NSG 530 ADVANCED
PATHOPHYSIOLOGY EXAM 4 -
COMPREHENSIVE STUDY PREP
QUESTIONS AND ANSWERS
1. Which phase of acute kidney injury (AKI) is characterized by a significant decrease in
glomerular filtration rate (GFR) and the accumulation of nitrogenous waste products in the
blood?
A. Initiation phase
B. Diuretic phase
C. Maintenance (Oliguric) phase
D. Recovery phase
Answer: C
Conceptual Explanation: The maintenance phase of AKI is characterized by a marked
decrease in GFR, leading to azotemia (accumulation of urea and creatinine) and often
oliguria. The initiation phase is the period of injury onset, while the recovery phase
involves repair and return of function.
,2. A patient presents with massive proteinuria (>3.5 g/day), hypoalbuminemia, and
generalized edema. Which condition is most likely?
A. Nephrotic Syndrome
B. Acute Nephritic Syndrome
C. Pyelonephritis
D. Renal Calculi
Answer: A
Conceptual Explanation: Nephrotic syndrome is defined by massive proteinuria due to
increased glomerular permeability, which leads to hypoalbuminemia and subsequent
edema (anasarca).
3. In chronic kidney disease (CKD), the primary cause of secondary hyperparathyroidism is:
A. Excessive excretion of calcium
B. Excessive production of Erythropoietin
C. Adrenal gland suppression
D. Hyperphosphatemia and decreased activated Vitamin D
Answer: D
Conceptual Explanation: In CKD, the kidneys fail to excrete phosphate and fail to activate
Vitamin D (calcitriol). Low calcium levels and high phosphate levels stimulate the
parathyroid glands to overproduce PTH.
, 4. Which hormone is primarily responsible for the concentration of urine by promoting water
reabsorption in the distal tubules and collecting ducts?
A. Aldosterone
B. Antidiuretic Hormone (ADH)
C. Atrial Natriuretic Peptide (ANP)
D. Renin
Answer: B
Conceptual Explanation: ADH (Vasopressin) increases the permeability of the collecting
ducts to water via aquaporins, allowing for water reabsorption and concentrated urine.
5. Prerenal acute kidney injury is most commonly caused by:
A. Obstruction of the urinary tract
B. Decreased renal perfusion (hypovolemia or hypotension)
C. Direct damage to the renal parenchyma
D. Nephrotoxic medications like aminoglycosides
Answer: B
Conceptual Explanation: Prerenal AKI results from conditions that decrease blood flow to
the kidneys, such as dehydration, hemorrhage, or heart failure, without initial damage to
the kidney tissue itself.
PATHOPHYSIOLOGY EXAM 4 -
COMPREHENSIVE STUDY PREP
QUESTIONS AND ANSWERS
1. Which phase of acute kidney injury (AKI) is characterized by a significant decrease in
glomerular filtration rate (GFR) and the accumulation of nitrogenous waste products in the
blood?
A. Initiation phase
B. Diuretic phase
C. Maintenance (Oliguric) phase
D. Recovery phase
Answer: C
Conceptual Explanation: The maintenance phase of AKI is characterized by a marked
decrease in GFR, leading to azotemia (accumulation of urea and creatinine) and often
oliguria. The initiation phase is the period of injury onset, while the recovery phase
involves repair and return of function.
,2. A patient presents with massive proteinuria (>3.5 g/day), hypoalbuminemia, and
generalized edema. Which condition is most likely?
A. Nephrotic Syndrome
B. Acute Nephritic Syndrome
C. Pyelonephritis
D. Renal Calculi
Answer: A
Conceptual Explanation: Nephrotic syndrome is defined by massive proteinuria due to
increased glomerular permeability, which leads to hypoalbuminemia and subsequent
edema (anasarca).
3. In chronic kidney disease (CKD), the primary cause of secondary hyperparathyroidism is:
A. Excessive excretion of calcium
B. Excessive production of Erythropoietin
C. Adrenal gland suppression
D. Hyperphosphatemia and decreased activated Vitamin D
Answer: D
Conceptual Explanation: In CKD, the kidneys fail to excrete phosphate and fail to activate
Vitamin D (calcitriol). Low calcium levels and high phosphate levels stimulate the
parathyroid glands to overproduce PTH.
, 4. Which hormone is primarily responsible for the concentration of urine by promoting water
reabsorption in the distal tubules and collecting ducts?
A. Aldosterone
B. Antidiuretic Hormone (ADH)
C. Atrial Natriuretic Peptide (ANP)
D. Renin
Answer: B
Conceptual Explanation: ADH (Vasopressin) increases the permeability of the collecting
ducts to water via aquaporins, allowing for water reabsorption and concentrated urine.
5. Prerenal acute kidney injury is most commonly caused by:
A. Obstruction of the urinary tract
B. Decreased renal perfusion (hypovolemia or hypotension)
C. Direct damage to the renal parenchyma
D. Nephrotoxic medications like aminoglycosides
Answer: B
Conceptual Explanation: Prerenal AKI results from conditions that decrease blood flow to
the kidneys, such as dehydration, hemorrhage, or heart failure, without initial damage to
the kidney tissue itself.
