NSG 530 EXAM 4 REVIEW |
QUESTIONS AND ANSWERS |
2026/2027 UPDATE | WITH 100%
VERIFIED SOLUTIONS - WILKES.
SECTION 1: RENAL SYSTEM PATHOPHYSIOLOGY
Question 1
What is the functional unit of the kidney?
A) Glomerulus
B) Nephron
C) Renal corpuscle
D) Collecting duct
Rationale: The nephron is the functional unit of the kidney, consisting of the renal
corpuscle (glomerulus and Bowman's capsule), proximal convoluted tubule, loop of
Henle, distal convoluted tubule, and collecting duct.
Question 2
,What is the normal glomerular filtration rate (GFR) in a healthy adult?
A) 50-75 mL/min
B) 90-120 mL/min
C) 150-200 mL/min
D) 30-60 mL/min
Rationale: Normal GFR is approximately 90-120 mL/min/1.73m². A GFR below 60
mL/min indicates chronic kidney disease (Stage 3 or higher), and below 15 mL/min
indicates end-stage renal disease.
Question 3
A patient with chronic kidney disease has a GFR of 25 mL/min. This corresponds to
which stage of CKD?
A) Stage 2
B) Stage 3
C) Stage 4
D) Stage 5
Rationale: CKD stages: Stage 1 (GFR ≥ 90), Stage 2 (60-89), Stage 3a (45-59), Stage 3b
(30-44), Stage 4 (15-29), Stage 5 (< 15 or dialysis). GFR 25 mL/min = Stage 4.
Question 4
What is the most common cause of chronic kidney disease in the United States?
,A) Diabetes mellitus
B) Hypertension
C) Glomerulonephritis
D) Polycystic kidney disease
Rationale: Diabetes mellitus is the most common cause of CKD in the United States,
followed by hypertension. Both cause progressive damage to the glomeruli and renal
vasculature.
Question 5
A patient with acute kidney injury (AKI) presents with oliguria (urine output < 400
mL/day), elevated BUN and creatinine, and hyperkalemia. This is most consistent
with which phase of AKI?
A) Prerenal azotemia
B) Initiation phase
C) Oliguric phase
D) Recovery phase
Rationale: The oliguric phase of AKI is characterized by urine output < 400 mL/day,
fluid retention, electrolyte disturbances (hyperkalemia, hyperphosphatemia), and
metabolic acidosis.
Question 6
What is the most common cause of prerenal azotemia?
, A) Acute tubular necrosis
B) Hypovolemia
C) Urinary obstruction
D) Glomerulonephritis
Rationale: Prerenal azotemia is caused by decreased renal perfusion. Common causes
include hypovolemia (hemorrhage, dehydration), decreased cardiac output (heart
failure), and renal vasoconstriction.
Question 7
A patient with acute tubular necrosis (ATN) would have which urine sediment
finding?
A) Muddy brown casts
B) Red blood cell casts
C) White blood cell casts
D) Fatty casts
Rationale: ATN is characterized by muddy brown casts (pigmented granular casts) on
urinalysis. This is a hallmark finding of intrinsic renal injury. RBC casts suggest
glomerulonephritis; WBC casts suggest pyelonephritis or interstitial nephritis.
Question 8
What is the most common cause of acute kidney injury (AKI) in hospitalized
patients?
QUESTIONS AND ANSWERS |
2026/2027 UPDATE | WITH 100%
VERIFIED SOLUTIONS - WILKES.
SECTION 1: RENAL SYSTEM PATHOPHYSIOLOGY
Question 1
What is the functional unit of the kidney?
A) Glomerulus
B) Nephron
C) Renal corpuscle
D) Collecting duct
Rationale: The nephron is the functional unit of the kidney, consisting of the renal
corpuscle (glomerulus and Bowman's capsule), proximal convoluted tubule, loop of
Henle, distal convoluted tubule, and collecting duct.
Question 2
,What is the normal glomerular filtration rate (GFR) in a healthy adult?
A) 50-75 mL/min
B) 90-120 mL/min
C) 150-200 mL/min
D) 30-60 mL/min
Rationale: Normal GFR is approximately 90-120 mL/min/1.73m². A GFR below 60
mL/min indicates chronic kidney disease (Stage 3 or higher), and below 15 mL/min
indicates end-stage renal disease.
Question 3
A patient with chronic kidney disease has a GFR of 25 mL/min. This corresponds to
which stage of CKD?
A) Stage 2
B) Stage 3
C) Stage 4
D) Stage 5
Rationale: CKD stages: Stage 1 (GFR ≥ 90), Stage 2 (60-89), Stage 3a (45-59), Stage 3b
(30-44), Stage 4 (15-29), Stage 5 (< 15 or dialysis). GFR 25 mL/min = Stage 4.
Question 4
What is the most common cause of chronic kidney disease in the United States?
,A) Diabetes mellitus
B) Hypertension
C) Glomerulonephritis
D) Polycystic kidney disease
Rationale: Diabetes mellitus is the most common cause of CKD in the United States,
followed by hypertension. Both cause progressive damage to the glomeruli and renal
vasculature.
Question 5
A patient with acute kidney injury (AKI) presents with oliguria (urine output < 400
mL/day), elevated BUN and creatinine, and hyperkalemia. This is most consistent
with which phase of AKI?
A) Prerenal azotemia
B) Initiation phase
C) Oliguric phase
D) Recovery phase
Rationale: The oliguric phase of AKI is characterized by urine output < 400 mL/day,
fluid retention, electrolyte disturbances (hyperkalemia, hyperphosphatemia), and
metabolic acidosis.
Question 6
What is the most common cause of prerenal azotemia?
, A) Acute tubular necrosis
B) Hypovolemia
C) Urinary obstruction
D) Glomerulonephritis
Rationale: Prerenal azotemia is caused by decreased renal perfusion. Common causes
include hypovolemia (hemorrhage, dehydration), decreased cardiac output (heart
failure), and renal vasoconstriction.
Question 7
A patient with acute tubular necrosis (ATN) would have which urine sediment
finding?
A) Muddy brown casts
B) Red blood cell casts
C) White blood cell casts
D) Fatty casts
Rationale: ATN is characterized by muddy brown casts (pigmented granular casts) on
urinalysis. This is a hallmark finding of intrinsic renal injury. RBC casts suggest
glomerulonephritis; WBC casts suggest pyelonephritis or interstitial nephritis.
Question 8
What is the most common cause of acute kidney injury (AKI) in hospitalized
patients?
