NR507 Week 8 Final Exam
Question 1
A 68-year-old man with a history of hypertension presents with progressive dyspnea, orthopnea,
and bilateral lower extremity edema. Echocardiography reveals an ejection fraction of 30%. Which
pathophysiologic mechanism most directly contributes to his symptoms?
A. Decreased activation of the renin-angiotensin-aldosterone system (RAAS)
B. Increased cardiac output leading to pulmonary vasodilation
C. Neurohormonal activation causing sodium and water retention
D. Reduced sympathetic nervous system activity
Correct Answer: C
,A patient with uncontrolled diabetes mellitus develops chronic kidney disease. Laboratory studies
reveal elevated serum creatinine and proteinuria. Which mechanism is primarily responsible for
diabetic nephropathy?
A. Immune complex deposition within Bowman's capsule
B. Thickening of the glomerular basement membrane due to chronic hyperglycemia
C. Acute tubular necrosis caused by ischemia
D. Renal artery vasospasm leading to nephron loss
Correct Answer: B
,A 34-year-old woman reports weight loss, heat intolerance, palpitations, and anxiety. Physical
examination reveals a diffuse goiter and exophthalmos. Which laboratory finding is most consistent
with the diagnosis?
A. Elevated TSH with low free T4
B. Low TSH with elevated free T4
C. Elevated TRH with elevated TSH
D. Low T3 with elevated reverse T3
Correct Answer: B
, A patient with severe emphysema has destruction of alveolar walls. Which physiologic change is
expected?
A. Increased elastic recoil of the lungs
B. Decreased lung compliance
C. Increased residual volume due to air trapping
D. Reduced total lung capacity
Correct Answer: C
Question 1
A 68-year-old man with a history of hypertension presents with progressive dyspnea, orthopnea,
and bilateral lower extremity edema. Echocardiography reveals an ejection fraction of 30%. Which
pathophysiologic mechanism most directly contributes to his symptoms?
A. Decreased activation of the renin-angiotensin-aldosterone system (RAAS)
B. Increased cardiac output leading to pulmonary vasodilation
C. Neurohormonal activation causing sodium and water retention
D. Reduced sympathetic nervous system activity
Correct Answer: C
,A patient with uncontrolled diabetes mellitus develops chronic kidney disease. Laboratory studies
reveal elevated serum creatinine and proteinuria. Which mechanism is primarily responsible for
diabetic nephropathy?
A. Immune complex deposition within Bowman's capsule
B. Thickening of the glomerular basement membrane due to chronic hyperglycemia
C. Acute tubular necrosis caused by ischemia
D. Renal artery vasospasm leading to nephron loss
Correct Answer: B
,A 34-year-old woman reports weight loss, heat intolerance, palpitations, and anxiety. Physical
examination reveals a diffuse goiter and exophthalmos. Which laboratory finding is most consistent
with the diagnosis?
A. Elevated TSH with low free T4
B. Low TSH with elevated free T4
C. Elevated TRH with elevated TSH
D. Low T3 with elevated reverse T3
Correct Answer: B
, A patient with severe emphysema has destruction of alveolar walls. Which physiologic change is
expected?
A. Increased elastic recoil of the lungs
B. Decreased lung compliance
C. Increased residual volume due to air trapping
D. Reduced total lung capacity
Correct Answer: C
