NURS 231/NURS231 Module 7 V2 |
Pathophysiology Q&A with Rationale |
Portage Learning
1. Which of the following describes the primary physiological mechanism behind prerenal
acute kidney injury?
A. Direct damage to the renal parenchyma from toxins
B. Obstruction of urine outflow in the ureters
C. Decreased blood flow to the kidneys leading to reduced glomerular perfusion
D. Inflammation of the glomerular basement membrane
Correct Answer: C
Rationale: Prerenal injury is characterized by conditions that diminish blood flow to the
kidney without causing immediate damage to the tissue itself. This leads to a drop in the
glomerular filtration rate (GFR) due to insufficient perfusion pressure. If left untreated, the
prolonged ischemia can eventually lead to intrarenal damage such as acute tubular
necrosis.
2. A patient is diagnosed with nephrotic syndrome. Which clinical finding is most
characteristic of this condition?
A. Elevated serum albumin levels
B. Gross hematuria with red blood cell casts
,C. Severe hypotension and tachycardia
D. Massive proteinuria exceeding 3.5 g/day
Correct Answer: D
Rationale: Nephrotic syndrome involves damage to the glomerular filtration barrier,
specifically the podocytes, leading to massive protein loss in the urine. This loss results in
hypoalbuminemia and subsequent generalized edema (anasarca) due to decreased plasma
oncotic pressure. In contrast, hematuria is more typical of nephritic syndrome, which
involves inflammatory processes.
3. What is the primary function of erythropoietin produced by the kidneys?
A. Stimulation of red blood cell production in the bone marrow
B. Regulation of calcium and phosphate balance
C. Activation of the renin-angiotensin-aldosterone system
D. Degradation of insulin and other hormones
Correct Answer: A
Rationale: Erythropoietin is a hormone synthesized by interstitial cells in the peritubular
capillary bed of the kidney in response to hypoxia. It travels to the bone marrow where it
stimulates erythropoiesis to increase the oxygen-carrying capacity of the blood. Patients
with chronic kidney disease often suffer from anemia because their kidneys can no longer
produce sufficient levels of this hormone.
, 4. In the context of Chronic Kidney Disease (CKD), osteodystrophy occurs primarily due to
which metabolic imbalance?
A. Hypercalcemia and hypophosphatemia
B. Excessive secretion of calcitonin
C. Failure to activate Vitamin D and hyperphosphatemia
D. Metabolic alkalosis
Correct Answer: C
Rationale: Renal osteodystrophy is a complex bone disease resulting from the kidney’s
inability to excrete phosphate and activate Vitamin D. Increased serum phosphate levels
bind with calcium, causing hypocalcemia, which triggers the parathyroid glands to secrete
PTH. High levels of PTH then stimulate bone resorption, leading to weakened bone
structures and increased fracture risk.
5. Which type of renal calculi is most frequently associated with urea-splitting bacterial
infections?
A. Struvite stones
B. Uric acid stones
C. Calcium oxalate stones
D. Cystine stones
Correct Answer: A
Pathophysiology Q&A with Rationale |
Portage Learning
1. Which of the following describes the primary physiological mechanism behind prerenal
acute kidney injury?
A. Direct damage to the renal parenchyma from toxins
B. Obstruction of urine outflow in the ureters
C. Decreased blood flow to the kidneys leading to reduced glomerular perfusion
D. Inflammation of the glomerular basement membrane
Correct Answer: C
Rationale: Prerenal injury is characterized by conditions that diminish blood flow to the
kidney without causing immediate damage to the tissue itself. This leads to a drop in the
glomerular filtration rate (GFR) due to insufficient perfusion pressure. If left untreated, the
prolonged ischemia can eventually lead to intrarenal damage such as acute tubular
necrosis.
2. A patient is diagnosed with nephrotic syndrome. Which clinical finding is most
characteristic of this condition?
A. Elevated serum albumin levels
B. Gross hematuria with red blood cell casts
,C. Severe hypotension and tachycardia
D. Massive proteinuria exceeding 3.5 g/day
Correct Answer: D
Rationale: Nephrotic syndrome involves damage to the glomerular filtration barrier,
specifically the podocytes, leading to massive protein loss in the urine. This loss results in
hypoalbuminemia and subsequent generalized edema (anasarca) due to decreased plasma
oncotic pressure. In contrast, hematuria is more typical of nephritic syndrome, which
involves inflammatory processes.
3. What is the primary function of erythropoietin produced by the kidneys?
A. Stimulation of red blood cell production in the bone marrow
B. Regulation of calcium and phosphate balance
C. Activation of the renin-angiotensin-aldosterone system
D. Degradation of insulin and other hormones
Correct Answer: A
Rationale: Erythropoietin is a hormone synthesized by interstitial cells in the peritubular
capillary bed of the kidney in response to hypoxia. It travels to the bone marrow where it
stimulates erythropoiesis to increase the oxygen-carrying capacity of the blood. Patients
with chronic kidney disease often suffer from anemia because their kidneys can no longer
produce sufficient levels of this hormone.
, 4. In the context of Chronic Kidney Disease (CKD), osteodystrophy occurs primarily due to
which metabolic imbalance?
A. Hypercalcemia and hypophosphatemia
B. Excessive secretion of calcitonin
C. Failure to activate Vitamin D and hyperphosphatemia
D. Metabolic alkalosis
Correct Answer: C
Rationale: Renal osteodystrophy is a complex bone disease resulting from the kidney’s
inability to excrete phosphate and activate Vitamin D. Increased serum phosphate levels
bind with calcium, causing hypocalcemia, which triggers the parathyroid glands to secrete
PTH. High levels of PTH then stimulate bone resorption, leading to weakened bone
structures and increased fracture risk.
5. Which type of renal calculi is most frequently associated with urea-splitting bacterial
infections?
A. Struvite stones
B. Uric acid stones
C. Calcium oxalate stones
D. Cystine stones
Correct Answer: A
