NRS 455 Final Exam V1 | NRS 455
Pathophysiology | Actual Q&A with
Rationale (NRS455 Final Exam) | Grand
Canyon University
1. A patient is diagnosed with secondary hypertension. Which of the following conditions is a
common underlying cause of this specific form of hypertension?
A. Renal artery stenosis
B. High sodium intake
C. Genetic predisposition
D. Sedentary lifestyle
Correct Answer: A
Rationale: Renal artery stenosis leads to decreased renal perfusion, which activates the
Renin-Angiotensin-Aldosterone System (RAAS), resulting in systemic hypertension. Unlike
primary hypertension, which has no single identifiable cause, secondary hypertension is
directly attributable to an underlying disease process. Identifying and treating the root
cause, such as correcting the stenosis, can often resolve the elevated blood pressure.
2. A clinician is evaluating a patient for clinical manifestations of systemic inflammation.
Which of the following findings would the nurse expect to observe? (Select All That Apply)
A. Fever
,B. Leukocytosis
C. Localized erythema
D. Increased acute-phase reactants (e.g., CRP)
E. Anorexia and lethargy
F. Bradycardia
Correct Answer: A, B, D, E
Rationale: Systemic inflammation involves whole-body responses such as fever induced
by pyrogens and leukocytosis where the white blood cell count increases significantly.
Acute-phase reactants like C-reactive protein (CRP) are synthesized by the liver in
response to cytokines released during the inflammatory process. Localized erythema is a
sign of local inflammation rather than systemic, and tachycardia, not bradycardia, is
typically seen.
3. In the pathophysiology of Type 1 Diabetes Mellitus, what is the primary mechanism leading
to hyperglycemia?
A. Insulin resistance in peripheral tissues
B. Excessive glucagon secretion from alpha cells
C. Autoimmune destruction of pancreatic beta cells
D. Increased glucose absorption in the small intestine
Correct Answer: C
,Rationale: Type 1 Diabetes Mellitus is characterized by an absolute insulin deficiency due
to the T-cell mediated destruction of insulin-producing beta cells in the Islets of
Langerhans. Without insulin, glucose cannot enter cells for energy, leading to high levels of
circulating blood glucose. This differs from Type 2 diabetes, where the primary issues are
insulin resistance and relative insulin deficiency.
4. Which of the following electrolyte imbalances is most closely associated with the
development of flattened T waves and the presence of U waves on an EKG?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Correct Answer: B
Rationale: Hypokalemia affects the repolarization phase of the cardiac action potential,
often manifesting as flattened or inverted T waves and the emergence of U waves. In
contrast, hyperkalemia is classically associated with peaked T waves and a widened QRS
complex. Correcting potassium levels is critical to prevent lethal cardiac dysrhythmias and
maintain myocardial stability.
5. A patient presents with signs of Left-Sided Heart Failure. Which clinical manifestation is a
direct result of pulmonary congestion?
A. Peripheral edema
, B. Orthopnea
C. Jugular venous distension (JVD)
D. Hepatosplenomegaly
Correct Answer: B
Rationale: Orthopnea, or difficulty breathing while lying flat, occurs because the failing left
ventricle cannot effectively pump blood into systemic circulation, causing blood to back up
into the pulmonary veins and capillaries. This increased hydrostatic pressure leads to
pulmonary edema, which impairs gas exchange and causes respiratory distress. Peripheral
edema and JVD are more characteristic of right-sided heart failure where blood backs up
into the systemic venous system.
6. What is the primary physiological compensatory mechanism triggered by the body in
response to a state of metabolic acidosis?
A. Renal excretion of bicarbonate
B. Hypoventilation to retain CO2
C. Increased intestinal absorption of H+ ions
D. Hyperventilation to blow off CO2
Correct Answer: D
Rationale: When the body experiences metabolic acidosis, the respiratory system
compensates by increasing the rate and depth of respirations, known as Kussmaul
Pathophysiology | Actual Q&A with
Rationale (NRS455 Final Exam) | Grand
Canyon University
1. A patient is diagnosed with secondary hypertension. Which of the following conditions is a
common underlying cause of this specific form of hypertension?
A. Renal artery stenosis
B. High sodium intake
C. Genetic predisposition
D. Sedentary lifestyle
Correct Answer: A
Rationale: Renal artery stenosis leads to decreased renal perfusion, which activates the
Renin-Angiotensin-Aldosterone System (RAAS), resulting in systemic hypertension. Unlike
primary hypertension, which has no single identifiable cause, secondary hypertension is
directly attributable to an underlying disease process. Identifying and treating the root
cause, such as correcting the stenosis, can often resolve the elevated blood pressure.
2. A clinician is evaluating a patient for clinical manifestations of systemic inflammation.
Which of the following findings would the nurse expect to observe? (Select All That Apply)
A. Fever
,B. Leukocytosis
C. Localized erythema
D. Increased acute-phase reactants (e.g., CRP)
E. Anorexia and lethargy
F. Bradycardia
Correct Answer: A, B, D, E
Rationale: Systemic inflammation involves whole-body responses such as fever induced
by pyrogens and leukocytosis where the white blood cell count increases significantly.
Acute-phase reactants like C-reactive protein (CRP) are synthesized by the liver in
response to cytokines released during the inflammatory process. Localized erythema is a
sign of local inflammation rather than systemic, and tachycardia, not bradycardia, is
typically seen.
3. In the pathophysiology of Type 1 Diabetes Mellitus, what is the primary mechanism leading
to hyperglycemia?
A. Insulin resistance in peripheral tissues
B. Excessive glucagon secretion from alpha cells
C. Autoimmune destruction of pancreatic beta cells
D. Increased glucose absorption in the small intestine
Correct Answer: C
,Rationale: Type 1 Diabetes Mellitus is characterized by an absolute insulin deficiency due
to the T-cell mediated destruction of insulin-producing beta cells in the Islets of
Langerhans. Without insulin, glucose cannot enter cells for energy, leading to high levels of
circulating blood glucose. This differs from Type 2 diabetes, where the primary issues are
insulin resistance and relative insulin deficiency.
4. Which of the following electrolyte imbalances is most closely associated with the
development of flattened T waves and the presence of U waves on an EKG?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Correct Answer: B
Rationale: Hypokalemia affects the repolarization phase of the cardiac action potential,
often manifesting as flattened or inverted T waves and the emergence of U waves. In
contrast, hyperkalemia is classically associated with peaked T waves and a widened QRS
complex. Correcting potassium levels is critical to prevent lethal cardiac dysrhythmias and
maintain myocardial stability.
5. A patient presents with signs of Left-Sided Heart Failure. Which clinical manifestation is a
direct result of pulmonary congestion?
A. Peripheral edema
, B. Orthopnea
C. Jugular venous distension (JVD)
D. Hepatosplenomegaly
Correct Answer: B
Rationale: Orthopnea, or difficulty breathing while lying flat, occurs because the failing left
ventricle cannot effectively pump blood into systemic circulation, causing blood to back up
into the pulmonary veins and capillaries. This increased hydrostatic pressure leads to
pulmonary edema, which impairs gas exchange and causes respiratory distress. Peripheral
edema and JVD are more characteristic of right-sided heart failure where blood backs up
into the systemic venous system.
6. What is the primary physiological compensatory mechanism triggered by the body in
response to a state of metabolic acidosis?
A. Renal excretion of bicarbonate
B. Hypoventilation to retain CO2
C. Increased intestinal absorption of H+ ions
D. Hyperventilation to blow off CO2
Correct Answer: D
Rationale: When the body experiences metabolic acidosis, the respiratory system
compensates by increasing the rate and depth of respirations, known as Kussmaul
