NR283 Exam 3 Actual Exam Style V1 | NR
283 Pathophysiology | Chamberlain
1. A patient presents with a sudden decrease in urine output and an elevation in serum
creatinine after suffering from severe dehydration. Which type of Acute Kidney Injury (AKI) is
this patient most likely experiencing?
A. Intrarenal AKI
B. Prerenal AKI
C. Postrenal AKI
D. Chronic Renal Failure
Answer: B
Rationale: Prerenal AKI is caused by factors that reduce systemic circulation, causing a
decrease in renal blood flow. Dehydration leads to decreased perfusion to the kidneys,
which lowers the glomerular filtration rate. If the underlying cause of decreased perfusion
is corrected, the kidney function typically returns to normal.
2. Which of the following electrolyte imbalances is most closely associated with the
development of peaked T waves on an electrocardiogram (ECG)?
A. Hypokalemia
B. Hypocalcemia
C. Hyponatremia
,D. Hyperkalemia
Answer: D
Rationale: Hyperkalemia refers to an elevated level of potassium in the blood, which
significantly impacts cardiac rhythm. The presence of peaked T waves is a classic early sign
of potassium toxicity on an ECG. High potassium levels alter the repolarization phase of the
cardiac action potential, necessitating urgent medical intervention.
3. A patient has an arterial blood gas (ABG) result showing a pH of 7.25, a PaCO2 of 55 mmHg,
and a HCO3 of 26 mEq/L. How should the nurse interpret these findings?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Rationale: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg indicates a
respiratory cause. In this case, the kidneys have not yet significantly compensated as the
bicarbonate level is still within the normal range. This condition is frequently seen in
patients with chronic obstructive pulmonary disease or respiratory depression.
4. Which clinical manifestation is considered a hallmark sign of Nephrotic Syndrome?
A. Hematuria
, B. Severe Proteinuria
C. Hypotension
D. Weight Loss
Answer: B
Rationale: Nephrotic syndrome is characterized by massive loss of protein in the urine,
often exceeding 3.5 grams per day. This occurs due to increased permeability of the
glomerular capillary membrane. The resulting hypoalbuminemia leads to generalized
edema because of a decrease in plasma oncotic pressure.
5. A patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is most likely to
exhibit which of the following laboratory findings?
A. Serum sodium of 120 mEq/L
B. Serum sodium of 155 mEq/L
C. Urine specific gravity of 1.001
D. Hyperglycemia
Answer: A
Rationale: SIADH involves the excessive release of ADH, which causes the body to retain
water. This water retention dilutes the blood, leading to dilutional hyponatremia where
serum sodium levels drop. Patients will also show high urine specific gravity because the
urine is highly concentrated.
283 Pathophysiology | Chamberlain
1. A patient presents with a sudden decrease in urine output and an elevation in serum
creatinine after suffering from severe dehydration. Which type of Acute Kidney Injury (AKI) is
this patient most likely experiencing?
A. Intrarenal AKI
B. Prerenal AKI
C. Postrenal AKI
D. Chronic Renal Failure
Answer: B
Rationale: Prerenal AKI is caused by factors that reduce systemic circulation, causing a
decrease in renal blood flow. Dehydration leads to decreased perfusion to the kidneys,
which lowers the glomerular filtration rate. If the underlying cause of decreased perfusion
is corrected, the kidney function typically returns to normal.
2. Which of the following electrolyte imbalances is most closely associated with the
development of peaked T waves on an electrocardiogram (ECG)?
A. Hypokalemia
B. Hypocalcemia
C. Hyponatremia
,D. Hyperkalemia
Answer: D
Rationale: Hyperkalemia refers to an elevated level of potassium in the blood, which
significantly impacts cardiac rhythm. The presence of peaked T waves is a classic early sign
of potassium toxicity on an ECG. High potassium levels alter the repolarization phase of the
cardiac action potential, necessitating urgent medical intervention.
3. A patient has an arterial blood gas (ABG) result showing a pH of 7.25, a PaCO2 of 55 mmHg,
and a HCO3 of 26 mEq/L. How should the nurse interpret these findings?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Rationale: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg indicates a
respiratory cause. In this case, the kidneys have not yet significantly compensated as the
bicarbonate level is still within the normal range. This condition is frequently seen in
patients with chronic obstructive pulmonary disease or respiratory depression.
4. Which clinical manifestation is considered a hallmark sign of Nephrotic Syndrome?
A. Hematuria
, B. Severe Proteinuria
C. Hypotension
D. Weight Loss
Answer: B
Rationale: Nephrotic syndrome is characterized by massive loss of protein in the urine,
often exceeding 3.5 grams per day. This occurs due to increased permeability of the
glomerular capillary membrane. The resulting hypoalbuminemia leads to generalized
edema because of a decrease in plasma oncotic pressure.
5. A patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is most likely to
exhibit which of the following laboratory findings?
A. Serum sodium of 120 mEq/L
B. Serum sodium of 155 mEq/L
C. Urine specific gravity of 1.001
D. Hyperglycemia
Answer: A
Rationale: SIADH involves the excessive release of ADH, which causes the body to retain
water. This water retention dilutes the blood, leading to dilutional hyponatremia where
serum sodium levels drop. Patients will also show high urine specific gravity because the
urine is highly concentrated.
