NR 545 PHARMACOLOGY, PHYSICAL ASSESSMENT &
PATHOPHYSIOLOGY EXAM 4 (PDF) | 2026 EXAM
QUESTIONS AND ANSWERS + RATIONALES | STUDY GUIDE |
100% CORRECT
Section 1: Renal and Urinary Disorders – Pathophysiology
1. Proteinuria is defined as:
A) The presence of glucose in the urine
B) The leakage of albumin or mixed plasma proteins into the filtrate
C) The presence of red blood cells in the urine
D) The presence of ketones in the urine
Correct Answer: B) The leakage of albumin or mixed plasma proteins into the
filtrate
Rationale: Proteinuria (albuminuria) indicates leakage of albumin or mixed
plasma proteins into the filtrate due to inflammation and increased glomerular
permeability . It is a key finding in glomerulonephritis and nephrotic syndrome.
2. What do BUN and creatinine measure?
A) Liver function
B) Kidney function (failure to excrete nitrogen waste)
C) Pancreatic function
D) Cardiac function
Correct Answer: B) Kidney function (failure to excrete nitrogen waste)
Rationale: BUN and creatinine are kidney function tests that measure the failure
to excrete nitrogen wastes. Normal BUN is 10-20 mg/dL, and normal creatinine is
0.6-1.2 mg/dL . Elevated levels indicate decreased GFR.
3. What is a normal GFR?
A) Less than 60 mL/min
B) Over 90 mL/min
C) 30-59 mL/min
D) 15-29 mL/min
Correct Answer: B) Over 90 mL/min
,Rationale: Normal GFR (glomerular filtration rate) is over 90 mL/min. GFR
assesses kidney function and declines in kidney disease . A GFR below 60 mL/min
for 3 months or more indicates chronic kidney disease.
4. What is renal colic?
A) Constant dull ache in the flank
B) Spasms in the flank area radiating to the groin
C) Pain in the suprapubic area
D) Painless hematuria
Correct Answer: B) Spasms in the flank area radiating to the groin
Rationale: Renal colic refers to spasms in the flank area radiating to the groin,
typically caused by kidney stones (urolithiasis) . The pain is severe and intermittent
as the stone passes through the ureter.
5. Which hormone controls sodium reabsorption and water by exchanging Na
ions for K or hydrogen ions in the distal convoluted tubule?
A) Antidiuretic hormone (ADH)
B) Aldosterone
C) Atrial natriuretic hormone
D) Renin
Correct Answer: B) Aldosterone
Rationale: Aldosterone, secreted by the adrenal cortex, controls sodium
reabsorption and water by exchanging Na ions for K or hydrogen ions in the distal
convoluted tubule . ADH controls water reabsorption by altering permeability of
the distal convoluted tubule and collecting duct.
6. What is the most common pathogen causing urinary tract infections?
A) Staphylococcus saprophyticus
B) Escherichia coli
C) Klebsiella pneumoniae
D) Pseudomonas aeruginosa
Correct Answer: B) Escherichia coli
,Rationale: Escherichia coli is the most common pathogen causing urinary tract
infections . It is a normal resident of the intestine that can ascend the urethra to
cause infection.
Section 2: Renal and Urinary Disorders – Cystitis and Pyelonephritis
7. What is pyelonephritis?
A) Inflammation of the bladder
B) An ascending infection from the urethra to the bladder
C) Infection of the kidney and renal pelvis
D) Inflammation of the glomeruli
Correct Answer: C) Infection of the kidney and renal pelvis
Rationale: Pyelonephritis is an infection of the kidney and renal pelvis. It is an
ascending infection from the urethra to the bladder, extending into the kidney .
8. What are the signs and symptoms of pyelonephritis?
A) Polyuria with dilute urine
B) Fever, cloudy urine with foul odor, chills, frequent urination, and costovertebral
angle tenderness
C) Painless hematuria
D) Oliguria and edema
Correct Answer: B) Fever, cloudy urine with foul odor, chills, frequent urination,
and costovertebral angle tenderness
Rationale: Signs and symptoms of pyelonephritis include fever, cloudy urine with
foul odor, chills, frequent urination, and costovertebral angle tenderness
[citation:2,12]. It is a more severe disease than cystitis.
9. What is cystitis?
A) Inflammation of the bladder wall
B) Infection of the kidney
C) Inflammation of the glomeruli
D) Obstruction of the ureter
Correct Answer: A) Inflammation of the bladder wall
, Rationale: Cystitis is an infection of the bladder wall. The bladder wall becomes
inflamed, red, swollen, and sometimes ulcerated, and bladder capacity is reduced .
10. What are the signs and symptoms of cystitis?
A) Fever and flank pain
B) Dysuria, urgency, frequency, nocturia, and lower abdominal pain
C) Polyuria and polydipsia
D) Painless hematuria
Correct Answer: B) Dysuria, urgency, frequency, nocturia, and lower abdominal
pain
Rationale: Cystitis presents with dysuria (painful urination), urgency, frequency,
nocturia, and lower abdominal pain . Systemic signs such as fever may also be
present.
Section 3: Renal Disorders – Glomerulonephritis
11. What is glomerulonephritis?
A) Inflammation of the bladder
B) Infection of the renal pelvis
C) Inflammation of the glomeruli
D) Obstruction of the ureter
Correct Answer: C) Inflammation of the glomeruli
Rationale: Glomerulonephritis is inflammation of the glomeruli . It can be acute or
chronic and may result from immune-mediated processes, often following a
streptococcal infection.
12. What is the pathophysiology of acute glomerulonephritis?
A) Bacterial infection of the renal tubules
B) Antigen-antibody complex deposition in the glomerular capillaries
C) Obstruction of the ureter by a stone
D) Direct viral invasion of the kidney
Correct Answer: B) Antigen-antibody complex deposition in the glomerular
capillaries
PATHOPHYSIOLOGY EXAM 4 (PDF) | 2026 EXAM
QUESTIONS AND ANSWERS + RATIONALES | STUDY GUIDE |
100% CORRECT
Section 1: Renal and Urinary Disorders – Pathophysiology
1. Proteinuria is defined as:
A) The presence of glucose in the urine
B) The leakage of albumin or mixed plasma proteins into the filtrate
C) The presence of red blood cells in the urine
D) The presence of ketones in the urine
Correct Answer: B) The leakage of albumin or mixed plasma proteins into the
filtrate
Rationale: Proteinuria (albuminuria) indicates leakage of albumin or mixed
plasma proteins into the filtrate due to inflammation and increased glomerular
permeability . It is a key finding in glomerulonephritis and nephrotic syndrome.
2. What do BUN and creatinine measure?
A) Liver function
B) Kidney function (failure to excrete nitrogen waste)
C) Pancreatic function
D) Cardiac function
Correct Answer: B) Kidney function (failure to excrete nitrogen waste)
Rationale: BUN and creatinine are kidney function tests that measure the failure
to excrete nitrogen wastes. Normal BUN is 10-20 mg/dL, and normal creatinine is
0.6-1.2 mg/dL . Elevated levels indicate decreased GFR.
3. What is a normal GFR?
A) Less than 60 mL/min
B) Over 90 mL/min
C) 30-59 mL/min
D) 15-29 mL/min
Correct Answer: B) Over 90 mL/min
,Rationale: Normal GFR (glomerular filtration rate) is over 90 mL/min. GFR
assesses kidney function and declines in kidney disease . A GFR below 60 mL/min
for 3 months or more indicates chronic kidney disease.
4. What is renal colic?
A) Constant dull ache in the flank
B) Spasms in the flank area radiating to the groin
C) Pain in the suprapubic area
D) Painless hematuria
Correct Answer: B) Spasms in the flank area radiating to the groin
Rationale: Renal colic refers to spasms in the flank area radiating to the groin,
typically caused by kidney stones (urolithiasis) . The pain is severe and intermittent
as the stone passes through the ureter.
5. Which hormone controls sodium reabsorption and water by exchanging Na
ions for K or hydrogen ions in the distal convoluted tubule?
A) Antidiuretic hormone (ADH)
B) Aldosterone
C) Atrial natriuretic hormone
D) Renin
Correct Answer: B) Aldosterone
Rationale: Aldosterone, secreted by the adrenal cortex, controls sodium
reabsorption and water by exchanging Na ions for K or hydrogen ions in the distal
convoluted tubule . ADH controls water reabsorption by altering permeability of
the distal convoluted tubule and collecting duct.
6. What is the most common pathogen causing urinary tract infections?
A) Staphylococcus saprophyticus
B) Escherichia coli
C) Klebsiella pneumoniae
D) Pseudomonas aeruginosa
Correct Answer: B) Escherichia coli
,Rationale: Escherichia coli is the most common pathogen causing urinary tract
infections . It is a normal resident of the intestine that can ascend the urethra to
cause infection.
Section 2: Renal and Urinary Disorders – Cystitis and Pyelonephritis
7. What is pyelonephritis?
A) Inflammation of the bladder
B) An ascending infection from the urethra to the bladder
C) Infection of the kidney and renal pelvis
D) Inflammation of the glomeruli
Correct Answer: C) Infection of the kidney and renal pelvis
Rationale: Pyelonephritis is an infection of the kidney and renal pelvis. It is an
ascending infection from the urethra to the bladder, extending into the kidney .
8. What are the signs and symptoms of pyelonephritis?
A) Polyuria with dilute urine
B) Fever, cloudy urine with foul odor, chills, frequent urination, and costovertebral
angle tenderness
C) Painless hematuria
D) Oliguria and edema
Correct Answer: B) Fever, cloudy urine with foul odor, chills, frequent urination,
and costovertebral angle tenderness
Rationale: Signs and symptoms of pyelonephritis include fever, cloudy urine with
foul odor, chills, frequent urination, and costovertebral angle tenderness
[citation:2,12]. It is a more severe disease than cystitis.
9. What is cystitis?
A) Inflammation of the bladder wall
B) Infection of the kidney
C) Inflammation of the glomeruli
D) Obstruction of the ureter
Correct Answer: A) Inflammation of the bladder wall
, Rationale: Cystitis is an infection of the bladder wall. The bladder wall becomes
inflamed, red, swollen, and sometimes ulcerated, and bladder capacity is reduced .
10. What are the signs and symptoms of cystitis?
A) Fever and flank pain
B) Dysuria, urgency, frequency, nocturia, and lower abdominal pain
C) Polyuria and polydipsia
D) Painless hematuria
Correct Answer: B) Dysuria, urgency, frequency, nocturia, and lower abdominal
pain
Rationale: Cystitis presents with dysuria (painful urination), urgency, frequency,
nocturia, and lower abdominal pain . Systemic signs such as fever may also be
present.
Section 3: Renal Disorders – Glomerulonephritis
11. What is glomerulonephritis?
A) Inflammation of the bladder
B) Infection of the renal pelvis
C) Inflammation of the glomeruli
D) Obstruction of the ureter
Correct Answer: C) Inflammation of the glomeruli
Rationale: Glomerulonephritis is inflammation of the glomeruli . It can be acute or
chronic and may result from immune-mediated processes, often following a
streptococcal infection.
12. What is the pathophysiology of acute glomerulonephritis?
A) Bacterial infection of the renal tubules
B) Antigen-antibody complex deposition in the glomerular capillaries
C) Obstruction of the ureter by a stone
D) Direct viral invasion of the kidney
Correct Answer: B) Antigen-antibody complex deposition in the glomerular
capillaries
