic syndrome is characterized by massive proteinuria due to increased
permeability of the glomerular basement membrane. This loss of protein leads to
hypoalbuminemia, which causes significant peripheral edema through decreased oncotic
pressure. Clinicians must monitor for these changes to distinguish nephrotic syndrome
from nephritic syndrome, which is more commonly associated with hematuria.
5. A patient is diagnosed with intrarenal acute kidney injury. Which of the following
conditions are potential causes of this type of injury? (Select all that apply)
A. Renal artery stenosis
B. Acute tubular necrosis (ATN)
