NSG 3850 Exam 3 Galen College Of Nursing Actual Exam Questions And Answers Practice
Questions with Solutions Newest | Already Graded A+
Question 1
Nephrotic syndrome is characterized by a specific set of clinical findings. Which of the following
is NOT typically a clinical manifestation of nephrotic syndrome?
A) Hyperlipidemia
B) Proteinuria
C) Gross hematuria
D) Generalized edema
E) Hypoalbuminemia
Correct Answer: C) Gross hematuria
Rationale: Nephrotic syndrome is defined by massive proteinuria (usually >3.5g/day), which
leads to hypoalbuminemia and a subsequent drop in oncotic pressure, causing generalized
edema. The liver increases lipid synthesis to compensate for protein loss, causing
hyperlipidemia. While microscopic hematuria can occur, gross hematuria is more
characteristic of Nephritic Syndrome (Glomerulonephritis).
Question 2
A patient is diagnosed with acute pyelonephritis. Which of the following systemic symptoms is
most typically experienced during this condition?
A) Fever and chills
B) Oliguria
C) Severe peripheral edema
D) Systemic hypertension
E) Bruising and petechiae
Correct Answer: A) fever
Rationale: Acute pyelonephritis is an infection of the kidney parenchyma and renal pelvis.
As an upper urinary tract infection, it presents with systemic signs of infection, including
high fever, chills, and costovertebral angle (CVA) tenderness. Edema and hypertension are
more common in glomerular disorders.
Question 3
What is the most common causative organism associated with the development of acute
pyelonephritis?
A) Streptococcus pyogenes
B) Escherichia coli
C) Klebsiella pneumoniae
D) Enterobacter
E) Staphylococcus aureus
Correct Answer: B) Escherichia coli
Rationale: Escherichia coli (E. coli), a gram-negative bacterium from the normal GI flora, is
responsible for approximately 80% of all acute pyelonephritis cases. It typically ascends
from the lower urinary tract (urethra and bladder) into the kidneys.
, 2
Question 4
Which of the following statements regarding Polycystic Kidney Disease (PKD) is correct?
A) It is always rapidly fatal within the first year of life.
B) It is caused by an untreated streptococcal throat infection.
C) It is characterized by the growth of a single, supernumerary kidney.
D) It is a genetically transmitted disorder.
E) It is exclusively caused by long-term dialysis.
Correct Answer: D) genetically transmitted
Rationale: Polycystic Kidney Disease is an inherited disorder (autosomal dominant is most
common) characterized by the formation of multiple fluid-filled cysts in the kidneys. These
cysts expand over time, compressing and eventually destroying healthy renal tissue, leading
to end-stage renal disease.
Question 5
What is the primary pathophysiologic basis for the development of acute glomerulonephritis?
A) Acute renal ischemia due to shock
B) Direct bacterial invasion of the glomerular capsule
C) An anaphylactic Type I hypersensitivity reaction
D) An immune complex (Type III) reaction
E) Obstruction of the renal artery by a stone
Correct Answer: D) an immune complex reaction
Rationale: Acute glomerulonephritis is usually an immunologic, not an infectious, process.
Antigen-antibody complexes (often following a strep infection) circulate in the blood and
become trapped in the glomerular basement membrane. This triggers an inflammatory
response that damages the filtration barrier.
Question 6
When reviewing a urinalysis for a patient with suspected glomerulonephritis, which finding is
most consistent with the diagnosis?
A) Anuria
B) Proteinuria
C) Red blood cell (RBC) casts
D) Foul-smelling urine
E) Glucose and ketones
Correct Answer: C) red blood cell casts in urine
Rationale: RBC casts are highly specific for glomerular bleeding. When red cells leak
through damaged glomeruli into the renal tubules, they are compressed into cylinder-
shaped "casts" by the Tamm-Horsfall protein. Their presence confirms that the hematuria
is coming from the kidney itself.
, 3
Question 7
A patient with a history of gouty arthritis develops renal calculi. Based on the underlying
metabolic disorder, what is the most likely composition of these stones?
A) Calcium oxalate
B) Struvite (Magnesium ammonium phosphate)
C) Cysteine
D) Uric acid crystals
E) Potassium chloride
Correct Answer: D) uric acid crystals
Rationale: Gout is characterized by hyperuricemia (high levels of uric acid in the blood).
When the urine becomes saturated with uric acid, particularly in acidic conditions, uric
acid crystals precipitate and form stones (nephrolithiasis).
Question 8
What is the most common chemical composition found in renal stones (nephrolithiasis) in the
United States?
A) Uric acid
B) Calcium (Oxalate or Phosphate)
C) Struvite
D) Cysteine
E) Xanthine
Correct Answer: B) calcium
Rationale: Approximately 75% to 80% of all kidney stones are composed of calcium,
usually in the form of calcium oxalate. Hypercalciuria (excess calcium in the urine) is the
primary driver for this type of stone formation.
Question 9
The formation of calcium oxalate stones is most directly facilitated by which of the following
factors?
A) Hypercalciuria
B) Hypoparathyroidism
C) High urine pH (alkaline urine)
D) Excessive protein intake alone
E) Vitamin C deficiency
Correct Answer: A) hypercalciuria
Rationale: Hypercalciuria (elevated urinary calcium) increases the concentration of calcium
in the renal tubules. When the concentration exceeds the solubility limit, calcium binds
with oxalate to form solid crystals/stones.
Question 10
A patient presents to the emergency department with suspected renal calculi. Which of the
Questions with Solutions Newest | Already Graded A+
Question 1
Nephrotic syndrome is characterized by a specific set of clinical findings. Which of the following
is NOT typically a clinical manifestation of nephrotic syndrome?
A) Hyperlipidemia
B) Proteinuria
C) Gross hematuria
D) Generalized edema
E) Hypoalbuminemia
Correct Answer: C) Gross hematuria
Rationale: Nephrotic syndrome is defined by massive proteinuria (usually >3.5g/day), which
leads to hypoalbuminemia and a subsequent drop in oncotic pressure, causing generalized
edema. The liver increases lipid synthesis to compensate for protein loss, causing
hyperlipidemia. While microscopic hematuria can occur, gross hematuria is more
characteristic of Nephritic Syndrome (Glomerulonephritis).
Question 2
A patient is diagnosed with acute pyelonephritis. Which of the following systemic symptoms is
most typically experienced during this condition?
A) Fever and chills
B) Oliguria
C) Severe peripheral edema
D) Systemic hypertension
E) Bruising and petechiae
Correct Answer: A) fever
Rationale: Acute pyelonephritis is an infection of the kidney parenchyma and renal pelvis.
As an upper urinary tract infection, it presents with systemic signs of infection, including
high fever, chills, and costovertebral angle (CVA) tenderness. Edema and hypertension are
more common in glomerular disorders.
Question 3
What is the most common causative organism associated with the development of acute
pyelonephritis?
A) Streptococcus pyogenes
B) Escherichia coli
C) Klebsiella pneumoniae
D) Enterobacter
E) Staphylococcus aureus
Correct Answer: B) Escherichia coli
Rationale: Escherichia coli (E. coli), a gram-negative bacterium from the normal GI flora, is
responsible for approximately 80% of all acute pyelonephritis cases. It typically ascends
from the lower urinary tract (urethra and bladder) into the kidneys.
, 2
Question 4
Which of the following statements regarding Polycystic Kidney Disease (PKD) is correct?
A) It is always rapidly fatal within the first year of life.
B) It is caused by an untreated streptococcal throat infection.
C) It is characterized by the growth of a single, supernumerary kidney.
D) It is a genetically transmitted disorder.
E) It is exclusively caused by long-term dialysis.
Correct Answer: D) genetically transmitted
Rationale: Polycystic Kidney Disease is an inherited disorder (autosomal dominant is most
common) characterized by the formation of multiple fluid-filled cysts in the kidneys. These
cysts expand over time, compressing and eventually destroying healthy renal tissue, leading
to end-stage renal disease.
Question 5
What is the primary pathophysiologic basis for the development of acute glomerulonephritis?
A) Acute renal ischemia due to shock
B) Direct bacterial invasion of the glomerular capsule
C) An anaphylactic Type I hypersensitivity reaction
D) An immune complex (Type III) reaction
E) Obstruction of the renal artery by a stone
Correct Answer: D) an immune complex reaction
Rationale: Acute glomerulonephritis is usually an immunologic, not an infectious, process.
Antigen-antibody complexes (often following a strep infection) circulate in the blood and
become trapped in the glomerular basement membrane. This triggers an inflammatory
response that damages the filtration barrier.
Question 6
When reviewing a urinalysis for a patient with suspected glomerulonephritis, which finding is
most consistent with the diagnosis?
A) Anuria
B) Proteinuria
C) Red blood cell (RBC) casts
D) Foul-smelling urine
E) Glucose and ketones
Correct Answer: C) red blood cell casts in urine
Rationale: RBC casts are highly specific for glomerular bleeding. When red cells leak
through damaged glomeruli into the renal tubules, they are compressed into cylinder-
shaped "casts" by the Tamm-Horsfall protein. Their presence confirms that the hematuria
is coming from the kidney itself.
, 3
Question 7
A patient with a history of gouty arthritis develops renal calculi. Based on the underlying
metabolic disorder, what is the most likely composition of these stones?
A) Calcium oxalate
B) Struvite (Magnesium ammonium phosphate)
C) Cysteine
D) Uric acid crystals
E) Potassium chloride
Correct Answer: D) uric acid crystals
Rationale: Gout is characterized by hyperuricemia (high levels of uric acid in the blood).
When the urine becomes saturated with uric acid, particularly in acidic conditions, uric
acid crystals precipitate and form stones (nephrolithiasis).
Question 8
What is the most common chemical composition found in renal stones (nephrolithiasis) in the
United States?
A) Uric acid
B) Calcium (Oxalate or Phosphate)
C) Struvite
D) Cysteine
E) Xanthine
Correct Answer: B) calcium
Rationale: Approximately 75% to 80% of all kidney stones are composed of calcium,
usually in the form of calcium oxalate. Hypercalciuria (excess calcium in the urine) is the
primary driver for this type of stone formation.
Question 9
The formation of calcium oxalate stones is most directly facilitated by which of the following
factors?
A) Hypercalciuria
B) Hypoparathyroidism
C) High urine pH (alkaline urine)
D) Excessive protein intake alone
E) Vitamin C deficiency
Correct Answer: A) hypercalciuria
Rationale: Hypercalciuria (elevated urinary calcium) increases the concentration of calcium
in the renal tubules. When the concentration exceeds the solubility limit, calcium binds
with oxalate to form solid crystals/stones.
Question 10
A patient presents to the emergency department with suspected renal calculi. Which of the
