Galen NSG 3850 Exam 3 | Pathophysiology for Nurses II
(2026) Actual Q&A PDF
1. A patient with nephrotic syndrome typically presents with which triad of findings?
A) Hematuria, hypertension, oliguria
B) Proteinuria, hypoalbuminemia, generalized edema
C) Pyuria, bacteriuria, fever
D) Polyuria, polydipsia, hyperglycemia
Correct Answer: Proteinuria, hypoalbuminemia, generalized edema
Rationale: Nephrotic syndrome is defined by massive proteinuria (>3.5 g/day) from
increased glomerular permeability, resulting in hypoalbuminemia and generalized edema.
Hematuria and hypertension are typical of glomerulonephritis. Pyuria, bacteriuria, and
fever indicate infection, while polyuria, polydipsia, and hyperglycemia are seen in diabetes
mellitus.
2. Which laboratory finding is most suggestive of glomerulonephritis rather than nephrotic
syndrome?
A) Serum albumin 2.8 g/dL
B) 24-hour urine protein 4.5 g
C) Red blood cell casts in urine
D) Serum cholesterol 320 mg/dL
Correct Answer: Red blood cell casts in urine
Rationale: RBC casts indicate glomerular bleeding, characteristic of glomerulonephritis.
Nephrotic syndrome typically shows fatty casts and oval fat bodies with protein but
,without significant hematuria. Low serum albumin, massive proteinuria, and
hypercholesterolemia are all features of nephrotic syndrome.
3. The pathophysiologic basis of acute glomerulonephritis is:
A) Renal ischemia
B) Bacterial invasion of the glomerulus
C) An anaphylactic reaction
D) An immune complex reaction
Correct Answer: An immune complex reaction
Rationale: Acute glomerulonephritis is typically an immune-complex mediated disease.
The immune complexes deposit in the glomeruli, triggering inflammation. Renal ischemia
causes acute tubular necrosis, bacterial invasion causes pyelonephritis, and anaphylaxis
causes distributive shock.
4. The infection frequently associated with development of post-infectious acute
glomerulonephritis is:
A) Pneumonia
B) Throat infection
C) Endocarditis
D) Urinary Tract Infection (UTI)
Correct Answer: Throat infection
Rationale: Post-streptococcal glomerulonephritis typically follows a Group A beta-
hemolytic streptococcal infection of the throat (pharyngitis) or skin (impetigo). Pneumonia,
endocarditis, and UTIs are not typically associated with this condition.
,5. A patient who reported 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 your 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."
Correct Answer: "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 your urine."
Rationale: Post-streptococcal glomerulonephritis is an immune-complex disease. The
immune response to the throat infection causes inflammation and damage to the
glomeruli, allowing red blood cells to leak into the urine (hematuria), giving it a smoky or
coffee-colored appearance. The other responses are inaccurate explanations of the
pathophysiology.
6. A patient with acute pyelonephritis would most typically experience:
A) Oliguria
B) Hypertension
C) Fever
D) Periorbital edema
Correct Answer: Fever
, Rationale: Acute pyelonephritis is a bacterial infection of the kidney, and fever is a classic
sign. Other symptoms include flank pain, chills, and costovertebral angle (CVA)
tenderness. Oliguria, hypertension, and periorbital edema are more characteristic of
glomerulonephritis or nephrotic syndrome.
7. The organism most commonly associated with acute pyelonephritis is:
A) Streptococcus
B) Escherichia coli
C) Klebsiella
D) Enterobacter
Correct Answer: Escherichia coli
Rationale: Escherichia coli is the most common causative organism of acute
pyelonephritis, accounting for approximately 80% of cases. Streptococcus is associated
with glomerulonephritis, while Klebsiella and Enterobacter are less common causes of
pyelonephritis.
8. It is true that polycystic kidney disease is:
A) Always rapidly fatal
B) Caused by a streptococcal infection
C) Associated with supernumerary kidney
D) Genetically transmitted
Correct Answer: Genetically transmitted
Rationale: Polycystic kidney disease is a genetic disorder characterized by the growth of
numerous cysts in the kidneys. It is not always rapidly fatal, is not caused by streptococcal
infection, and is not associated with a supernumerary kidney.
(2026) Actual Q&A PDF
1. A patient with nephrotic syndrome typically presents with which triad of findings?
A) Hematuria, hypertension, oliguria
B) Proteinuria, hypoalbuminemia, generalized edema
C) Pyuria, bacteriuria, fever
D) Polyuria, polydipsia, hyperglycemia
Correct Answer: Proteinuria, hypoalbuminemia, generalized edema
Rationale: Nephrotic syndrome is defined by massive proteinuria (>3.5 g/day) from
increased glomerular permeability, resulting in hypoalbuminemia and generalized edema.
Hematuria and hypertension are typical of glomerulonephritis. Pyuria, bacteriuria, and
fever indicate infection, while polyuria, polydipsia, and hyperglycemia are seen in diabetes
mellitus.
2. Which laboratory finding is most suggestive of glomerulonephritis rather than nephrotic
syndrome?
A) Serum albumin 2.8 g/dL
B) 24-hour urine protein 4.5 g
C) Red blood cell casts in urine
D) Serum cholesterol 320 mg/dL
Correct Answer: Red blood cell casts in urine
Rationale: RBC casts indicate glomerular bleeding, characteristic of glomerulonephritis.
Nephrotic syndrome typically shows fatty casts and oval fat bodies with protein but
,without significant hematuria. Low serum albumin, massive proteinuria, and
hypercholesterolemia are all features of nephrotic syndrome.
3. The pathophysiologic basis of acute glomerulonephritis is:
A) Renal ischemia
B) Bacterial invasion of the glomerulus
C) An anaphylactic reaction
D) An immune complex reaction
Correct Answer: An immune complex reaction
Rationale: Acute glomerulonephritis is typically an immune-complex mediated disease.
The immune complexes deposit in the glomeruli, triggering inflammation. Renal ischemia
causes acute tubular necrosis, bacterial invasion causes pyelonephritis, and anaphylaxis
causes distributive shock.
4. The infection frequently associated with development of post-infectious acute
glomerulonephritis is:
A) Pneumonia
B) Throat infection
C) Endocarditis
D) Urinary Tract Infection (UTI)
Correct Answer: Throat infection
Rationale: Post-streptococcal glomerulonephritis typically follows a Group A beta-
hemolytic streptococcal infection of the throat (pharyngitis) or skin (impetigo). Pneumonia,
endocarditis, and UTIs are not typically associated with this condition.
,5. A patient who reported 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 your 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."
Correct Answer: "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 your urine."
Rationale: Post-streptococcal glomerulonephritis is an immune-complex disease. The
immune response to the throat infection causes inflammation and damage to the
glomeruli, allowing red blood cells to leak into the urine (hematuria), giving it a smoky or
coffee-colored appearance. The other responses are inaccurate explanations of the
pathophysiology.
6. A patient with acute pyelonephritis would most typically experience:
A) Oliguria
B) Hypertension
C) Fever
D) Periorbital edema
Correct Answer: Fever
, Rationale: Acute pyelonephritis is a bacterial infection of the kidney, and fever is a classic
sign. Other symptoms include flank pain, chills, and costovertebral angle (CVA)
tenderness. Oliguria, hypertension, and periorbital edema are more characteristic of
glomerulonephritis or nephrotic syndrome.
7. The organism most commonly associated with acute pyelonephritis is:
A) Streptococcus
B) Escherichia coli
C) Klebsiella
D) Enterobacter
Correct Answer: Escherichia coli
Rationale: Escherichia coli is the most common causative organism of acute
pyelonephritis, accounting for approximately 80% of cases. Streptococcus is associated
with glomerulonephritis, while Klebsiella and Enterobacter are less common causes of
pyelonephritis.
8. It is true that polycystic kidney disease is:
A) Always rapidly fatal
B) Caused by a streptococcal infection
C) Associated with supernumerary kidney
D) Genetically transmitted
Correct Answer: Genetically transmitted
Rationale: Polycystic kidney disease is a genetic disorder characterized by the growth of
numerous cysts in the kidneys. It is not always rapidly fatal, is not caused by streptococcal
infection, and is not associated with a supernumerary kidney.
