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Portage Learning Pathophysiology NURS 231/BIOD 331
Module 8 Exam All Versions Latest Update
All Versions Of Exam 8 Categorized By Question Types 2025
NURS 231/BIOD 231 Pathophysiology Portage Learning.
Table of Contents
Version Exam 8.1..................................................................................................................................... 1 Version Exam 8.2..................................................................................................................................... 6 Version Exam 8.3................................................................................................................................... 10
Questions Type Breakdown In Each Version
➢ True and false: ➢ Matching, multiple choice and short answer: ➢ Clinical questions: Only questions are provided for clinical questions as examinees are strongly encouraged to answer them in their own words. All the Best!
Version Exam 8.
True And False: Questions if False make the statement True Angiotensin II stimulates the release of a aldosterone. True Angiotensin I is converted to angiotensin II in the Kidneys. false, angiotensin I is converted to angiotensin II in the lungs When the blood pressure rises, the enzyme renin is released by the juxtaglomerular (JG) cells of the nephron. False, when blood pressure drops, the enzyme renin is released by the juxtaglomerular (JG) cells of the nephron The kidneys have compensatory mechanisms needed to conserve K+ during periods of excessive loss. False, there is no compensatory mechanism Hyperkalemia can be caused by movement of K+ from the ECF to the ICF compartment. False, hyperkalemia can be cause by the movement of K+ from the ICF to the ECF compartment Matching, Multiple Choice And Short Answer: Each of the following statements are true regarding control over the GFR except: The RAA responds when blood pressure rises above normal limits
Each of the following statements are true regarding control over the GFR except: The sympathetic nervous system cannot supersede the renal autoregulatory system. Which of the following statements is false regarding ADH? Elevated levels of ADH will lead to dilute urine. alcohol is a diuretic and will inhibit the release of ADH. Which of the following statements is true regarding nephrons? The glomerulus filters the blood while the tubule reabsorbs needed nutrients Low Na+ levels in the plasma and interstitial compartment is characteristic of which of the following fluid imbalances? water intoxication Tubular reabsorption is characterized by which of the following? Necessary solutes and fluids are reabsorbed into the peritubular capillaries Acute postinfectious glomerulonephritis is characterized by the following except: Associated with a poor prognosis as it often leads to CKD the prognosis is good when underlying cause is treated Which of the following is characteristic of chronic transplant rejection? It is the active form of vitamin D, converted in the kidney A patient is said to be in stage 3a kidney disease. What would you expect their GFR to be? B 42 mL/min/1.73m The following are true regarding tubular secretion except: K+ is secreted in the intercalated cells A decrease in Na+ reabsorption is achieved through the action of which of the following? Diuretics Cortical nephrons are characterized by the following except: They originate deep in the cortex ,they originate superficially in the cortex Excess accumulation of fluid within the interstitial compartment is characteristic of which of the following fluid imbalances? edema Which of the following is/are true regarding acid-base disorders? (mark all that apply) Metabolic disorders are a result of a change in plasma HCO3 – levels, Respiratory disorders are a result of a change in plasma CO2 levels, Normal blood pH = 7.35-7.45! Chronic glomerulonephritis is characterized by the following except: Rarely progresses to CKD it will typically progress to CKD over time Which of the following is true of cholecalciferol? It is the inactive form of vitamin D taken in through the skin via UV rays The following are true regarding tubular secretion except: H+ along with organic acids and bases are secreted from the distal tubule ( the are secreted from the proximal tube a decrease in Na+ reabsorption is achieved through the action of which of the following? diuretics Which of the following statements is false regarding ADH? Alcohol increases ADH levels. alcohol is a diuretic and will inhibit the release of ADH. Acute postinfectious glomerulonephritis is characterized by the following except: Hypocellularity
Explain why pancreatitis would lead to this imbalance. Hypocalcemia. Acute pancreatitis causes the release of proteolytic and lipolytic enzymes. Free fatty acids are released during lipolysis in the pancreas. Ca2+ binds to these fatty acids removing them from the blood A patient has a diagnosis of glomerular disease. Given what you know about the structural framework of the glomerular capillaries, what would be detected in this patient's urine, and explain why this would happen Blood and protein may be present in the urine. Spaces within the basement membrane of the glomerular capillaries, under normal circumstances prevent red blood cells and plasma proteins from passing through the glomerular membrane into the filtrate. The disease process would compromise this A patient with chronic kidney disease must undergo dialysis treatments as they wait for transplantation. Give 1 reason peritoneal dialysis would be preferable to the patient over hemodialysis and 1 concern in choosing peritoneal dialysis over hemodialysis: Peritoneal dialysis can be done in the patient's home as opposed to going to a dialysis clinic multiple times per week. A major concern of the utilization of peritoneal dialysis is the risk for infection at the catheter site A patient presents to the emergency department with complaints of sharp pain that comes in waves in the upper lateral quadrant of the abdomen. Their skin is clammy, and they have been experiencing nausea and vomiting all day long. They have a past medical history of hyperparathyroidism. Urinalysis reveals calcium in their urine. A CT scan is ordered, and it reveals a stone 6 mm in diameter. What type of renal calculi do you suspect? What treatment is needed? Explain your reasoning for both answers. The patient has a calcium stone given their past medical history and the findings of calcium in their urine. The stone will be unable to pass on its own given the diameter greater than 5 mm. It can be removed through ureteroscopic removal or extracorporeal shockwave lithotripsy. The patient may also be put on medication for pain management A patient presents in the emergency department with severe dehydration secondary to vomiting. The following are the results of their blood work: pH = 8.2, PCO2 = 39 mm, and HCO3 - = 33 mEq/L. Based upon these results, what type of acid-base disorder are they experiencing? Is compensation occurring? Describe a treatment intervention for this disorder. Normal values are as follows: pH = 7.35-7.45, PCO2 = 35-45 mm, HCO3 - = 22-26 mEq/L: The patient is in metabolic alkalosis. The respiratory system is not compensating as PCO2 compensation falls within normal limits. Fluids are replaced with normal saline solution A patient is in the ICU following open heart surgery. The patient was feeling well earlier in the day, but suddenly began to demonstrate signs of confusion and disorientation. Blood results reveal Na+ = 100 mEq/L. Based upon these symptoms and results of blood work, what electrolyte imbalance is this patient experiencing? What treatment is indicated for this imbalance? This patient is experiencing euvolemic hypotonic hyponatremia. The administration of intravenous saline solution would be indicated to correct the sodium deficiency
Explain why renal flow is decreased with sympathetic activity; Sympathetic activity diverts blood to the heart, brain, and skeletal muscles. During these times the renal autoregulatory system may be superseded by nervous system control. In this event, a narrowing of the afferent arteriole is caused by sympathetic nerve fibers followed by a release of epinephrine from the adrenal medulla which leads to a subsequent decrease in renal flow and the GFR. Explain why the glomerulus is situated between 2 arterioles; Arterioles are high resistance vessels resulting in an extremely high-pressure system which can easily force fluid and solutes out of the blood into the glomerular capillary along its entire length Explain why a patient with chronic kidney disease may develop anemia: Under normal circumstances, erythropoietin is synthesized in the kidneys and regulates the differentiation of red blood cells within the bone marrow. The formation of erythropoietin is hindered in chronic kidney disease. A patient presents to the emergency department with complaints of sharp pain that comes in waves in the upper lateral quadrant of the abdomen. Their skin is clammy, and they have been experiencing nausea and vomiting all day long. They have a history of UTIs. Urinalysis reveals that the pH of their urine is 7.8. A CT scan is ordered, and it reveals a stone 4 mm in diameter. What type of renal calculi do you suspect? What treatment is needed? Explain your reasoning for both answers. The patient has a magnesium ammonium phosphate stone given the elevated pH of their urine. These types of stones are the result of a UTI caused by bacteria that contains urease. Urease breaks urea down to form ammonia which raises the pH of the urine. This patient has a history of UTIs so this should be taken into consideration. This patient does not require a procedure to remove the stone. Since it is less than 5 mm in diameter, the stone should pass on its own. The patient should be placed on antibiotics to treat the UTI as well as medication for pain management. A patient is admitted to the hospital with pneumonia. The following are the results of their blood work: pH = 6.9, PCO2 = 52 mm, and HCO3- = 30 mEq/L. Based upon these results, what type of acid- base disorder are they experiencing? Is compensation occurring? Describe a treatment intervention for this disorder. Normal values are as follows: pH = 7.35-7.45, PCO2 = 35-45 mm, HCO3 - = 22- 26 mEq/L: The patient is in respiratory acidosis. The renal system is attempting to compensate as HCO3 - concentration is elevated above normal limits. The goal of treatment for respiratory acidosis is improving ventilation. Supplemental O2 can be administered; in severe cases mechanical ventilation may be indicated. explain how the kidney can maintain a constant GFR despite variations in the arterial blood pressure of the rest of the body. The renal autoregulatory system causes the efferent arteriole to constrict leading to an increased resistance to outflow from the glomeruli with a subsequent increase in glomerular pressure and the GFR. When the afferent arteriole constricts there is a reduction in renal blood flow, glomerular pressure, and the GFR.
Dilation of the afferent arterioles is achieved through the action of which of the following? ANS: Cardiovascular baroreceptors The outer portion of the kidney that houses the glomeruli and convoluted tubules is called the: ANS: Renal Cortex the formation of erythropoietin is preceded by low levels of: ANS: oxygen A person who has a blood Mg2+ concentration of 3.3 mg/dL. Is considered to have: ANS: hypermagnesemia Angiotensin I is converted to angiotensin II in the kidney. ANS: False, angiotensin I is converted to angiotensin in the lungs. Hyperkalemia can be caused by movement of K+ from the ECF to the ICF compartment. ANS: False, hyperkalemia can be caused by the movement of K+ from the ICF to the ECF compartment. Explain why renal flow is decreased with sympathetic activity. ANS: Renal flow is decreased when there is an increase in sympathetic activity. This is due to afferent vasoconstriction. A patients plasma Ca2+ levels are 11.0 mg/dL. Given these levels, list a symptom affecting the GI tract they may experience and explain why it would be occurring. ANS: The patient has hypercalcemia. Constipation, nausea, and/or vomiting may result secondary to a decrease in smooth muscle activity. A patient has a diagnosis of glomerular disease. Given what you know about the structural framework of the glomerular capillaries, what would be detected in this patient's urine, and explain what would happen. ANS: Blood and protein will be detected in the urine. This happens because of an increased permeability of the glomerular capillary wall. A patient with chronic kidney disease must undergo dialysis treatment as they wait for transplantation. Give 1 reason peritoneal dialysis would be preferable to the patient over hemodialysis and 1 concern in choosing peritoneal dialysis over hemodialysis. ANS: Peritoneal dialysis can be done at home as opposed to going to a dialysis site multiple times a week. A major concern is the risk of infection at the catheter site.
A patient presents to the ER with complaints of sharp pain that comes in waves in the upper lateral abdomen. Their skin is clammy, and they have been experiencing nausea and vomiting all day. They have a past medical history of hyperparathyroidism. UA reveals calcium in the urine. A CT scan is ordered, and it reveals a stone 6mm in diameter. What type of renal calculi do you suspect? What treatment is needed? Explain your reasoning. ANS: Calcium stone is suspected due to the medical history and the increased calcium in the UA. Since the stone is 6mm it may not pass naturally. It can be removed through ureteroscopy which allows the doctor to dilate the ureter to remove the stone. Which of the following statements is false regarding ADH? ANS: Elevated levels of ADH will lead to dilute urine. (false b/c DECREASED levels of ADH will lead to dilute urine) Cortical nephrons are characterized by the following except: ANS: they originate deep in the cortex (false b/c they originate superficially in the cortex) Excess accumulation of fluid within the interstitial compartment is characteristic of which of the following fluid imbalances? ANS: edema Reabsorption in the loop of Henle is characterized by the following except: ANS: Na+ and water are reabsorbed in equal proportions (The loop of Henle reabsorbed more Na+ and Cl- than water) Which of the following is/are true regarding acid-base disorders? (mark all that apply) ANS: Metabolic disorders are a result of a change in plasma HCO3- levels Respiratory disorders are a result of a change in plasma CO2 levels Normal blood pH = 7.35-7. Acute postinfectious glomerulonephritis is characterized by the following except: ANS: Associated with a poor prognosis as it often leads to CKD (the prognosis is good when underlying cause is treated) Which of the following is characteristic of chronic transplant rejection? ANS: it involves humoral immunity Which of the following is true of 25-hydroxycholecalciferol? ANS: It is the active form of vitamin D, converted in the liver
A patient presents to the emergency department with complaints of sharp pain that comes in waves in the upper lateral quadrant of the abdomen. Their skin is clammy, and they have been experiencing nausea and vomiting all day long. They have a history of UTIs. Urinalysis reveals that the pH of their urine is 7.8. A CT scan is ordered, and it reveals a stone 4 mm in diameter. What type of renal calculi do you suspect? What treatment is needed? Explain your reasoning for both answers. ANS: The patient has a magnesium ammonium phosphate stone given the elevated pH of their urine. These types of stones are the result of a UTI caused by bacteria that contains urease. Urease breaks urea down to form ammonia which raises the pH of the urine. This patient has a history of UTIs so this should be taken into consideration. This patient does not require a procedure to remove the stone. Since it is less than 5 mm in diameter, the stone should pass on its own. The patient should be placed on antibiotics to treat the UTI as well as medication for pain management. A patient presents in the emergency department with severe dehydration secondary to vomiting. The following are the results of their blood work: pH = 8.2, PCO2 = 39 mm, and HCO3- = 33 mEq/L. Based upon these results, what type of acid-base disorder are they experiencing? Is compensation occurring? Describe a treatment intervention for this disorder. Normal values are as follows: pH = 7.35-7.45, PCO2 = 35-45 mm, HCO3- = 22-26 mEq/L. ANS: The patient is in metabolic alkalosis. The respiratory system is not compensating as PCO2 compensation falls within normal limits. Fluids are replaced with normal saline solution. A patient is in the ICU following open heart surgery. The patient was feeling well earlier in the day, but suddenly began to demonstrate signs of confusion and disorientation. Blood results reveal Na+ = 100 mEq/L. Based upon these symptoms and results of blood work, what electrolyte imbalance is this patient experiencing? What treatment is indicated for this imbalance? ANS: This patient is experiencing euvolemic hypotonic hyponatremia. The administration of intravenous saline solution would be indicated to correct the sodium deficiency. Version Exam 8. 3 (multiple choice) Each of the following statements are true regarding control over the GFR except: The sympathetic nervous system cannot supersede the renal autoregulatory system or The RAA responds when blood pressure rises above normal limits. The RAA responds when blood pressure drops below normal limits.
or The GFR will change with alterations in the body's arterial blood pressure (multiple choice) ADH levels will rise under which of the following circumstances? A. Severe hemorrhage B. Excessive sweating C. Diarrhea all of the above (multiple choice) Which of the following statements is false regarding ADH? elevated levels of ADH will lead to dilute urine AND Alcohol increases ADH levels. Alcohol is a diuretic and will inhibit the release of ADH. (multiple choice) Which of the following statements is true regarding nephrons? The glomerulus filters the blood while the tubule reabsorbs needed nutrients (multiple choice) Juxtamedullary nephrons are characterized by the following except: They make up 85% of all nephrons (multiple choice) Low Na+ levels in the plasma and interstitial compartment is characteristic of which of the following fluid imbalances?
A. Metabolic disorders are a result of a change in plasma HCO3- levels B. Respiratory disorders are a result of a change in plasma CO2 levels C. Normal HCO3- = 35-45 mm D. Normal blood pH = 7.35-7. A, B, D Which of the following is/are true regarding acid-base balance? (mark all that apply) Acid-base balance refers to the balance of the concentration of hydrogen ions (H+) in the blood Venous blood is characterized by a more acidic pH A higher concentration of OH- ions will increase the pH of the blood A higher concentration of H+ ions will decrease the pH of the blood (multiple choice) Acute postinfectious glomerulonephritis is characterized by the following except: Associated with a poor prognosis as it often leads to CKD. The prognosis is good when underlying cause is treated AND Hypocellularity (multiple choice) Chronic glomerulonephritis is characterized by the following except: Rarely progresses to CKD Which of the following are necessary components of nutritional management for a patient with CKD? (mark all that apply)
A decrease in dietary protein Adequate caloric intake in the form of carbohydrates and fats Fluid restrictions A decrease in dietary protein Adequate caloric intake in the form of carbohydrates and fats Fluid restrictions (multiple choice) Which of the following is characteristic of acute transplant rejection? involves increased T lymphocytes (multiple choice) Which of the following is the characteristic of chronic transplant rejection? Involves humoral immunity (multiple choice) Which of the following is true of 1,25-dihydroxycholecalciferol? It is the active form of vitamin D, converted in the kidney (multiple choice) Which of the following is true of 25-hydroxycholecalciferol? It is the active form of vitamin D, converted in the liver
(multiple choice) Which of the following is TRUE regarding tubular secretion? H+ is secreted in the intercalated cells (multiple choice) Na+ reabsorption, through the excretion of H+ ions, is achieved through the action of which of the following? Aldosterone (multiple choice) A decrease in Na+ reabsorption is achieved through the action of which of the following? Diurectics (multiple choice) Dilation of afferent arterioles is achieved through the action of which of the following? Cardiovascular baroreceptors (Fill in the Blank) The outer portion of the kidney that houses the glomeruli and convoluted tubules is called the _______. renal cortex (Fill in the blank) The inner portion of the kidney that houses the loop of henle and the renal pyramids is called the _______. Renal medulla
(Fill in the blank) In the nephron, the mass of capillaries surrounded by an epithelial capsule that opens into a tubule is collectively referred to as the _______. renal corpuscle (fill in the blank) The formation of erythropoietin is preceded by low levels of _______. oxygen (fill in the blank) The hormone that is synthesized in the kidneys and regulates the differentiation of red blood cells is _____. erythropoietin (Fill in the blank) The enzyme _______ causes CO2 to react reversibly with water to form carbonic acid to regulate blood pH. Carbonase anhydrase (Fill in the blank) The ________ react within seconds to minimize changes in the pH by binding free H+ or free OH- chemical buffer systems (Fill in the blank) The _______ causes CO2 to react reversibly with water to form carbonic acid to regulate blood pH.
Postrenal T/F, if False make the statement True Angiotensin I is converted to angiotensin II in the kidneys. False; in the lungs T/F, if False make the statement True When blood pressure rises, the enzyme renin is released by the juxtaglomerular cells of the nephron. False, when the blood pressure drops T/F, if False make the statement True One should take in at least 40 - 50 m Eq / day of potassium through the diet or by supplement. True (T/F), if False make the statement True The kidneys have compensatory mechanisms needed to conserve K+ during periods of excessive loss. False - there is no compensatory mechanism T/F, if False make the statement True Hyperkalemia can be caused by movement of K+ from the ECF to the ICF compartment.
False, caused by the movement of K+ from ICF to ECF (short answer) Explain how the kidney can maintain a constant GFR despite variations in the arterial blood pressure of the rest of the body. The renal autoregulatory system causes the efferent arteriole to constrict leading to an increased resistance to outflow from the glomeruli with a subsequent increase in glomerular pressure and the GFR. When the afferent arteriole constricts there is a reduction in renal blood flow, glomerular pressure, and the GFR. Short Answer: Explain why renal flow is decreased with sympathetic activity. there is a decrease in renal blood flow with increased renal sympathetic nervous system activity. This decrease in flow is primarily mediated through increased afferent renal arteriolar vasoconstriction (short answer) A patient's plasma Ca2+ levels are 11.0 mg/dL. Given these levels, list a symptom affecting the GI tract they may experience and explain why it would be occurring. The patient has hypercalcemia. Constipation, nausea, and/or vomiting may result secondary to a decrease in smooth muscle activity. (short answer) a patient has a diagnosis of acute pancreatitis and a subsequent electrolyte imbalance. Which electrolyte imbalance may they experience given this condition? explain why pancreatitis would lead to this imbalance. Hypocalcemia. Acute pancreatitis causes the release of proteolytic and lipolytic enzymes leading to dehydration and water output exceeding water intake.
