NUR 121 PATHO FINAL EXAM 1-4 TEST
BANK 200 QUESTIONS ANd 100% CORRECT
ANSwERS (2026 UPdATE) ALREAdY
GRAdEd A+
HOW TO USE THIS TEST BANK
This comprehensive test bank contains actual exam-style questions for the NUR 121
Pathophysiology Final Exam, covering Exams 1-4. Questions are organized by topic area with
verified correct answers and detailed rationales to help you understand the underlying
pathophysiological concepts. Content is current for the 2026 testing year.
SECTION 1: ENDOCRINE DISORDERS (Questions 1-45)
Q1. A patient has a free T4 level of 0.6 and a free T3 of 220. The patient asks the nurse what
these laboratory values mean. How will the nurse respond?
A) "We will need to obtain a TSH level to better evaluate your diagnosis."
B) "These results suggest you have hyperthyroidism."
C) "We will need to obtain a total T3 and total T4 to know for sure."
D) "These values indicate you may have Graves' disease."
Answer: A) "We will need to obtain a TSH level to better evaluate your diagnosis."
Rationale: A low free T4 (0.6) with an elevated free T3 (220) is an atypical pattern. TSH is the
most sensitive indicator of thyroid function and should be obtained to determine if the patient
is hyperthyroid (low TSH) or hypothyroid (high TSH). Total T3/T4 levels are less accurate than
free levels .
Q2. A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid). The
nurse learns the patient also takes warfarin (Coumadin). The nurse will notify the provider to
discuss what?
,A) Increasing the warfarin dose
B) Reducing the warfarin dose
C) Decreasing the levothyroxine dose
D) Increasing the levothyroxine dose
Answer: B) Reducing the warfarin dose
Rationale: Levothyroxine increases the metabolism of warfarin, reducing its anticoagulant
effect. When starting levothyroxine, the warfarin dose may need to be reduced to prevent
bleeding. Conversely, if levothyroxine is discontinued, the warfarin dose may need to be
increased .
Q3. A nurse is teaching a patient who will begin taking methimazole (Tapazole) for Graves'
disease. Which statement by the patient indicates understanding of the teaching?
A) "I must take it with food every morning to aid absorption."
B) "It is safe to get pregnant while taking this medication."
C) "Because of the risk for liver toxicity, I will need frequent liver function tests."
D) "I should report a sore throat or fever to my provider if either occurs."
Answer: D) "I should report a sore throat or fever to my provider if either occurs."
Rationale: Methimazole can cause agranulocytosis, a serious side effect characterized by a
sudden drop in white blood cells. Sore throat, fever, or signs of infection should be reported
immediately. Methimazole is NOT safe during pregnancy (can cause fetal harm), and liver
toxicity is less common than agranulocytosis .
Q4. A nurse obtaining an admission history on an adult patient notes the patient has a heart
rate of 62 bpm, blood pressure of 105/62, and temperature of 96.2°F. The patient appears
pale and complains of always feeling cold and tired. The nurse will contact the provider to
discuss testing for what condition?
A) Plummer's disease
B) Hypothyroidism
C) Cretinism
D) Graves' disease
Answer: B) Hypothyroidism
,Rationale: These findings—bradycardia, mild hypotension, low temperature, pallor, cold
intolerance, and fatigue—are classic signs of hypothyroidism. Graves' disease and Plummer's
disease cause hyperthyroidism with opposite findings. Cretinism is congenital hypothyroidism in
infants .
Q5. A nurse caring for a patient notes the patient has a temperature of 104°F, heart rate of
110 bpm, warm moist skin, and complains that the room is too warm. The patient appears
nervous and has protuberant eyes. The nurse will contact the provider to discuss:
A) Cretinism
B) Myxedema
C) Graves' disease
D) Plummer's disease
Answer: C) Graves' disease
Rationale: The classic presentation of Graves' disease includes hyperthyroidism symptoms:
fever, tachycardia, heat intolerance, diaphoresis, nervousness, and exophthalmos (protruding
eyes). Myxedema is severe hypothyroidism. Cretinism is congenital hypothyroidism .
Q6. Which mineral is needed for thyroid stimulating hormone (TSH) to stimulate the secretion
of thyroid hormone (TH)?
A) Zinc
B) Iodine
C) Copper
D) Iron
Answer: B) Iodine
Rationale: Iodine is essential for the synthesis of thyroid hormones (T3 and T4). TSH stimulates
the thyroid gland to take up iodine and incorporate it into thyroglobulin to form thyroid
hormones. Without adequate iodine, thyroid hormone production is impaired .
Q7. What effect does hyperphosphatemia have on other electrolytes?
A) Decreases serum magnesium
B) Increases serum calcium
, C) Increases serum magnesium
D) Decreases serum calcium
Answer: D) Decreases serum calcium
Rationale: Hyperphosphatemia causes calcium to precipitate with phosphate, forming calcium
phosphate deposits in tissues. This leads to decreased serum calcium levels (hypocalcemia). This
is often seen in chronic kidney disease .
Q8. Parathyroid hormone (PTH) has which of the following effects on the kidney?
A) Decreased calcium reabsorption
B) Increased phosphate reabsorption
C) Increased calcium reabsorption
D) Decreased phosphate excretion
Answer: C) Increased calcium reabsorption
Rationale: PTH increases calcium reabsorption in the distal convoluted tubule of the kidney. It
also decreases phosphate reabsorption (increasing phosphate excretion) and stimulates the
conversion of vitamin D to its active form (calcitriol) .
Q9. Graves' disease is characterized by:
A) Decreased metabolic rate
B) Autoimmune destruction of thyroid tissue
C) Thyroid-stimulating immunoglobulins (TSI) that stimulate the TSH receptor
D) Decreased T3 and T4 levels
Answer: C) Thyroid-stimulating immunoglobulins (TSI) that stimulate the TSH receptor
Rationale: Graves' disease is an autoimmune disorder where antibodies (TSI) bind to and
activate TSH receptors on thyroid cells, causing unregulated thyroid hormone production. TSI
levels are elevated. This results in hyperthyroidism with increased T3/T4 and suppressed TSH .
Q10. A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse
assesses the patient at the beginning of the shift and notes a heart rate of 62 bpm,
temperature of 92.7°F, and the patient is lethargic and difficult to arouse. The nurse will
contact the provider to request an order for which drug?
BANK 200 QUESTIONS ANd 100% CORRECT
ANSwERS (2026 UPdATE) ALREAdY
GRAdEd A+
HOW TO USE THIS TEST BANK
This comprehensive test bank contains actual exam-style questions for the NUR 121
Pathophysiology Final Exam, covering Exams 1-4. Questions are organized by topic area with
verified correct answers and detailed rationales to help you understand the underlying
pathophysiological concepts. Content is current for the 2026 testing year.
SECTION 1: ENDOCRINE DISORDERS (Questions 1-45)
Q1. A patient has a free T4 level of 0.6 and a free T3 of 220. The patient asks the nurse what
these laboratory values mean. How will the nurse respond?
A) "We will need to obtain a TSH level to better evaluate your diagnosis."
B) "These results suggest you have hyperthyroidism."
C) "We will need to obtain a total T3 and total T4 to know for sure."
D) "These values indicate you may have Graves' disease."
Answer: A) "We will need to obtain a TSH level to better evaluate your diagnosis."
Rationale: A low free T4 (0.6) with an elevated free T3 (220) is an atypical pattern. TSH is the
most sensitive indicator of thyroid function and should be obtained to determine if the patient
is hyperthyroid (low TSH) or hypothyroid (high TSH). Total T3/T4 levels are less accurate than
free levels .
Q2. A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid). The
nurse learns the patient also takes warfarin (Coumadin). The nurse will notify the provider to
discuss what?
,A) Increasing the warfarin dose
B) Reducing the warfarin dose
C) Decreasing the levothyroxine dose
D) Increasing the levothyroxine dose
Answer: B) Reducing the warfarin dose
Rationale: Levothyroxine increases the metabolism of warfarin, reducing its anticoagulant
effect. When starting levothyroxine, the warfarin dose may need to be reduced to prevent
bleeding. Conversely, if levothyroxine is discontinued, the warfarin dose may need to be
increased .
Q3. A nurse is teaching a patient who will begin taking methimazole (Tapazole) for Graves'
disease. Which statement by the patient indicates understanding of the teaching?
A) "I must take it with food every morning to aid absorption."
B) "It is safe to get pregnant while taking this medication."
C) "Because of the risk for liver toxicity, I will need frequent liver function tests."
D) "I should report a sore throat or fever to my provider if either occurs."
Answer: D) "I should report a sore throat or fever to my provider if either occurs."
Rationale: Methimazole can cause agranulocytosis, a serious side effect characterized by a
sudden drop in white blood cells. Sore throat, fever, or signs of infection should be reported
immediately. Methimazole is NOT safe during pregnancy (can cause fetal harm), and liver
toxicity is less common than agranulocytosis .
Q4. A nurse obtaining an admission history on an adult patient notes the patient has a heart
rate of 62 bpm, blood pressure of 105/62, and temperature of 96.2°F. The patient appears
pale and complains of always feeling cold and tired. The nurse will contact the provider to
discuss testing for what condition?
A) Plummer's disease
B) Hypothyroidism
C) Cretinism
D) Graves' disease
Answer: B) Hypothyroidism
,Rationale: These findings—bradycardia, mild hypotension, low temperature, pallor, cold
intolerance, and fatigue—are classic signs of hypothyroidism. Graves' disease and Plummer's
disease cause hyperthyroidism with opposite findings. Cretinism is congenital hypothyroidism in
infants .
Q5. A nurse caring for a patient notes the patient has a temperature of 104°F, heart rate of
110 bpm, warm moist skin, and complains that the room is too warm. The patient appears
nervous and has protuberant eyes. The nurse will contact the provider to discuss:
A) Cretinism
B) Myxedema
C) Graves' disease
D) Plummer's disease
Answer: C) Graves' disease
Rationale: The classic presentation of Graves' disease includes hyperthyroidism symptoms:
fever, tachycardia, heat intolerance, diaphoresis, nervousness, and exophthalmos (protruding
eyes). Myxedema is severe hypothyroidism. Cretinism is congenital hypothyroidism .
Q6. Which mineral is needed for thyroid stimulating hormone (TSH) to stimulate the secretion
of thyroid hormone (TH)?
A) Zinc
B) Iodine
C) Copper
D) Iron
Answer: B) Iodine
Rationale: Iodine is essential for the synthesis of thyroid hormones (T3 and T4). TSH stimulates
the thyroid gland to take up iodine and incorporate it into thyroglobulin to form thyroid
hormones. Without adequate iodine, thyroid hormone production is impaired .
Q7. What effect does hyperphosphatemia have on other electrolytes?
A) Decreases serum magnesium
B) Increases serum calcium
, C) Increases serum magnesium
D) Decreases serum calcium
Answer: D) Decreases serum calcium
Rationale: Hyperphosphatemia causes calcium to precipitate with phosphate, forming calcium
phosphate deposits in tissues. This leads to decreased serum calcium levels (hypocalcemia). This
is often seen in chronic kidney disease .
Q8. Parathyroid hormone (PTH) has which of the following effects on the kidney?
A) Decreased calcium reabsorption
B) Increased phosphate reabsorption
C) Increased calcium reabsorption
D) Decreased phosphate excretion
Answer: C) Increased calcium reabsorption
Rationale: PTH increases calcium reabsorption in the distal convoluted tubule of the kidney. It
also decreases phosphate reabsorption (increasing phosphate excretion) and stimulates the
conversion of vitamin D to its active form (calcitriol) .
Q9. Graves' disease is characterized by:
A) Decreased metabolic rate
B) Autoimmune destruction of thyroid tissue
C) Thyroid-stimulating immunoglobulins (TSI) that stimulate the TSH receptor
D) Decreased T3 and T4 levels
Answer: C) Thyroid-stimulating immunoglobulins (TSI) that stimulate the TSH receptor
Rationale: Graves' disease is an autoimmune disorder where antibodies (TSI) bind to and
activate TSH receptors on thyroid cells, causing unregulated thyroid hormone production. TSI
levels are elevated. This results in hyperthyroidism with increased T3/T4 and suppressed TSH .
Q10. A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse
assesses the patient at the beginning of the shift and notes a heart rate of 62 bpm,
temperature of 92.7°F, and the patient is lethargic and difficult to arouse. The nurse will
contact the provider to request an order for which drug?
