,NR 547 Advanced Pathophysiology final exam 2025 Complete Actual
Exam Questions 1- 00 Examplify Online Proctored Exam Full Review
2026/2027 update with Rationales chamberlain college of nursing.
1. What is acute renal failure?
Correct Answer: Reversible
Rationale: This question tests knowledge of the definition and prognosis of acute renal failure.
Acute renal failure (also called acute kidney injury) is a sudden decline in kidney function that is
potentially reversible if the underlying cause is identified and treated promptly. The detailed
rationale should explain that the reversibility distinguishes acute renal failure from chronic
kidney disease, which is progressive and irreversible, and that the nurse should monitor urine
output, creatinine, BUN, and electrolyte levels to evaluate recovery.
2. How is prognosis determined in acute renal failure?
Correct Answer: Kidneys respond to diuretic with good output; this indicates that kidneys are
functioning well
Rationale: This question tests knowledge of how prognosis is determined in acute renal failure.
The detailed rationale should explain that if the kidneys respond to a diuretic with good urine
output, this indicates that the renal tubules are still functioning and that the kidneys are
recovering. The nurse should monitor the response to diuretics, urine output, and renal
function tests to evaluate the patient's prognosis.
3. What is acute pyelonephritis?
Correct Answer: Diagnosing by clinical symptoms alone can be difficult; can be similar to cystitis.
Diagnosis established by urine culture, urinalysis (WBC casts indicates pyelonephritis, but may
not always be present), signs/symptoms, and complicated pyelonephritis requires blood
cultures and urinary tract imaging
Rationale: This question tests knowledge of acute pyelonephritis. The detailed rationale should
explain that acute pyelonephritis is an infection of the kidney that can be difficult to distinguish
from cystitis (bladder infection) based on symptoms alone, and that diagnosis requires urine
culture, urinalysis (looking for WBC casts), and in complicated cases, blood cultures and urinary
tract imaging. The nurse should anticipate administering antibiotics and monitoring for
complications such as sepsis.
4. What are the goals of treatment for renal calculi (renal stones)?
,Correct Answer: Manage acute pain, promote passage of stone, reduce size of stone, prevent
new stone formation
Rationale: This question tests knowledge of the treatment goals for renal calculi. The detailed
rationale should explain that the goals of treatment are to manage acute pain (with analgesics
and antispasmodics), promote passage of the stone (with hydration and ambulation), reduce
the size of the stone (with lithotripsy or medications), and prevent new stone formation (with
dietary modifications and medications). The nurse should strain the urine to catch the stone for
analysis and teach the patient about prevention.
5. What is chronic renal failure?
Correct Answer: Chronic Kidney Disease (CKD) is a progressive loss of renal function associated
with systemic disease such as hypertension, diabetes mellitus (most significant risk factor),
systemic lupus erythematosus, or intrinsic kidney disease. CKD stage is determined by estimates
of GFR and albuminuria
Rationale: This question tests knowledge of chronic renal failure. The detailed rationale should
explain that CKD is a progressive and irreversible loss of kidney function that is most commonly
caused by diabetes mellitus and hypertension, and that staging is based on GFR and
albuminuria. The nurse should monitor renal function, blood pressure, blood glucose, and
electrolyte levels.
6. Who is a candidate for dialysis?
Correct Answer: End-stage renal disease (ESRD) is the final stage of CKD with the number one
cause being diabetes mellitus combined with hypertension. At this point, the patient is
completely dependent on dialysis to survive. CKD is classified into five stages and is based on
the patient's GFR rather than symptoms. Patients will need dialysis when the following
symptoms are present: metabolic acidosis, hyperkalemia (with EKG changes such as peaked T-
waves), drug toxicity (salicylates, lithium, isopropanol, methanol, ethylene glycol), fluid volume
overload not responsive to diuretics, and uremic symptoms due to nitrogenous wastes in the
bloodstream
Rationale: This question tests knowledge of the indications for dialysis. The detailed rationale
should explain that dialysis is indicated for end-stage renal disease and for specific
complications of kidney failure, including metabolic acidosis, hyperkalemia with EKG changes,
drug toxicity, fluid overload unresponsive to diuretics, and uremic symptoms. The nurse should
monitor for these indications and prepare the patient for dialysis when they occur.
7. What is Stage I CKD?
Correct Answer: There is kidney damage with normal or elevated GFR (90-120)
, Rationale: This question tests knowledge of the stages of chronic kidney disease. The detailed
rationale should explain that Stage I CKD is characterized by kidney damage with a normal or
elevated GFR of 90 to 120 mL/min, and that the nurse should focus on identifying and treating
the underlying cause to prevent progression.
8. What is Stage II CKD?
Correct Answer: There is kidney damage with mild decrease in GFR (60-89)
Rationale: This question tests knowledge of the stages of chronic kidney disease. The detailed
rationale should explain that Stage II CKD is characterized by kidney damage with a mild
decrease in GFR of 60 to 89 mL/min, and that the nurse should monitor renal function and
manage risk factors such as hypertension and diabetes.
9. What is Stage III CKD?
Correct Answer: There is a moderate decrease in GFR (30-59)
Rationale: This question tests knowledge of the stages of chronic kidney disease. The detailed
rationale should explain that Stage III CKD is characterized by a moderate decrease in GFR of 30
to 59 mL/min, and that the nurse should monitor for complications such as anemia,
hyperparathyroidism, and hyperphosphatemia.
10. What is Stage IV CKD?
Correct Answer: There is a severe decrease in GFR (15-29)
Rationale: This question tests knowledge of the stages of chronic kidney disease. The detailed
rationale should explain that Stage IV CKD is characterized by a severe decrease in GFR of 15 to
29 mL/min, and that once Stage IV is reached, progression to Stage V is inevitable, as is the need
for dialysis or kidney transplant. The nurse should prepare the patient for renal replacement
therapy.
11. What is Stage V CKD?
Correct Answer: Kidney failure - End-stage renal disease (<15, dialysis). Once Stage IV is
reached, progression to Stage V is inevitable as well as dialysis or kidney transplant
Rationale: This question tests knowledge of the stages of chronic kidney disease. The detailed
rationale should explain that Stage V CKD is end-stage renal disease with a GFR of less than 15
mL/min, requiring dialysis or kidney transplant for survival. The nurse should provide
comprehensive education and support to the patient and family.
12. What are the complications of decreased GFR?
Exam Questions 1- 00 Examplify Online Proctored Exam Full Review
2026/2027 update with Rationales chamberlain college of nursing.
1. What is acute renal failure?
Correct Answer: Reversible
Rationale: This question tests knowledge of the definition and prognosis of acute renal failure.
Acute renal failure (also called acute kidney injury) is a sudden decline in kidney function that is
potentially reversible if the underlying cause is identified and treated promptly. The detailed
rationale should explain that the reversibility distinguishes acute renal failure from chronic
kidney disease, which is progressive and irreversible, and that the nurse should monitor urine
output, creatinine, BUN, and electrolyte levels to evaluate recovery.
2. How is prognosis determined in acute renal failure?
Correct Answer: Kidneys respond to diuretic with good output; this indicates that kidneys are
functioning well
Rationale: This question tests knowledge of how prognosis is determined in acute renal failure.
The detailed rationale should explain that if the kidneys respond to a diuretic with good urine
output, this indicates that the renal tubules are still functioning and that the kidneys are
recovering. The nurse should monitor the response to diuretics, urine output, and renal
function tests to evaluate the patient's prognosis.
3. What is acute pyelonephritis?
Correct Answer: Diagnosing by clinical symptoms alone can be difficult; can be similar to cystitis.
Diagnosis established by urine culture, urinalysis (WBC casts indicates pyelonephritis, but may
not always be present), signs/symptoms, and complicated pyelonephritis requires blood
cultures and urinary tract imaging
Rationale: This question tests knowledge of acute pyelonephritis. The detailed rationale should
explain that acute pyelonephritis is an infection of the kidney that can be difficult to distinguish
from cystitis (bladder infection) based on symptoms alone, and that diagnosis requires urine
culture, urinalysis (looking for WBC casts), and in complicated cases, blood cultures and urinary
tract imaging. The nurse should anticipate administering antibiotics and monitoring for
complications such as sepsis.
4. What are the goals of treatment for renal calculi (renal stones)?
,Correct Answer: Manage acute pain, promote passage of stone, reduce size of stone, prevent
new stone formation
Rationale: This question tests knowledge of the treatment goals for renal calculi. The detailed
rationale should explain that the goals of treatment are to manage acute pain (with analgesics
and antispasmodics), promote passage of the stone (with hydration and ambulation), reduce
the size of the stone (with lithotripsy or medications), and prevent new stone formation (with
dietary modifications and medications). The nurse should strain the urine to catch the stone for
analysis and teach the patient about prevention.
5. What is chronic renal failure?
Correct Answer: Chronic Kidney Disease (CKD) is a progressive loss of renal function associated
with systemic disease such as hypertension, diabetes mellitus (most significant risk factor),
systemic lupus erythematosus, or intrinsic kidney disease. CKD stage is determined by estimates
of GFR and albuminuria
Rationale: This question tests knowledge of chronic renal failure. The detailed rationale should
explain that CKD is a progressive and irreversible loss of kidney function that is most commonly
caused by diabetes mellitus and hypertension, and that staging is based on GFR and
albuminuria. The nurse should monitor renal function, blood pressure, blood glucose, and
electrolyte levels.
6. Who is a candidate for dialysis?
Correct Answer: End-stage renal disease (ESRD) is the final stage of CKD with the number one
cause being diabetes mellitus combined with hypertension. At this point, the patient is
completely dependent on dialysis to survive. CKD is classified into five stages and is based on
the patient's GFR rather than symptoms. Patients will need dialysis when the following
symptoms are present: metabolic acidosis, hyperkalemia (with EKG changes such as peaked T-
waves), drug toxicity (salicylates, lithium, isopropanol, methanol, ethylene glycol), fluid volume
overload not responsive to diuretics, and uremic symptoms due to nitrogenous wastes in the
bloodstream
Rationale: This question tests knowledge of the indications for dialysis. The detailed rationale
should explain that dialysis is indicated for end-stage renal disease and for specific
complications of kidney failure, including metabolic acidosis, hyperkalemia with EKG changes,
drug toxicity, fluid overload unresponsive to diuretics, and uremic symptoms. The nurse should
monitor for these indications and prepare the patient for dialysis when they occur.
7. What is Stage I CKD?
Correct Answer: There is kidney damage with normal or elevated GFR (90-120)
, Rationale: This question tests knowledge of the stages of chronic kidney disease. The detailed
rationale should explain that Stage I CKD is characterized by kidney damage with a normal or
elevated GFR of 90 to 120 mL/min, and that the nurse should focus on identifying and treating
the underlying cause to prevent progression.
8. What is Stage II CKD?
Correct Answer: There is kidney damage with mild decrease in GFR (60-89)
Rationale: This question tests knowledge of the stages of chronic kidney disease. The detailed
rationale should explain that Stage II CKD is characterized by kidney damage with a mild
decrease in GFR of 60 to 89 mL/min, and that the nurse should monitor renal function and
manage risk factors such as hypertension and diabetes.
9. What is Stage III CKD?
Correct Answer: There is a moderate decrease in GFR (30-59)
Rationale: This question tests knowledge of the stages of chronic kidney disease. The detailed
rationale should explain that Stage III CKD is characterized by a moderate decrease in GFR of 30
to 59 mL/min, and that the nurse should monitor for complications such as anemia,
hyperparathyroidism, and hyperphosphatemia.
10. What is Stage IV CKD?
Correct Answer: There is a severe decrease in GFR (15-29)
Rationale: This question tests knowledge of the stages of chronic kidney disease. The detailed
rationale should explain that Stage IV CKD is characterized by a severe decrease in GFR of 15 to
29 mL/min, and that once Stage IV is reached, progression to Stage V is inevitable, as is the need
for dialysis or kidney transplant. The nurse should prepare the patient for renal replacement
therapy.
11. What is Stage V CKD?
Correct Answer: Kidney failure - End-stage renal disease (<15, dialysis). Once Stage IV is
reached, progression to Stage V is inevitable as well as dialysis or kidney transplant
Rationale: This question tests knowledge of the stages of chronic kidney disease. The detailed
rationale should explain that Stage V CKD is end-stage renal disease with a GFR of less than 15
mL/min, requiring dialysis or kidney transplant for survival. The nurse should provide
comprehensive education and support to the patient and family.
12. What are the complications of decreased GFR?
