U N I V E R S I T Y O F A L A B A M A AT B I R M I N G H A M · S C H O O L O F N U R S I N G
NUR 612 Exam 3
Practice Question Bank
Advanced Pathophysiology — NCLEX-Style Practice Questions with
Rationales
Topic Focus: Gastroenterology, Endocrinology, Nephrology, Nutrition &
Geriatric Syndromes
Edition 1 · September 2026
Table of Contents
1. Instructions for Use 2
2. Practice Questions with Answers & Rationales — Advanced Pathophysiology Module 3 2
NUR 612 · UAB School of Nursing Page 1
,NUR 612 EXAM 3 PRACTICE GUIDE INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is.
Category: Advanced Pathophysiology — Module 3: Gastroenterology,
Endocrinology, Nephrology, Nutrition
1 Mrs. Borden is 67 years old and her primary care physician wants her to be seen by a
nurse practitioner who specializes in geriatric issues. On completing the interview
and examination, the nurse practitioner tells Mrs. Borden that she will order a blood
laboratory specimen for thyroid function and pancreatic function. Mrs. Borden asks
what the reason is. Which of the following is the nurse practitioner's best response?
A "Diabetes is more common in older patients."
B "Thyroid issues are less common in older patients."
C "These are common tests to be done on any new patient."
D "These tests are necessary to obtain baseline information."
Why D is correct: Obtaining baseline laboratory values for thyroid and pancreatic function
provides essential information for future comparison and early detection of endocrine
disorders in older adults.
A — While diabetes is more common in older adults, this is not the primary reason for
obtaining baseline labs.
B — Thyroid issues are actually more common in older adults.
C — These are not routine tests for all new patients; they are targeted based on age-related
risks.
,2 Mr. Jones is 70 years old and sees the nurse practitioner for a yearly checkup. He
states that he needs to urinate a lot and seems to always be thirsty. He also finds
himself gaining some weight. In the process of the examination, the nurse
practitioner detects that he is vague in his answers. Which of the following may be
the reason?
A Mr. Jones is cold and bundled in a sweater.
B There is no family history of diabetes.
C The symptoms seem to have appeared slowly.
D He does not want to admit to eating too much.
Why C is correct: In older adults, endocrine disorder symptoms often appear slowly and
are vague. Slow-onset symptoms may lead to vague answers during assessment as the
patient may not clearly recognize the progression of symptoms.
A — Being cold is not the reason for vague answers.
B — Family history is not the reason for vagueness.
D — There is no indication of denial about eating.
3 Ms. Allen, 72 years old, is being evaluated by the nurse practitioner for type 2
diabetes. Because symptoms of endocrine disorders in older adults are vague, which
of the following questions is best to ask?
A "Do you have any trouble carrying out your daily activities?"
B "Can you tell me what you ate yesterday?"
C "Have you seen a dentist in the last year?"
D "Have you noticed that you have less hair?"
Why A is correct: Functional decline (trouble carrying out daily activities) is a key indicator
of undiagnosed endocrine disorders in older adults. This question helps assess the impact
of vague symptoms on daily functioning.
B — Dietary recall is important but does not assess functional decline.
C — Dental history is not directly related to endocrine assessment.
D — Hair loss is not a primary indicator of diabetes.
, 4 Mrs. Smith, 80 years old, has been vomiting and having bouts of loose stools for
several days. She is taking several medications that are prescribed. The nurse
practitioner conducts a medication review because:
A An accounting of all prescribed and over-the-counter (OTC) medications may
uncover reasons for her symptoms.
B There could be drug-drug interactions leading to her symptoms.
C Side effects of the gastrointestinal tract are not seen in many medications.
D The administration of some of her medications may be appropriate.
Why B is correct: Older adults often take multiple medications, increasing the risk of drug-
drug interactions that can cause gastrointestinal symptoms such as vomiting and diarrhea.
A — While medication review is important, the primary concern is drug-drug interactions.
C — GI side effects are common with many medications.
D — Medication appropriateness is part of the review but not the primary reason.
5 Mr. Jameson, 75 years old, comes to the clinic with complaints of severe sharp
epigastric pain that radiates to his back. He has been nauseous and has vomited
three times today. The nurse practitioner suspects which of the following?
A Appendicitis
B Gastrointestinal influenza
C Acute pancreatitis
D Insulin shock
Why C is correct: Severe sharp epigastric pain that radiates to the back, accompanied by
nausea and vomiting, is classic presentation of acute pancreatitis.
A — Appendicitis typically presents with right lower quadrant pain.
B — GI influenza presents with diffuse symptoms, not severe epigastric pain radiating to the
back.
D — Insulin shock would present with hypoglycemic symptoms, not epigastric pain.
NUR 612 Exam 3
Practice Question Bank
Advanced Pathophysiology — NCLEX-Style Practice Questions with
Rationales
Topic Focus: Gastroenterology, Endocrinology, Nephrology, Nutrition &
Geriatric Syndromes
Edition 1 · September 2026
Table of Contents
1. Instructions for Use 2
2. Practice Questions with Answers & Rationales — Advanced Pathophysiology Module 3 2
NUR 612 · UAB School of Nursing Page 1
,NUR 612 EXAM 3 PRACTICE GUIDE INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is.
Category: Advanced Pathophysiology — Module 3: Gastroenterology,
Endocrinology, Nephrology, Nutrition
1 Mrs. Borden is 67 years old and her primary care physician wants her to be seen by a
nurse practitioner who specializes in geriatric issues. On completing the interview
and examination, the nurse practitioner tells Mrs. Borden that she will order a blood
laboratory specimen for thyroid function and pancreatic function. Mrs. Borden asks
what the reason is. Which of the following is the nurse practitioner's best response?
A "Diabetes is more common in older patients."
B "Thyroid issues are less common in older patients."
C "These are common tests to be done on any new patient."
D "These tests are necessary to obtain baseline information."
Why D is correct: Obtaining baseline laboratory values for thyroid and pancreatic function
provides essential information for future comparison and early detection of endocrine
disorders in older adults.
A — While diabetes is more common in older adults, this is not the primary reason for
obtaining baseline labs.
B — Thyroid issues are actually more common in older adults.
C — These are not routine tests for all new patients; they are targeted based on age-related
risks.
,2 Mr. Jones is 70 years old and sees the nurse practitioner for a yearly checkup. He
states that he needs to urinate a lot and seems to always be thirsty. He also finds
himself gaining some weight. In the process of the examination, the nurse
practitioner detects that he is vague in his answers. Which of the following may be
the reason?
A Mr. Jones is cold and bundled in a sweater.
B There is no family history of diabetes.
C The symptoms seem to have appeared slowly.
D He does not want to admit to eating too much.
Why C is correct: In older adults, endocrine disorder symptoms often appear slowly and
are vague. Slow-onset symptoms may lead to vague answers during assessment as the
patient may not clearly recognize the progression of symptoms.
A — Being cold is not the reason for vague answers.
B — Family history is not the reason for vagueness.
D — There is no indication of denial about eating.
3 Ms. Allen, 72 years old, is being evaluated by the nurse practitioner for type 2
diabetes. Because symptoms of endocrine disorders in older adults are vague, which
of the following questions is best to ask?
A "Do you have any trouble carrying out your daily activities?"
B "Can you tell me what you ate yesterday?"
C "Have you seen a dentist in the last year?"
D "Have you noticed that you have less hair?"
Why A is correct: Functional decline (trouble carrying out daily activities) is a key indicator
of undiagnosed endocrine disorders in older adults. This question helps assess the impact
of vague symptoms on daily functioning.
B — Dietary recall is important but does not assess functional decline.
C — Dental history is not directly related to endocrine assessment.
D — Hair loss is not a primary indicator of diabetes.
, 4 Mrs. Smith, 80 years old, has been vomiting and having bouts of loose stools for
several days. She is taking several medications that are prescribed. The nurse
practitioner conducts a medication review because:
A An accounting of all prescribed and over-the-counter (OTC) medications may
uncover reasons for her symptoms.
B There could be drug-drug interactions leading to her symptoms.
C Side effects of the gastrointestinal tract are not seen in many medications.
D The administration of some of her medications may be appropriate.
Why B is correct: Older adults often take multiple medications, increasing the risk of drug-
drug interactions that can cause gastrointestinal symptoms such as vomiting and diarrhea.
A — While medication review is important, the primary concern is drug-drug interactions.
C — GI side effects are common with many medications.
D — Medication appropriateness is part of the review but not the primary reason.
5 Mr. Jameson, 75 years old, comes to the clinic with complaints of severe sharp
epigastric pain that radiates to his back. He has been nauseous and has vomited
three times today. The nurse practitioner suspects which of the following?
A Appendicitis
B Gastrointestinal influenza
C Acute pancreatitis
D Insulin shock
Why C is correct: Severe sharp epigastric pain that radiates to the back, accompanied by
nausea and vomiting, is classic presentation of acute pancreatitis.
A — Appendicitis typically presents with right lower quadrant pain.
B — GI influenza presents with diffuse symptoms, not severe epigastric pain radiating to the
back.
D — Insulin shock would present with hypoglycemic symptoms, not epigastric pain.
