NSG 3850 – PATHOPHYSIOLOGY II EXAM 3
COMPREHENSIVE STUDY GUIDE ORIGINAL
MULTIPLE-CHOICE QUESTIONS
Renal, Hepatobiliary, Pancreatic, Hematology & Endocrine Disorders
Answers + Detailed Rationales
SECTION A: RENAL & URINARY PATHOPHYSIOLOGY
QUESTION 1
A patient with chronic kidney disease (CKD) has a GFR of 20 mL/min. Which
complication is expected due to decreased erythropoietin production?
A) Polycythemia
B) Normocytic, normochromic anemia
C) Microcytic hypochromic anemia
D) Hemolytic anemia
Correct Answer: B
Rationale: The kidneys produce erythropoietin (EPO) in response to hypoxia. In
CKD, the kidneys cannot produce adequate EPO, leading to normocytic,
normochromic anemia .
1
,QUESTION 2
A client with CKD has a phosphorus level of 6.8 mg/dL. Which medication does
the nurse anticipate administering?
A) Loop diuretic
B) Potassium supplement
C) Phosphate binder (such as calcium acetate or sevelamer)
D) Calcium channel blocker
Correct Answer: C
Rationale: Hyperphosphatemia is a common issue in CKD. Phosphate binders are
given with meals to bind dietary phosphate and prevent its absorption .
QUESTION 3
Which finding is most consistent with a diagnosis of nephrotic syndrome?
A) Hematuria with red cell casts
2
,B) Proteinuria >3.5 g/day with hypoalbuminemia
C) Elevated BUN and creatinine with hyperkalemia
D) Foul-smelling urine
Correct Answer: B
Rationale: Nephrotic syndrome is characterized by massive proteinuria (>3.5
g/day), hypoalbuminemia, edema, and hyperlipidemia .
QUESTION 4
A patient with status asthmaticus is nonresponsive to albuterol and requires
intubation. Which finding indicates severe asthma exacerbation?
A) PaCO2 30 mmHg (low)
B) PaCO2 48 mmHg (elevated)
C) PaO2 90 mmHg
D) Respiratory rate 16/min
Correct Answer: B
Rationale: In asthma, early stages typically show low PaCO2 due to
hyperventilation. A normal or elevated PaCO2 indicates respiratory fatigue and
impending failure .
3
, QUESTION 5
A patient is diagnosed with renal calculi. Which type of kidney stone is most
common?
A) Uric acid stones
B) Calcium oxalate stones
C) Struvite stones
D) Cystine stones
Correct Answer: B
Rationale: Calcium oxalate stones are the most common type of renal calculi,
accounting for approximately 75-80% of cases .
QUESTION 6
A patient with acute kidney injury (AKI) is in the oliguric phase. The nurse
understands that oliguria is defined as:
A) Urine output less than 400 mL/day
4
COMPREHENSIVE STUDY GUIDE ORIGINAL
MULTIPLE-CHOICE QUESTIONS
Renal, Hepatobiliary, Pancreatic, Hematology & Endocrine Disorders
Answers + Detailed Rationales
SECTION A: RENAL & URINARY PATHOPHYSIOLOGY
QUESTION 1
A patient with chronic kidney disease (CKD) has a GFR of 20 mL/min. Which
complication is expected due to decreased erythropoietin production?
A) Polycythemia
B) Normocytic, normochromic anemia
C) Microcytic hypochromic anemia
D) Hemolytic anemia
Correct Answer: B
Rationale: The kidneys produce erythropoietin (EPO) in response to hypoxia. In
CKD, the kidneys cannot produce adequate EPO, leading to normocytic,
normochromic anemia .
1
,QUESTION 2
A client with CKD has a phosphorus level of 6.8 mg/dL. Which medication does
the nurse anticipate administering?
A) Loop diuretic
B) Potassium supplement
C) Phosphate binder (such as calcium acetate or sevelamer)
D) Calcium channel blocker
Correct Answer: C
Rationale: Hyperphosphatemia is a common issue in CKD. Phosphate binders are
given with meals to bind dietary phosphate and prevent its absorption .
QUESTION 3
Which finding is most consistent with a diagnosis of nephrotic syndrome?
A) Hematuria with red cell casts
2
,B) Proteinuria >3.5 g/day with hypoalbuminemia
C) Elevated BUN and creatinine with hyperkalemia
D) Foul-smelling urine
Correct Answer: B
Rationale: Nephrotic syndrome is characterized by massive proteinuria (>3.5
g/day), hypoalbuminemia, edema, and hyperlipidemia .
QUESTION 4
A patient with status asthmaticus is nonresponsive to albuterol and requires
intubation. Which finding indicates severe asthma exacerbation?
A) PaCO2 30 mmHg (low)
B) PaCO2 48 mmHg (elevated)
C) PaO2 90 mmHg
D) Respiratory rate 16/min
Correct Answer: B
Rationale: In asthma, early stages typically show low PaCO2 due to
hyperventilation. A normal or elevated PaCO2 indicates respiratory fatigue and
impending failure .
3
, QUESTION 5
A patient is diagnosed with renal calculi. Which type of kidney stone is most
common?
A) Uric acid stones
B) Calcium oxalate stones
C) Struvite stones
D) Cystine stones
Correct Answer: B
Rationale: Calcium oxalate stones are the most common type of renal calculi,
accounting for approximately 75-80% of cases .
QUESTION 6
A patient with acute kidney injury (AKI) is in the oliguric phase. The nurse
understands that oliguria is defined as:
A) Urine output less than 400 mL/day
4
