NURS 231/NURS231 Module 8 V1 |
Pathophysiology Q&A with Rationale |
Portage Learning
1. Which of the following conditions is characterized by a significant decrease in blood flow to
the kidneys, leading to decreased glomerular filtration rate without initial damage to the
renal parenchyma?
A. Intrarenal Acute Kidney Injury
B. Postrenal Acute Kidney Injury
C. Chronic Kidney Disease Stage 3
D. Prerenal Acute Kidney Injury
Correct Answer: D
Rationale: Prerenal injury is primarily caused by hypoperfusion of the kidneys, which can
result from dehydration, hemorrhage, or heart failure. This lack of blood flow reduces the
pressure necessary for filtration, but the kidney tissues remain healthy at the onset. If the
underlying cause of reduced flow is not corrected, it can eventually progress to intrarenal
damage due to ischemia.
2. In the context of Nephrotic Syndrome, which clinical finding is most directly caused by the
massive loss of albumin in the urine?
A. Generalized Edema
,B. Hematuria
C. Flank Pain
D. Increased Specific Gravity
Correct Answer: A
Rationale: Nephrotic syndrome involves damage to the glomerular basement membrane,
leading to high permeability for proteins, especially albumin. The resulting
hypoalbuminemia reduces the plasma oncotic pressure that normally keeps fluid within
the intravascular space. This imbalance causes fluid to shift into the interstitial tissues,
leading to generalized edema or anasarca.
3. A patient presents with high fever, chills, and costovertebral angle (CVA) tenderness.
Which of the following is the most likely diagnosis?
A. Acute Pyelonephritis
B. Urethritis
C. Cystitis
D. Renal Calculi
Correct Answer: A
Rationale: Acute pyelonephritis is an infection of the upper urinary tract involving the
renal pelvis and kidney parenchyma. It typically presents with systemic symptoms like
fever and chills, which are usually absent in lower urinary tract infections like cystitis. The
, presence of CVA tenderness is a classic physical exam finding indicating inflammation of
the kidney.
4. Which hormone’s deficiency is primarily responsible for the development of anemia in
patients with Chronic Kidney Disease (CKD)?
A. Renin
B. Aldosterone
C. Erythropoietin
D. Calcitriol
Correct Answer: C
Rationale: The kidneys are the primary site for the production of erythropoietin, the
hormone that stimulates red blood cell production in the bone marrow. As renal function
declines in CKD, the kidneys can no longer produce adequate amounts of this hormone.
Consequently, red blood cell production decreases, leading to the normocytic,
normochromic anemia typically seen in advanced renal failure.
5. Which type of renal calculi is most frequently associated with urea-splitting bacteria, such
as Proteus mirabilis, and often forms ‘staghorn’ shapes?
A. Calcium Oxalate
B. Uric Acid
C. Struvite
Pathophysiology Q&A with Rationale |
Portage Learning
1. Which of the following conditions is characterized by a significant decrease in blood flow to
the kidneys, leading to decreased glomerular filtration rate without initial damage to the
renal parenchyma?
A. Intrarenal Acute Kidney Injury
B. Postrenal Acute Kidney Injury
C. Chronic Kidney Disease Stage 3
D. Prerenal Acute Kidney Injury
Correct Answer: D
Rationale: Prerenal injury is primarily caused by hypoperfusion of the kidneys, which can
result from dehydration, hemorrhage, or heart failure. This lack of blood flow reduces the
pressure necessary for filtration, but the kidney tissues remain healthy at the onset. If the
underlying cause of reduced flow is not corrected, it can eventually progress to intrarenal
damage due to ischemia.
2. In the context of Nephrotic Syndrome, which clinical finding is most directly caused by the
massive loss of albumin in the urine?
A. Generalized Edema
,B. Hematuria
C. Flank Pain
D. Increased Specific Gravity
Correct Answer: A
Rationale: Nephrotic syndrome involves damage to the glomerular basement membrane,
leading to high permeability for proteins, especially albumin. The resulting
hypoalbuminemia reduces the plasma oncotic pressure that normally keeps fluid within
the intravascular space. This imbalance causes fluid to shift into the interstitial tissues,
leading to generalized edema or anasarca.
3. A patient presents with high fever, chills, and costovertebral angle (CVA) tenderness.
Which of the following is the most likely diagnosis?
A. Acute Pyelonephritis
B. Urethritis
C. Cystitis
D. Renal Calculi
Correct Answer: A
Rationale: Acute pyelonephritis is an infection of the upper urinary tract involving the
renal pelvis and kidney parenchyma. It typically presents with systemic symptoms like
fever and chills, which are usually absent in lower urinary tract infections like cystitis. The
, presence of CVA tenderness is a classic physical exam finding indicating inflammation of
the kidney.
4. Which hormone’s deficiency is primarily responsible for the development of anemia in
patients with Chronic Kidney Disease (CKD)?
A. Renin
B. Aldosterone
C. Erythropoietin
D. Calcitriol
Correct Answer: C
Rationale: The kidneys are the primary site for the production of erythropoietin, the
hormone that stimulates red blood cell production in the bone marrow. As renal function
declines in CKD, the kidneys can no longer produce adequate amounts of this hormone.
Consequently, red blood cell production decreases, leading to the normocytic,
normochromic anemia typically seen in advanced renal failure.
5. Which type of renal calculi is most frequently associated with urea-splitting bacteria, such
as Proteus mirabilis, and often forms ‘staghorn’ shapes?
A. Calcium Oxalate
B. Uric Acid
C. Struvite
