NUR 631 Advanced Physiology
and Pathophysiology Final Exam
– 2026 Latest Update: Questions
with Verified Answers &
Rationales
Renal System
1. Which clinical manifestations of a urinary tract
infection may be demonstrated in an 85-year-old
individual?
A. Confusion and poorly localized abdominal discomfort
B. Dysuria, frequency, and suprapubic pain
C. Hematuria and flank pain
D. Pyuria, urgency, and frequency
Ans: A. Confusion and poorly localized abdominal discomfort
Rationale: Older adults with cystitis may demonstrate
confusion or vague abdominal discomfort or otherwise be
asymptomatic.
2. Pyelonephritis is usually caused by which type of
organism?
A. Bacteria
B. Fungi
C. Viruses
D. Parasite
Ans: A. Bacteria
Rationale: Pyelonephritis is usually caused by the bacteria
Escherichia coli, Proteus, or Pseudomonas.
3. A patient exhibits symptoms including hematuria
with red blood cell casts and proteinuria exceeding 3
to 5 g/day with albumin as the major protein. These
data suggest the presence of which disorder?
A. Cystitis
B. Chronic pyelonephritis
1
,C. Glomerulonephritis
D. Nephrotic syndrome
Ans: C. Glomerulonephritis
Rationale: Two major changes distinctive of more severe
glomerulonephritis are (1) hematuria with red blood cell
casts and (2) proteinuria exceeding 3–5 g/day with albumin
as the major protein.
4. How are glucose and insulin used to treat
hyperkalemia associated with acute renal failure?
A. Glucose has an osmotic effect, which attracts water and
sodium resulting in more dilute blood and a lower potassium
concentration.
B. When insulin transports glucose into the cell, it also
carries potassium with it.
C. Potassium attaches to receptors on the cell membrane of
glucose and is carried into the cell.
D. Increasing insulin causes ketoacidosis, which causes
potassium to move into the cell in exchange for hydrogen.
Ans: B. When insulin transports glucose into the cell, it also
carries potassium with it.
Rationale: Insulin infusions can be effective in shifting
potassium from the extracellular to intracellular space, along
with the transport of glucose.
5. What is used to correct the chronic anemia
associated with chronic renal failure?
A. Intrinsic factor
B. Vitamin B12
C. Vitamin D
D. Erythropoietin
Ans: D. Erythropoietin
Rationale: Erythropoietin is used to correct the chronic
anemia associated with chronic renal failure.
6. In glomerulonephritis, what damages the epithelial
cells resulting in proteinuria? (Select all that apply.)
2
,A. Ischemia
B. Lysosomal enzymes
C. Compression from edema
D. Activated complement
E. Altered membrane permeability
Ans: D, E
Rationale: Activated complement, inflammatory cytokines,
oxidants, proteases, and growth factors attack epithelial
cells, alter membrane permeability, and cause proteinuria.
7. Prerenal injury from poor perfusion can result from
which condition? (Select all that apply.)
A. Bilateral ureteral obstruction
B. Renal vasoconstriction
C. Renal artery thrombosis
D. Hemorrhage
E. Hypotension
Ans: B, C, D, E
Rationale: Poor perfusion can result from renal artery
thrombosis, hypotension related to hypovolemia,
hemorrhage, renal vasoconstriction, and alterations in renal
regional blood flow. Bilateral ureteral obstruction is not
associated with prerenal injuries.
8. What initiates inflammation in acute
poststreptococcal glomerulonephritis?
A. Lysosomal enzymes
B. Endotoxins from Streptococcus
C. Immune complexes
D. Immunoglobulin E (IgE) mediated response
Ans: C. Immune complexes
Rationale: Antigen-antibody complexes are deposited in the
glomerulus, or the antigen may be trapped within the
glomerulus and immune complexes formed in situ, initiating
inflammation.
9. In immunoglobulin G (IgG) nephropathies such as
glomerulonephritis, IgG is deposited in which
location?
3
, A. Juxtamedullary nephrons
B. Glomerulus basement membranes
C. Mesangium of the glomerular capillaries
D. Parietal epithelium
Ans: B. Glomerulus basement membranes
Rationale: Immunofluorescence microscopy shows lumpy
deposits of IgG and C3 complement on the glomerular
basement membrane.
Gastrointestinal System
10. What is intussusception?
A. Telescoping of part of the intestine into another section of
intestine, usually causing strangulation of the blood supply
B. Twisting the intestine on its mesenteric pedicle, causing
occlusion of the blood supply
C. Loss of peristaltic motor activity in the intestine, causing
an adynamic ileus
D. Forming fibrin and scar tissue that attach to the intestinal
omentum, causing obstruction
Ans: A. Telescoping of part of the intestine into another
section of intestine, usually causing strangulation of the
blood supply
Rationale: Intussusception is the telescoping of part of the
intestine into another section of intestine, usually causing
strangulation of the blood supply.
11. After a partial gastrectomy or pyloroplasty,
clinical manifestations that include increased pulse,
hypotension, weakness, pallor, sweating, and
dizziness are the results of which mechanism?
A. Anaphylactic reaction
B. Postoperative hemorrhage
C. Concentrated bolus causing hyperglycemia
D. Rapid gastric emptying and the creation of a high osmotic
gradient in the small intestine, causing a sudden shift of fluid
from the blood vessels to the intestinal lumen
Ans: D. Rapid gastric emptying and the creation of a high
osmotic gradient in the small intestine, causing a sudden
shift of fluid from the blood vessels to the intestinal lumen
Rationale: Dumping syndrome occurs with rapid gastric
4
and Pathophysiology Final Exam
– 2026 Latest Update: Questions
with Verified Answers &
Rationales
Renal System
1. Which clinical manifestations of a urinary tract
infection may be demonstrated in an 85-year-old
individual?
A. Confusion and poorly localized abdominal discomfort
B. Dysuria, frequency, and suprapubic pain
C. Hematuria and flank pain
D. Pyuria, urgency, and frequency
Ans: A. Confusion and poorly localized abdominal discomfort
Rationale: Older adults with cystitis may demonstrate
confusion or vague abdominal discomfort or otherwise be
asymptomatic.
2. Pyelonephritis is usually caused by which type of
organism?
A. Bacteria
B. Fungi
C. Viruses
D. Parasite
Ans: A. Bacteria
Rationale: Pyelonephritis is usually caused by the bacteria
Escherichia coli, Proteus, or Pseudomonas.
3. A patient exhibits symptoms including hematuria
with red blood cell casts and proteinuria exceeding 3
to 5 g/day with albumin as the major protein. These
data suggest the presence of which disorder?
A. Cystitis
B. Chronic pyelonephritis
1
,C. Glomerulonephritis
D. Nephrotic syndrome
Ans: C. Glomerulonephritis
Rationale: Two major changes distinctive of more severe
glomerulonephritis are (1) hematuria with red blood cell
casts and (2) proteinuria exceeding 3–5 g/day with albumin
as the major protein.
4. How are glucose and insulin used to treat
hyperkalemia associated with acute renal failure?
A. Glucose has an osmotic effect, which attracts water and
sodium resulting in more dilute blood and a lower potassium
concentration.
B. When insulin transports glucose into the cell, it also
carries potassium with it.
C. Potassium attaches to receptors on the cell membrane of
glucose and is carried into the cell.
D. Increasing insulin causes ketoacidosis, which causes
potassium to move into the cell in exchange for hydrogen.
Ans: B. When insulin transports glucose into the cell, it also
carries potassium with it.
Rationale: Insulin infusions can be effective in shifting
potassium from the extracellular to intracellular space, along
with the transport of glucose.
5. What is used to correct the chronic anemia
associated with chronic renal failure?
A. Intrinsic factor
B. Vitamin B12
C. Vitamin D
D. Erythropoietin
Ans: D. Erythropoietin
Rationale: Erythropoietin is used to correct the chronic
anemia associated with chronic renal failure.
6. In glomerulonephritis, what damages the epithelial
cells resulting in proteinuria? (Select all that apply.)
2
,A. Ischemia
B. Lysosomal enzymes
C. Compression from edema
D. Activated complement
E. Altered membrane permeability
Ans: D, E
Rationale: Activated complement, inflammatory cytokines,
oxidants, proteases, and growth factors attack epithelial
cells, alter membrane permeability, and cause proteinuria.
7. Prerenal injury from poor perfusion can result from
which condition? (Select all that apply.)
A. Bilateral ureteral obstruction
B. Renal vasoconstriction
C. Renal artery thrombosis
D. Hemorrhage
E. Hypotension
Ans: B, C, D, E
Rationale: Poor perfusion can result from renal artery
thrombosis, hypotension related to hypovolemia,
hemorrhage, renal vasoconstriction, and alterations in renal
regional blood flow. Bilateral ureteral obstruction is not
associated with prerenal injuries.
8. What initiates inflammation in acute
poststreptococcal glomerulonephritis?
A. Lysosomal enzymes
B. Endotoxins from Streptococcus
C. Immune complexes
D. Immunoglobulin E (IgE) mediated response
Ans: C. Immune complexes
Rationale: Antigen-antibody complexes are deposited in the
glomerulus, or the antigen may be trapped within the
glomerulus and immune complexes formed in situ, initiating
inflammation.
9. In immunoglobulin G (IgG) nephropathies such as
glomerulonephritis, IgG is deposited in which
location?
3
, A. Juxtamedullary nephrons
B. Glomerulus basement membranes
C. Mesangium of the glomerular capillaries
D. Parietal epithelium
Ans: B. Glomerulus basement membranes
Rationale: Immunofluorescence microscopy shows lumpy
deposits of IgG and C3 complement on the glomerular
basement membrane.
Gastrointestinal System
10. What is intussusception?
A. Telescoping of part of the intestine into another section of
intestine, usually causing strangulation of the blood supply
B. Twisting the intestine on its mesenteric pedicle, causing
occlusion of the blood supply
C. Loss of peristaltic motor activity in the intestine, causing
an adynamic ileus
D. Forming fibrin and scar tissue that attach to the intestinal
omentum, causing obstruction
Ans: A. Telescoping of part of the intestine into another
section of intestine, usually causing strangulation of the
blood supply
Rationale: Intussusception is the telescoping of part of the
intestine into another section of intestine, usually causing
strangulation of the blood supply.
11. After a partial gastrectomy or pyloroplasty,
clinical manifestations that include increased pulse,
hypotension, weakness, pallor, sweating, and
dizziness are the results of which mechanism?
A. Anaphylactic reaction
B. Postoperative hemorrhage
C. Concentrated bolus causing hyperglycemia
D. Rapid gastric emptying and the creation of a high osmotic
gradient in the small intestine, causing a sudden shift of fluid
from the blood vessels to the intestinal lumen
Ans: D. Rapid gastric emptying and the creation of a high
osmotic gradient in the small intestine, causing a sudden
shift of fluid from the blood vessels to the intestinal lumen
Rationale: Dumping syndrome occurs with rapid gastric
4
