NRS 455 Exam 3 V1 | NRS 455
Pathophysiology | Actual Q&A with
Rationale (NRS455 Exam 3) | Grand
Canyon University
1. A patient presents with a glomerular filtration rate (GFR) of 25 mL/min/1.73m². According
to the stages of Chronic Kidney Disease (CKD), which stage is this patient currently in?
A. Stage 2
B. Stage 4
C. Stage 3
D. Stage 5
Correct Answer: B
Rationale: Chronic Kidney Disease Stage 4 is defined by a severely decreased GFR ranging
from 15 to 29 mL/min/1.73m². At this stage, the patient is often prepared for renal
replacement therapy as kidney function is significantly compromised. This classification
system helps clinicians determine the appropriate level of intervention and monitoring
required for the patient’s condition.
2. Select All That Apply (SATA): A nurse is evaluating a patient with hypokalemia. Which of
the following clinical manifestations are associated with a low serum potassium level?
A. Muscle weakness and leg cramps
,B. U waves on an EKG
C. Hyperactive bowel sounds
D. Cardiac dysrhythmias
E. Peaked T waves
F. Decreased deep tendon reflexes
Correct Answer: A, B, D, F
Rationale: Hypokalemia affects the electrical conductivity of the heart and the excitability
of neuromuscular tissues. The presence of U waves and flattened T waves are classic
electrocardiogram changes seen when potassium levels drop. Furthermore, muscle
weakness and decreased bowel motility (rather than hyperactive) are common due to the
hyperpolarization of the cell membranes.
3. Which pathophysiological mechanism best explains the development of prerenal acute
kidney injury (AKI)?
A. Reduced blood flow and perfusion to the kidneys
B. Direct damage to the renal parenchyma
C. Obstruction of the urinary tract outflow
D. Inflammation of the basement membrane
Correct Answer: A
,Rationale: Prerenal AKI is primarily caused by factors that reduce systemic blood flow to
the kidneys, leading to decreased glomerular perfusion. This can result from hypovolemia,
cardiogenic shock, or severe dehydration that limits the pressure needed for filtration.
Unlike intrarenal injury, the kidney tissue itself is initially healthy but lacks the necessary
blood supply to function.
4. A patient with Type 1 Diabetes Mellitus presents with Kussmaul respirations, fruity breath
odor, and a blood glucose of 550 mg/dL. What is the primary acid-base imbalance occurring?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Metabolic Acidosis
D. Respiratory Alkalosis
Correct Answer: C
Rationale: Diabetic Ketoacidosis (DKA) leads to an accumulation of ketones, which are
organic acids that lower the blood pH. The body attempts to compensate for this metabolic
acidosis through Kussmaul respirations, which increase the excretion of carbon dioxide.
This condition is a medical emergency that requires insulin therapy and fluid resuscitation
to restore metabolic balance.
5. In the context of the Renin-Angiotensin-Aldosterone System (RAAS), what is the specific
role of Angiotensin II?
A. Stimulating the release of insulin
, B. Causing potent vasoconstriction and stimulating aldosterone secretion
C. Inhibiting the reabsorption of sodium in the distal tubule
D. Increasing the excretion of potassium in the urine
Correct Answer: B
Rationale: Angiotensin II acts as a powerful vasoconstrictor, which increases peripheral
vascular resistance and systemic blood pressure. It also acts on the adrenal cortex to
stimulate the release of aldosterone, which promotes sodium and water retention. These
mechanisms are central to the body’s long-term regulation of blood pressure and fluid
volume.
6. SATA: A patient is diagnosed with Nephrotic Syndrome. Which clinical findings should the
nurse anticipate?
A. Massive proteinuria (>3.5g/day)
B. Generalized edema (anasarca)
C. Hypoalbuminemia
D. Hematuria with red blood cell casts
E. Hyperlipidemia
Correct Answer: A, B, C, E
Rationale: Nephrotic syndrome is characterized by increased glomerular permeability to
proteins, leading to massive proteinuria and subsequent hypoalbuminemia. The loss of
Pathophysiology | Actual Q&A with
Rationale (NRS455 Exam 3) | Grand
Canyon University
1. A patient presents with a glomerular filtration rate (GFR) of 25 mL/min/1.73m². According
to the stages of Chronic Kidney Disease (CKD), which stage is this patient currently in?
A. Stage 2
B. Stage 4
C. Stage 3
D. Stage 5
Correct Answer: B
Rationale: Chronic Kidney Disease Stage 4 is defined by a severely decreased GFR ranging
from 15 to 29 mL/min/1.73m². At this stage, the patient is often prepared for renal
replacement therapy as kidney function is significantly compromised. This classification
system helps clinicians determine the appropriate level of intervention and monitoring
required for the patient’s condition.
2. Select All That Apply (SATA): A nurse is evaluating a patient with hypokalemia. Which of
the following clinical manifestations are associated with a low serum potassium level?
A. Muscle weakness and leg cramps
,B. U waves on an EKG
C. Hyperactive bowel sounds
D. Cardiac dysrhythmias
E. Peaked T waves
F. Decreased deep tendon reflexes
Correct Answer: A, B, D, F
Rationale: Hypokalemia affects the electrical conductivity of the heart and the excitability
of neuromuscular tissues. The presence of U waves and flattened T waves are classic
electrocardiogram changes seen when potassium levels drop. Furthermore, muscle
weakness and decreased bowel motility (rather than hyperactive) are common due to the
hyperpolarization of the cell membranes.
3. Which pathophysiological mechanism best explains the development of prerenal acute
kidney injury (AKI)?
A. Reduced blood flow and perfusion to the kidneys
B. Direct damage to the renal parenchyma
C. Obstruction of the urinary tract outflow
D. Inflammation of the basement membrane
Correct Answer: A
,Rationale: Prerenal AKI is primarily caused by factors that reduce systemic blood flow to
the kidneys, leading to decreased glomerular perfusion. This can result from hypovolemia,
cardiogenic shock, or severe dehydration that limits the pressure needed for filtration.
Unlike intrarenal injury, the kidney tissue itself is initially healthy but lacks the necessary
blood supply to function.
4. A patient with Type 1 Diabetes Mellitus presents with Kussmaul respirations, fruity breath
odor, and a blood glucose of 550 mg/dL. What is the primary acid-base imbalance occurring?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Metabolic Acidosis
D. Respiratory Alkalosis
Correct Answer: C
Rationale: Diabetic Ketoacidosis (DKA) leads to an accumulation of ketones, which are
organic acids that lower the blood pH. The body attempts to compensate for this metabolic
acidosis through Kussmaul respirations, which increase the excretion of carbon dioxide.
This condition is a medical emergency that requires insulin therapy and fluid resuscitation
to restore metabolic balance.
5. In the context of the Renin-Angiotensin-Aldosterone System (RAAS), what is the specific
role of Angiotensin II?
A. Stimulating the release of insulin
, B. Causing potent vasoconstriction and stimulating aldosterone secretion
C. Inhibiting the reabsorption of sodium in the distal tubule
D. Increasing the excretion of potassium in the urine
Correct Answer: B
Rationale: Angiotensin II acts as a powerful vasoconstrictor, which increases peripheral
vascular resistance and systemic blood pressure. It also acts on the adrenal cortex to
stimulate the release of aldosterone, which promotes sodium and water retention. These
mechanisms are central to the body’s long-term regulation of blood pressure and fluid
volume.
6. SATA: A patient is diagnosed with Nephrotic Syndrome. Which clinical findings should the
nurse anticipate?
A. Massive proteinuria (>3.5g/day)
B. Generalized edema (anasarca)
C. Hypoalbuminemia
D. Hematuria with red blood cell casts
E. Hyperlipidemia
Correct Answer: A, B, C, E
Rationale: Nephrotic syndrome is characterized by increased glomerular permeability to
proteins, leading to massive proteinuria and subsequent hypoalbuminemia. The loss of
