NUR 631/NUR631 Exam 3 V2 | Advanced
Physiology and Pathophysiology Q&A with
Rationale | Grand Canyon University
1. Which hormone is primarily responsible for the reabsorption of water in the distal
convoluted tubule and collecting duct?
A. Aldosterone
B. Atrial Natriuretic Peptide
C. Antidiuretic Hormone (ADH)
D. Renin
Answer: C
Rationale: Antidiuretic Hormone (ADH), also known as vasopressin, acts on the V2
receptors of the collecting duct to insert aquaporins. This increase in permeability allows
for significant water reabsorption into the medullary interstitium. Without ADH, the
collecting duct remains relatively impermeable to water, leading to dilute urine.
2. In the Renin-Angiotensin-Aldosterone System (RAAS), what is the direct effect of
Angiotensin II on the blood vessels?
A. Systemic Vasoconstriction
B. Systemic Vasodilation
C. Increased Capillary Permeability
,D. Inhibition of sympathetic activity
Answer: A
Rationale: Angiotensin II is a potent vasoconstrictor that increases systemic vascular
resistance and arterial blood pressure. It acts directly on AT1 receptors located on smooth
muscle cells of the vasculature. This mechanism is a key component in the body’s long-term
regulation of blood pressure and fluid volume.
3. Which type of acute kidney injury (AKI) is caused by a sudden drop in blood pressure or
interruption of blood flow to the kidneys?
A. Intrinsic renal AKI
B. Post-renal AKI
C. Pre-renal AKI
D. Chronic Kidney Disease
Answer: C
Rationale: Pre-renal AKI occurs when there is a reduction in renal perfusion without
direct damage to the kidney parenchyma. Common causes include dehydration,
hemorrhage, or heart failure leading to decreased cardiac output. If the perfusion is
restored quickly, the renal function typically returns to baseline without permanent
damage.
4. What is the most common cause of Chronic Kidney Disease (CKD) in the United States?
A. Polycystic Kidney Disease
, B. Glomerulonephritis
C. Diabetes Mellitus
D. Systemic Lupus Erythematosus
Answer: C
Rationale: Diabetes Mellitus is the leading cause of CKD, often resulting in diabetic
nephropathy characterized by glomerular basement membrane thickening. High blood
glucose levels cause oxidative stress and non-enzymatic glycosylation of proteins in the
kidney. Hypertension is the second most common cause, frequently occurring alongside
diabetes.
5. Which clinical manifestation is a hallmark of Nephrotic Syndrome?
A. Gross Hematuria
B. Hypernatremia
C. Hypokalemia
D. Heavy Proteinuria (>3.5g/day)
Answer: D
Rationale: Nephrotic syndrome is defined by massive proteinuria exceeding 3.5 grams per
day due to increased glomerular permeability. This loss of protein leads to
hypoalbuminemia, which causes a decrease in plasma oncotic pressure and subsequent
generalized edema. Lipiduria and hyperlipidemia are also frequently observed as the liver
increases lipoprotein synthesis to compensate for lost albumin.
Physiology and Pathophysiology Q&A with
Rationale | Grand Canyon University
1. Which hormone is primarily responsible for the reabsorption of water in the distal
convoluted tubule and collecting duct?
A. Aldosterone
B. Atrial Natriuretic Peptide
C. Antidiuretic Hormone (ADH)
D. Renin
Answer: C
Rationale: Antidiuretic Hormone (ADH), also known as vasopressin, acts on the V2
receptors of the collecting duct to insert aquaporins. This increase in permeability allows
for significant water reabsorption into the medullary interstitium. Without ADH, the
collecting duct remains relatively impermeable to water, leading to dilute urine.
2. In the Renin-Angiotensin-Aldosterone System (RAAS), what is the direct effect of
Angiotensin II on the blood vessels?
A. Systemic Vasoconstriction
B. Systemic Vasodilation
C. Increased Capillary Permeability
,D. Inhibition of sympathetic activity
Answer: A
Rationale: Angiotensin II is a potent vasoconstrictor that increases systemic vascular
resistance and arterial blood pressure. It acts directly on AT1 receptors located on smooth
muscle cells of the vasculature. This mechanism is a key component in the body’s long-term
regulation of blood pressure and fluid volume.
3. Which type of acute kidney injury (AKI) is caused by a sudden drop in blood pressure or
interruption of blood flow to the kidneys?
A. Intrinsic renal AKI
B. Post-renal AKI
C. Pre-renal AKI
D. Chronic Kidney Disease
Answer: C
Rationale: Pre-renal AKI occurs when there is a reduction in renal perfusion without
direct damage to the kidney parenchyma. Common causes include dehydration,
hemorrhage, or heart failure leading to decreased cardiac output. If the perfusion is
restored quickly, the renal function typically returns to baseline without permanent
damage.
4. What is the most common cause of Chronic Kidney Disease (CKD) in the United States?
A. Polycystic Kidney Disease
, B. Glomerulonephritis
C. Diabetes Mellitus
D. Systemic Lupus Erythematosus
Answer: C
Rationale: Diabetes Mellitus is the leading cause of CKD, often resulting in diabetic
nephropathy characterized by glomerular basement membrane thickening. High blood
glucose levels cause oxidative stress and non-enzymatic glycosylation of proteins in the
kidney. Hypertension is the second most common cause, frequently occurring alongside
diabetes.
5. Which clinical manifestation is a hallmark of Nephrotic Syndrome?
A. Gross Hematuria
B. Hypernatremia
C. Hypokalemia
D. Heavy Proteinuria (>3.5g/day)
Answer: D
Rationale: Nephrotic syndrome is defined by massive proteinuria exceeding 3.5 grams per
day due to increased glomerular permeability. This loss of protein leads to
hypoalbuminemia, which causes a decrease in plasma oncotic pressure and subsequent
generalized edema. Lipiduria and hyperlipidemia are also frequently observed as the liver
increases lipoprotein synthesis to compensate for lost albumin.
