Final Exam: NUR631/ NUR 631 (New 2024/2025 Update) Advanced Physiology and Pathophysiology Exam| Questions and Verified Answers with Rationales| 100% Correct| Graded A- GCU

QUESTION Which clinical manifestations of a urinary tract infection may be demonstrated in an 85-year-old individual? a. Confusion and poorly localized abdominal discomfort b. Dysuria, frequency, and suprapubic pain c. Hematuria and flank pain d. Pyuria, urgency, and frequency Answer: a. Confusion and poorly localized abdominal discomfort Rationale: Older adults with cystitis may demonstrate confusion or vague abdominal discomfort or otherwise be asymptomatic. page 1351 QUESTION Pyelonephritis is usually caused by which type of organism? a. Bacteria b. Fungi c. Viruses d. Parasite Answer: a. Bacteria Rationale: Pyelonephritis is usually caused by the bacteria Escherichia coli, Proteus, or Pseudomonas. pages 1351-52 QUESTION A patient exhibits symptoms including hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/ day with albumin as the major protein. These data suggest the presence of which disorder? a. Cystitis b. Chronic pyelonephritis c. Glomerulonephritis d. Nephrotic syndrome Answer: c. Glomerulonephritis Rationale: The data suggest the patient has the disorder known as glomerulonephritis. Two major changes distinctive of more severe glomerulonephritis are (1) hematuria with red blood cell casts and (2) proteinuria exceeding 3-5 g/ day with albumin as the major protein. These symptoms do not support the diagnosis of the other options. page 1357 QUESTION How are glucose and insulin used to treat hyperkalemia associated with acute renal failure? a. Glucose has an osmotic effect, which attracts water and sodium resulting in more dilute blood and a lower potassium concentration. b. When insulin transports glucose into the cell, it also carries potassium with it. c. Potassium attaches to receptors on the cell membrane of glucose and is carried into the cell. d. Increasing insulin causes ketoacidosis, which causes potassium to move into the cell in exchange for hydrogen Answer: b. When insulin transports glucose into the cell, it also carries potassium with it. Rationale: This selection is the only option that accurately describes glucose metabolism causing potassium to move to the intracellular fluid; insulin infusions therefore can be effective in shifting potassium from the extracellular to intracellular space, along with the transport of glucose. page 1363 QUESTION is used to correct the chronic anemia associated with chronic renal failure a. Intrinsic factor b. Vitamin B12 c. Vitamin D d. Erythropoietin Answer: d. Erythropoietin QUESTION In glomerulonephritis, what damages the epithelial cells resulting in proteinuria? (Select all that apply) a. Ischemia b. Lysosomal enzymes c. Compression from edema d. Activated complement e. Altered membrane permeability Answer: d. Activated complement e. Altered membrane permeability Rationale: Activated complement, inflammatory cytokines, oxidants, proteases, and growth factors attack epithelial cells, alter membrane permeability, and cause proteinuria. None of the other options are responsible for this process. page QUESTION Prerenal injury from poor perfusion can result from which condition? (Select all that apply.) a. Bilateral ureteral obstruction b. Renal vasoconstriction c. Renal artery thrombosis d. Hemorrhage e. Hypotension Answer: b. Renal vasoconstriction c. Renal artery thrombosis d. Hemorrhage e. Hypotension Rationale: Poor perfusion can result from renal artery thrombosis, hypotension related to hypovolemia (dehydration, diarrhea, fluid shifts) or hemorrhage, renal vasoconstriction and alterations in renal regional blood flow, microthrombi, or kidney edema that restricts arterial blood flow. Bilateral ureteral obstruction is not associated with prerenal injuries. page 1360. QUESTION What initiates inflammation in acute poststreptococcal glomerulonephritis? a. Lysosomal enzymes b. Endotoxins from Streptococcus c. Immune complexes d. Immunoglobulin E (IgE) mediated response Answer: c. Immune complexes Rationale: The immune complexes initiate inflammation and glomerular injury in acute poststreptococcal glomerulonephritis. Antigen-antibody complexes are deposited in the glomerulus, or the antigen may be trapped within the glomerulus and immune complexes formed in situ. The other options are not involved in initiating inflammation in this situation. page 1381 QUESTION In immunoglobulin G (IgG) nephropathies such as glomerulonephritis, IgG is deposited in which location? a. Juxtamedullary nephrons b. Glomerulus basement membranes c. Mesangium of the glomerular capillaries d. Parietal epithelium Answer: b. Glomerulus basement membranes Rationale: Glomerulonephritis develops with the deposition of antigen-antibody complexes (IgG, immunoglobulin A [IgA] and C3 complement) in the glomerulus, or the antigen may be trapped within the glomerulus and immune complexes formed in situ. Immunofluorescence microscopy shows lumpy deposits of IgG and C3 complement on the glomerular basement membrane (see figure 39-5) When considering IgG nephropathies the only location of the IgG immunoglobulins is the correct option. page 1381 QUESTION By what mechanism does intussusception cause an intestinal obstruction? a. Telescoping of part of the intestine into another section of intestine, usually causing strangulation of the blood supply b. Twisting the intestine on its mesenteric pedicle, causing occlusion of the blood supply c. Loss of peristaltic motor activity in the intestine, causing an adynamic ileus d. Forming fibrin and scar tissue that attach to the intestinal omentum, causing obstruction Answer: a. Telescoping of part of the intestine into another section of intestine, usually causing strangulation of the blood supply