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NURS 5315 Advanced Pathophysiology – (Exam 4) 50 Original Questions
with Answers and Rationales UPDATED!!!
Renal, GI, Endocrine, and Neurologic
1. A patient presents with hematuria, proteinuria, and red
blood cell casts. These findings are most suggestive of:
A) Nephrotic syndrome
B) Acute glomerulonephritis
C) Acute tubular necrosis
D) Pyelonephritis
Answer: B) Acute glomerulonephritis
Rationale: RBC casts and hematuria indicate glomerular
inflammation. Nephrotic syndrome presents with heavy
proteinuria without hematuria or RBC casts.
2. The hallmark of nephrotic syndrome is:
A) Hematuria
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B) Proteinuria greater than 3.5 g/day
C) Pyuria
D) Oliguria
Answer: B) Proteinuria greater than 3.5 g/day
Rationale: Nephrotic syndrome is defined by heavy
proteinuria (>3.5 g/day), hypoalbuminemia, edema, and
hyperlipidemia.
3. A patient with diabetic nephropathy develops proteinuria.
The earliest structural change in the glomerulus is:
A) Crescent formation
B) Mesangial expansion and thickening of the glomerular
basement membrane
C) Fibrinoid necrosis
D) Kimmelstiel-Wilson nodules
Answer: B) Mesangial expansion and thickening of the
glomerular basement membrane
Rationale: Early diabetic nephropathy involves mesangial
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matrix expansion and GBM thickening; Kimmelstiel-Wilson
nodules occur later.
4. The most common cause of acute kidney injury (AKI) is:
A) Postrenal obstruction
B) Acute tubular necrosis
C) Glomerulonephritis
D) Interstitial nephritis
Answer: B) Acute tubular necrosis
Rationale: ATN from ischemia or nephrotoxins is the most
common intrarenal cause of AKI.
5. A patient with AKI has a urine osmolality of 300 mOsm/kg
and a fractional excretion of sodium (FENa) of 3%. This is
most consistent with:
A) Prerenal azotemia
B) Acute tubular necrosis
C) Acute glomerulonephritis
D) Postrenal obstruction
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NURS 5315 Advanced Pathophysiology – (Exam 4) 50 Original Questions
with Answers and Rationales UPDATED!!!
Renal, GI, Endocrine, and Neurologic
1. A patient presents with hematuria, proteinuria, and red
blood cell casts. These findings are most suggestive of:
A) Nephrotic syndrome
B) Acute glomerulonephritis
C) Acute tubular necrosis
D) Pyelonephritis
Answer: B) Acute glomerulonephritis
Rationale: RBC casts and hematuria indicate glomerular
inflammation. Nephrotic syndrome presents with heavy
proteinuria without hematuria or RBC casts.
2. The hallmark of nephrotic syndrome is:
A) Hematuria
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, Page |2
B) Proteinuria greater than 3.5 g/day
C) Pyuria
D) Oliguria
Answer: B) Proteinuria greater than 3.5 g/day
Rationale: Nephrotic syndrome is defined by heavy
proteinuria (>3.5 g/day), hypoalbuminemia, edema, and
hyperlipidemia.
3. A patient with diabetic nephropathy develops proteinuria.
The earliest structural change in the glomerulus is:
A) Crescent formation
B) Mesangial expansion and thickening of the glomerular
basement membrane
C) Fibrinoid necrosis
D) Kimmelstiel-Wilson nodules
Answer: B) Mesangial expansion and thickening of the
glomerular basement membrane
Rationale: Early diabetic nephropathy involves mesangial
2|Page
, Page |3
matrix expansion and GBM thickening; Kimmelstiel-Wilson
nodules occur later.
4. The most common cause of acute kidney injury (AKI) is:
A) Postrenal obstruction
B) Acute tubular necrosis
C) Glomerulonephritis
D) Interstitial nephritis
Answer: B) Acute tubular necrosis
Rationale: ATN from ischemia or nephrotoxins is the most
common intrarenal cause of AKI.
5. A patient with AKI has a urine osmolality of 300 mOsm/kg
and a fractional excretion of sodium (FENa) of 3%. This is
most consistent with:
A) Prerenal azotemia
B) Acute tubular necrosis
C) Acute glomerulonephritis
D) Postrenal obstruction
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