D236 Pathophysiology Week 7: Renal, Fluid, and Electrolyte
Imbalances 2026 |WGU
1. Which laboratory value is considered the best estimator of overall kidney
function?
A. Blood Urea Nitrogen (BUN)
B. Glomerular Filtration Rate (GFR)
C. Serum Creatinine
D. Urine Specific Gravity
Answer: B
Rationale: GFR is the best estimate of functioning renal tissue and the overall filter power
of the kidneys.
2. A patient presents with hypovolemia. Which type of Acute Kidney Injury (AKI)
is this patient at highest risk for?
A. Chronic Renal Failure
B. Intrarenal AKI
C. Postrenal AKI
D. Prerenal AKI
Answer: D
Rationale: Prerenal AKI is caused by factors that reduce systemic circulation, such as
hypovolemia or hypotension, leading to decreased renal blood flow.
,3. Which hormone is synthesized and secreted by the kidneys to stimulate red
blood cell production in the bone marrow?
A. Renin
B. Calcitriol
C. Aldosterone
D. Erythropoietin
Answer: D
Rationale: Erythropoietin is produced by the kidneys in response to hypoxia to stimulate
the production of erythrocytes.
4. Nephrotic syndrome is characterized by which of the following clinical
findings?
A. Gross hematuria and hypertension
B. Pyuria and flank pain
C. Proteinuria exceeding 3.5 grams per day
D. Elevated serum albumin
Answer: C
Rationale: Nephrotic syndrome involves massive proteinuria (usually >3.5g/day) due to
glomerular damage.
5. Which electrolyte imbalance is most commonly associated with the
development of tall, peaked T-waves on an EKG?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypocalcemia
Answer: A
Rationale: Hyperkalemia alters cardiac conduction, typically manifesting as tall peaked T-
waves and a widened QRS complex.
, 6. What is the most common cause of intrarenal acute kidney injury?
A. Acute tubular necrosis (ATN)
B. Kidney stones
C. Congestive heart failure
D. Urethral obstruction
Answer: A
Rationale: Acute tubular necrosis caused by ischemia or nephrotoxins is the most common
cause of intrarenal AKI.
7. Which compensatory mechanism does the body use during metabolic
acidosis?
A. Kidneys excrete bicarbonate
B. Lungs increase the respiratory rate (Kussmaul respirations)
C. Lungs decrease the respiratory rate
D. Kidneys retain hydrogen ions
Answer: B
Rationale: During metabolic acidosis, the lungs compensate by increasing the rate and
depth of breathing to blow off CO2 and raise pH.
8. A patient has a serum sodium level of 125 mEq/L. Which symptom is a
priority concern for the nurse?
A. Dry mucous membranes
B. Confusion and seizures
C. Peaked T-waves
D. Muscle tetany
Answer: B
Rationale: Severe hyponatremia (below 135 mEq/L) causes water to shift into brain cells,
leading to cerebral edema and neurological symptoms like seizures.
Imbalances 2026 |WGU
1. Which laboratory value is considered the best estimator of overall kidney
function?
A. Blood Urea Nitrogen (BUN)
B. Glomerular Filtration Rate (GFR)
C. Serum Creatinine
D. Urine Specific Gravity
Answer: B
Rationale: GFR is the best estimate of functioning renal tissue and the overall filter power
of the kidneys.
2. A patient presents with hypovolemia. Which type of Acute Kidney Injury (AKI)
is this patient at highest risk for?
A. Chronic Renal Failure
B. Intrarenal AKI
C. Postrenal AKI
D. Prerenal AKI
Answer: D
Rationale: Prerenal AKI is caused by factors that reduce systemic circulation, such as
hypovolemia or hypotension, leading to decreased renal blood flow.
,3. Which hormone is synthesized and secreted by the kidneys to stimulate red
blood cell production in the bone marrow?
A. Renin
B. Calcitriol
C. Aldosterone
D. Erythropoietin
Answer: D
Rationale: Erythropoietin is produced by the kidneys in response to hypoxia to stimulate
the production of erythrocytes.
4. Nephrotic syndrome is characterized by which of the following clinical
findings?
A. Gross hematuria and hypertension
B. Pyuria and flank pain
C. Proteinuria exceeding 3.5 grams per day
D. Elevated serum albumin
Answer: C
Rationale: Nephrotic syndrome involves massive proteinuria (usually >3.5g/day) due to
glomerular damage.
5. Which electrolyte imbalance is most commonly associated with the
development of tall, peaked T-waves on an EKG?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypocalcemia
Answer: A
Rationale: Hyperkalemia alters cardiac conduction, typically manifesting as tall peaked T-
waves and a widened QRS complex.
, 6. What is the most common cause of intrarenal acute kidney injury?
A. Acute tubular necrosis (ATN)
B. Kidney stones
C. Congestive heart failure
D. Urethral obstruction
Answer: A
Rationale: Acute tubular necrosis caused by ischemia or nephrotoxins is the most common
cause of intrarenal AKI.
7. Which compensatory mechanism does the body use during metabolic
acidosis?
A. Kidneys excrete bicarbonate
B. Lungs increase the respiratory rate (Kussmaul respirations)
C. Lungs decrease the respiratory rate
D. Kidneys retain hydrogen ions
Answer: B
Rationale: During metabolic acidosis, the lungs compensate by increasing the rate and
depth of breathing to blow off CO2 and raise pH.
8. A patient has a serum sodium level of 125 mEq/L. Which symptom is a
priority concern for the nurse?
A. Dry mucous membranes
B. Confusion and seizures
C. Peaked T-waves
D. Muscle tetany
Answer: B
Rationale: Severe hyponatremia (below 135 mEq/L) causes water to shift into brain cells,
leading to cerebral edema and neurological symptoms like seizures.
