NR507/ NR 507 Midterm Exam (Latest
2026/ 2026 Update) Advanced
Pathophysiology | Questions and Verified
Answers| 100% Correct |Grade A –
Chamberlain
A 45-year-old male presents to the primary care office with right flank pain that he describes as
unremitting; he also reports nausea and vomiting. The NP performs an exam and observes him
writhing in pain on the exam table with the inability to find a comfortable position. He is afebrile, BP
156/88 mmHg and HR 106/min. Right flank is mildly tender on palpation. Abdominal exam is negative
for any abnormality. A urinalysis was performed and revealed 1+ blood. Urine microscopy also
revealed 10-20 RBCs per high-power field (hpf). A kidney stone is suspected. The patient reports no
prior history of a kidney stone. After providing the patient an analgesic, where the patient reported
mild relief, the NP had the patient transferred to the emergency room for intravenous fluids, pain
management and further work-up for the kidney stone. Upon follow-up in the office a week later, the
patient reported that he was diagnosed with
adequate hydration
balanced diet
Lithotripsy is an invasive procedure used to break up the stone
false
The most common stone found in the patient with gout is:
Page 1 of 33
,uric acid stone
Hematuria can be seen with kidney stones because:
The stone injures the urinary structures as it passes through them.
Renal colic is caused by the passing of the stone through the ureter.
true
At least half of individuals with renal stones will have a reoccurrence within 10 years of the prior
stone.
true
Which of the following actions will relax the detrusor muscle of the bladder?
Activation of Beta-2 receptors by the sympathetic nervous system.
The relay station in the brain that plays a major role in regulating micturition is:
Pontine micturition center.
The location of the internal sphincter is under the urogenital diaphragm.
false (located in the bladder)
When the bladder is empty, the detrusor muscle relaxes, and the internal and external sphincters
constrict.
true
The levator ani muscle plays a major role in constriction of the external sphincter.
true
stress incontinence
leakage of urine with activity
Increased intra-abdominal pressure causes leaking because there is no resistance to counteract the
intra-abdominal pressure
urge incontinence
Page 2 of 33
,leakage of urine with sensation of need to urinate
Detrusor muscle hyperactivity leads to urine leakage
neurogenic incontinence
unimpeded urine leakage
Neurological lesions alter nervous system impulses that innervate the detrusor muscle. The result is
decreased bladder compliance and decreased sphincter tone
overflow incontinence
leakage of urine is associated with urgency, frequency, dribbling, and hesitancy
Leakage is due to retained urine in the bladder that leads to over-distention
A 54-year-old female reports to the primary care office with complaints of frequent urination. She
reports that she is "leaking" urine several times a day, especially when she coughs, sneezes, or lifts a
heavy object. She indicates that she has not experienced any dysuria or any urgency. The NP looked at
the patient's previous urine culture obtained approximately 1 month ago and determined that it was
negative. Other than her urinary complaints, she is in otherwise good health. BP 128/76; HR 78 bpm; T
98.6; Ht. 5'4"; Wt: 180lbs.; BMI 30.9. The NP performs a physical exam and all findings are normal. The
urinalysis obtained was negative as well.
Based on patient's symptoms and negative physical exam, she has a typical
1. blank.
The leaking occurs when the abdominal pressure increases during coughing, sneezing, and lifting. We
can rule out urge incontinence because the denied urgency with her urination. We could not
1. stress incontinence
2. stress incontinence
A sphincter malfunction that prevents urine from flowing out of the bladder would most likely result
in:
overflow incontinence
The major cause of stress incontinence in women is hypermobility of the external sphincter.
true
The pathophysiology of neurogenic bladder is:
Page 3 of 33
, Lesions alter nervous system impulses that innervate the detrusor muscle to decrease bladder
compliance and decreased sphincter tone.
Involuntary loss of urine caused by dementia or immobility is known as:
functional incontinence
Which of the following is considered be a transient cause of urinary incontinence?
UTI
A pre-renal cause of acute renal failure is:
hypotension
One of the first pathophysiological responses to the decreased GFR in acute renal failure is:
Activation of the renin-angiotensin-aldosterone system.
One of the major markers for glomerular filtration rate is creatinine.
true
Pre-renal is the most common cause of acute renal failure.
The most common cause of acute renal failure is due to a pre-renal failure.
true
Acute renal failure
Oliguria (< 30ml/hr).
Increased blood urea nitrogen (BUN) and creatinine.
Fluid and electrolyte abnormalities.
Pre-renal
sudden and severe drop in blood pressure or interruption of blood flow to the kidneys from severe
injury or illness
Intra-renal
direct damage to the kidneys by inflammation, toxins, drugs, infection, or reduced blood supply
Page 4 of 33
2026/ 2026 Update) Advanced
Pathophysiology | Questions and Verified
Answers| 100% Correct |Grade A –
Chamberlain
A 45-year-old male presents to the primary care office with right flank pain that he describes as
unremitting; he also reports nausea and vomiting. The NP performs an exam and observes him
writhing in pain on the exam table with the inability to find a comfortable position. He is afebrile, BP
156/88 mmHg and HR 106/min. Right flank is mildly tender on palpation. Abdominal exam is negative
for any abnormality. A urinalysis was performed and revealed 1+ blood. Urine microscopy also
revealed 10-20 RBCs per high-power field (hpf). A kidney stone is suspected. The patient reports no
prior history of a kidney stone. After providing the patient an analgesic, where the patient reported
mild relief, the NP had the patient transferred to the emergency room for intravenous fluids, pain
management and further work-up for the kidney stone. Upon follow-up in the office a week later, the
patient reported that he was diagnosed with
adequate hydration
balanced diet
Lithotripsy is an invasive procedure used to break up the stone
false
The most common stone found in the patient with gout is:
Page 1 of 33
,uric acid stone
Hematuria can be seen with kidney stones because:
The stone injures the urinary structures as it passes through them.
Renal colic is caused by the passing of the stone through the ureter.
true
At least half of individuals with renal stones will have a reoccurrence within 10 years of the prior
stone.
true
Which of the following actions will relax the detrusor muscle of the bladder?
Activation of Beta-2 receptors by the sympathetic nervous system.
The relay station in the brain that plays a major role in regulating micturition is:
Pontine micturition center.
The location of the internal sphincter is under the urogenital diaphragm.
false (located in the bladder)
When the bladder is empty, the detrusor muscle relaxes, and the internal and external sphincters
constrict.
true
The levator ani muscle plays a major role in constriction of the external sphincter.
true
stress incontinence
leakage of urine with activity
Increased intra-abdominal pressure causes leaking because there is no resistance to counteract the
intra-abdominal pressure
urge incontinence
Page 2 of 33
,leakage of urine with sensation of need to urinate
Detrusor muscle hyperactivity leads to urine leakage
neurogenic incontinence
unimpeded urine leakage
Neurological lesions alter nervous system impulses that innervate the detrusor muscle. The result is
decreased bladder compliance and decreased sphincter tone
overflow incontinence
leakage of urine is associated with urgency, frequency, dribbling, and hesitancy
Leakage is due to retained urine in the bladder that leads to over-distention
A 54-year-old female reports to the primary care office with complaints of frequent urination. She
reports that she is "leaking" urine several times a day, especially when she coughs, sneezes, or lifts a
heavy object. She indicates that she has not experienced any dysuria or any urgency. The NP looked at
the patient's previous urine culture obtained approximately 1 month ago and determined that it was
negative. Other than her urinary complaints, she is in otherwise good health. BP 128/76; HR 78 bpm; T
98.6; Ht. 5'4"; Wt: 180lbs.; BMI 30.9. The NP performs a physical exam and all findings are normal. The
urinalysis obtained was negative as well.
Based on patient's symptoms and negative physical exam, she has a typical
1. blank.
The leaking occurs when the abdominal pressure increases during coughing, sneezing, and lifting. We
can rule out urge incontinence because the denied urgency with her urination. We could not
1. stress incontinence
2. stress incontinence
A sphincter malfunction that prevents urine from flowing out of the bladder would most likely result
in:
overflow incontinence
The major cause of stress incontinence in women is hypermobility of the external sphincter.
true
The pathophysiology of neurogenic bladder is:
Page 3 of 33
, Lesions alter nervous system impulses that innervate the detrusor muscle to decrease bladder
compliance and decreased sphincter tone.
Involuntary loss of urine caused by dementia or immobility is known as:
functional incontinence
Which of the following is considered be a transient cause of urinary incontinence?
UTI
A pre-renal cause of acute renal failure is:
hypotension
One of the first pathophysiological responses to the decreased GFR in acute renal failure is:
Activation of the renin-angiotensin-aldosterone system.
One of the major markers for glomerular filtration rate is creatinine.
true
Pre-renal is the most common cause of acute renal failure.
The most common cause of acute renal failure is due to a pre-renal failure.
true
Acute renal failure
Oliguria (< 30ml/hr).
Increased blood urea nitrogen (BUN) and creatinine.
Fluid and electrolyte abnormalities.
Pre-renal
sudden and severe drop in blood pressure or interruption of blood flow to the kidneys from severe
injury or illness
Intra-renal
direct damage to the kidneys by inflammation, toxins, drugs, infection, or reduced blood supply
Page 4 of 33
