NR 507 / NR507 Advanced Pathophysiology Final Exam Study guide | Verified Answers | Latest Update 2026 / 2027 | Chamberlain University | Exam Review & Practice Questions

NR 507 / NR507 Advanced Pathophysiology Final Exam Study guide | Verified Answers | Latest Update 2026 / 2027 | Chamberlain University | Exam Review & Practice Questions Question: Acute renal failure Answer Reversible Determining prognosis- kidneys respond to diuretic with good output; this indicates that kidneys are functioning well Question: Acute Pyelonephritis Answer Diagnosing by clinical symptoms alone can be difficult; can be similar to cystitis Question: Diagnosis established by: Answer -Urine culture -Urinalysis (WBC casts indicates pyelonephritis, but may not always be present) -Signs/Symptoms -Complicated pyelonephritis requires blood cultures and urinary tract imaging Question: Renal Calculi (Renal Stones) Goals of Treatment: Answer Manage acute pain Promote passage of stone Reduce size of stone Prevent new stone formation Question: Chronic Renal Failure Answer Chronic Kidney Disease (CKD) is a progressive loss of renal function associated with systemic disease such as hypertension, diabetes mellitus (most significant risk factor), systemic lupus erythematosus or intrinsic kidney disease CKD stage is determined by estimates of GFR and albuminuria Question: Who is a candidate for dialysis? Answer End-stage renal disease (ESRD) is the final stage of CKD with the number one cause being diabetes mellitus combined with hypertension. At this point, the patient is completely dependent on dialysis to survive. CKD is classified into five stages and is based on the patient's GFR rather than symptoms. Question: Patients will need dialysis when the following symptoms are present: Answer --Metabolic acidosis. --Hyperkalemia: Hyperkalemia in the presence of EKG changes (peaked T-waves) is an indication for dialysis. --Hyperkalemia by itself is not an indication for dialysis. --Drug toxicity: Drug toxicity due to the following drugs is an indication for dialysis and include salicylates, Lithium, Isopropanol, Methanol and Ethylene glycol). --Fluid volume overload that is not responsive to diuretics. --Uremic symptoms due to nitrogenous wastes in the blood stream. Question: Stage I CKD Answer There is kidney damage with normal or elevated GFR 90-120 Question: Stage II CKD Answer There is kidney damage with mild decrease in GFR 60-89 Question: Stage III CKD Answer There is a moderate decrease in GFR 30-59 Question: Stage IV CKD Answer There is a severe decrease in GFR 15-29 Question: Stage V CKD Answer Kidney failure- End-stage renal disease 15 (dialysis) Once Stage IV is reached, progression to Stage V is inevitable as well as dialysis or kidney transplant Question: Complications of Decreased GFR Answer Anemia Hypertension Decreased calcium absorption Hyperlipidemia Heart failure Left ventricular hypertrophy Fluid volume overload Hyperkalemia Hyperparathyroidism Hyperphosphatemia Metabolic acidosis Malnutrition (late complication) Question: GERD Warning signs include: Symptoms over age of 50: Answer -Dysphagia (difficulty swallowing) -Odynophagia (pain on swallowing) -Nausea and vomiting -Weight loss -Melena -Early satiety (feeling full after eating very little food Question: Hiatal Hernia Answer Often asymptomatic Generally, a wide variety of symptoms develop later in life and are associated with other GI disorders, primarily GERD --Sliding hiatal hernia: treatment usually conservative. Individuals can diminish reflux by eating small, frequent meals and avoiding the recumbent position after eating. Abdominal supports and tight clothing are avoided and weight control recommended for obese individuals. Question: Duodenal Ulcer Answer Characteristic manifestation = chronic intermittent pain in epigastric area Pain begins 30 minutes to 2 hours after eating when stomach is empty Not unusual for pain to occur in middle of the night and disappear by morning Question: Peptic Ulcer Disease Answer Peptic ulcer is a break or ulceration in the protective mucosal lining of the lower esophagus, stomach or duodenum Least likely to occur in the large intestine Question: Major Depressive Disorder Answer SSRIs are the standard first-line treatment for major depression Question: Initial selection of an antidepressant includes: Answer -Assessment of symptoms -Age -Side effects -Safety -Cost Question: Social Anxiety Disorder Answer Fear and avoidance of social situations Example: anxious person may feel very uncomfortable having a conversation or interacting with others and very conscious of being scrutinized and humiliated or rejected by others Answer Question: Schizophrenia Diagnosis: Advanced neuroimaging techniques have revealed structural brain abnormalities A consistent finding is the enlargement of the lateral and third ventricles and the widening of frontocortical fissures and sulci . Question: Schizophrenia Positive symptoms ("More" symptoms): Answer Hallucinations Delusions Formal thought disorder Bizarre behavior Question: Schizophrenia Negative symptoms Answer Flattened affect Alogia Anhedonia Attention deficits Apathy Question: Schizophrenia Cognitive symptoms: Answer Inability to perform daily tasks requiring attention and planning Question: Hypothyroidism Answer Most common thyroid function disorder Affects between 0.1% and 2% of the U.S. population More common in women and elderly Hormone replacement therapy with the hormone levothyroxine is the treatment of choice Question: Thyroid-Stimulating Hormone (TSH) Answer TSH released by anterior pituitary Review hypothalamic-pituitary axis (Picture) Thyroid-releasing hormone (hypothalamus) Hyperthyroidism/ Grave's Disease Answer Two most distinguishing factors of Grave's disease = pretibial myxedema and exophthalmos Treatment directed at controlling excessive TH production, secretion or action and includes antithyroid drug therapy (methimazole or propylthiouracil), radioactive iodine therapy (absorbed only by thyroid tissue, causing death of cells), and surgery Goal of radioactive iodine ablation for the treatment of Grave's disease is to destroy overactive thyroid tissue Two categories of ophthalmopathy associated with Grave's Disease: Answer Functional Abnormalities: resulting from hyperactivity of the sympathetic division of the autonomic nervous system (lag of the globe on upward gaze or a lag of the upper lid on downward gaze) Infiltrative Changes: involving the orbital contents with enlargement of the ocular muscles. These changes affect more than half of individuals with Grave's Disease. Increased secretion of hyaluronic acid, adipogenesis, inflammation and edema of the orbital contents results in exophthalmos (protrusion of the eyeball), periorbital edema and extraocular muscle weakness leading to strabismus and diplopia (double vision) Hyperparathyroidism Answer Characterized by stimulation of parathyroid gland in response to hypocalcemia Hypercalcemia Answer Hypercalcemia & Hypophosphatemia may be asymptomatic or affected individuals may present with symptoms related to the neuromuscular changes that include paresthesias and muscle cramps Patients with hypercalcemia can have low bone density that is most noted in the distal one-third of the radius Hypoparathyroidism Answer Hypomagnesemia inhibits PTH secretion Hypomagnesemia may be related to chronic alcoholism, malnutrition, malabsorption, increased renal clearance of magnesium caused by the use of aminoglycoside antibiotics or certain chemotherapeutic agents, or prolonged magnesium-deficient parenteral nutritional therapy Hypocalcemia Symptoms: Answer Dry skin Loss of body and scalp hair Hypoplasia of developing teeth Horizontal ridges on nails Cataracts Basal ganglia calcifications Bone deformities Bowing of the long bones Hypercortisolism Glucose intolerance associated with hypercortisolism --Occurs because of cortisol-induced insulin resistance and increased gluconeogenesis and glycogen storage by the liver Cushing's syndrome characterized by patterns of fat deposition have been described as "truncal obesity", "moon face" and "buffalo hump" Adrenal Crisis- Hypocortisolism Onset of adrenal crisis is signified by hypotension Hypotension can progress to complete vascular collapse and shock. This is known as adrenal crisis or addisonian crisis and develops with undiagnosed disease, acute withdrawal of glucocorticoid therapy or the occurrence of infection or other comorbid stressful events Primary Hypocortisolism- Adrenal Insufficiency Lab work that indicates primary hypocortisolism: --Serum and urine levels of cortisol are depressed with primary hypocortisolism, and ACTH levels are increased When prescribing cortisol, the NP should keep in mind: --With acute stressors (infection, surgery, trauma), additional cortisol must be administered to approximate the amount of cortisol that might be expected to be secreted if normal adrenal function were present Type 1 Diabetes Environmental factors: Viral infections, particularly enteroviruses, coxsackievirus, other infectious microorganisms Helicobacter pylori Exposure to cow's milk proteins Lack of Vitamin D Diagnostic Criteria for Diabetes According to American Diabetes Association is: Hemoglobin A1C greater than or equal to 6.5% Actions of Insulin Insulin promotes glucose uptake mostly in the liver, muscle and adipose tissue Autonomic Neuropathy-Complication of Diabetes Autonomic Neuropathy includes: GI Symptoms: --Decreased esophageal motility --Gastroparesis --Delayed gastric emptying Hypoglycemia Neurogenic reactions occur when the decrease in blood glucose level is rapid and present with --Tachycardia --Palpitations --Diaphoresis --Tremors --Pallor --Arousal anxiety Alzheimer's Disease Decreased short-term memory occurs with mild cognitive decline as a result of a reduced hippocampus size Parkinson's Disease Symptoms associated with bradykinesia = shuffling gait Other classic symptoms: --Resting tremor --Rigidity --Postural disturbance --Dysarthria --Dysphagia Multiple Sclerosis (MS) Risk factors that may be involved in the development of MS include: --Smoking --Vitamin D deficiency --Epstein-Barr Virus Infection Febrile Seizures One possibility for the development of a febrile seizure is that neurons are excited by decreased CO2 levels caused by hyperventilation during a febrile state Cluster Headache Unilateral trigeminal distribution of severe pain with ipsilateral autonomic manifestations, including tearing on the affected side, ptosis of the ipsilateral eye and congestion of the nasal mucosa Occurs in one side of the head primarily in men between 20 to 50 years of age Pain may alternate sides with each headache episode Severe, stabbing and throbbing Pain often referred to the midface and teeth Migraine Headache Episodic neurologic disorder whose marker is headache lasting 4 to 72 hours Diagnosed when any two of the following occur: --Unilateral head pain --Throbbing pain --Pain worsens with activity --Moderate or severe pain intensity And at least one of the following: --Nausea and/or vomiting --Photophobia and phonophobia Migraine with aura with visual, sensory or motor symptoms Migraine without aura (most common) Chronic migraine Tension Headache (Tension Type Headache/TTH) Most prevalent type of recurrent headache Not vascular or migrainous Average age of onset is during the second decade of life Usually mild to moderate bilateral headache with sensation of a tight band or pressure around head Bell's Palsy Associated with Cranial Nerve VII paralysis and results in facial asymmetry and inability to close eye, smile or frown on the affected side Bacterial Meningitis Associated with compression of Cranial nerve V and results in severe and sharp stabbing pain that can worsen with chewing Trigeminal neuralgia Characterized by clinical manifestations of systemic infection including Characterized by clinical manifestations of systemic infection including --Fever --Tachycardia --Chills And clinical manifestations of meningeal irritation including --Severe throbbing headache --Severe photophobia --Nuchal rigidity --Positive Kernig and Brudzinski signs --Fever --Tachycardia --Chills And clinical manifestations of meningeal irritation including --Severe throbbing headache --Severe photophobia --Nuchal rigidity --Positive Kernig and Brudzinski signs Cerebrovascular Accident Review s/s depending on the artery infarcted Example: infarct in the ACA will result in motor: contralateral paralysis or paresis (greater in foot and thigh) Sensory deficits associated with basilar artery infarct include contralateral loss of vibratory sense, sense of position with dysmetria, loss of two-point discrimination, impaired rapid alternating movements Rosacea Familial tendency, several genes identified Neurovascular dysregulation, infection and factors that trigger altered innate and adaptive immune response involved (ex: chronic sun exposure/damage, heat, drinking alcohol or hot beverages, hormonal fluctuations, Demodex folliculorum/mites colonization, mental stress and anxiety) Melanoma Most aggressive skin cancer Thickness of lesion impacts prognosis Plaque Psoriasis Typical lesion is well-demarcated, thick, silery, erythematous plaque surrounded by normal skin that can appear anywhere on the body