NR507 Final Exam Study Guide 2026/2027 / NR
507 Week 5 - 8 Advanced Pathophysiology
Actual Exam UP-TO-DATE 2026 EXAM
QUESTIONS AND 100% ACCURATE SOLUTIONS
| Question And VERIFIED ANSWERS
Week 5: Renal & Urinary System Pathophysiology
1. A patient with chronic kidney disease (CKD) has a GFR of 25 mL/min. Which
stage of CKD is this?
A) Stage 2
B) Stage 3
C) Stage 4
D) Stage 5
Answer: C
Explanation: Stage 4 CKD is defined by a GFR of 15–29 mL/min. Stage 5 (ESRD) is <15
mL/min .
2. Which electrolyte imbalance is most concerning in acute kidney injury (AKI) due
to rhabdomyolysis?
A) Hyponatremia
B) Hyperkalemia
C) Hypocalcemia
D) Hyperphosphatemia
Answer: B
,Explanation: Rhabdomyolysis releases massive amounts of intracellular potassium and
myoglobin, leading to life-threatening hyperkalemia and acute tubular necrosis .
3. A patient with hypertensive emergency and rapidly rising creatinine is found to
have "flea-bitten" appearance on kidney biopsy. What is the diagnosis?
A) IgA nephropathy
B) Malignant hypertension nephrosclerosis
C) Minimal change disease
D) Poststreptococcal glomerulonephritis
Answer: B
Explanation: Malignant hypertension causes fibrinoid necrosis of arterioles and "onion-
skinning" (hyperplastic arteriolosclerosis). Renal biopsy may show a "flea-bitten"
appearance due to microhemorrhages .
4. What is the most common cause of end-stage renal disease (ESRD) in adults
worldwide?
A) Hypertension
B) Glomerulonephritis
C) Diabetes mellitus
D) Polycystic kidney disease
Answer: C
Explanation: Diabetic nephropathy is the leading cause of ESRD. Hyperglycemia causes
glomerular hyperfiltration, thickening of the glomerular basement membrane, and
mesangial expansion .
5. A patient with nephrotic syndrome develops a sudden onset of flank pain and
hematuria. What complication should be suspected?
A) Renal calculi
B) Pyelonephritis
C) Renal vein thrombosis
D) Acute interstitial nephritis
Answer: C
,Explanation: Nephrotic syndrome causes a hypercoagulable state due to loss of
antithrombin III. Renal vein thrombosis is a known complication, presenting with flank
pain, hematuria, and worsening renal function .
6. The earliest sign of diabetic nephropathy is:
A) Overt proteinuria (>3.5 g/day)
B) Microalbuminuria (30–300 mg/day)
C) Elevated serum creatinine
D) Decreased GFR
Answer: B
Explanation: Microalbuminuria is the earliest detectable sign of diabetic nephropathy
and precedes overt proteinuria and decline in GFR .
7. A patient is diagnosed with Goodpasture syndrome. Which antibody is
associated with this condition?
A) Anti-dsDNA
B) Anti-GBM antibody
C) Anti-CCP
D) Anti-nuclear antibody (ANA)
Answer: B
Explanation: Goodpasture syndrome is caused by autoantibodies against the alpha-3
chain of type IV collagen in the glomerular and alveolar basement membranes, leading
to pulmonary hemorrhage and rapidly progressive glomerulonephritis .
8. In prerenal AKI, the BUN:Cr ratio is typically:
A) <10:1
B) 15:1
C) >20:1
D) 1:1
Answer: C
Explanation: In prerenal AKI (decreased renal perfusion), the kidney retains urea due to
increased reabsorption, leading to an elevated BUN:Cr ratio (>20:1) .
, 9. A patient taking nitrofurantoin for a UTI develops acute hemolytic anemia and
acute kidney injury. The NP suspects an enzyme deficiency. Which deficiency is the
most likely cause?
A) Pyruvate kinase deficiency
B) Glucose-6-phosphate dehydrogenase (G6PD) deficiency
C) Adenylate kinase deficiency
D) Hexokinase deficiency
Answer: B
Explanation: G6PD deficiency is an X-linked disorder that makes RBCs susceptible to
oxidative stress. Drugs like nitrofurantoin, sulfonamides, and fava beans trigger oxidative
hemolysis, which can lead to hemoglobinuria and acute kidney injury .
10. Which finding is seen in Fanconi syndrome?
A) Hyperglycemia with elevated serum glucose
B) Glucosuria with normal serum glucose
C) Proteinuria with selective albumin loss
D) Hematuria with RBC casts
Answer: B
Explanation: Fanconi syndrome is a generalized dysfunction of the proximal tubule
leading to impaired reabsorption of glucose, amino acids, phosphate, and bicarbonate.
This causes glucosuria despite normal serum glucose levels .
Week 6: Endocrine Pathophysiology
11. A patient presents with polyuria, polydipsia, and normal serum glucose. What
is the next step in evaluation?
A) Oral glucose tolerance test
B) Water deprivation test
C) Serum cortisol level
507 Week 5 - 8 Advanced Pathophysiology
Actual Exam UP-TO-DATE 2026 EXAM
QUESTIONS AND 100% ACCURATE SOLUTIONS
| Question And VERIFIED ANSWERS
Week 5: Renal & Urinary System Pathophysiology
1. A patient with chronic kidney disease (CKD) has a GFR of 25 mL/min. Which
stage of CKD is this?
A) Stage 2
B) Stage 3
C) Stage 4
D) Stage 5
Answer: C
Explanation: Stage 4 CKD is defined by a GFR of 15–29 mL/min. Stage 5 (ESRD) is <15
mL/min .
2. Which electrolyte imbalance is most concerning in acute kidney injury (AKI) due
to rhabdomyolysis?
A) Hyponatremia
B) Hyperkalemia
C) Hypocalcemia
D) Hyperphosphatemia
Answer: B
,Explanation: Rhabdomyolysis releases massive amounts of intracellular potassium and
myoglobin, leading to life-threatening hyperkalemia and acute tubular necrosis .
3. A patient with hypertensive emergency and rapidly rising creatinine is found to
have "flea-bitten" appearance on kidney biopsy. What is the diagnosis?
A) IgA nephropathy
B) Malignant hypertension nephrosclerosis
C) Minimal change disease
D) Poststreptococcal glomerulonephritis
Answer: B
Explanation: Malignant hypertension causes fibrinoid necrosis of arterioles and "onion-
skinning" (hyperplastic arteriolosclerosis). Renal biopsy may show a "flea-bitten"
appearance due to microhemorrhages .
4. What is the most common cause of end-stage renal disease (ESRD) in adults
worldwide?
A) Hypertension
B) Glomerulonephritis
C) Diabetes mellitus
D) Polycystic kidney disease
Answer: C
Explanation: Diabetic nephropathy is the leading cause of ESRD. Hyperglycemia causes
glomerular hyperfiltration, thickening of the glomerular basement membrane, and
mesangial expansion .
5. A patient with nephrotic syndrome develops a sudden onset of flank pain and
hematuria. What complication should be suspected?
A) Renal calculi
B) Pyelonephritis
C) Renal vein thrombosis
D) Acute interstitial nephritis
Answer: C
,Explanation: Nephrotic syndrome causes a hypercoagulable state due to loss of
antithrombin III. Renal vein thrombosis is a known complication, presenting with flank
pain, hematuria, and worsening renal function .
6. The earliest sign of diabetic nephropathy is:
A) Overt proteinuria (>3.5 g/day)
B) Microalbuminuria (30–300 mg/day)
C) Elevated serum creatinine
D) Decreased GFR
Answer: B
Explanation: Microalbuminuria is the earliest detectable sign of diabetic nephropathy
and precedes overt proteinuria and decline in GFR .
7. A patient is diagnosed with Goodpasture syndrome. Which antibody is
associated with this condition?
A) Anti-dsDNA
B) Anti-GBM antibody
C) Anti-CCP
D) Anti-nuclear antibody (ANA)
Answer: B
Explanation: Goodpasture syndrome is caused by autoantibodies against the alpha-3
chain of type IV collagen in the glomerular and alveolar basement membranes, leading
to pulmonary hemorrhage and rapidly progressive glomerulonephritis .
8. In prerenal AKI, the BUN:Cr ratio is typically:
A) <10:1
B) 15:1
C) >20:1
D) 1:1
Answer: C
Explanation: In prerenal AKI (decreased renal perfusion), the kidney retains urea due to
increased reabsorption, leading to an elevated BUN:Cr ratio (>20:1) .
, 9. A patient taking nitrofurantoin for a UTI develops acute hemolytic anemia and
acute kidney injury. The NP suspects an enzyme deficiency. Which deficiency is the
most likely cause?
A) Pyruvate kinase deficiency
B) Glucose-6-phosphate dehydrogenase (G6PD) deficiency
C) Adenylate kinase deficiency
D) Hexokinase deficiency
Answer: B
Explanation: G6PD deficiency is an X-linked disorder that makes RBCs susceptible to
oxidative stress. Drugs like nitrofurantoin, sulfonamides, and fava beans trigger oxidative
hemolysis, which can lead to hemoglobinuria and acute kidney injury .
10. Which finding is seen in Fanconi syndrome?
A) Hyperglycemia with elevated serum glucose
B) Glucosuria with normal serum glucose
C) Proteinuria with selective albumin loss
D) Hematuria with RBC casts
Answer: B
Explanation: Fanconi syndrome is a generalized dysfunction of the proximal tubule
leading to impaired reabsorption of glucose, amino acids, phosphate, and bicarbonate.
This causes glucosuria despite normal serum glucose levels .
Week 6: Endocrine Pathophysiology
11. A patient presents with polyuria, polydipsia, and normal serum glucose. What
is the next step in evaluation?
A) Oral glucose tolerance test
B) Water deprivation test
C) Serum cortisol level
