NSG 3850 Exam 3 - Pathophysiology II
Comprehensive Examination 2026!!!!
1. The nurse is caring for a client who has postinfectious acute glomerulonephritis. Which of the
following clinical manifestations should the nurse expect in this client?
a. Urinary hesitancy.
b. High glomerular filtration rate (GFR).
c. Hypertension and serum sodium of 129 mEq/L.
d. Smokey or coffee-colored urine.
ANSWER✔✨--: d. Smokey or coffee-colored urine.
Rationale:
Option a: Urinary hesitancy is associated with benign prostatic hyperplasia or urethral obstruction, not
glomerulonephritis. This is incorrect.
Option b: GFR is decreased, not increased, in acute glomerulonephritis due to inflammation and damage
to the glomerular membrane. This is incorrect.
Option c: While hypertension may occur, serum sodium of 129 mEq/L (hyponatremia) is not a classic
finding. Sodium retention with fluid overload is more common. This is incorrect.
Option d: Correct. Smokey or coffee-colored urine indicates hematuria, which is a hallmark finding in
postinfectious acute glomerulonephritis due to red blood cell leakage through damaged glomerular
membranes.
,2. The nurse is assessing edema in a client diagnosed with nephrotic syndrome. The nurse understands
that the edema is caused by
a. increased sodium loss leads to increased third spacing of fluids.
b. serum albumin is lost, oncotic pressure decreases allowing fluids to escape.
c. large glucose molecules increase and crowd out all other molecules.
d. oncotic pressure increases forcing fluids out into the interstitial spaces.
ANSWER✔✨--: b. serum albumin is lost, oncotic pressure decreases allowing fluids to escape.
Rationale:
Option a: Sodium is retained, not lost, in nephrotic syndrome due to compensatory mechanisms. This is
incorrect.
Option b: Correct. Massive proteinuria leads to hypoalbuminemia, reducing plasma oncotic pressure,
which allows fluid to shift from the intravascular to interstitial space causing edema.
Option c: Glucose molecules are not involved in this process; this describes diabetic complications. This
is incorrect.
Option d: Oncotic pressure decreases, not increases, in nephrotic syndrome. This is incorrect.
3. The nurse preceptor has discussed with a newly hired nurse the types of urinary incontinence. Which
of the following statements by the newly hired nurse indicates a correct understanding of the
discussion?
a. "Stress incontinence develops in response to bladder lining irritants."
b. "Pregnancy puts a client at increased risk for having urge incontinence."
c. "Neuron demyelination causes a loss of messages to the bladder."
d. "Functional incontinence occurs due to a fecal impaction."
,ANSWER✔✨--: c. "Neuron demyelination causes a loss of messages to the bladder."
Rationale:
Option a: Stress incontinence is caused by weakened pelvic floor muscles, not bladder irritants. Bladder
irritants cause urge incontinence. This is incorrect.
Option b: Pregnancy increases risk for stress incontinence due to pelvic floor weakness, not urge
incontinence. This is incorrect.
Option c: Correct. Demyelinating conditions like multiple sclerosis can disrupt neural pathways to the
bladder, causing neurogenic bladder and overflow incontinence.
Option d: Fecal impaction causes overflow incontinence, not functional incontinence. Functional
incontinence results from physical or cognitive impairments. This is incorrect.
4. The nurse is providing care to a client diagnosed with nephrotic syndrome. The urinalysis reveals
proteinuria. Which of the following is the most likely cause for this finding?
a. The glomerular membrane has increased permeability which causes leakage of the protein.
b. Glomeruli are damaged by the immune system as part of the disease process causing protein to be
spilled.
c. The renal tubules become clogged with cellular debris causing the protein to be spilled.
d. Due to the nephrotoxic environment, the liver becomes overactive and synthesizes more protein.
ANSWER✔✨--: a. The glomerular membrane has increased permeability which causes leakage of the
protein.
Rationale:
, Option a: Correct. In nephrotic syndrome, the glomerular basement membrane becomes more
permeable, allowing large proteins such as albumin to pass through into the urine.
Option b: Immune-mediated damage is more characteristic of glomerulonephritis, not nephrotic
syndrome. This is incorrect.
Option c: Tubular obstruction does not cause proteinuria; it causes decreased urine output. This is
incorrect.
Option d: The liver may increase protein synthesis in response to losses, but this is a compensatory
mechanism, not the cause of proteinuria. This is incorrect.
5. The nurse has taught a group of newly hired nurses about chronic pyelonephritis. Which of the
following statements by the group indicates a need for follow up?
a. "Obstruction from renal calculi causes urinary stasis and growth of bacteria."
b. "Renal imaging confirms diagnosis by revealing kidney atrophy and scarring."
c. "Sepsis and abscesses often develop in older adult clients."
d. "Infected urine will backflow into the kidneys due to an anatomic abnormality of the urinary tract."
ANSWER✔✨--: d. "Infected urine will backflow into the kidneys due to an anatomic abnormality of
the urinary tract."
Rationale:
Option a: This is correct. Urinary stasis from obstruction promotes bacterial growth and is a risk factor
for pyelonephritis. No follow-up needed.
Option b: This is correct. Chronic pyelonephritis causes scarring and atrophy visible on imaging. No
follow-up needed.
Comprehensive Examination 2026!!!!
1. The nurse is caring for a client who has postinfectious acute glomerulonephritis. Which of the
following clinical manifestations should the nurse expect in this client?
a. Urinary hesitancy.
b. High glomerular filtration rate (GFR).
c. Hypertension and serum sodium of 129 mEq/L.
d. Smokey or coffee-colored urine.
ANSWER✔✨--: d. Smokey or coffee-colored urine.
Rationale:
Option a: Urinary hesitancy is associated with benign prostatic hyperplasia or urethral obstruction, not
glomerulonephritis. This is incorrect.
Option b: GFR is decreased, not increased, in acute glomerulonephritis due to inflammation and damage
to the glomerular membrane. This is incorrect.
Option c: While hypertension may occur, serum sodium of 129 mEq/L (hyponatremia) is not a classic
finding. Sodium retention with fluid overload is more common. This is incorrect.
Option d: Correct. Smokey or coffee-colored urine indicates hematuria, which is a hallmark finding in
postinfectious acute glomerulonephritis due to red blood cell leakage through damaged glomerular
membranes.
,2. The nurse is assessing edema in a client diagnosed with nephrotic syndrome. The nurse understands
that the edema is caused by
a. increased sodium loss leads to increased third spacing of fluids.
b. serum albumin is lost, oncotic pressure decreases allowing fluids to escape.
c. large glucose molecules increase and crowd out all other molecules.
d. oncotic pressure increases forcing fluids out into the interstitial spaces.
ANSWER✔✨--: b. serum albumin is lost, oncotic pressure decreases allowing fluids to escape.
Rationale:
Option a: Sodium is retained, not lost, in nephrotic syndrome due to compensatory mechanisms. This is
incorrect.
Option b: Correct. Massive proteinuria leads to hypoalbuminemia, reducing plasma oncotic pressure,
which allows fluid to shift from the intravascular to interstitial space causing edema.
Option c: Glucose molecules are not involved in this process; this describes diabetic complications. This
is incorrect.
Option d: Oncotic pressure decreases, not increases, in nephrotic syndrome. This is incorrect.
3. The nurse preceptor has discussed with a newly hired nurse the types of urinary incontinence. Which
of the following statements by the newly hired nurse indicates a correct understanding of the
discussion?
a. "Stress incontinence develops in response to bladder lining irritants."
b. "Pregnancy puts a client at increased risk for having urge incontinence."
c. "Neuron demyelination causes a loss of messages to the bladder."
d. "Functional incontinence occurs due to a fecal impaction."
,ANSWER✔✨--: c. "Neuron demyelination causes a loss of messages to the bladder."
Rationale:
Option a: Stress incontinence is caused by weakened pelvic floor muscles, not bladder irritants. Bladder
irritants cause urge incontinence. This is incorrect.
Option b: Pregnancy increases risk for stress incontinence due to pelvic floor weakness, not urge
incontinence. This is incorrect.
Option c: Correct. Demyelinating conditions like multiple sclerosis can disrupt neural pathways to the
bladder, causing neurogenic bladder and overflow incontinence.
Option d: Fecal impaction causes overflow incontinence, not functional incontinence. Functional
incontinence results from physical or cognitive impairments. This is incorrect.
4. The nurse is providing care to a client diagnosed with nephrotic syndrome. The urinalysis reveals
proteinuria. Which of the following is the most likely cause for this finding?
a. The glomerular membrane has increased permeability which causes leakage of the protein.
b. Glomeruli are damaged by the immune system as part of the disease process causing protein to be
spilled.
c. The renal tubules become clogged with cellular debris causing the protein to be spilled.
d. Due to the nephrotoxic environment, the liver becomes overactive and synthesizes more protein.
ANSWER✔✨--: a. The glomerular membrane has increased permeability which causes leakage of the
protein.
Rationale:
, Option a: Correct. In nephrotic syndrome, the glomerular basement membrane becomes more
permeable, allowing large proteins such as albumin to pass through into the urine.
Option b: Immune-mediated damage is more characteristic of glomerulonephritis, not nephrotic
syndrome. This is incorrect.
Option c: Tubular obstruction does not cause proteinuria; it causes decreased urine output. This is
incorrect.
Option d: The liver may increase protein synthesis in response to losses, but this is a compensatory
mechanism, not the cause of proteinuria. This is incorrect.
5. The nurse has taught a group of newly hired nurses about chronic pyelonephritis. Which of the
following statements by the group indicates a need for follow up?
a. "Obstruction from renal calculi causes urinary stasis and growth of bacteria."
b. "Renal imaging confirms diagnosis by revealing kidney atrophy and scarring."
c. "Sepsis and abscesses often develop in older adult clients."
d. "Infected urine will backflow into the kidneys due to an anatomic abnormality of the urinary tract."
ANSWER✔✨--: d. "Infected urine will backflow into the kidneys due to an anatomic abnormality of
the urinary tract."
Rationale:
Option a: This is correct. Urinary stasis from obstruction promotes bacterial growth and is a risk factor
for pyelonephritis. No follow-up needed.
Option b: This is correct. Chronic pyelonephritis causes scarring and atrophy visible on imaging. No
follow-up needed.
