NRS 455 Exam 2 V2 | NRS 455 Pathophysiology |
Actual Q&A with Rationale (NRS455 Exam 2) |
Grand Canyon University
1. A 45-year-old patient presents with polyuria, polydipsia, and unexplained weight loss. The
laboratory results show a fasting blood glucose of 250 mg/dL and the presence of
autoantibodies against glutamic acid decarboxylase (GAD). Which pathophysiological process
is most likely occurring?
A. Insulin resistance in peripheral tissues
B. Decreased glucose uptake by the GLUT-4 transporters
C. Autoimmune destruction of pancreatic beta cells
D. Excessive glucagon secretion by alpha cells
Correct Answer: C
Explanation: The presence of autoantibodies against GAD strongly indicates Type 1
Diabetes Mellitus. In this condition, the immune system targets and destroys the beta cells
in the Islets of Langerhans within the pancreas. This lead to an absolute insulin deficiency,
resulting in the classic symptoms of hyperglycemia and weight loss.
2. Which of the following findings are characteristic of a patient diagnosed with Grave’s
disease? (Select All That Apply)
A. Exophthalmos
B. Weight gain
,C. Heat intolerance
D. Bradycardia
E. Goiter
F. Pretibial myxedema
Correct Answer: A, C, E, F
Explanation: Grave’s disease is an autoimmune disorder that results in hyperthyroidism
due to thyroid-stimulating immunoglobulins. Clinical manifestations include exophthalmos,
heat intolerance, goiter, and pretibial myxedema due to the hypermetabolic state. Weight
gain and bradycardia are typically associated with hypothyroidism, not hyperthyroidism.
3. A patient with chronic kidney disease (CKD) is found to have a low hemoglobin level. The
nurse understands that this anemia is primarily caused by:
A. Increased destruction of red blood cells in the spleen
B. Decreased production of erythropoietin by the kidneys
C. Blood loss through the glomerular filtration barrier
D. Iron deficiency due to poor dietary intake
Correct Answer: B
Explanation: The kidneys are responsible for producing erythropoietin (EPO), a hormone
that stimulates the bone marrow to produce red blood cells. In CKD, the damaged kidneys
fail to produce adequate EPO, leading to a normocytic, normochromic anemia. This
,condition is typically managed with exogenous erythropoiesis-stimulating agents to
maintain hemoglobin levels.
4. In a patient presenting with Acute Kidney Injury (AKI), which of the following scenarios
would be classified as a prerenal cause?
A. Acute tubular necrosis due to contrast dye
B. Benign prostatic hyperplasia causing obstruction
C. Glomerulonephritis following a streptococcal infection
D. Hypovolemia resulting from severe dehydration
Correct Answer: D
Explanation: Prerenal AKI is caused by factors that reduce renal blood flow and perfusion
without direct damage to the renal parenchyma. Severe dehydration leads to hypovolemia,
which decreases the glomerular filtration rate (GFR). Timely restoration of blood flow can
often reverse prerenal AKI before structural damage occurs.
5. A client is diagnosed with Cushing’s Syndrome. Which clinical manifestations should the
nurse expect to assess? (Select All That Apply)
A. Moon face
B. Hypotension
C. Truncal obesity
D. Thinning of the skin
, E. Hirsutism
Correct Answer: A, C, D, E
Explanation: Cushing’s syndrome is characterized by an excess of glucocorticoids,
particularly cortisol. Common clinical findings include a rounded ‘moon face’, central or
truncal obesity, thin skin with purple striae, and hirsutism. Hypotension is not expected;
instead, these patients often present with hypertension due to fluid retention and
mineralocorticoid effects.
6. Which statement best describes the pathophysiology of Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. A deficiency of ADH causing excessive water loss
B. Excessive secretion of ADH leading to water retention and hyponatremia
C. A lack of response by the renal tubules to ADH
D. Hypernatremia caused by excessive intake of free water
Correct Answer: B
Explanation: SIADH involves the hypersecretion of ADH, which causes the kidneys to
reabsorb excessive amounts of water regardless of serum osmolality. This leads to
dilutional hyponatremia and fluid volume overload without edema. Management typically
focuses on fluid restriction and identifying the underlying cause, such as a small cell lung
carcinoma.
Actual Q&A with Rationale (NRS455 Exam 2) |
Grand Canyon University
1. A 45-year-old patient presents with polyuria, polydipsia, and unexplained weight loss. The
laboratory results show a fasting blood glucose of 250 mg/dL and the presence of
autoantibodies against glutamic acid decarboxylase (GAD). Which pathophysiological process
is most likely occurring?
A. Insulin resistance in peripheral tissues
B. Decreased glucose uptake by the GLUT-4 transporters
C. Autoimmune destruction of pancreatic beta cells
D. Excessive glucagon secretion by alpha cells
Correct Answer: C
Explanation: The presence of autoantibodies against GAD strongly indicates Type 1
Diabetes Mellitus. In this condition, the immune system targets and destroys the beta cells
in the Islets of Langerhans within the pancreas. This lead to an absolute insulin deficiency,
resulting in the classic symptoms of hyperglycemia and weight loss.
2. Which of the following findings are characteristic of a patient diagnosed with Grave’s
disease? (Select All That Apply)
A. Exophthalmos
B. Weight gain
,C. Heat intolerance
D. Bradycardia
E. Goiter
F. Pretibial myxedema
Correct Answer: A, C, E, F
Explanation: Grave’s disease is an autoimmune disorder that results in hyperthyroidism
due to thyroid-stimulating immunoglobulins. Clinical manifestations include exophthalmos,
heat intolerance, goiter, and pretibial myxedema due to the hypermetabolic state. Weight
gain and bradycardia are typically associated with hypothyroidism, not hyperthyroidism.
3. A patient with chronic kidney disease (CKD) is found to have a low hemoglobin level. The
nurse understands that this anemia is primarily caused by:
A. Increased destruction of red blood cells in the spleen
B. Decreased production of erythropoietin by the kidneys
C. Blood loss through the glomerular filtration barrier
D. Iron deficiency due to poor dietary intake
Correct Answer: B
Explanation: The kidneys are responsible for producing erythropoietin (EPO), a hormone
that stimulates the bone marrow to produce red blood cells. In CKD, the damaged kidneys
fail to produce adequate EPO, leading to a normocytic, normochromic anemia. This
,condition is typically managed with exogenous erythropoiesis-stimulating agents to
maintain hemoglobin levels.
4. In a patient presenting with Acute Kidney Injury (AKI), which of the following scenarios
would be classified as a prerenal cause?
A. Acute tubular necrosis due to contrast dye
B. Benign prostatic hyperplasia causing obstruction
C. Glomerulonephritis following a streptococcal infection
D. Hypovolemia resulting from severe dehydration
Correct Answer: D
Explanation: Prerenal AKI is caused by factors that reduce renal blood flow and perfusion
without direct damage to the renal parenchyma. Severe dehydration leads to hypovolemia,
which decreases the glomerular filtration rate (GFR). Timely restoration of blood flow can
often reverse prerenal AKI before structural damage occurs.
5. A client is diagnosed with Cushing’s Syndrome. Which clinical manifestations should the
nurse expect to assess? (Select All That Apply)
A. Moon face
B. Hypotension
C. Truncal obesity
D. Thinning of the skin
, E. Hirsutism
Correct Answer: A, C, D, E
Explanation: Cushing’s syndrome is characterized by an excess of glucocorticoids,
particularly cortisol. Common clinical findings include a rounded ‘moon face’, central or
truncal obesity, thin skin with purple striae, and hirsutism. Hypotension is not expected;
instead, these patients often present with hypertension due to fluid retention and
mineralocorticoid effects.
6. Which statement best describes the pathophysiology of Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. A deficiency of ADH causing excessive water loss
B. Excessive secretion of ADH leading to water retention and hyponatremia
C. A lack of response by the renal tubules to ADH
D. Hypernatremia caused by excessive intake of free water
Correct Answer: B
Explanation: SIADH involves the hypersecretion of ADH, which causes the kidneys to
reabsorb excessive amounts of water regardless of serum osmolality. This leads to
dilutional hyponatremia and fluid volume overload without edema. Management typically
focuses on fluid restriction and identifying the underlying cause, such as a small cell lung
carcinoma.
