NR283 Exam 4 Actual Exam Style V3 | NR
283 Pathophysiology | Chamberlain
1. A patient presents with sudden oliguria and an elevation in serum creatinine after a severe
hemorrhage. What is the most likely classification of this acute kidney injury (AKI)?
A. Prerenal AKI
B. Postrenal AKI
C. Intrarenal AKI
D. Chronic Kidney Disease
Answer: A
Rationale: Prerenal AKI is caused by factors that reduce systemic circulation, causing a
decrease in renal blood flow. In this case, hemorrhage leads to hypovolemia and decreased
perfusion to the kidneys. Without adequate blood flow, the glomerular filtration rate drops
significantly before actual tissue damage occurs.
2. Which clinical finding is most characteristic of nephrotic syndrome?
A. Proteinuria greater than 3.5 g/day
B. Hypolipidemia
C. Gross hematuria
D. Increased serum albumin
,Answer: A
Rationale: Nephrotic syndrome is defined by massive proteinuria resulting from increased
glomerular permeability. This loss of protein leads to hypoalbuminemia and subsequent
generalized edema. It is distinguished from nephritic syndrome, which is more commonly
associated with hematuria and hypertension.
3. A patient with chronic kidney disease (CKD) has a hemoglobin level of 8 g/dL. What is the
primary cause of this anemia?
A. Iron deficiency due to poor diet
B. Chronic blood loss during dialysis
C. Inadequate production of erythropoietin
D. Destruction of red blood cells by toxins
Answer: C
Rationale: The kidneys are responsible for producing erythropoietin, a hormone that
stimulates red blood cell production in the bone marrow. As renal function declines in CKD,
the production of this hormone decreases, leading to normochromic normocytic anemia.
This condition often requires treatment with synthetic erythropoiesis-stimulating agents.
4. Which electrolyte imbalance is a common and life-threatening complication of late-stage
Chronic Kidney Disease?
A. Hyperkalemia
B. Hypokalemia
, C. Hyponatremia
D. Hypomagnesemia
Answer: A
Rationale: Hyperkalemia occurs in CKD because the kidneys lose the ability to excrete
potassium effectively. Elevated potassium levels can lead to lethal cardiac dysrhythmias
and muscle weakness. Monitoring dietary intake and renal clearance is vital for preventing
this dangerous electrolyte surge.
5. Which condition is characterized by an overproduction of antidiuretic hormone (ADH)
leading to water retention and hyponatremia?
A. Diabetes Insipidus
B. SIADH
C. Cushing’s Syndrome
D. Addison’s Disease
Answer: B
Rationale: Syndrome of Inappropriate Antidiuretic Hormone (SIADH) results in excessive
water reabsorption by the kidneys. This causes the blood to become diluted, leading to a
low serum sodium level known as hyponatremia. Patients typically present with fluid
overload and highly concentrated urine.
283 Pathophysiology | Chamberlain
1. A patient presents with sudden oliguria and an elevation in serum creatinine after a severe
hemorrhage. What is the most likely classification of this acute kidney injury (AKI)?
A. Prerenal AKI
B. Postrenal AKI
C. Intrarenal AKI
D. Chronic Kidney Disease
Answer: A
Rationale: Prerenal AKI is caused by factors that reduce systemic circulation, causing a
decrease in renal blood flow. In this case, hemorrhage leads to hypovolemia and decreased
perfusion to the kidneys. Without adequate blood flow, the glomerular filtration rate drops
significantly before actual tissue damage occurs.
2. Which clinical finding is most characteristic of nephrotic syndrome?
A. Proteinuria greater than 3.5 g/day
B. Hypolipidemia
C. Gross hematuria
D. Increased serum albumin
,Answer: A
Rationale: Nephrotic syndrome is defined by massive proteinuria resulting from increased
glomerular permeability. This loss of protein leads to hypoalbuminemia and subsequent
generalized edema. It is distinguished from nephritic syndrome, which is more commonly
associated with hematuria and hypertension.
3. A patient with chronic kidney disease (CKD) has a hemoglobin level of 8 g/dL. What is the
primary cause of this anemia?
A. Iron deficiency due to poor diet
B. Chronic blood loss during dialysis
C. Inadequate production of erythropoietin
D. Destruction of red blood cells by toxins
Answer: C
Rationale: The kidneys are responsible for producing erythropoietin, a hormone that
stimulates red blood cell production in the bone marrow. As renal function declines in CKD,
the production of this hormone decreases, leading to normochromic normocytic anemia.
This condition often requires treatment with synthetic erythropoiesis-stimulating agents.
4. Which electrolyte imbalance is a common and life-threatening complication of late-stage
Chronic Kidney Disease?
A. Hyperkalemia
B. Hypokalemia
, C. Hyponatremia
D. Hypomagnesemia
Answer: A
Rationale: Hyperkalemia occurs in CKD because the kidneys lose the ability to excrete
potassium effectively. Elevated potassium levels can lead to lethal cardiac dysrhythmias
and muscle weakness. Monitoring dietary intake and renal clearance is vital for preventing
this dangerous electrolyte surge.
5. Which condition is characterized by an overproduction of antidiuretic hormone (ADH)
leading to water retention and hyponatremia?
A. Diabetes Insipidus
B. SIADH
C. Cushing’s Syndrome
D. Addison’s Disease
Answer: B
Rationale: Syndrome of Inappropriate Antidiuretic Hormone (SIADH) results in excessive
water reabsorption by the kidneys. This causes the blood to become diluted, leading to a
low serum sodium level known as hyponatremia. Patients typically present with fluid
overload and highly concentrated urine.
