NURS 5315 Exam 2 V1 | NURS 5315
Advanced Pathophysiology | Actual Q&A
with Rationale (NURS5315 Exam 2) | The
University of Texas at Arlington
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?
A. Initiation phase
B. Oliguric phase
C. Diuretic phase
D. Recovery phase
Answer: B
Rationale: The oliguric phase is defined by a significant reduction in urine output and a
sharp decline in GFR. During this time, metabolic waste products like urea and creatinine
begin to build up in the blood. Clinical management focuses on preventing fluid overload
and managing electrolyte imbalances like hyperkalemia.
2. In Chronic Kidney Disease (CKD), what is the underlying mechanism leading to secondary
hyperparathyroidism?
A. Excessive excretion of Vitamin D
B. Increased renal production of erythropoietin
,C. Hyperphosphatemia and hypocalcemia
D. Decreased production of aldosterone
Answer: C
Rationale: As renal function declines, phosphate is retained, which inversely lowers serum
calcium levels. Additionally, the failing kidneys cannot activate Vitamin D, further
suppressing calcium absorption. The parathyroid glands respond to low calcium by
overproducing parathyroid hormone to mobilize calcium from the bones.
3. A patient presents with sudden onset of flank pain and hematuria. Which condition is the
most likely pathological cause?
A. Nephrolithiasis
B. Acute Cystitis
C. Polycystic Kidney Disease
D. Glomerulonephritis
Answer: A
Rationale: Nephrolithiasis refers to the formation of stones within the urinary tract that
cause obstruction. The classic presentation includes colicky pain that radiates toward the
groin as the stone moves through the ureter. Hematuria occurs because the stone causes
local tissue trauma and irritation to the mucosal lining.
, 4. Which characteristic differentiates nephrotic syndrome from nephritic syndrome?
A. The presence of hypertension
B. The presence of hematuria
C. Massive proteinuria exceeding 3.5g/day
D. Elevated serum creatinine
Answer: C
Rationale: Nephrotic syndrome is primarily characterized by increased glomerular
permeability to proteins, leading to heavy proteinuria. This loss of albumin results in
generalized edema due to decreased plasma oncotic pressure. In contrast, nephritic
syndrome is more commonly associated with inflammatory processes and hematuria.
5. What is the primary pathophysiological driver of Left-sided Heart Failure?
A. Systemic venous congestion
B. Right ventricular hypertrophy
C. Peripheral edema
D. Increased pulmonary capillary wedge pressure
Answer: D
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation
when the left ventricle fails to pump effectively. This increase in hydrostatic pressure in the
Advanced Pathophysiology | Actual Q&A
with Rationale (NURS5315 Exam 2) | The
University of Texas at Arlington
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?
A. Initiation phase
B. Oliguric phase
C. Diuretic phase
D. Recovery phase
Answer: B
Rationale: The oliguric phase is defined by a significant reduction in urine output and a
sharp decline in GFR. During this time, metabolic waste products like urea and creatinine
begin to build up in the blood. Clinical management focuses on preventing fluid overload
and managing electrolyte imbalances like hyperkalemia.
2. In Chronic Kidney Disease (CKD), what is the underlying mechanism leading to secondary
hyperparathyroidism?
A. Excessive excretion of Vitamin D
B. Increased renal production of erythropoietin
,C. Hyperphosphatemia and hypocalcemia
D. Decreased production of aldosterone
Answer: C
Rationale: As renal function declines, phosphate is retained, which inversely lowers serum
calcium levels. Additionally, the failing kidneys cannot activate Vitamin D, further
suppressing calcium absorption. The parathyroid glands respond to low calcium by
overproducing parathyroid hormone to mobilize calcium from the bones.
3. A patient presents with sudden onset of flank pain and hematuria. Which condition is the
most likely pathological cause?
A. Nephrolithiasis
B. Acute Cystitis
C. Polycystic Kidney Disease
D. Glomerulonephritis
Answer: A
Rationale: Nephrolithiasis refers to the formation of stones within the urinary tract that
cause obstruction. The classic presentation includes colicky pain that radiates toward the
groin as the stone moves through the ureter. Hematuria occurs because the stone causes
local tissue trauma and irritation to the mucosal lining.
, 4. Which characteristic differentiates nephrotic syndrome from nephritic syndrome?
A. The presence of hypertension
B. The presence of hematuria
C. Massive proteinuria exceeding 3.5g/day
D. Elevated serum creatinine
Answer: C
Rationale: Nephrotic syndrome is primarily characterized by increased glomerular
permeability to proteins, leading to heavy proteinuria. This loss of albumin results in
generalized edema due to decreased plasma oncotic pressure. In contrast, nephritic
syndrome is more commonly associated with inflammatory processes and hematuria.
5. What is the primary pathophysiological driver of Left-sided Heart Failure?
A. Systemic venous congestion
B. Right ventricular hypertrophy
C. Peripheral edema
D. Increased pulmonary capillary wedge pressure
Answer: D
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation
when the left ventricle fails to pump effectively. This increase in hydrostatic pressure in the
