Galen: Exam 3 Pathophysiology For Nurses II (NSG 3850)/ NSG3850 | Complete Questions & Answers | 100% Updated 2026/2027.

Galen: Exam 3 Pathophysiology For Nurses II (NSG 3850)/ NSG3850 | Complete Questions & Answers | 100% Updated 2026/2027. ### 1. A patient reports urine leakage whenever she coughs, laughs, or lifts a heavy object. Which type of incontinence is most consistent with this pattern? A. Overflow urinary incontinence B. Urgency urinary incontinence C. Functional incontinence D. Stress urinary incontinence ### 2. Which pathophysiologic problem most directly underlies urgency urinary incontinence in the uploaded notes? A. A bladder that is chronically overfilled from obstruction B. Weak pelvic floor support only C. An overactive detrusor muscle D. Inability to physically reach a toilet ### 3. An older man with an enlarged prostate has a bladder that becomes very full and then leaks small amounts of urine. Which incontinence pattern is most likely? A. Overflow urinary incontinence B. Functional incontinence C. Transient incontinence D. Stress urinary incontinence ### 4. A patient with a broken leg cannot reach the bathroom quickly enough but has no primary bladder disorder. Which type of incontinence best fits this situation? A. Overflow urinary incontinence B. Functional incontinence C. Urgency urinary incontinence D. Stress urinary incontinence ### 5. Which finding most strongly supports transient rather than chronic urinary incontinence? A. Leakage with coughing for several years B. Sudden onset associated with a reversible problem such as a UTI, constipation, or fecal impaction C. Leakage immediately after a strong urge caused by an overactive detrusor D. Leakage from an overfilled bladder due to prostate enlargement ### 6. Which statement about urinary incontinence is consistent with the uploaded Exam 3 materials? A. It always results from permanent neurologic damage. B. It occurs only when the urinary tract is infected. C. It is involuntary urine loss and is not considered a normal part of aging. D. It is expected in all adults older than 65. ### 7. A patient has suprapubic pain as the bladder fills, urinary urgency and dysuria, and pain that improves after voiding. Which disorder best matches the notes? A. Nephrotic syndrome B. Acute pyelonephritis C. Postrenal acute kidney injury D. Bladder pain syndrome/interstitial cystitis ### 8. Which organism is identified as responsible for most community cases of bacterial cystitis in the uploaded notes? A. Escherichia coli B. Helicobacter pylori C. Herpes simplex virus D. Clostridium difficile ### 9. An older adult develops new confusion, urinary frequency, urgency, and cloudy urine. Which disorder should be strongly considered based on the uploaded materials? A. Nephrotic syndrome B. Polycystic kidney disease C. Lower urinary tract infection/cystitis D. Chronic glomerulonephritis ### 10. Which test combination is specifically listed for evaluating a suspected lower urinary tract infection? A. CT scan with parathyroid hormone level B. Clean-catch urine specimen with nitrite and leukocyte esterase testing C. Renal biopsy with BUN D. Serum albumin with lipid profile ### 11. A patient presents with sudden fever, chills, nausea, vomiting, and marked costovertebral-angle tenderness. Which disorder is most consistent with this presentation? A. Cystitis only B. Acute pyelonephritis C. Chronic pyelonephritis D. Nephrotic syndrome ### 12. Which mechanism most directly contributes to acute pyelonephritis according to the source materials? A. Obstruction or ureteral reflux allowing contaminated urine to enter the kidney B. Loss of serum albumin from glomerular leakiness C. Rapid gastric emptying into the small intestine D. Progressive nephron hypertrophy after CKD ### 13. Which patient characteristic is specifically identified as a risk factor for acute pyelonephritis? A. Chronic alcohol intake without urinary symptoms B. Low-fiber diet C. Pregnancy D. Recent gastrectomy ### 14. Which urinalysis finding is emphasized in the diagnosis of acute pyelonephritis? A. Significant bacteria with white blood cell casts B. Low serum albumin without urinary findings C. Heavy protein loss greater than 3 to 3.5 g/day only D. Isolated hyperlipidemia ### 15. A patient has recurrent kidney infections, chronic reflux of infected urine into the renal pelvis, and progressive loss of functional nephrons. Which diagnosis best fits? A. Acute cystitis B. Chronic pyelonephritis C. Prerenal AKI D. Stress incontinence ### 16. Which imaging pattern is expected with chronic pyelonephritis according to the source? A. Small, atrophied kidneys with scarring B. Kidneys enlarged only from acute volume overload C. Normal kidneys with isolated bladder wall thickening D. Bilaterally enlarged kidneys with expanding cysts only ### 17. Which definition correctly distinguishes nephrolithiasis from urolithiasis? A. Nephrolithiasis is bladder infection; urolithiasis is kidney infection. B. Nephrolithiasis is glomerular inflammation; urolithiasis is urethral inflammation. C. Nephrolithiasis is urinary incontinence; urolithiasis is urinary retention. D. Nephrolithiasis refers to stones formed in the kidneys; urolithiasis refers to stones anywhere in the urinary tract. ### 18. Which condition most directly promotes urinary crystal formation in the renal calculi section? A. Reduced intra-abdominal pressure B. Increased intestinal motility C. Dehydration that decreases the solvent portion of urine D. High fluid intake ### 19. Which intervention is identified as an inhibitor of renal stone formation? A. Prolonged immobility B. Adequate fluid intake C. Increasing gastric acidity D. Restricting all fluid intake ### 20. A patient with a kidney stone describes spasmodic, intermittent, sharp flank pain with nausea and hematuria. Which term best describes this pain pattern? A. Functional incontinence B. Reflux esophagitis C. Renal colic D. Uremic syndrome ### 21. What is the major danger of a persistent postrenal obstruction? A. It directly causes Crohn disease. B. Increasing retrograde urine pressure can progress to intrinsic kidney injury/acute tubular necrosis. C. It always causes stress incontinence only. D. It immediately causes nephrotic syndrome. ### 22. Which feature best characterizes autosomal recessive polycystic kidney disease in the uploaded materials? A. It is acquired from dehydration. B. It is caused by recurrent lower urinary tract infections. C. It is usually first seen only after age 70. D. It is often identified in the neonatal period and may be associated with pulmonary hypoplasia. ### 23. A neonate with palpable enlarged kidneys, respiratory distress, and systemic hypertension most closely matches which disorder? A. Autosomal recessive polycystic kidney disease B. Nephrotic syndrome C. Autosomal dominant polycystic kidney disease D. Acute cystitis ### 24. Which statement best describes autosomal dominant polycystic kidney disease? A. It resolves once bladder pressure decreases. B. It is caused by a low-fiber diet. C. It is a transient lower urinary tract infection. D. It is the most common hereditary cystic kidney disease and can progress to end-stage kidney disease. ### 25. Which clinical pattern is consistent with autosomal dominant polycystic kidney disease in adults? A. Only constipation and bloating B. Hypertension, proteinuria, hematuria, impaired urine-concentrating ability, and kidney-stone symptoms C. Only stress-related urine leakage D. Only fever and productive cough ### 26. Which cluster of findings most strongly points to acute glomerulonephritis? A. Diarrhea, dehydration, and low blood pressure B. Polyuria, hypotension, and low BUN C. Urgency, stress leakage, and normal renal function D. Hematuria, proteinuria, oliguria, azotemia, edema, and hypertension ### 27. Which urine description is strongly associated with acute glomerulonephritis in the notes? A. Clear urine with no sediment B. Milky urine after meals C. Bright orange urine from dehydration D. Smoky or coffee-colored urine ### 28. Why does edema develop in acute glomerulonephritis according to the source? A. The bladder loses voluntary sphincter control. B. The small intestine draws water into its lumen. C. Reduced GFR increases circulating volume and promotes fluid retention. D. The liver produces excess albumin. ### 29. Which process initiates the inflammatory response in many cases of acute glomerulonephritis? A. Infectious organisms trigger antibody production and inflammation affecting the glomeruli. B. Loss of bowel motility C. Rapid gastric emptying D. Overactive detrusor contraction ### 30. Which finding is most characteristic of chronic glomerulonephritis rather than acute cystitis? A. Sudden dysuria and urgency only B. Suprapubic pain relieved by voiding C. Persistent proteinuria with or without hematuria and slowly declining renal function D. Leakage with coughing ### 31. Which pathophysiologic event is central to nephrotic syndrome? A. Glomerular leakiness causing urinary protein loss greater than 3 to 3.5 g/day B. Rapid emptying of gastric contents C. Failure of the external sphincter to relax D. Bacterial infection limited to the bladder ### 32. Why does generalized edema occur in nephrotic syndrome according to the notes? A. Loss of serum albumin lowers oncotic pressure, allowing fluid to escape into tissues. B. High albumin draws fluid out of vessels. C. Increased bowel motility pulls sodium into plasma. D. An overactive detrusor raises hydrostatic pressure. ### 33. Which additional finding is associated with nephrotic syndrome? A. Low urine protein B. Hyperlipidemia with increased risk of thrombus formation C. Persistent hypocapnia D. Severe constipation as the defining feature ### 34. Which criterion meets the uploaded definition of acute kidney injury? A. Urine output above 2 mL/kg/hr B. An increase in serum creatinine of more than 0.3 mg/dL within 48 hours C. A single episode of stress incontinence D. A stable creatinine for 6 months ### 35. Which urine output finding is used in the notes as a criterion for acute kidney injury? A. Less than 0.5 mL/kg/hr for 6 hours B. Exactly 1 mL/kg/hr for 2 hours C. Any voiding frequency above three times daily D. More than 3 mL/kg/hr for 1 hour ### 36. A patient with severe dehydration and hypotension develops oliguria. Which category of AKI is most likely? A. Chronic glomerulonephritis B. Postrenal kidney injury C. Intrinsic kidney injury D. Prerenal kidney injury ### 37. Which compensatory response is especially emphasized in prerenal kidney injury? A. Loss of detrusor tone B. Activation of the renin-angiotensin-aldosterone system C. Increased intestinal chloride secretion D. Suppression of all sympathetic activity ### 38. What may occur if prerenal hypoperfusion is not corrected? A. Development of Barrett esophagus B. Immediate resolution to normal renal function regardless of perfusion C. Conversion to stress incontinence D. Progression to intrinsic kidney injury with acute tubular necrosis ### 39. Which cause is most closely associated with intrinsic/intrarenal AKI in the uploaded materials? A. Limited access to a toilet B. Low dietary fiber C. Exposure to nephrotoxic substances such as contrast media D. Hiatal hernia ### 40. Which statement best defines postrenal AKI? A. It results from obstruction of normal urine outflow distal to the kidneys. B. It results from reduced kidney perfusion without obstruction. C. It results only from glomerular autoimmunity. D. It is caused by rapid gastric emptying. ### 41. Which patient is at risk for postrenal AKI based on the uploaded materials? A. A patient with diarrhea and volume depletion only B. A patient with benign prostatic hypertrophy causing urinary outflow obstruction C. A patient with Crohn disease and no urinary symptoms D. A patient exposed to contrast media without obstruction ### 42. Which combination is expected during AKI as renal filtration worsens? A. Increased GFR with immediate correction of all electrolytes B. Increased serum creatinine with decreased GFR and retention of nitrogenous wastes C. Only urinary frequency with normal laboratory values D. Decreased serum creatinine with increased GFR ### 43. During the oliguric phase of intrinsic kidney injury, which electrolyte abnormality is a major concern in the notes? A. Hypercalcemia from increased renal activation B. Hypokalemia from massive renal excretion C. Isolated hypophosphatemia D. Hyperkalemia ### 44. Why can metabolic acidosis develop during acute kidney injury? A. The kidneys lose the ability to excrete the acid load effectively. B. The kidneys excrete too much hydrogen ion. C. The stomach stops producing acid. D. The bladder absorbs bicarbonate. ### 45. Which clinical pattern suggests fluid overload during the oliguric phase of AKI? A. Isolated heartburn after meals B. Stress leakage with coughing C. Weight gain, edema, jugular venous distention, crackles, and hypertension D. Dry mucous membranes with no edema and low blood pressure only ### 46. Which phase of AKI is marked by gradually returning urine output but continued tubular dysfunction and risk of volume/electrolyte depletion? A. Postrenal obstruction phase B. Stable CKD stage 1 C. Initiation phase only D. Diuretic/recovery phase ### 47. A patient develops AKI after prolonged sepsis-related ischemia affecting the renal tubules. Which type is most consistent? A. Prerenal AKI with fully intact tubules B. Functional urinary incontinence C. Transient cystitis D. Intrinsic/intrarenal AKI with acute tubular necrosis ### 48. Which change would most strongly suggest that prerenal kidney injury has improved after restoring perfusion? A. Renal function and urine output return toward normal before permanent parenchymal injury occurs. B. Increasing scar formation in both kidneys C. Continued oliguria despite corrected perfusion for weeks D. Progressive retrograde urine pressure ### 49. How is chronic kidney disease defined in the uploaded materials? A. A single episode of cystitis B. Decreased kidney function or kidney damage lasting 3 months or more C. Urinary incontinence in an older adult D. Any transient creatinine increase lasting 24 hours ### 50. Which two conditions are repeatedly identified as major risk factors for chronic kidney disease? A. GERD and hiatal hernia B. Stress and urgency incontinence C. Diabetes mellitus and hypertension D. Appendicitis and diverticulosis ### 51. Why can renal function appear relatively preserved early in CKD? A. The bladder produces new nephrons. B. Remaining nephrons enlarge and increase their clearance capacity to compensate. C. Renal cysts always improve filtration. D. The colon removes nitrogenous waste in place of the kidneys. ### 52. Approximately how much nephron loss may occur before renal function becomes markedly impaired according to the notes? A. About 10% of nephrons B. About 75% to 80% of nephrons C. About 5% of nephrons D. About 25% of nephrons ### 53. Which CKD stage is identified as end-stage kidney disease? A. Stage 3 B. Stage 1 C. Stage 2 D. Stage 5 ### 54. Which complication of CKD is directly related to reduced erythropoietin production? A. Anemia B. Stress incontinence C. Toxic megacolon D. Hyperlipidemia from nephrotic syndrome only ### 55. Which mineral pattern is associated with CKD-related bone and mineral disorder in the notes? A. Elevated phosphorus and parathyroid hormone with impaired calcium handling B. Low phosphorus with suppressed parathyroid hormone C. High calcium from enhanced renal reabsorption D. No change in mineral metabolism ### 56. Which situation is specifically listed as an indication for emergency dialysis? A. Mild stress incontinence B. Simple constipation C. Hyperkalemia unresponsive to treatment or severe volume overload D. Stable GERD ### 57. Which vascular access is preferred for maintenance hemodialysis in the uploaded materials? A. An arteriovenous fistula, usually in the arm B. A peripheral IV used only for fluids C. A urinary catheter D. A nasogastric tube ### 58. Which complication is emphasized immediately after hemodialysis? A. Toxic megacolon B. Severe hypotension C. Stress urinary incontinence D. Hypervolemic hypertension from retained fluid ### 59. How does peritoneal dialysis differ from hemodialysis in the source materials? A. It requires no dialyzing membrane. B. It uses only the lungs to remove urea. C. It always uses an AV fistula. D. The patient's peritoneum serves as the dialyzing membrane through an abdominal catheter. ### 60. Which complication is specifically associated with peritoneal dialysis? A. Stress incontinence B. Acute bronchitis C. Barrett esophagus D. Peritonitis ### 61. Which definition best matches diarrhea in the uploaded GI materials? A. Fewer than three stools per week B. Increased frequency and fluidity of bowel movements, often related to reduced transit time C. Backflow of gastric contents into the esophagus D. Involuntary urine loss ### 62. Which population is specifically highlighted as being at increased risk for dehydration from diarrhea? A. Children and older adults B. Only healthy young adults C. Only patients with stress incontinence D. Only middle-aged athletes ### 63. Which finding meets the source definition of constipation? A. More than five liquid stools per day B. Hematemesis after meals C. Urinary frequency with dysuria D. Fewer than three bowel movements per week with small, infrequent, or difficult stools ### 64. Which combination contributes to constipation in older adults according to the notes? A. Excessive urine production B. Rapid gastric emptying and diarrhea C. Lower physical activity, slower peristalsis, and low-fiber dietary patterns D. Increased bowel motility and high fiber intake ### 65. A patient develops tingling and itching followed by painful vesicles on an erythematous oral base. Which disorder best matches the notes? A. Diverticulitis B. Peptic ulcer disease C. Acute herpetic gingivostomatitis D. Celiac disease ### 66. Which mechanism is central to gastroesophageal reflux disease? A. Reduced effectiveness of the lower esophageal sphincter or increased intra-abdominal pressure B. Renal tubular obstruction C. Overactive detrusor contraction D. Glomerular protein leak ### 67. Which condition is a recognized complication of chronic GERD in the uploaded materials? A. Overflow incontinence B. Barrett esophagus with increased cancer risk C. Autosomal recessive polycystic kidney disease D. Acute glomerulonephritis ### 68. Which factor can increase intra-abdominal pressure and predispose a patient to hiatal hernia? A. AV fistula placement B. Obesity C. Reduced urine osmolality D. Low serum albumin only ### 69. Which description best defines a hiatal hernia? A. The kidney descends into the pelvis. B. The colon herniates into the bladder. C. The urethra protrudes through the bladder wall. D. A portion of the stomach passes through the diaphragmatic opening into the thorax. ### 70. Which factor is repeatedly emphasized in the pathogenesis of gastritis? A. Neisseria gonorrhoeae B. Clostridium difficile only C. Helicobacter pylori D. Renin-angiotensin activation ### 71. Which presentation is consistent with acute gastritis? A. Anorexia, nausea, vomiting, postprandial discomfort, and possible hematemesis B. Stress leakage with coughing C. Flank pain with WBC casts D. Painless generalized edema with heavy proteinuria ### 72. Which disorder is described as inflammation of the stomach and small intestine, often with diarrhea, abdominal discomfort, nausea, vomiting, and fever? A. Nephrotic syndrome B. Cystitis C. Chronic glomerulonephritis D. Gastroenteritis ### 73. Which two factors are emphasized as major contributors to peptic ulcer disease? A. Pregnancy and urinary reflux B. Diabetes and hypertension C. Low fiber and immobility D. Helicobacter pylori and NSAID-related mucosal injury ### 74. A patient reports burning epigastric pain 2 to 3 hours after a meal when the stomach has emptied into the duodenum. Which ulcer pattern is this most consistent with in the notes? A. Nephrotic syndrome B. Acute pyelonephritis C. Duodenal ulcer pattern D. Stress urinary incontinence ### 75. Which diagnostic test is specifically listed for peptic ulcer disease and can directly visualize the mucosa? A. Pulse oximetry B. Renal ultrasound only C. Bladder pressure-flow study D. Endoscopy ### 76. Which statement best distinguishes ulcerative colitis from Crohn disease in the uploaded materials? A. There is no difference in location or depth of involvement. B. Ulcerative colitis is limited to the colon and begins in the rectum, whereas Crohn disease may involve the GI tract more extensively and affects all bowel-wall layers. C. Ulcerative colitis affects the kidney while Crohn disease affects the bladder. D. Ulcerative colitis is caused by urinary obstruction while Crohn disease is caused by dehydration. ### 77. Which complication is emphasized as the most serious acute complication of ulcerative colitis? A. Acute tubular necrosis B. Polycystic kidney disease C. Overflow urinary incontinence D. Toxic megacolon ### 78. Which finding is considered a cardinal diagnostic feature of Crohn disease in the uploaded notes? A. Nitrite-positive urine only B. Smoky-colored urine C. Granulomas on histopathologic analysis D. WBC casts in urine ### 79. Which complication results when deep linear Crohn disease ulcers extend into adjacent tissue? A. Stress incontinence B. Fistula formation C. Hydronephrosis only D. Barrett esophagus ### 80. A patient develops profuse foul-smelling watery diarrhea, abdominal pain, fever, and leukocytosis after prolonged antibiotic use. Which disorder is most likely? A. Hiatal hernia B. Clostridium difficile-associated pseudomembranous colitis C. Stress urinary incontinence D. Acute glomerulonephritis ### 81. Which serious complication is associated with Clostridium difficile-associated colitis in the source? A. Barrett esophagus B. Polycystic kidney disease C. Toxic megacolon and possible perforation D. Renal colic ### 82. A patient develops periumbilical pain that migrates to the right lower quadrant at McBurney's point. Which disorder is most consistent? A. Diverticulitis B. GERD C. Appendicitis D. Cystitis ### 83. What is a major consequence of an untreated perforated appendix in the uploaded notes? A. Peritonitis B. Autosomal dominant polycystic kidney disease C. Nephrotic syndrome D. Overflow incontinence ### 84. Which dietary pattern is associated with diverticular disease in the uploaded materials? A. High fluid intake B. Gluten avoidance C. Low dietary fiber intake leading to increased intraluminal pressure D. High-fiber intake with low pressure ### 85. Which presentation is most consistent with diverticulitis? A. CVA tenderness with WBC casts B. Painless jaundice C. Urinary leakage with coughing D. Acute left lower abdominal pain, fever, leukocytosis, and altered bowel pattern ### 86. Which pattern best describes irritable bowel syndrome in the source? A. Urinary reflux into the kidney B. Persistent glomerular protein loss C. Alternating diarrhea and constipation with cramping and no identifiable structural GI pathology D. Continuous colonic ulceration with toxic megacolon ### 87. Which feature suggests a functional rather than mechanical intestinal obstruction? A. Positive urine nitrites B. Absence of bowel sounds without a physical blockage C. Visible gallstones D. Initial increased bowel sounds around a mechanical blockage ### 88. Which is identified as the most common cause of mechanical intestinal obstruction in the uploaded review? A. Bladder infection B. Nephrotic syndrome C. Low erythropoietin D. Adhesions, especially after abdominal surgery ### 89. What is the central pathophysiologic problem in celiac disease? A. Bacterial invasion of renal tubules B. Excess aldosterone production C. Loss of bladder sphincter control D. Autoimmune response to gliadin leading to inflammation and atrophy of intestinal villi ### 90. A patient develops diarrhea, abdominal pain, low blood pressure, and later rebound hypoglycemia after gastric surgery. Which disorder best fits? A. Acute pyelonephritis B. Nephrotic syndrome C. Dumping syndrome D. Stress incontinence ### 91. A patient with cirrhosis suddenly develops hematemesis and melena. Which complication from the uploaded materials should be suspected? A. Gastroesophageal variceal bleeding B. Renal calculi C. Transient urinary incontinence D. Celiac disease ### 92. When is the greatest risk of rebleeding after a gastroesophageal variceal hemorrhage according to the notes? A. After 6 months only B. Only after dialysis C. Within the first 72 hours D. Only during urinary obstruction ### 93. Which mechanism best describes osmotic diarrhea in the uploaded Exam 3 notes? A. Poorly absorbed solutes retain or draw water into the intestinal lumen. B. Urinary obstruction causes water to enter the bowel. C. Bacterial toxins always suppress intestinal fluid secretion. D. The colon completely stops all motility. ### 94. Which type of diarrhea is associated with mucus, blood, and protein because of intestinal inflammation? A. Exudative diarrhea B. Functional urinary incontinence C. Postrenal diarrhea D. Osmotic diarrhea ### 95. Which statement best defines malabsorption according to the uploaded materials? A. Excessive gastric acid production only B. Failure of the bladder to store urine C. Complete obstruction of the urethra D. Failure of the small intestine to absorb or normally digest one or more dietary constituents ### 96. A patient has severe diarrhea and nutritional deficiencies after surgical removal of a large portion of the small intestine. Which disorder best matches this pattern? A. Short bowel syndrome B. Stress urinary incontinence C. Hiatal hernia D. Acute glomerulonephritis ### 97. Which bowel-sound pattern is most consistent with the early phase of a mechanical intestinal obstruction? A. Increased bowel sounds B. Bowel sounds limited to the urinary bladder C. Normal bowel sounds with no abdominal symptoms D. Absent bowel sounds from the beginning ### 98. A patient with an upper jejunal obstruction is most likely to develop which problem emphasized in the review? A. Painless hematuria only B. Vomiting with dehydration and electrolyte depletion C. Hyperalbuminemia without fluid loss D. Isolated stress incontinence ### 99. Why can dumping syndrome cause hypovolemia shortly after a meal? A. The colon stops absorbing all protein. B. The bladder loses sphincter control. C. Hyperosmolar intestinal contents draw fluid from the blood into the intestinal lumen. D. The kidneys suddenly excrete all circulating sodium. ### 100. What is the primary hemodynamic disorder that gives rise to gastroesophageal varices in the uploaded materials? A. Prerenal hypoperfusion B. Isolated detrusor overactivity C. Portal hypertension D. Low intracranial pressure