NSG 3850 EXAM 4 PATHOPHYSIOLOGY
FOR NURSES II REVIEW QUESTIONS
AND ANSWERS
1. In Chronic Kidney Disease (CKD), which compensatory mechanism initially maintains GFR
despite the loss of functioning nephrons?
A. Hyperfiltration of the remaining intact nephrons
B. Systemic hypotension to reduce glomerular pressure
C. Decreased production of Renin and Angiotensin II
D. Constriction of the afferent arterioles
Answer: A
Conceptual Explanation: When nephrons are lost, the remaining functional nephrons
undergo hypertrophy and hyperfiltration to compensate for the lost surface area,
maintaining GFR until significant damage occurs.
2. Which clinical finding is the hallmark sign that distinguishes Nephrotic Syndrome from
Nephritic Syndrome?
A. Hematuria with red blood cell casts
,B. Massive proteinuria exceeding 3.5 grams per day
C. Rapidly progressive hypertension
D. Decreased serum creatinine levels
Answer: B
Conceptual Explanation: Nephrotic syndrome is characterized by massive proteinuria
(>3.5g/day), hypoalbuminemia, and edema, whereas Nephritic syndrome is characterized
by hematuria and inflammation.
3. During the progression of CKD, why do patients develop secondary hyperparathyroidism?
A. Excessive excretion of calcium by the renal tubules
B. Increased intestinal absorption of calcium
C. Hypocalcemia resulting from hyperphosphatemia and decreased Vitamin D activation
D. Primary tumor growth in the parathyroid glands
Answer: C
Conceptual Explanation: Failing kidneys cannot excrete phosphate or activate Vitamin D.
Hyperphosphatemia binds calcium, leading to hypocalcemia, which stimulates the
parathyroid glands to release PTH.
4. A patient presents with acute kidney injury (AKI) following severe hemorrhage. Which type
of AKI is this considered?
A. Intrarenal
, B. Prerenal
C. Chronic
D. Postrenal
Answer: B
Conceptual Explanation: Prerenal AKI is caused by factors that decrease systemic
circulation, such as hemorrhage or dehydration, leading to reduced renal blood flow
without initial damage to the kidney tissue.
5. Which electrolyte abnormality is most dangerous in a patient with End-Stage Renal Disease
(ESRD) and why?
A. Hyperkalemia, because it can cause lethal cardiac dysrhythmias
B. Hyponatremia, because it leads to excessive fluid retention
C. Hypocalcemia, because it causes immediate skeletal muscle paralysis
D. Hypomagnesemia, because it causes hypertension
Answer: A
Conceptual Explanation: The kidneys are the primary route for potassium excretion. In
ESRD, potassium accumulates, which alters the resting membrane potential of cardiac cells,
leading to arrest.
FOR NURSES II REVIEW QUESTIONS
AND ANSWERS
1. In Chronic Kidney Disease (CKD), which compensatory mechanism initially maintains GFR
despite the loss of functioning nephrons?
A. Hyperfiltration of the remaining intact nephrons
B. Systemic hypotension to reduce glomerular pressure
C. Decreased production of Renin and Angiotensin II
D. Constriction of the afferent arterioles
Answer: A
Conceptual Explanation: When nephrons are lost, the remaining functional nephrons
undergo hypertrophy and hyperfiltration to compensate for the lost surface area,
maintaining GFR until significant damage occurs.
2. Which clinical finding is the hallmark sign that distinguishes Nephrotic Syndrome from
Nephritic Syndrome?
A. Hematuria with red blood cell casts
,B. Massive proteinuria exceeding 3.5 grams per day
C. Rapidly progressive hypertension
D. Decreased serum creatinine levels
Answer: B
Conceptual Explanation: Nephrotic syndrome is characterized by massive proteinuria
(>3.5g/day), hypoalbuminemia, and edema, whereas Nephritic syndrome is characterized
by hematuria and inflammation.
3. During the progression of CKD, why do patients develop secondary hyperparathyroidism?
A. Excessive excretion of calcium by the renal tubules
B. Increased intestinal absorption of calcium
C. Hypocalcemia resulting from hyperphosphatemia and decreased Vitamin D activation
D. Primary tumor growth in the parathyroid glands
Answer: C
Conceptual Explanation: Failing kidneys cannot excrete phosphate or activate Vitamin D.
Hyperphosphatemia binds calcium, leading to hypocalcemia, which stimulates the
parathyroid glands to release PTH.
4. A patient presents with acute kidney injury (AKI) following severe hemorrhage. Which type
of AKI is this considered?
A. Intrarenal
, B. Prerenal
C. Chronic
D. Postrenal
Answer: B
Conceptual Explanation: Prerenal AKI is caused by factors that decrease systemic
circulation, such as hemorrhage or dehydration, leading to reduced renal blood flow
without initial damage to the kidney tissue.
5. Which electrolyte abnormality is most dangerous in a patient with End-Stage Renal Disease
(ESRD) and why?
A. Hyperkalemia, because it can cause lethal cardiac dysrhythmias
B. Hyponatremia, because it leads to excessive fluid retention
C. Hypocalcemia, because it causes immediate skeletal muscle paralysis
D. Hypomagnesemia, because it causes hypertension
Answer: A
Conceptual Explanation: The kidneys are the primary route for potassium excretion. In
ESRD, potassium accumulates, which alters the resting membrane potential of cardiac cells,
leading to arrest.
