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NR507 Week 4 Midterm Exam

 

Question 1

What is the consequence of decreased renal production of vitamin D on the body?

Answers: A – D

1. Elevated levels of parathyroid hormone (PTH)
2. Increased absorption of calcium from the intestine
3. Impaired bone mineralization and increased risk of fractures ✅
4. Enhanced excretion of phosphate by the kidneys

Question 2

A patient with a history of hypertension and coronary artery disease presents with symptoms of left-sided heart failure. What is the primary pathophysiological mechanism underlying left-sided heart failure?

Answers: A – D

1. Impaired relaxation of the left ventricle
2. Decreased afterload leading to reduced cardiac output
3. Ineffective contraction of the left atrium
4. Inability of the left ventricle to adequately eject blood ✅

Question 3

A 40-year-old patient presents with severe colicky flank pain, hematuria, and nausea. The provider suspects renal calculi. Which of the following signs and symptoms is most indicative of renal calculi?

Answers: A – D

1. Severe flank pain that can radiate to the groin ✅
2. Urgency and frequency on urination
3. Fever and chills
4. Suprapubic tenderness

Question 4

A 45-year-old patient presents with shortness of breath. Pulmonary function tests indicate a decreased forced vital capacity (FVC) and a decreased FEV1/FVC ratio. Which of the following characteristics is more consistent with an obstructive pulmonary disorder rather than a restrictive pulmonary disorder?

Answers: A – D

1. Decreased lung compliance
2. Decreased total lung capacity (TLC)
3. Increased residual volume (RV) ✅
4. Decreased diffusing capacity for carbon monoxide (DLCO)

Question 5

Which of the following is an example of a cause of secondary immunodeficiency?

Answers: A – D

1. All the choices are correct ✅
2. Eating disorders
3. Pregnancy
4. Dietary insufficiencies

Question 6

What can cause an alloimmune phenomenon?

Answers: A – D

1. Infection with a pathogenic virus
2. Exposure to environmental toxins and pollutants
3. Genetic mutations in the hosts immune system
4. Transfusion of blood from a different blood type ✅

Question 7

In staging acute kidney injury, which of the creatinine values below indicates Stage 2 acute kidney injury?

Answers: A – D

2. 2.0–2.9 times the baseline ✅
3. 1.5–1.9 times the baseline
4. Four times the baseline
5. Three times the baseline

Question 8

A 45-year-old individual with a family history of coronary artery disease (CAD) is concerned about modifiable risk factors. Which of the following is an example of the individual modifying a risk factor to prevent CAD?

Answers: A – D

1. Increase high-density lipoprotein (HDL) cholesterol levels
2. Reduce systolic blood pressure to below 120 mmHg
3. Achieve and maintain a body mass index (BMI) within the normal range ✅
4. Normalize fasting blood glucose levels to prevent insulin resistance

Question 9

A patient with chronic respiratory symptoms presents with chronic cough, sputum production, and dyspnea. Further evaluation indicates airflow limitation on pulmonary function tests. Which of the following features is more indicative of chronic bronchitis rather than emphysema?

Answers: A – D

1. Destruction of alveolar walls
2. Increased airway inflammation and mucus production ✅
3. Hyperinflation of the lungs
4. Reduced elasticity of lung tissue

Question 10

A patient undergoes pulmonary function tests (PFTs) due to suspected restrictive lung disease. The PFT results demonstrate a decreased forced vital capacity (FVC) and a decreased total lung capacity (TLC). Which of the following patterns is consistent with a restrictive pulmonary disorder?

Answers: A – D

1. Decreased FVC with a normal TLC
2. Decreased FVC with a decreased residual volume (RV)
3. Decreased FVC with a decreased FEV1/FVC ratio
4. Decreased FVC with a normal or increased FEV1/FVC ratio ✅

Question 11

What is the primary pathophysiological process underlying pre-renal failure?

Answers: A – D

1. Obstruction of the urinary tract
2. Inflammation and infection of the renal tubules
3. Direct damage to the renal parenchyma
4. Inadequate blood flow to the kidneys ✅

Question 12

Untreated Stage 5 chronic kidney disease (CKD) will result in which of the following symptoms?

Answers: A – D

1. Anemia
2. Severe hypertension
3. All the choices are correct ✅
4. Hyperphosphatemia

Question 13

Among the following individuals, who is most at risk for developing benign prostatic hypertrophy (BPH)?

Answers: A – D

1. A 60-year-old male with a family history of BPH ✅
2. A 50-year-old male with hypertension
3. A 30-year-old male with a history of sexually transmitted infections
4. A 45-year-old male who consumes a diet high in monounsaturated fatty acids

Question 14

A patient with a history of alcohol abuse presents with weakness, fatigue, and difficulty concentrating. Laboratory tests show an elevated mean corpuscular volume (MCV) and low vitamin B-12 levels. What type of anemia is likely present?

Answers: A – D

1. Macrocytic anemia ✅
2. Microcytic anemia
3. Hemolytic anemia
4. Normocytic anemia

Question 15

A 28-year-old female presents with dysuria, urgency, and increased frequency of urination. On physical examination, suprapubic tenderness is noted. The patient reports no fever, flank pain, or costovertebral angle tenderness. Based on these findings, what is the most likely cause of the patient’s symptoms?

Answers: A – D

1. Cystitis ✅
2. Renal calculi
3. Pyelonephritis
4. Urethral stricture

Question 16

During inhalation, which of the following changes occurs in the thoracic cavity that facilitates air entry into the lungs?

Answers: A – D

1. Contraction of the diaphragm and an increase in its dome shape ✅
2. Relaxation of the intercostal muscles and a decrease in ribcage expansion
3. Expansion of the alveoli and an increase in surface tension
4. Contraction of the trachea and a decrease in its diameter

Question 17

Which of the following symptoms are seen in Stage 1 chronic kidney disease?

Answers: A – D

1. Usually no symptoms are seen at this stage ✅
2. Mild hypertension
3. Hyperphosphatemia
4. Anemia

Question 18

What does the term azotemia denote in the context of kidney function?

Answers: A – D

1. Impaired glucose metabolism
2. Excessive sodium retention
3. Insufficient production of red blood cells
4. Elevated levels of nitrogen-containing compounds in the blood ✅

Question 19

What are the primary effector cells involved in a Type 1 hypersensitivity reaction?

Answers: A – D

1. Eosinophils
2. T-cells
3. Neutrophils
4. Mast cells ✅

Question 20

What are the common impacts of chronic kidney disease (CKD) on the cardiovascular system?

Answers: A – D

1. Left ventricular hypertrophy and ischemia ✅
2. Increased risk of hypertension and hyperthyroidism
3. Enhanced cardiac contractility and reduced vascular resistance
4. Decreased incidence of atherosclerosis and heart failure

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