NUR 355 EXAM 2 CERTIFICATION EVALUATION
2026 QUESTIONS WITH SOLUTIONS GRADED
A+
◉ nephrotic syndrome. Answer: Abnormality in glomerular
capillaries, increased permeability, large amounts of plasma proteins
escape into filtrate
May be secondary to SLE, exposure to nephrotoxins or drugs
◉ nephrotic pathophysiology and signs and symptoms. Answer:
Hypoalbuminemia with decreased plasma osmotic pressure
Subsequent generalized edema
Blood pressure remains low or normal.
May be elevated depending on angiotensin II levels
Increased aldosterone secretion in response to reduced blood
volume
More severe edema
High blood cholesterol, lipoprotein in urine, lipiduria with milky
appearance to the urine (liver secrete lipids bc decreased protein)
s/s: Proteinuria, lipiduria, casts
Massive edema - anasarca
Sudden increase in girth
,◉ Urinary Tract Obstructions. Answer: Urolithiasis
Hydronephrosis
Tumors
◉ Urolithiasis (calculi or stone). Answer: Can develop anywhere in
urinary tract
Stones range from small to very large. medium cause problems
Tend to form with:
Excessive amounts of solutes in filtrate
Insufficient fluid intake—major factor for calculi formation
Urinary tract infection
Manifestations only occur with obstruction of urine flow.
May lead to infection
Hydronephrosis with dilation of calyces
If located in kidney or ureter -> atrophy of renal tissueCalculi
composed of calcium salts
High urine calcium levels
Form readily with highly alkaline urine
Uric acid stones
Hyperuricemia
Gout, high-purine diets, cancer chemotherapy
,Especially with acidic urine
Struvite and cystine stones
Stone formation depends on predisposing factor.
◉ signs and symptoms of urolithiasis. Answer: Stones in kidney or
bladder often asymptomatic
Frequent infections may lead to investigation.
Flank pain possible caused by distention of renal capsule
Renal colic caused by obstruction of the ureter
Intense spasms of pain in flank area
Radiating into groin area
Lasts until stone passes or is removed
Possible nausea and vomiting, cool moist skin, rapid pulse
Radiologic examination confirms location of calculi.
◉ Urolithiasis prevention. Answer: Treatment of underlying
predisposing condition
Adjustment of urine pH through dietary modifications
Consistent increased fluid intake
◉ hydronephrosis. Answer: Secondary problem caused by back up
of urine:
, Complication of calculi
Tumors, scar tissue in kidney or ureter
Untreated prostatic enlargement
Developmental abnormalities restricting urine flow
Frequently asymptomatic in early stages
If cause is not removed—> chronic renal failure
◉ renal cell carcinoma. Answer: Primary tumor
Tends to symptomatic in early stages
Often has metastasized to liver, lung, bone, or central nervous
system at time of diagnosis
Occurs more frequently in men and smokers
Treatment is removal of kidney
Tumor is radioresistant, and chemotherapy is not used in most cases
-Painless hematuria initially
Gross or microscopic
Dull, aching flank pain
Palpable mass
Unexplained weight loss
Anemia or erythrocytosis
◉ bladder cancer. Answer: Most bladder tumors are malignant
2026 QUESTIONS WITH SOLUTIONS GRADED
A+
◉ nephrotic syndrome. Answer: Abnormality in glomerular
capillaries, increased permeability, large amounts of plasma proteins
escape into filtrate
May be secondary to SLE, exposure to nephrotoxins or drugs
◉ nephrotic pathophysiology and signs and symptoms. Answer:
Hypoalbuminemia with decreased plasma osmotic pressure
Subsequent generalized edema
Blood pressure remains low or normal.
May be elevated depending on angiotensin II levels
Increased aldosterone secretion in response to reduced blood
volume
More severe edema
High blood cholesterol, lipoprotein in urine, lipiduria with milky
appearance to the urine (liver secrete lipids bc decreased protein)
s/s: Proteinuria, lipiduria, casts
Massive edema - anasarca
Sudden increase in girth
,◉ Urinary Tract Obstructions. Answer: Urolithiasis
Hydronephrosis
Tumors
◉ Urolithiasis (calculi or stone). Answer: Can develop anywhere in
urinary tract
Stones range from small to very large. medium cause problems
Tend to form with:
Excessive amounts of solutes in filtrate
Insufficient fluid intake—major factor for calculi formation
Urinary tract infection
Manifestations only occur with obstruction of urine flow.
May lead to infection
Hydronephrosis with dilation of calyces
If located in kidney or ureter -> atrophy of renal tissueCalculi
composed of calcium salts
High urine calcium levels
Form readily with highly alkaline urine
Uric acid stones
Hyperuricemia
Gout, high-purine diets, cancer chemotherapy
,Especially with acidic urine
Struvite and cystine stones
Stone formation depends on predisposing factor.
◉ signs and symptoms of urolithiasis. Answer: Stones in kidney or
bladder often asymptomatic
Frequent infections may lead to investigation.
Flank pain possible caused by distention of renal capsule
Renal colic caused by obstruction of the ureter
Intense spasms of pain in flank area
Radiating into groin area
Lasts until stone passes or is removed
Possible nausea and vomiting, cool moist skin, rapid pulse
Radiologic examination confirms location of calculi.
◉ Urolithiasis prevention. Answer: Treatment of underlying
predisposing condition
Adjustment of urine pH through dietary modifications
Consistent increased fluid intake
◉ hydronephrosis. Answer: Secondary problem caused by back up
of urine:
, Complication of calculi
Tumors, scar tissue in kidney or ureter
Untreated prostatic enlargement
Developmental abnormalities restricting urine flow
Frequently asymptomatic in early stages
If cause is not removed—> chronic renal failure
◉ renal cell carcinoma. Answer: Primary tumor
Tends to symptomatic in early stages
Often has metastasized to liver, lung, bone, or central nervous
system at time of diagnosis
Occurs more frequently in men and smokers
Treatment is removal of kidney
Tumor is radioresistant, and chemotherapy is not used in most cases
-Painless hematuria initially
Gross or microscopic
Dull, aching flank pain
Palpable mass
Unexplained weight loss
Anemia or erythrocytosis
◉ bladder cancer. Answer: Most bladder tumors are malignant
