1
Final Exam: NUR631/ NUR 631 (New
2023/2024 Update) Advanced Physiology and
Pathophysiology Exam| Questions and
Verified Answers with Rationales| 100%
Correct| Graded A- GCU
QUESTION
Which clinical manifestations of a urinary tract infection may be demonstrated in an 85-year-old
individual?
a. Confusion and poorly localized abdominal discomfort
b. Dysuria, frequency, and suprapubic pain
c. Hematuria and flank pain
d. Pyuria, urgency, and frequency
Answer:
a. Confusion and poorly localized abdominal discomfort
Rationale: Older adults with cystitis may demonstrate confusion or vague abdominal discomfort
or otherwise be asymptomatic. page 1351
QUESTION
Pyelonephritis is usually caused by which type of organism?
a. Bacteria
b. Fungi
c. Viruses
d. Parasite
Answer:
a. Bacteria
Rationale: Pyelonephritis is usually caused by the bacteria Escherichia coli, Proteus, or
Pseudomonas. pages 1351-52
,2
QUESTION
A patient exhibits symptoms including hematuria with red blood cell casts and proteinuria
exceeding 3 to 5 g/ day with albumin as the major protein. These data suggest the presence of
which disorder?
a. Cystitis
b. Chronic pyelonephritis
c. Glomerulonephritis
d. Nephrotic syndrome
Answer:
c. Glomerulonephritis
Rationale: The data suggest the patient has the disorder known as glomerulonephritis. Two
major changes distinctive of more severe glomerulonephritis are (1) hematuria with red blood
cell casts and (2) proteinuria exceeding 3-5 g/ day with albumin as the major protein. These
symptoms do not support the diagnosis of the other options. page 1357
QUESTION
How are glucose and insulin used to treat hyperkalemia associated with acute renal failure?
a. Glucose has an osmotic effect, which attracts water and sodium resulting in more dilute blood
and a lower potassium concentration.
b. When insulin transports glucose into the cell, it also carries potassium with it.
c. Potassium attaches to receptors on the cell membrane of glucose and is carried into the cell.
d. Increasing insulin causes ketoacidosis, which causes potassium to move into the cell in
exchange for hydrogen
Answer:
b. When insulin transports glucose into the cell, it also carries potassium with it.
Rationale: This selection is the only option that accurately describes glucose metabolism
causing potassium to move to the intracellular fluid; insulin infusions therefore can be effective
in shifting potassium from the extracellular to intracellular space, along with the transport of
glucose. page 1363
QUESTION
________ is used to correct the chronic anemia associated with chronic renal failure
a. Intrinsic factor
,3
b. Vitamin B12
c. Vitamin D
d. Erythropoietin
Answer:
d. Erythropoietin
QUESTION
In glomerulonephritis, what damages the epithelial cells resulting in proteinuria?
(Select all that apply)
a. Ischemia
b. Lysosomal enzymes
c. Compression from edema
d. Activated complement
e. Altered membrane permeability
Answer:
d. Activated complement
e. Altered membrane permeability
Rationale: Activated complement, inflammatory cytokines, oxidants, proteases, and growth
factors attack epithelial cells, alter membrane permeability, and cause proteinuria. None of the
other options are responsible for this process. page 1353-1357
QUESTION
Prerenal injury from poor perfusion can result from which condition? (Select all that apply.)
a. Bilateral ureteral obstruction
b. Renal vasoconstriction
c. Renal artery thrombosis
d. Hemorrhage
e. Hypotension
Answer:
b. Renal vasoconstriction
c. Renal artery thrombosis
d. Hemorrhage
e. Hypotension
, 4
Rationale: Poor perfusion can result from renal artery thrombosis, hypotension related to
hypovolemia (dehydration, diarrhea, fluid shifts) or hemorrhage, renal vasoconstriction and
alterations in renal regional blood flow, microthrombi, or kidney edema that restricts arterial
blood flow. Bilateral ureteral obstruction is not associated with prerenal injuries. page 1360.
QUESTION
What initiates inflammation in acute poststreptococcal glomerulonephritis?
a. Lysosomal enzymes
b. Endotoxins from Streptococcus
c. Immune complexes
d. Immunoglobulin E (IgE) mediated response
Answer:
c. Immune complexes
Rationale: The immune complexes initiate inflammation and glomerular injury in acute
poststreptococcal glomerulonephritis. Antigen-antibody complexes are deposited in the
glomerulus, or the antigen may be trapped within the glomerulus and immune complexes formed
in situ. The other options are not involved in initiating inflammation in this situation. page 1381
QUESTION
In immunoglobulin G (IgG) nephropathies such as glomerulonephritis, IgG is deposited in
which location?
a. Juxtamedullary nephrons
b. Glomerulus basement membranes
c. Mesangium of the glomerular capillaries
d. Parietal epithelium
Answer:
b. Glomerulus basement membranes
Rationale: Glomerulonephritis develops with the deposition of antigen-antibody complexes
(IgG, immunoglobulin A [IgA] and C3 complement) in the glomerulus, or the antigen may be
trapped within the glomerulus and immune complexes formed in situ. Immunofluorescence
microscopy shows lumpy deposits of IgG and C3 complement on the glomerular basement
membrane (see figure 39-5) When considering IgG nephropathies the only location of the IgG
immunoglobulins is the correct option. page 1381
Final Exam: NUR631/ NUR 631 (New
2023/2024 Update) Advanced Physiology and
Pathophysiology Exam| Questions and
Verified Answers with Rationales| 100%
Correct| Graded A- GCU
QUESTION
Which clinical manifestations of a urinary tract infection may be demonstrated in an 85-year-old
individual?
a. Confusion and poorly localized abdominal discomfort
b. Dysuria, frequency, and suprapubic pain
c. Hematuria and flank pain
d. Pyuria, urgency, and frequency
Answer:
a. Confusion and poorly localized abdominal discomfort
Rationale: Older adults with cystitis may demonstrate confusion or vague abdominal discomfort
or otherwise be asymptomatic. page 1351
QUESTION
Pyelonephritis is usually caused by which type of organism?
a. Bacteria
b. Fungi
c. Viruses
d. Parasite
Answer:
a. Bacteria
Rationale: Pyelonephritis is usually caused by the bacteria Escherichia coli, Proteus, or
Pseudomonas. pages 1351-52
,2
QUESTION
A patient exhibits symptoms including hematuria with red blood cell casts and proteinuria
exceeding 3 to 5 g/ day with albumin as the major protein. These data suggest the presence of
which disorder?
a. Cystitis
b. Chronic pyelonephritis
c. Glomerulonephritis
d. Nephrotic syndrome
Answer:
c. Glomerulonephritis
Rationale: The data suggest the patient has the disorder known as glomerulonephritis. Two
major changes distinctive of more severe glomerulonephritis are (1) hematuria with red blood
cell casts and (2) proteinuria exceeding 3-5 g/ day with albumin as the major protein. These
symptoms do not support the diagnosis of the other options. page 1357
QUESTION
How are glucose and insulin used to treat hyperkalemia associated with acute renal failure?
a. Glucose has an osmotic effect, which attracts water and sodium resulting in more dilute blood
and a lower potassium concentration.
b. When insulin transports glucose into the cell, it also carries potassium with it.
c. Potassium attaches to receptors on the cell membrane of glucose and is carried into the cell.
d. Increasing insulin causes ketoacidosis, which causes potassium to move into the cell in
exchange for hydrogen
Answer:
b. When insulin transports glucose into the cell, it also carries potassium with it.
Rationale: This selection is the only option that accurately describes glucose metabolism
causing potassium to move to the intracellular fluid; insulin infusions therefore can be effective
in shifting potassium from the extracellular to intracellular space, along with the transport of
glucose. page 1363
QUESTION
________ is used to correct the chronic anemia associated with chronic renal failure
a. Intrinsic factor
,3
b. Vitamin B12
c. Vitamin D
d. Erythropoietin
Answer:
d. Erythropoietin
QUESTION
In glomerulonephritis, what damages the epithelial cells resulting in proteinuria?
(Select all that apply)
a. Ischemia
b. Lysosomal enzymes
c. Compression from edema
d. Activated complement
e. Altered membrane permeability
Answer:
d. Activated complement
e. Altered membrane permeability
Rationale: Activated complement, inflammatory cytokines, oxidants, proteases, and growth
factors attack epithelial cells, alter membrane permeability, and cause proteinuria. None of the
other options are responsible for this process. page 1353-1357
QUESTION
Prerenal injury from poor perfusion can result from which condition? (Select all that apply.)
a. Bilateral ureteral obstruction
b. Renal vasoconstriction
c. Renal artery thrombosis
d. Hemorrhage
e. Hypotension
Answer:
b. Renal vasoconstriction
c. Renal artery thrombosis
d. Hemorrhage
e. Hypotension
, 4
Rationale: Poor perfusion can result from renal artery thrombosis, hypotension related to
hypovolemia (dehydration, diarrhea, fluid shifts) or hemorrhage, renal vasoconstriction and
alterations in renal regional blood flow, microthrombi, or kidney edema that restricts arterial
blood flow. Bilateral ureteral obstruction is not associated with prerenal injuries. page 1360.
QUESTION
What initiates inflammation in acute poststreptococcal glomerulonephritis?
a. Lysosomal enzymes
b. Endotoxins from Streptococcus
c. Immune complexes
d. Immunoglobulin E (IgE) mediated response
Answer:
c. Immune complexes
Rationale: The immune complexes initiate inflammation and glomerular injury in acute
poststreptococcal glomerulonephritis. Antigen-antibody complexes are deposited in the
glomerulus, or the antigen may be trapped within the glomerulus and immune complexes formed
in situ. The other options are not involved in initiating inflammation in this situation. page 1381
QUESTION
In immunoglobulin G (IgG) nephropathies such as glomerulonephritis, IgG is deposited in
which location?
a. Juxtamedullary nephrons
b. Glomerulus basement membranes
c. Mesangium of the glomerular capillaries
d. Parietal epithelium
Answer:
b. Glomerulus basement membranes
Rationale: Glomerulonephritis develops with the deposition of antigen-antibody complexes
(IgG, immunoglobulin A [IgA] and C3 complement) in the glomerulus, or the antigen may be
trapped within the glomerulus and immune complexes formed in situ. Immunofluorescence
microscopy shows lumpy deposits of IgG and C3 complement on the glomerular basement
membrane (see figure 39-5) When considering IgG nephropathies the only location of the IgG
immunoglobulins is the correct option. page 1381
