3 Latest 2026 Update: Renal & Gastrointestinal
Disorders
NSG 3850 Pathophysiology for Nurses II - Exam 3
Latest 2026 Update: Renal & Gastrointestinal Disorders
Complete Study Guide with 100 Questions and Answers
SECTION 1: RENAL DISORDERS - Glomerular and Tubular Function
Question 1
A patient presents with hypertension, edema, hematuria, and cola-colored urine
following a recent streptococcal throat infection. Which condition is most likely?
A. Acute pyelonephritis
B. Acute glomerulonephritis
C. Nephrotic syndrome
D. Polycystic kidney disease
Correct Answer: B. Acute glomerulonephritis
Rationale: Acute glomerulonephritis often follows a streptococcal infection by 1-3
weeks. Antigen-antibody complexes deposit in glomeruli, causing inflammation,
hematuria, proteinuria, hypertension, and fluid retention (edema). The cola-
colored urine results from RBCs in the urine .
Question 2
Which of the following findings is characteristic of nephrotic syndrome?
,A. Hematuria and red blood cell casts
B. Hypertension and azotemia
C. Massive proteinuria (>3.5 g/day) and hypoalbuminemia
D. White blood cell casts and fever
Correct Answer: C. Massive proteinuria (>3.5 g/day) and hypoalbuminemia
Rationale: Nephrotic syndrome results from increased glomerular permeability to
proteins. Key features include massive proteinuria, hypoalbuminemia, generalized
edema, hyperlipidemia, and lipiduria. Hematuria and hypertension are more
characteristic of nephritic syndrome .
Question 3
A patient with nephrotic syndrome is at increased risk for which complication?
A. Metabolic acidosis
B. Hyperkalemia
C. Thromboembolism
D. Hypocalcemia
Correct Answer: C. Thromboembolism
Rationale: Loss of anticoagulant proteins (protein C, protein S, antithrombin III) in
the urine, along with increased hepatic synthesis of procoagulant factors, creates
a hypercoagulable state. Renal vein thrombosis is a particular risk .
Question 4
Which statement accurately distinguishes acute glomerulonephritis from
nephrotic syndrome?
A. Glomerulonephritis typically presents with nephrotic-range proteinuria
B. Nephrotic syndrome typically presents with hypertension and hematuria
C. Glomerulonephritis involves inflammation; nephrotic syndrome involves
increased permeability
D. Nephrotic syndrome is caused by streptococcal infection
,Correct Answer: C. Glomerulonephritis involves inflammation; nephrotic
syndrome involves increased permeability
Rationale: The key distinction is pathophysiology: glomerulonephritis is primarily
inflammatory (causing hematuria, RBC casts, hypertension), while nephrotic
syndrome results from podocyte injury causing massive protein loss .
Question 5
Rapidly progressive glomerulonephritis (RPGN) is characterized by:
A. Slow decline in renal function over years
B. Crescent formation in the glomerulus
C. Isolated hematuria without proteinuria
D. Response to antibiotics
Correct Answer: B. Crescent formation in the glomerulus
Rationale: RPGN is defined by rapid loss of renal function (weeks to months) with
histologic evidence of crescent formation in Bowman's space. Crescents are
proliferations of parietal epithelial cells and macrophages that compress the
glomerulus .
Question 6
Goodpasture syndrome involves autoantibodies against:
A. Glomerular basement membrane
B. Podocytes
C. Mesangial cells
D. Tubular epithelium
Correct Answer: A. Glomerular basement membrane
Rationale: Goodpasture syndrome is caused by antibodies against type IV
collagen in the glomerular and alveolar basement membranes, causing rapidly
progressive glomerulonephritis and pulmonary hemorrhage .
, Question 7
In IgA nephropathy (Berger disease), which finding is most characteristic?
A. Gross hematuria following upper respiratory infection
B. Nephrotic-range proteinuria
C. Rapidly progressive renal failure
D. Hypocomplementemia
Correct Answer: A. Gross hematuria following upper respiratory infection
Rationale: IgA nephropathy typically presents with recurrent episodes of gross
hematuria shortly after mucosal infections (pharyngitis, gastroenteritis). Unlike
post-streptococcal glomerulonephritis, the hematuria appears within 1-2 days of
infection .
Question 8
Alport syndrome is a hereditary disorder affecting:
A. Podocytes
B. Type IV collagen
C. Tubular transport
D. Renin production
Correct Answer: B. Type IV collagen
Rationale: Alport syndrome results from mutations in genes encoding type IV
collagen, causing defective glomerular basement membrane. It presents with
hematuria, progressive nephritis, sensorineural hearing loss, and ocular
abnormalities .
Question 9
Acute tubular necrosis (ATN) most commonly results from:
A. Glomerular inflammation
B. Ischemic or toxic injury to tubular epithelial cells
C. Urinary tract obstruction
D. Autoimmune complex deposition