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NURS 201 Adult Health Nursing Exam 2 | Actual Exam
Questions with Verified Answers & Detailed Rationales |
(2026–2027) Updated Nursing Study Guide | Grade A
1. A nurse is teaching about Polycystic Kidney Disease (PKD). What is the underlying
pathophysiology of this disorder?
A. An autoimmune disorder causing glomerular inflammation
B. A genetic (autosomal dominant) disorder characterized by multiple fluid-filled cysts in
the kidneys, progressive nephron destruction, enlarged kidneys, and eventual renal
failure
C. A bacterial infection of the renal pelvis
D. A malignant tumor of the kidney tissue
CORRECT ANSWER: B
Rationale: PKD is a genetic disorder (usually autosomal dominant) where multiple fluid-
filled cysts develop in the kidneys, progressively destroying nephrons, enlarging the
kidneys, and leading to end-stage renal failure. It is progressive and incurable.
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2. A nurse is explaining why hypertension develops in Polycystic Kidney Disease (PKD).
What is the primary mechanism?
A. Increased cardiac output from fluid overload
B. As cysts grow, they increase renal volume, press on arteries, and cause chronic
ischemia, triggering renin release and RAAS activation
C. Decreased renal perfusion pressure
D. Overproduction of aldosterone by the adrenal glands
CORRECT ANSWER: B
Rationale: Enlarging cysts compress adjacent renal arteries, causing chronic ischemia.
The ischemic kidney releases renin, activating the RAAS (angiotensin II), leading to
vasoconstriction, sodium/fluid retention, and hypertension.
3. A nurse is describing the pathophysiological progression of Polycystic Kidney
Disease (PKD). Place the following events in the correct sequence:
A. Kidney failure occurs
B. Cysts grow
C. RAAS activates, HTN develops
D. Nephrons are compressed and destroyed
E. Kidney function declines, GFR decreases, waste accumulates
CORRECT ANSWER: B, D, E, C, A
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Rationale: In PKD: cysts grow → nephrons compressed/destroyed → kidney function
declines (↓GFR, ↑waste) → RAAS activates → hypertension develops → kidney failure
eventually occurs.
4. A nurse is assessing a patient with early Polycystic Kidney Disease (PKD). Which
clinical manifestations are expected? (Select all that apply.)
A. Flank pain
B. Increased abdominal girth and distention (enlarged kidneys)
C. Hematuria (from cyst rupture)
D. Hypertension
E. Constipation
CORRECT ANSWER: A, B, C, D, E
Rationale: Early PKD manifestations include flank pain, increased abdominal girth,
hematuria, and hypertension. Constipation occurs due to fluid imbalance (decreased
fluid in bowel) and abdominal pressure slowing motility.
5. A nurse is explaining why constipation occurs in Polycystic Kidney Disease (PKD).
What is the underlying mechanism?
A. Increased peristalsis from kidney enlargement
B. Kidney failure causes fluid imbalance, decreasing fluid movement into intestines,
causing stool hardening, and increased abdominal pressure slows motility
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C. Opioid pain medication use only
D. Dietary lack of fiber
CORRECT ANSWER: B
Rationale: Constipation in PKD results from fluid imbalance (decreased fluid in the
bowel) due to kidney dysfunction, combined with increased intra-abdominal pressure
from enlarged kidneys, which slows stool movement.
6. A nurse is teaching about hypertension in Polycystic Kidney Disease (PKD). What are
the effects of RAAS activation? (Select all that apply.)
A. Vasoconstriction
B. Sodium retention
C. Fluid retention
D. Increased blood pressure
E. Bradycardia
CORRECT ANSWER: A, B, C, D
Rationale: RAAS activation causes vasoconstriction, sodium and fluid retention, and
increased BP. This hypertension accelerates further kidney destruction. Bradycardia is
not a direct effect.
7. A nurse is reviewing laboratory findings for a patient with Polycystic Kidney Disease
(PKD). Which expected lab changes indicate declining kidney function? (Select all that
NURS 201 Adult Health Nursing Exam 2 | Actual Exam
Questions with Verified Answers & Detailed Rationales |
(2026–2027) Updated Nursing Study Guide | Grade A
1. A nurse is teaching about Polycystic Kidney Disease (PKD). What is the underlying
pathophysiology of this disorder?
A. An autoimmune disorder causing glomerular inflammation
B. A genetic (autosomal dominant) disorder characterized by multiple fluid-filled cysts in
the kidneys, progressive nephron destruction, enlarged kidneys, and eventual renal
failure
C. A bacterial infection of the renal pelvis
D. A malignant tumor of the kidney tissue
CORRECT ANSWER: B
Rationale: PKD is a genetic disorder (usually autosomal dominant) where multiple fluid-
filled cysts develop in the kidneys, progressively destroying nephrons, enlarging the
kidneys, and leading to end-stage renal failure. It is progressive and incurable.
,2|Page
2. A nurse is explaining why hypertension develops in Polycystic Kidney Disease (PKD).
What is the primary mechanism?
A. Increased cardiac output from fluid overload
B. As cysts grow, they increase renal volume, press on arteries, and cause chronic
ischemia, triggering renin release and RAAS activation
C. Decreased renal perfusion pressure
D. Overproduction of aldosterone by the adrenal glands
CORRECT ANSWER: B
Rationale: Enlarging cysts compress adjacent renal arteries, causing chronic ischemia.
The ischemic kidney releases renin, activating the RAAS (angiotensin II), leading to
vasoconstriction, sodium/fluid retention, and hypertension.
3. A nurse is describing the pathophysiological progression of Polycystic Kidney
Disease (PKD). Place the following events in the correct sequence:
A. Kidney failure occurs
B. Cysts grow
C. RAAS activates, HTN develops
D. Nephrons are compressed and destroyed
E. Kidney function declines, GFR decreases, waste accumulates
CORRECT ANSWER: B, D, E, C, A
,3|Page
Rationale: In PKD: cysts grow → nephrons compressed/destroyed → kidney function
declines (↓GFR, ↑waste) → RAAS activates → hypertension develops → kidney failure
eventually occurs.
4. A nurse is assessing a patient with early Polycystic Kidney Disease (PKD). Which
clinical manifestations are expected? (Select all that apply.)
A. Flank pain
B. Increased abdominal girth and distention (enlarged kidneys)
C. Hematuria (from cyst rupture)
D. Hypertension
E. Constipation
CORRECT ANSWER: A, B, C, D, E
Rationale: Early PKD manifestations include flank pain, increased abdominal girth,
hematuria, and hypertension. Constipation occurs due to fluid imbalance (decreased
fluid in bowel) and abdominal pressure slowing motility.
5. A nurse is explaining why constipation occurs in Polycystic Kidney Disease (PKD).
What is the underlying mechanism?
A. Increased peristalsis from kidney enlargement
B. Kidney failure causes fluid imbalance, decreasing fluid movement into intestines,
causing stool hardening, and increased abdominal pressure slows motility
, 4|Page
C. Opioid pain medication use only
D. Dietary lack of fiber
CORRECT ANSWER: B
Rationale: Constipation in PKD results from fluid imbalance (decreased fluid in the
bowel) due to kidney dysfunction, combined with increased intra-abdominal pressure
from enlarged kidneys, which slows stool movement.
6. A nurse is teaching about hypertension in Polycystic Kidney Disease (PKD). What are
the effects of RAAS activation? (Select all that apply.)
A. Vasoconstriction
B. Sodium retention
C. Fluid retention
D. Increased blood pressure
E. Bradycardia
CORRECT ANSWER: A, B, C, D
Rationale: RAAS activation causes vasoconstriction, sodium and fluid retention, and
increased BP. This hypertension accelerates further kidney destruction. Bradycardia is
not a direct effect.
7. A nurse is reviewing laboratory findings for a patient with Polycystic Kidney Disease
(PKD). Which expected lab changes indicate declining kidney function? (Select all that
