NR-283 Pathophysiology Exam 3 Updated and Latest
Questions and Correct Answers with Rationale
1. Which phase of acute kidney injury is characterized by a significant decrease in
glomerular filtration rate and the onset of oliguria?
A. Oliguric phase
B. Initiation phase
C. Recovery phase
D. Diuretic phase
Ans: A
Rationale: The oliguric phase is the second stage of acute kidney injury where urine output drops
significantly. This phase occurs as a direct result of damage to the renal tubules or a severe drop in blood
flow. Patients often experience an accumulation of nitrogenous waste products like urea and creatinine in
the blood. Fluid retention and electrolyte imbalances such as hyperkalemia are common clinical findings
during this time. Medical management focuses on monitoring fluid intake and preventing complications
from metabolic acidosis. It is crucial to identify this phase early to minimize the risk of permanent renal
damage.
,2. A patient with chronic kidney disease presents with a hemoglobin of 8 g/dL. What is the
primary cause of this anemia?
A. Reduced production of erythropoietin
B. Chronic blood loss in the stool
C. Iron deficiency from poor diet
D. Shortened life span of red blood cells
Ans: A
Rationale: Erythropoietin is a hormone produced by the kidneys that stimulates red blood cell
production in the bone marrow. In chronic kidney disease, the damaged renal tissues cannot produce
sufficient amounts of this hormone. This deficiency leads to a normochromic and normocytic anemia that
worsens as renal function declines. Patients often report symptoms of fatigue, pallor, and shortness of
breath due to decreased oxygen-carrying capacity. Treatment typically involves the administration of
synthetic erythropoiesis-stimulating agents to improve hemoglobin levels. Addressing this complication
is vital for maintaining the patient’s overall quality of life and cardiovascular health.
,3. Which endocrine disorder is characterized by an overproduction of growth hormone after
the closure of the epiphyseal plates?
A. Gigantism
B. Cushing Syndrome
C. Acromegaly
D. Hyperthyroidism
Ans: C
Rationale: Acromegaly occurs when a pituitary adenoma secretes excessive growth hormone in adults.
Since the long bones can no longer grow in length, the bones increase in thickness and width. Common
physical changes include an enlarged jaw, protruding brow, and increased size of the hands and feet.
Internal organs like the heart and liver may also undergo hypertrophy, leading to systemic complications.
Patients often develop secondary conditions such as glucose intolerance or hypertension due to
hormonal imbalances. Early diagnosis is essential to prevent irreversible changes to the skeletal system
and vital organs.
, 4. A patient exhibits polyuria, polydipsia, and a very low urine specific gravity. Which
condition does the nurse suspect?
A. Diabetes Mellitus
B. Diabetes Insipidus
C. SIADH
D. Hyperaldosteronism
Ans: B
Rationale: Diabetes Insipidus is caused by a deficiency of antidiuretic hormone or a lack of renal
response to it. Without sufficient ADH, the kidneys are unable to concentrate urine, leading to massive
water loss. This results in the production of large volumes of dilute urine with a low specific gravity. The
patient experiences intense thirst as the body attempts to compensate for the significant fluid deficit.
Hypernatremia often occurs because the loss of water exceeds the loss of sodium in the blood. Effective
management involves hormone replacement therapy or addressing the underlying cause of renal
resistance.
Questions and Correct Answers with Rationale
1. Which phase of acute kidney injury is characterized by a significant decrease in
glomerular filtration rate and the onset of oliguria?
A. Oliguric phase
B. Initiation phase
C. Recovery phase
D. Diuretic phase
Ans: A
Rationale: The oliguric phase is the second stage of acute kidney injury where urine output drops
significantly. This phase occurs as a direct result of damage to the renal tubules or a severe drop in blood
flow. Patients often experience an accumulation of nitrogenous waste products like urea and creatinine in
the blood. Fluid retention and electrolyte imbalances such as hyperkalemia are common clinical findings
during this time. Medical management focuses on monitoring fluid intake and preventing complications
from metabolic acidosis. It is crucial to identify this phase early to minimize the risk of permanent renal
damage.
,2. A patient with chronic kidney disease presents with a hemoglobin of 8 g/dL. What is the
primary cause of this anemia?
A. Reduced production of erythropoietin
B. Chronic blood loss in the stool
C. Iron deficiency from poor diet
D. Shortened life span of red blood cells
Ans: A
Rationale: Erythropoietin is a hormone produced by the kidneys that stimulates red blood cell
production in the bone marrow. In chronic kidney disease, the damaged renal tissues cannot produce
sufficient amounts of this hormone. This deficiency leads to a normochromic and normocytic anemia that
worsens as renal function declines. Patients often report symptoms of fatigue, pallor, and shortness of
breath due to decreased oxygen-carrying capacity. Treatment typically involves the administration of
synthetic erythropoiesis-stimulating agents to improve hemoglobin levels. Addressing this complication
is vital for maintaining the patient’s overall quality of life and cardiovascular health.
,3. Which endocrine disorder is characterized by an overproduction of growth hormone after
the closure of the epiphyseal plates?
A. Gigantism
B. Cushing Syndrome
C. Acromegaly
D. Hyperthyroidism
Ans: C
Rationale: Acromegaly occurs when a pituitary adenoma secretes excessive growth hormone in adults.
Since the long bones can no longer grow in length, the bones increase in thickness and width. Common
physical changes include an enlarged jaw, protruding brow, and increased size of the hands and feet.
Internal organs like the heart and liver may also undergo hypertrophy, leading to systemic complications.
Patients often develop secondary conditions such as glucose intolerance or hypertension due to
hormonal imbalances. Early diagnosis is essential to prevent irreversible changes to the skeletal system
and vital organs.
, 4. A patient exhibits polyuria, polydipsia, and a very low urine specific gravity. Which
condition does the nurse suspect?
A. Diabetes Mellitus
B. Diabetes Insipidus
C. SIADH
D. Hyperaldosteronism
Ans: B
Rationale: Diabetes Insipidus is caused by a deficiency of antidiuretic hormone or a lack of renal
response to it. Without sufficient ADH, the kidneys are unable to concentrate urine, leading to massive
water loss. This results in the production of large volumes of dilute urine with a low specific gravity. The
patient experiences intense thirst as the body attempts to compensate for the significant fluid deficit.
Hypernatremia often occurs because the loss of water exceeds the loss of sodium in the blood. Effective
management involves hormone replacement therapy or addressing the underlying cause of renal
resistance.
