NURS 231/NURS231 Module 6 V1 |
Pathophysiology Q&A with Rationale | Portage
Learning
1. A patient is diagnosed with prerenal acute kidney injury (AKI). Which of the following
conditions most likely contributed to this diagnosis?
A. Benign prostatic hyperplasia (BPH)
B. Acute tubular necrosis from aminoglycosides
C. Severe dehydration and hypovolemia
D. Glomerulonephritis following a strep infection
Correct Answer: C
Explanation: Prerenal AKI is characterized by conditions that decrease blood flow to the
kidneys without causing direct damage to the renal parenchyma. Severe dehydration leads
to decreased renal perfusion and a drop in glomerular filtration rate. It is the most common
cause of AKI and is typically reversible if the underlying volume deficit is corrected
promptly.
2. Which laboratory value is considered the most reliable indicator of the glomerular
filtration rate (GFR)?
A. Blood Urea Nitrogen (BUN)
B. Serum Potassium
,C. Urine Specific Gravity
D. Serum Creatinine
Correct Answer: D
Explanation: Serum creatinine is a byproduct of muscle metabolism that is filtered
primarily by the glomerulus and not reabsorbed. As the GFR decreases, the level of serum
creatinine rises in a predictable, inverse relationship. While BUN also rises in renal failure,
it is influenced by protein intake and hydration status, making creatinine a more specific
marker.
3. A patient presents with massive proteinuria, hypoalbuminemia, and generalized edema.
Which condition is most consistent with these findings?
A. Nephritic Syndrome
B. Nephrotic Syndrome
C. Acute Cystitis
D. Nephrolithiasis
Correct Answer: B
Explanation: Nephrotic syndrome is defined by a massive loss of protein in the urine,
typically exceeding 3.5 grams per day. This loss of protein leads to hypoalbuminemia,
which decreases the plasma oncotic pressure and results in significant systemic edema. It is
often caused by damage to the glomerular basement membrane or podocytes.
, 4. What is the primary physiological reason for the development of anemia in patients with
Chronic Kidney Disease (CKD)?
A. Inadequate production of erythropoietin by the kidneys
B. Loss of blood through the urinary tract
C. Increased destruction of red blood cells in the spleen
D. Iron deficiency due to dietary restrictions
Correct Answer: A
Explanation: The kidneys are responsible for producing erythropoietin, a hormone that
stimulates the bone marrow to produce red blood cells. In CKD, the functional renal mass
decreases, leading to a significant drop in erythropoietin synthesis. Consequently, patients
develop a normocytic, normochromic anemia that often requires exogenous hormone
replacement.
5. Which of the following is a classic clinical manifestation of postrenal acute kidney injury?
A. Hypotension and tachycardia
B. Low urine specific gravity and high sodium
C. Hematuria with red blood cell casts
D. Bilateral flank pain and urinary tract obstruction
Correct Answer: D
Pathophysiology Q&A with Rationale | Portage
Learning
1. A patient is diagnosed with prerenal acute kidney injury (AKI). Which of the following
conditions most likely contributed to this diagnosis?
A. Benign prostatic hyperplasia (BPH)
B. Acute tubular necrosis from aminoglycosides
C. Severe dehydration and hypovolemia
D. Glomerulonephritis following a strep infection
Correct Answer: C
Explanation: Prerenal AKI is characterized by conditions that decrease blood flow to the
kidneys without causing direct damage to the renal parenchyma. Severe dehydration leads
to decreased renal perfusion and a drop in glomerular filtration rate. It is the most common
cause of AKI and is typically reversible if the underlying volume deficit is corrected
promptly.
2. Which laboratory value is considered the most reliable indicator of the glomerular
filtration rate (GFR)?
A. Blood Urea Nitrogen (BUN)
B. Serum Potassium
,C. Urine Specific Gravity
D. Serum Creatinine
Correct Answer: D
Explanation: Serum creatinine is a byproduct of muscle metabolism that is filtered
primarily by the glomerulus and not reabsorbed. As the GFR decreases, the level of serum
creatinine rises in a predictable, inverse relationship. While BUN also rises in renal failure,
it is influenced by protein intake and hydration status, making creatinine a more specific
marker.
3. A patient presents with massive proteinuria, hypoalbuminemia, and generalized edema.
Which condition is most consistent with these findings?
A. Nephritic Syndrome
B. Nephrotic Syndrome
C. Acute Cystitis
D. Nephrolithiasis
Correct Answer: B
Explanation: Nephrotic syndrome is defined by a massive loss of protein in the urine,
typically exceeding 3.5 grams per day. This loss of protein leads to hypoalbuminemia,
which decreases the plasma oncotic pressure and results in significant systemic edema. It is
often caused by damage to the glomerular basement membrane or podocytes.
, 4. What is the primary physiological reason for the development of anemia in patients with
Chronic Kidney Disease (CKD)?
A. Inadequate production of erythropoietin by the kidneys
B. Loss of blood through the urinary tract
C. Increased destruction of red blood cells in the spleen
D. Iron deficiency due to dietary restrictions
Correct Answer: A
Explanation: The kidneys are responsible for producing erythropoietin, a hormone that
stimulates the bone marrow to produce red blood cells. In CKD, the functional renal mass
decreases, leading to a significant drop in erythropoietin synthesis. Consequently, patients
develop a normocytic, normochromic anemia that often requires exogenous hormone
replacement.
5. Which of the following is a classic clinical manifestation of postrenal acute kidney injury?
A. Hypotension and tachycardia
B. Low urine specific gravity and high sodium
C. Hematuria with red blood cell casts
D. Bilateral flank pain and urinary tract obstruction
Correct Answer: D
