NSG 3850 Exam 3 – Pathophysiology
II:Exam Complete Questions And Correct
Answers With Rationales | Already Graded
A+||Brand New Version!!.
Topics Covered: Renal, Urinary, Gastrointestinal, Endocrine,
and Inflammatory Disorders
This comprehensive practice exam follows the Exam 3 format for Galen College NSG
3850, covering renal disorders (CKD, AKI, glomerulonephritis, nephrotic syndrome, PKD,
pyelonephritis, cystitis, incontinence, renal calculi), gastrointestinal disorders (GERD,
PUD, IBD, bowel obstruction, celiac disease), and endocrine concepts as tested.
Section 1: Renal Disorders – Glomerulonephritis &
Nephrotic Syndrome (Questions 1–30)
1. The pathophysiologic basis of acute glomerulonephritis is:
A) Direct bacterial invasion of the glomerulus
B) Renal ischemia from hypotension
C) An immune complex reaction
D) Obstruction of the renal tubules
Answer: C
Acute glomerulonephritis is caused by an immune complex reaction, typically following a
streptococcal infection. Antigen-antibody complexes deposit in the glomerular basement
membrane, triggering inflammation that damages the glomerulus and impairs its
permeability. The bacteria themselves do not invade the kidney directly.
,2. The infection most frequently associated with post-infectious acute
glomerulonephritis is:
A) Pneumonia
B) Throat infection (Group A Streptococcus)
C) Endocarditis
D) Urinary tract infection
Answer: B
Post-streptococcal glomerulonephritis typically occurs 1–3 weeks after a Group A beta-
hemolytic streptococcal infection, most commonly a pharyngitis (strep throat) or impetigo.
The immune response to the infection causes glomerular damage.
3. A patient who had a very painful sore throat 3 weeks ago is now diagnosed with
acute post-streptococcal glomerulonephritis. When asked, "Why is my urine the
color of coffee?", the nurse's best response is:
A) "Normally, red blood cells that enter the urine are taken back into the blood, but in
your condition, they stay in the urine."
B) "Your immune system was activated by your sore throat and has caused some
damage in your kidneys that allows red blood cells to leak into the fluid that becomes
urine."
C) "The bacteria that caused your sore throat have traveled to your kidneys and are
causing damage there."
D) "When parts of your kidneys stopped working, your blood kept flowing and broke
some of your little blood vessels."
Answer: B
The immune response to the streptococcal infection causes immune complex deposition in
the glomeruli, leading to inflammation and increased glomerular permeability. This allows
red blood cells to leak into the urine, giving it a dark, coffee-colored appearance
(hematuria). The bacteria themselves do not travel to the kidneys.
4. Which assessment finding is characteristic of acute glomerulonephritis?
A) Clear, pale urine
B) Smoky/cola/coffee/tea-colored urine
,C) Bright red urine with clots
D) Cloudy urine with sediment
Answer: B
Hematuria is a hallmark of acute glomerulonephritis, producing dark, smoky, or cola-
colored urine. Proteinuria also occurs but may be less prominent than in nephrotic
syndrome. Bright red urine with clots is more suggestive of trauma or stones; cloudy urine
suggests infection.
5. The major underlying factor leading to the edema associated with
glomerulonephritis and nephrotic syndrome is:
A) Hematuria
B) Bacteriuria
C) Glycosuria
D) Proteinuria
Answer: D
Proteinuria (loss of protein in the urine) leads to hypoalbuminemia, which decreases
plasma oncotic pressure. This allows fluid to shift from the vascular space into the
interstitial space, causing edema. Hematuria and bacteriuria do not directly cause edema;
glycosuria is seen in diabetes.
6. A patient with nephrotic syndrome would most likely exhibit which laboratory
finding?
A) Hyperalbuminemia
B) Hypoalbuminemia
C) Hypolipidemia
D) Hypernatremia
Answer: B
Nephrotic syndrome is characterized by massive proteinuria leading to hypoalbuminemia
(low serum albumin). The liver attempts to compensate by synthesizing more proteins,
including lipoproteins, leading to hyperlipidemia. Sodium levels may be normal or low due
to fluid retention.
, 7. Which of the following is a classic manifestation of nephrotic syndrome? (Select
all that apply)
A) Proteinuria
B) Hypoalbuminemia
C) Hyperlipidemia
D) Hematuria (severe)
E) Generalized edema
Answer: A, B, C, E
The classic triad of nephrotic syndrome is proteinuria, hypoalbuminemia, and
hyperlipidemia, with generalized edema. Hematuria is more characteristic of nephritic
syndrome (glomerulonephritis), though some hematuria may occur in nephrotic
syndrome.
8. A patient with nephrotic syndrome develops edema. The primary mechanism is:
A) Increased capillary hydrostatic pressure from hypertension
B) Decreased plasma oncotic pressure from hypoalbuminemia
C) Increased capillary permeability from inflammation
D) Lymphatic obstruction from fibrosis
Answer: B
Loss of albumin in the urine (proteinuria) causes hypoalbuminemia. Low albumin reduces
plasma oncotic (colloid osmotic) pressure, reducing the force that pulls fluid back into the
capillaries, leading to fluid accumulation in interstitial spaces and edema.
9. Hyperlipidemia occurs in nephrotic syndrome because:
A) The kidneys fail to filter lipids
B) Hepatocytes synthesize excessive lipids in response to decreased plasma oncotic
pressure
C) The patient consumes a high-fat diet
D) Lipids are not excreted in the urine
II:Exam Complete Questions And Correct
Answers With Rationales | Already Graded
A+||Brand New Version!!.
Topics Covered: Renal, Urinary, Gastrointestinal, Endocrine,
and Inflammatory Disorders
This comprehensive practice exam follows the Exam 3 format for Galen College NSG
3850, covering renal disorders (CKD, AKI, glomerulonephritis, nephrotic syndrome, PKD,
pyelonephritis, cystitis, incontinence, renal calculi), gastrointestinal disorders (GERD,
PUD, IBD, bowel obstruction, celiac disease), and endocrine concepts as tested.
Section 1: Renal Disorders – Glomerulonephritis &
Nephrotic Syndrome (Questions 1–30)
1. The pathophysiologic basis of acute glomerulonephritis is:
A) Direct bacterial invasion of the glomerulus
B) Renal ischemia from hypotension
C) An immune complex reaction
D) Obstruction of the renal tubules
Answer: C
Acute glomerulonephritis is caused by an immune complex reaction, typically following a
streptococcal infection. Antigen-antibody complexes deposit in the glomerular basement
membrane, triggering inflammation that damages the glomerulus and impairs its
permeability. The bacteria themselves do not invade the kidney directly.
,2. The infection most frequently associated with post-infectious acute
glomerulonephritis is:
A) Pneumonia
B) Throat infection (Group A Streptococcus)
C) Endocarditis
D) Urinary tract infection
Answer: B
Post-streptococcal glomerulonephritis typically occurs 1–3 weeks after a Group A beta-
hemolytic streptococcal infection, most commonly a pharyngitis (strep throat) or impetigo.
The immune response to the infection causes glomerular damage.
3. A patient who had a very painful sore throat 3 weeks ago is now diagnosed with
acute post-streptococcal glomerulonephritis. When asked, "Why is my urine the
color of coffee?", the nurse's best response is:
A) "Normally, red blood cells that enter the urine are taken back into the blood, but in
your condition, they stay in the urine."
B) "Your immune system was activated by your sore throat and has caused some
damage in your kidneys that allows red blood cells to leak into the fluid that becomes
urine."
C) "The bacteria that caused your sore throat have traveled to your kidneys and are
causing damage there."
D) "When parts of your kidneys stopped working, your blood kept flowing and broke
some of your little blood vessels."
Answer: B
The immune response to the streptococcal infection causes immune complex deposition in
the glomeruli, leading to inflammation and increased glomerular permeability. This allows
red blood cells to leak into the urine, giving it a dark, coffee-colored appearance
(hematuria). The bacteria themselves do not travel to the kidneys.
4. Which assessment finding is characteristic of acute glomerulonephritis?
A) Clear, pale urine
B) Smoky/cola/coffee/tea-colored urine
,C) Bright red urine with clots
D) Cloudy urine with sediment
Answer: B
Hematuria is a hallmark of acute glomerulonephritis, producing dark, smoky, or cola-
colored urine. Proteinuria also occurs but may be less prominent than in nephrotic
syndrome. Bright red urine with clots is more suggestive of trauma or stones; cloudy urine
suggests infection.
5. The major underlying factor leading to the edema associated with
glomerulonephritis and nephrotic syndrome is:
A) Hematuria
B) Bacteriuria
C) Glycosuria
D) Proteinuria
Answer: D
Proteinuria (loss of protein in the urine) leads to hypoalbuminemia, which decreases
plasma oncotic pressure. This allows fluid to shift from the vascular space into the
interstitial space, causing edema. Hematuria and bacteriuria do not directly cause edema;
glycosuria is seen in diabetes.
6. A patient with nephrotic syndrome would most likely exhibit which laboratory
finding?
A) Hyperalbuminemia
B) Hypoalbuminemia
C) Hypolipidemia
D) Hypernatremia
Answer: B
Nephrotic syndrome is characterized by massive proteinuria leading to hypoalbuminemia
(low serum albumin). The liver attempts to compensate by synthesizing more proteins,
including lipoproteins, leading to hyperlipidemia. Sodium levels may be normal or low due
to fluid retention.
, 7. Which of the following is a classic manifestation of nephrotic syndrome? (Select
all that apply)
A) Proteinuria
B) Hypoalbuminemia
C) Hyperlipidemia
D) Hematuria (severe)
E) Generalized edema
Answer: A, B, C, E
The classic triad of nephrotic syndrome is proteinuria, hypoalbuminemia, and
hyperlipidemia, with generalized edema. Hematuria is more characteristic of nephritic
syndrome (glomerulonephritis), though some hematuria may occur in nephrotic
syndrome.
8. A patient with nephrotic syndrome develops edema. The primary mechanism is:
A) Increased capillary hydrostatic pressure from hypertension
B) Decreased plasma oncotic pressure from hypoalbuminemia
C) Increased capillary permeability from inflammation
D) Lymphatic obstruction from fibrosis
Answer: B
Loss of albumin in the urine (proteinuria) causes hypoalbuminemia. Low albumin reduces
plasma oncotic (colloid osmotic) pressure, reducing the force that pulls fluid back into the
capillaries, leading to fluid accumulation in interstitial spaces and edema.
9. Hyperlipidemia occurs in nephrotic syndrome because:
A) The kidneys fail to filter lipids
B) Hepatocytes synthesize excessive lipids in response to decreased plasma oncotic
pressure
C) The patient consumes a high-fat diet
D) Lipids are not excreted in the urine
