NURS 611 Advanced
Pathophysiology Exam – 2026
Latest Update: Questions
with Verified Answers &
Rationales
Renal System
1. Acute unilateral renal obstruction and
hypertension. What amount of cardiac output to
kidneys require?
A. 10–15% of cardiac output
B. At least 20–25% of cardiac output
C. 50% of cardiac output
D. 5–10% of cardiac output
Ans: B. At least 20–25% of cardiac output (MAP)
Rationale: The kidneys require at least 20–25% of cardiac
output to maintain adequate perfusion and filtration.
2. What does reduced perfusion of kidneys cause?
(Select all that apply.)
A. Activation of the renin-angiotensin-aldosterone system
(RAAS)
B. Constriction of peripheral arterioles
C. Decreased heart rate
D. Increased urine output
Ans: A, B
Rationale: Reduced renal perfusion activates RAAS and
causes constriction of peripheral arterioles, which increases
blood pressure.
3. What is the most common type of renal stone?
A. Uric acid stone
B. Calcium oxalate stone
1
,C. Struvite stone
D. Cystine stone
Ans: B. Calcium oxalate stone
Rationale: Calcium oxalate stones are the most common
type of renal stone.
4. Passage of kidney stones can be extremely painful.
What may they produce? Why?
A. Referred pain to the umbilicus area; due to sensory
innervation of the upper ureter from the 10th thoracic nerve
roots
B. Referred pain to the lower back; due to lumbar nerve
roots
C. Referred pain to the groin; due to sacral nerve roots
D. Referred pain to the shoulder; due to phrenic nerve
Ans: A. Referred pain to the umbilicus area; due to sensory
innervation of the upper ureter from the 10th thoracic nerve
roots
Rationale: Kidney stones can produce referred pain to the
umbilicus area because the sensory innervation of the upper
ureter arises from the 10th thoracic nerve roots.
5. What are the two common clinical manifestations of
a urinary tract infection in an older adult?
A. Fever and dysuria
B. Confusion and poorly localized abdominal discomfort
C. Hematuria and flank pain
D. Frequency and urgency
Ans: B. Confusion and poorly localized abdominal discomfort
Rationale: Older adults with UTIs often present with
confusion and poorly localized abdominal discomfort rather
than classic symptoms.
6. Why can UTIs in older adults be very difficult to
diagnose?
A. Due to vague symptoms
B. Due to lack of available tests
2
,C. Due to patient noncompliance
D. Due to rapid progression
Ans: A. Due to vague symptoms
Rationale: UTIs in older adults are difficult to diagnose
because symptoms are often vague and nonspecific.
7. What is pyelonephritis?
A. Infection of the bladder
B. Infection of one or both upper urinary tracts (ureter, renal
pelvis, and kidney interstitium)
C. Inflammation of the glomerulus
D. Infection of the urethra
Ans: B. Infection of one or both upper urinary tracts (ureter,
renal pelvis, and kidney interstitium)
Rationale: Pyelonephritis is an infection of one or both
upper urinary tracts, including the ureter, renal pelvis, and
kidney interstitium.
8. What are the two most common underlying risk
factors to pyelonephritis?
A. Urinary obstruction and reflux of urine from the bladder
(vesicoureteral reflux)
B. Diabetes and hypertension
C. Smoking and alcohol use
D. Dehydration and poor hygiene
Ans: A. Urinary obstruction and reflux of urine from the
bladder (vesicoureteral reflux)
Rationale: The two most common underlying risk factors for
pyelonephritis are urinary obstruction and vesicoureteral
reflux.
9. Name 3 microorganisms usually associated with
acute pyelonephritis.
A. E. coli, Proteus, and Pseudomonas
B. Staphylococcus, Streptococcus, and Enterococcus
C. Candida, Aspergillus, and Cryptococcus
D. Klebsiella, Serratia, and Acinetobacter
3
, Ans: A. E. coli, Proteus, and Pseudomonas
Rationale: E. coli, Proteus, and Pseudomonas are commonly
associated with acute pyelonephritis.
10. How do pyelonephritis-associated microorganisms
increase the risk of stone formation?
A. They split urea into ammonia, making alkaline urine
B. They increase calcium excretion
C. They decrease urine pH
D. They cause dehydration
Ans: A. They split urea into ammonia, making alkaline urine
Rationale: These microorganisms split urea into ammonia,
making the urine alkaline, which promotes stone formation.
11. What does Painful Bladder Syndrome/Interstitial
Cystitis (PBS/IC) include? (Select all that apply.)
A. Nonbacterial infectious cystitis (viral, mycobacterial,
chlamydial, fungal)
B. Noninfectious cystitis (radiation, chemical, autoimmune,
hypersensitivity)
C. Bacterial cystitis
D. Obstructive uropathy
Ans: A, B
Rationale: PBS/IC includes nonbacterial infectious cystitis
and noninfectious cystitis.
12. What is the cause of PBS/IC?
A. The exact cause is unknown, but an autoimmune reaction
may be responsible for the inflammatory response
B. Bacterial infection
C. Urinary obstruction
D. Genetic mutation
Ans: A. The exact cause is unknown, but an autoimmune
reaction may be responsible for the inflammatory response
Rationale: The exact cause of PBS/IC is unknown, but an
autoimmune reaction may be responsible for the
inflammatory response.
4
Pathophysiology Exam – 2026
Latest Update: Questions
with Verified Answers &
Rationales
Renal System
1. Acute unilateral renal obstruction and
hypertension. What amount of cardiac output to
kidneys require?
A. 10–15% of cardiac output
B. At least 20–25% of cardiac output
C. 50% of cardiac output
D. 5–10% of cardiac output
Ans: B. At least 20–25% of cardiac output (MAP)
Rationale: The kidneys require at least 20–25% of cardiac
output to maintain adequate perfusion and filtration.
2. What does reduced perfusion of kidneys cause?
(Select all that apply.)
A. Activation of the renin-angiotensin-aldosterone system
(RAAS)
B. Constriction of peripheral arterioles
C. Decreased heart rate
D. Increased urine output
Ans: A, B
Rationale: Reduced renal perfusion activates RAAS and
causes constriction of peripheral arterioles, which increases
blood pressure.
3. What is the most common type of renal stone?
A. Uric acid stone
B. Calcium oxalate stone
1
,C. Struvite stone
D. Cystine stone
Ans: B. Calcium oxalate stone
Rationale: Calcium oxalate stones are the most common
type of renal stone.
4. Passage of kidney stones can be extremely painful.
What may they produce? Why?
A. Referred pain to the umbilicus area; due to sensory
innervation of the upper ureter from the 10th thoracic nerve
roots
B. Referred pain to the lower back; due to lumbar nerve
roots
C. Referred pain to the groin; due to sacral nerve roots
D. Referred pain to the shoulder; due to phrenic nerve
Ans: A. Referred pain to the umbilicus area; due to sensory
innervation of the upper ureter from the 10th thoracic nerve
roots
Rationale: Kidney stones can produce referred pain to the
umbilicus area because the sensory innervation of the upper
ureter arises from the 10th thoracic nerve roots.
5. What are the two common clinical manifestations of
a urinary tract infection in an older adult?
A. Fever and dysuria
B. Confusion and poorly localized abdominal discomfort
C. Hematuria and flank pain
D. Frequency and urgency
Ans: B. Confusion and poorly localized abdominal discomfort
Rationale: Older adults with UTIs often present with
confusion and poorly localized abdominal discomfort rather
than classic symptoms.
6. Why can UTIs in older adults be very difficult to
diagnose?
A. Due to vague symptoms
B. Due to lack of available tests
2
,C. Due to patient noncompliance
D. Due to rapid progression
Ans: A. Due to vague symptoms
Rationale: UTIs in older adults are difficult to diagnose
because symptoms are often vague and nonspecific.
7. What is pyelonephritis?
A. Infection of the bladder
B. Infection of one or both upper urinary tracts (ureter, renal
pelvis, and kidney interstitium)
C. Inflammation of the glomerulus
D. Infection of the urethra
Ans: B. Infection of one or both upper urinary tracts (ureter,
renal pelvis, and kidney interstitium)
Rationale: Pyelonephritis is an infection of one or both
upper urinary tracts, including the ureter, renal pelvis, and
kidney interstitium.
8. What are the two most common underlying risk
factors to pyelonephritis?
A. Urinary obstruction and reflux of urine from the bladder
(vesicoureteral reflux)
B. Diabetes and hypertension
C. Smoking and alcohol use
D. Dehydration and poor hygiene
Ans: A. Urinary obstruction and reflux of urine from the
bladder (vesicoureteral reflux)
Rationale: The two most common underlying risk factors for
pyelonephritis are urinary obstruction and vesicoureteral
reflux.
9. Name 3 microorganisms usually associated with
acute pyelonephritis.
A. E. coli, Proteus, and Pseudomonas
B. Staphylococcus, Streptococcus, and Enterococcus
C. Candida, Aspergillus, and Cryptococcus
D. Klebsiella, Serratia, and Acinetobacter
3
, Ans: A. E. coli, Proteus, and Pseudomonas
Rationale: E. coli, Proteus, and Pseudomonas are commonly
associated with acute pyelonephritis.
10. How do pyelonephritis-associated microorganisms
increase the risk of stone formation?
A. They split urea into ammonia, making alkaline urine
B. They increase calcium excretion
C. They decrease urine pH
D. They cause dehydration
Ans: A. They split urea into ammonia, making alkaline urine
Rationale: These microorganisms split urea into ammonia,
making the urine alkaline, which promotes stone formation.
11. What does Painful Bladder Syndrome/Interstitial
Cystitis (PBS/IC) include? (Select all that apply.)
A. Nonbacterial infectious cystitis (viral, mycobacterial,
chlamydial, fungal)
B. Noninfectious cystitis (radiation, chemical, autoimmune,
hypersensitivity)
C. Bacterial cystitis
D. Obstructive uropathy
Ans: A, B
Rationale: PBS/IC includes nonbacterial infectious cystitis
and noninfectious cystitis.
12. What is the cause of PBS/IC?
A. The exact cause is unknown, but an autoimmune reaction
may be responsible for the inflammatory response
B. Bacterial infection
C. Urinary obstruction
D. Genetic mutation
Ans: A. The exact cause is unknown, but an autoimmune
reaction may be responsible for the inflammatory response
Rationale: The exact cause of PBS/IC is unknown, but an
autoimmune reaction may be responsible for the
inflammatory response.
4
