• NSG 530 ACTUAL 09/16/2026
EXAM
NSG 530 ACTUAL EXAM 2026 5/2027 | Advanced
Pathophysiology – Wilkes University | Exams 1-4
Comprehensive Bank | Verified Q&A with Detailed
Rationales | Pass Guaranteed - A+ Graded
P 1
, • NSG 530 ACTUAL 09/16/2026
EXAM
A child who is experiencing the signs and symptoms of influenza has vomited frequently over the last 24 hours.
While discussing vomiting with a group of nursing students, the instructor asks, "What site in the neurologic
system is responsible for vomiting?" Which student response is most accurate?
A) Myenteric plexus
B) Intramural plexus
C) Vagus nerve
D) Chemoreceptor trigger zone
- Correct Answer :Ans: D
Feedback:
The act of vomiting is integrated in the vomiting center, which is located in the dorsal portion of the reticular
formation of the medulla near the sensory nuclei of the vagus. The vomiting center can be activated directly by
irritants or indirectly following input from four different sources, one of which is the chemoreceptor trigger zone
(which is activated by chemical agents such as drugs and toxins).
When caring for a cancer client experiencing chemotherapy-induced nausea and vomiting, which of the
following drugs work to delay this nausea and vomiting by acting on the CNS to block the activation of the NK-1
receptors? Select all that apply.
A) Serotonin (5-hydroxytryamine) antagonists
B) Neurokinin-1 receptor antagonists
C) Promethazine, a neuroleptic medication
D) Compazine, a dopamine (D2) receptor antagonist –
Correct Answer :Ans: A, B
Feedback:
The recently developed Neurokinin-1 (NK-1) receptor antagonists are used for the treatment of acute and
delayed chemotherapy-induced nausea and vomiting. These drugs act centrally to block the activation of the NK-
1 receptors in the vomiting center. Serotonin (5-hydroxytryamine) antagonists are involved in the nausea and
emesis associated with cancer chemotherapy and radiation. Promethazine is a neuroleptic medication.
Compazine, a dopamine (D2) receptor antagonist, depresses vomiting caused by stimulation of the
chemoreceptor trigger zone.
P 2
, • NSG 530 ACTUAL 09/16/2026
EXAM
A client with a history of chronic pyelonephritis has been admitted several times with recurrent bacterial
infection of the urinary tract. The nurse should anticipate educating this client with regard to which common
treatment regimen?
A) Increase intake of cranberry juice to 2 L/day.
B) Continue taking antibiotics for full 10 to 14 days even if symptoms of infection disappear.
C) Force micturition every 2 hours while awake.
D) Take prescribed diuretics early in the day to avoid having to get up during the night.
- Correct Answer :Ans: B
Feedback:
Chronic pyelonephritis involves a recurrent or persistent bacterial infection superimposed on urinary tract
obstruction, urine reflux, or both. Chronic obstructive pyelonephritis can be bilateral, caused by conditions that
obstruct bladder outflow; or unilateral, such as occurs with ureteral obstruction. Cranberry juice, forced
micturition, and diuretics are not standard treatments for chronic pyelonephritis.
Prior to undergoing diagnostic testing with contrast, it is recommended that older adult clients have their
creatinine level checked. The rationale for this is to ensure the client:
A) Is not allergic to shell fish or iodine
B) Will not undergo an acute kidney injury by decreasing renal blood flow
C) Does not have a kidney stone obstructing the urethra
D) Is in good enough health to withstand a walking on a treadmill –
Correct Answer :Ans: B
Feedback:
Some drugs, such as diuretics, high molecular weight radiocontrast media, the immunosuppressive drugs
cyclosporine and tacrolimus, and the nonsteroidal anti-inflammatory drugs (NSAIDs), can cause acute kidney
injury by decreasing renal blood flow. Checking creatinine levels do not predict the client's allergies, a kidney
stone, or tolerance for stress testing.
The most damaging effects of urinary obstruction are the result unrelieved obstruction of urine outflow and:
P 3
, • NSG 530 ACTUAL 09/16/2026
EXAM
A) Urinary stasis
B) Concentrated urine
C) Kidney hyperplasia
D) Renal hypertension –
Correct Answer :Ans: A
Feedback:
The most damaging effects of urinary obstruction are stasis of urine, which predisposes to infection and stone
formation, and unrelieved obstruction of urine outflow. Most commonly, the person has pain, signs, and
symptoms of urinary tract infection (UTI) and manifestations of renal dysfunction, such as an impaired ability to
concentrate urine. Progressive atrophy of the kidney is caused by obstruction of the outflow of urine.
Hypertension is an occasional complication of urinary tract obstruction, since urine flow is obstructed rather than
renal blood flow.
The physician suspects that a client with kidney stones has developed magnesium ammonium phosphate
(struvite) stones based on which of the following urinalysis results? Select all that apply.
A) Elevated uric acid levels
B) Alkaline urine pH
C) High urine phosphate level
D) High bacterial count
E) Presence of cystine particles –
Correct Answer :Ans: B, C, D
Feedback:
Magnesium ammonium phosphate stones, also called struvite stones, form only in alkaline urine and in the
presence of bacteria that possess an enzyme called urease, which splits the urea in the urine into ammonia and
carbon dioxide. The ammonia that is formed takes up a hydrogen ion to become an ammonium ion, increasing
the pH of the urine so that it becomes more alkaline. Because phosphate levels are increased in alkaline urine
and because magnesium always is present in the urine, struvite stones form. Uric acid stones develop in
conditions of gout and high concentrations of uric acid in the urine. Cystine stones account for less than 1% of
kidney stones overall but represent a significant proportion of childhood calculi. They are seen in cystinuria,
which results from a genetic defect in renal transport of cystine.
P 4
EXAM
NSG 530 ACTUAL EXAM 2026 5/2027 | Advanced
Pathophysiology – Wilkes University | Exams 1-4
Comprehensive Bank | Verified Q&A with Detailed
Rationales | Pass Guaranteed - A+ Graded
P 1
, • NSG 530 ACTUAL 09/16/2026
EXAM
A child who is experiencing the signs and symptoms of influenza has vomited frequently over the last 24 hours.
While discussing vomiting with a group of nursing students, the instructor asks, "What site in the neurologic
system is responsible for vomiting?" Which student response is most accurate?
A) Myenteric plexus
B) Intramural plexus
C) Vagus nerve
D) Chemoreceptor trigger zone
- Correct Answer :Ans: D
Feedback:
The act of vomiting is integrated in the vomiting center, which is located in the dorsal portion of the reticular
formation of the medulla near the sensory nuclei of the vagus. The vomiting center can be activated directly by
irritants or indirectly following input from four different sources, one of which is the chemoreceptor trigger zone
(which is activated by chemical agents such as drugs and toxins).
When caring for a cancer client experiencing chemotherapy-induced nausea and vomiting, which of the
following drugs work to delay this nausea and vomiting by acting on the CNS to block the activation of the NK-1
receptors? Select all that apply.
A) Serotonin (5-hydroxytryamine) antagonists
B) Neurokinin-1 receptor antagonists
C) Promethazine, a neuroleptic medication
D) Compazine, a dopamine (D2) receptor antagonist –
Correct Answer :Ans: A, B
Feedback:
The recently developed Neurokinin-1 (NK-1) receptor antagonists are used for the treatment of acute and
delayed chemotherapy-induced nausea and vomiting. These drugs act centrally to block the activation of the NK-
1 receptors in the vomiting center. Serotonin (5-hydroxytryamine) antagonists are involved in the nausea and
emesis associated with cancer chemotherapy and radiation. Promethazine is a neuroleptic medication.
Compazine, a dopamine (D2) receptor antagonist, depresses vomiting caused by stimulation of the
chemoreceptor trigger zone.
P 2
, • NSG 530 ACTUAL 09/16/2026
EXAM
A client with a history of chronic pyelonephritis has been admitted several times with recurrent bacterial
infection of the urinary tract. The nurse should anticipate educating this client with regard to which common
treatment regimen?
A) Increase intake of cranberry juice to 2 L/day.
B) Continue taking antibiotics for full 10 to 14 days even if symptoms of infection disappear.
C) Force micturition every 2 hours while awake.
D) Take prescribed diuretics early in the day to avoid having to get up during the night.
- Correct Answer :Ans: B
Feedback:
Chronic pyelonephritis involves a recurrent or persistent bacterial infection superimposed on urinary tract
obstruction, urine reflux, or both. Chronic obstructive pyelonephritis can be bilateral, caused by conditions that
obstruct bladder outflow; or unilateral, such as occurs with ureteral obstruction. Cranberry juice, forced
micturition, and diuretics are not standard treatments for chronic pyelonephritis.
Prior to undergoing diagnostic testing with contrast, it is recommended that older adult clients have their
creatinine level checked. The rationale for this is to ensure the client:
A) Is not allergic to shell fish or iodine
B) Will not undergo an acute kidney injury by decreasing renal blood flow
C) Does not have a kidney stone obstructing the urethra
D) Is in good enough health to withstand a walking on a treadmill –
Correct Answer :Ans: B
Feedback:
Some drugs, such as diuretics, high molecular weight radiocontrast media, the immunosuppressive drugs
cyclosporine and tacrolimus, and the nonsteroidal anti-inflammatory drugs (NSAIDs), can cause acute kidney
injury by decreasing renal blood flow. Checking creatinine levels do not predict the client's allergies, a kidney
stone, or tolerance for stress testing.
The most damaging effects of urinary obstruction are the result unrelieved obstruction of urine outflow and:
P 3
, • NSG 530 ACTUAL 09/16/2026
EXAM
A) Urinary stasis
B) Concentrated urine
C) Kidney hyperplasia
D) Renal hypertension –
Correct Answer :Ans: A
Feedback:
The most damaging effects of urinary obstruction are stasis of urine, which predisposes to infection and stone
formation, and unrelieved obstruction of urine outflow. Most commonly, the person has pain, signs, and
symptoms of urinary tract infection (UTI) and manifestations of renal dysfunction, such as an impaired ability to
concentrate urine. Progressive atrophy of the kidney is caused by obstruction of the outflow of urine.
Hypertension is an occasional complication of urinary tract obstruction, since urine flow is obstructed rather than
renal blood flow.
The physician suspects that a client with kidney stones has developed magnesium ammonium phosphate
(struvite) stones based on which of the following urinalysis results? Select all that apply.
A) Elevated uric acid levels
B) Alkaline urine pH
C) High urine phosphate level
D) High bacterial count
E) Presence of cystine particles –
Correct Answer :Ans: B, C, D
Feedback:
Magnesium ammonium phosphate stones, also called struvite stones, form only in alkaline urine and in the
presence of bacteria that possess an enzyme called urease, which splits the urea in the urine into ammonia and
carbon dioxide. The ammonia that is formed takes up a hydrogen ion to become an ammonium ion, increasing
the pH of the urine so that it becomes more alkaline. Because phosphate levels are increased in alkaline urine
and because magnesium always is present in the urine, struvite stones form. Uric acid stones develop in
conditions of gout and high concentrations of uric acid in the urine. Cystine stones account for less than 1% of
kidney stones overall but represent a significant proportion of childhood calculi. They are seen in cystinuria,
which results from a genetic defect in renal transport of cystine.
P 4
