,NSG3850/NSG 3850 Exam 3 | Advanced Pathophysiology |
Galen College | Q & A | 2026/2027 Edition (PDF)
1. A patient with nephrotic syndrome typically presents with which triad of findings?
A) Hematuria, hypertension, oliguria
B) Proteinuria, hypoalbuminemia, generalized edema
C) Pyuria, bacteriuria, fever
D) Polyuria, polydipsia, hyperglycemia
Correct Answer: Proteinuria, hypoalbuminemia, generalized edema
Expert Rationale: Nephrotic syndrome is defined by massive proteinuria (>3.5 g/day) from increased
glomerular permeability, resulting in hypoalbuminemia and generalized edema. Hematuria and
hypertension are typical of glomerulonephritis, while pyuria suggests infection and polyuria/polydipsia
suggests diabetes.
2. Which laboratory finding is most suggestive of glomerulonephritis rather than nephrotic syndrome?
A) Serum albumin 2.8 g/dL
B) 24-hour urine protein 4.5 g
C) Red blood cell casts in urine
D) Serum cholesterol 320 mg/dL
Correct Answer: Red blood cell casts in urine
Expert Rationale: Red blood cell casts indicate glomerular bleeding, characteristic of glomerulonephritis.
Nephrotic syndrome typically shows fatty casts and oval fat bodies with proteinuria but without
significant hematuria. RBC casts result from inflammation and damage to the glomerular basement
membrane.
3. A patient with acute pyelonephritis would most typically experience which symptom?
A) Oliguria
,B) Fever
C) Edema
D) Hypertension
Correct Answer: Fever
Expert Rationale: Acute pyelonephritis typically presents with fever, chills, and costovertebral angle
tenderness. Oliguria, edema, and hypertension are more characteristic of glomerular or renal failure
conditions, not acute infection of the renal parenchyma.
4. The organism most commonly associated with acute pyelonephritis is:
A) Streptococcus
B) Escherichia coli
C) Klebsiella
D) Enterobacter
Correct Answer: Escherichia coli
Expert Rationale: Escherichia coli is the most common cause of acute pyelonephritis, accounting for the
majority of cases. While Klebsiella, Enterobacter, and other organisms can cause pyelonephritis, E. coli is
the predominant pathogen.
5. A patient with a history of gouty arthritis develops renal calculi. The composition of these calculi is
most likely to be:
A) Potassium oxalate
B) Struvite
C) Cysteine
D) Uric acid crystals
Correct Answer: Uric acid crystals
, Expert Rationale: Patients with gouty arthritis have elevated serum uric acid levels, predisposing them to
uric acid renal calculi. Calcium oxalate stones are the most common type overall, struvite stones are
associated with infection, and cysteine stones are rare and genetic.
6. The most common type of renal stone is:
A) Uric acid
B) Calcium
C) Struvite
D) Cysteine
Correct Answer: Calcium
Expert Rationale: Calcium stones, primarily calcium oxalate, are the most common type of renal calculi.
Uric acid stones are associated with gout, struvite stones with infection, and cysteine stones are a rare
inherited disorder.
7. Adult polycystic kidney disease manifests with which clinical presentation?
A) Acute kidney injury in childhood
B) Decreasing renal function and hypertension in adulthood
C) Rapidly progressive glomerulonephritis
D) Recurrent urinary tract infections only
Correct Answer: Decreasing renal function and hypertension in adulthood
Expert Rationale: Adult polycystic kidney disease (PKD) is a genetic disorder in which fluid-filled cysts
develop in the kidneys, typically manifesting with decreasing renal function and hypertension in
adulthood. The disease progresses gradually and often leads to end-stage renal disease.
8. In chronic glomerulonephritis, which outcome is common?
A) Complete recovery of renal function
Galen College | Q & A | 2026/2027 Edition (PDF)
1. A patient with nephrotic syndrome typically presents with which triad of findings?
A) Hematuria, hypertension, oliguria
B) Proteinuria, hypoalbuminemia, generalized edema
C) Pyuria, bacteriuria, fever
D) Polyuria, polydipsia, hyperglycemia
Correct Answer: Proteinuria, hypoalbuminemia, generalized edema
Expert Rationale: Nephrotic syndrome is defined by massive proteinuria (>3.5 g/day) from increased
glomerular permeability, resulting in hypoalbuminemia and generalized edema. Hematuria and
hypertension are typical of glomerulonephritis, while pyuria suggests infection and polyuria/polydipsia
suggests diabetes.
2. Which laboratory finding is most suggestive of glomerulonephritis rather than nephrotic syndrome?
A) Serum albumin 2.8 g/dL
B) 24-hour urine protein 4.5 g
C) Red blood cell casts in urine
D) Serum cholesterol 320 mg/dL
Correct Answer: Red blood cell casts in urine
Expert Rationale: Red blood cell casts indicate glomerular bleeding, characteristic of glomerulonephritis.
Nephrotic syndrome typically shows fatty casts and oval fat bodies with proteinuria but without
significant hematuria. RBC casts result from inflammation and damage to the glomerular basement
membrane.
3. A patient with acute pyelonephritis would most typically experience which symptom?
A) Oliguria
,B) Fever
C) Edema
D) Hypertension
Correct Answer: Fever
Expert Rationale: Acute pyelonephritis typically presents with fever, chills, and costovertebral angle
tenderness. Oliguria, edema, and hypertension are more characteristic of glomerular or renal failure
conditions, not acute infection of the renal parenchyma.
4. The organism most commonly associated with acute pyelonephritis is:
A) Streptococcus
B) Escherichia coli
C) Klebsiella
D) Enterobacter
Correct Answer: Escherichia coli
Expert Rationale: Escherichia coli is the most common cause of acute pyelonephritis, accounting for the
majority of cases. While Klebsiella, Enterobacter, and other organisms can cause pyelonephritis, E. coli is
the predominant pathogen.
5. A patient with a history of gouty arthritis develops renal calculi. The composition of these calculi is
most likely to be:
A) Potassium oxalate
B) Struvite
C) Cysteine
D) Uric acid crystals
Correct Answer: Uric acid crystals
, Expert Rationale: Patients with gouty arthritis have elevated serum uric acid levels, predisposing them to
uric acid renal calculi. Calcium oxalate stones are the most common type overall, struvite stones are
associated with infection, and cysteine stones are rare and genetic.
6. The most common type of renal stone is:
A) Uric acid
B) Calcium
C) Struvite
D) Cysteine
Correct Answer: Calcium
Expert Rationale: Calcium stones, primarily calcium oxalate, are the most common type of renal calculi.
Uric acid stones are associated with gout, struvite stones with infection, and cysteine stones are a rare
inherited disorder.
7. Adult polycystic kidney disease manifests with which clinical presentation?
A) Acute kidney injury in childhood
B) Decreasing renal function and hypertension in adulthood
C) Rapidly progressive glomerulonephritis
D) Recurrent urinary tract infections only
Correct Answer: Decreasing renal function and hypertension in adulthood
Expert Rationale: Adult polycystic kidney disease (PKD) is a genetic disorder in which fluid-filled cysts
develop in the kidneys, typically manifesting with decreasing renal function and hypertension in
adulthood. The disease progresses gradually and often leads to end-stage renal disease.
8. In chronic glomerulonephritis, which outcome is common?
A) Complete recovery of renal function
