NRS 455 Exam 2 V3 | NRS 455 Pathophysiology |
Actual Q&A with Rationale (NRS455 Exam 2) |
Grand Canyon University
1. A patient is admitted with a diagnosis of Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which of the following findings would the nurse expect to observe? (Select All That
Apply)
A. Serum sodium 120 mEq/L
B. Urine specific gravity 1.035
C. Polyuria and polydipsia
D. Bounding pulse and hypertension
E. Serum osmolality 260 mOsm/kg
F. Decreased skin turgor and dry mucous membranes
Correct Answer: A, B, D, E
Explanation: SIADH results in the excessive release of ADH, causing significant water
retention and dilutional hyponatremia. The serum sodium level of 120 mEq/L and low
serum osmolality reflect this dilution. Urine specific gravity is elevated because the urine is
highly concentrated, and the fluid volume excess typically manifests as bounding pulses
and hypertension. Unlike Diabetes Insipidus, SIADH does not present with polyuria or signs
of dehydration like dry mucous membranes; rather, it involves water intoxication and
weight gain without edema typically seen in heart failure. The primary pathophysiology
,involves the inability to excrete diluted urine, leading to fluid shifts that can cause cerebral
edema.
2. A patient with chronic kidney disease (CKD) presents with a hemoglobin of 8.2 g/dL. What
is the primary pathophysiological mechanism causing this condition?
A. Chronic blood loss during hemodialysis sessions
B. Folic acid and Vitamin B12 deficiency due to dietary restrictions
C. Insufficient production of erythropoietin by the kidneys
D. Increased destruction of red blood cells by uremic toxins
Correct Answer: C
Explanation: In patients with CKD, the kidneys are unable to produce adequate amounts of
erythropoietin, the hormone responsible for stimulating red blood cell production in the
bone marrow. This deficiency is the hallmark cause of anemia in renal failure patients.
While uremic toxins can shorten the lifespan of existing RBCs, the fundamental problem is
the lack of production. Therefore, synthetic erythropoietin (Epogen) is commonly
administered to manage this condition.
3. A nurse is reviewing the lab results of a patient in the oliguric phase of Acute Kidney Injury
(AKI). Which findings are consistent with this diagnosis?
A. Urine output greater than 400 mL/day
B. Hypokalemia and respiratory alkalosis
C. Low BUN and creatinine levels
,D. Hyperkalemia and metabolic acidosis
Correct Answer: D
Explanation: During the oliguric phase of AKI, the kidneys fail to excrete potassium and
hydrogen ions, leading to hyperkalemia and metabolic acidosis. The inability to filter
metabolic waste results in elevated blood urea nitrogen (BUN) and creatinine levels. The
urine output in this phase is strictly defined as less than 400 mL per day. Monitoring for
cardiac arrhythmias is critical because the rising potassium levels can interfere with
myocardial conduction.
4. Which of the following hormones is responsible for increasing blood calcium levels by
stimulating bone resorption?
A. Calcitonin
B. Parathyroid Hormone (PTH)
C. Aldosterone
D. Cortisol
Correct Answer: B
Explanation: Parathyroid Hormone (PTH) is secreted by the parathyroid glands in
response to low serum calcium levels. It acts by stimulating osteoclasts to break down bone
matrix, which releases calcium into the bloodstream. Calcitonin, on the other hand, works
to lower calcium levels by inhibiting osteoclasts. This delicate balance is essential for
maintaining neuromuscular stability and skeletal integrity.
, 5. A patient is experiencing an acute exacerbation of Crohn’s disease. Which of the following
clinical manifestations are characteristic of this disorder? (Select All That Apply)
A. Transmural inflammation
B. Skip lesions throughout the GI tract
C. Bloody stools with mucus (hematochezia)
D. Cobblestone appearance of the mucosa
E. Fistula and abscess formation
Correct Answer: A, B, D, E
Explanation: Crohn’s disease is characterized by transmural inflammation, meaning it
affects all layers of the intestinal wall. It typically presents with ‘skip lesions’ where healthy
tissue is interspersed with diseased tissue, creating a cobblestone appearance. Because it
affects the full thickness of the wall, fistulas and abscesses are common complications. In
contrast, bloody stools are more frequently associated with Ulcerative Colitis, which is
confined to the mucosal layer of the colon.
6. A patient presents with tremors, exophthalmos, and heat intolerance. Which laboratory
finding would support a diagnosis of Graves’ disease?
A. Elevated TSH and low T3/T4
B. Low TSH and elevated T3/T4
C. Elevated TSH and elevated T3/T4
Actual Q&A with Rationale (NRS455 Exam 2) |
Grand Canyon University
1. A patient is admitted with a diagnosis of Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which of the following findings would the nurse expect to observe? (Select All That
Apply)
A. Serum sodium 120 mEq/L
B. Urine specific gravity 1.035
C. Polyuria and polydipsia
D. Bounding pulse and hypertension
E. Serum osmolality 260 mOsm/kg
F. Decreased skin turgor and dry mucous membranes
Correct Answer: A, B, D, E
Explanation: SIADH results in the excessive release of ADH, causing significant water
retention and dilutional hyponatremia. The serum sodium level of 120 mEq/L and low
serum osmolality reflect this dilution. Urine specific gravity is elevated because the urine is
highly concentrated, and the fluid volume excess typically manifests as bounding pulses
and hypertension. Unlike Diabetes Insipidus, SIADH does not present with polyuria or signs
of dehydration like dry mucous membranes; rather, it involves water intoxication and
weight gain without edema typically seen in heart failure. The primary pathophysiology
,involves the inability to excrete diluted urine, leading to fluid shifts that can cause cerebral
edema.
2. A patient with chronic kidney disease (CKD) presents with a hemoglobin of 8.2 g/dL. What
is the primary pathophysiological mechanism causing this condition?
A. Chronic blood loss during hemodialysis sessions
B. Folic acid and Vitamin B12 deficiency due to dietary restrictions
C. Insufficient production of erythropoietin by the kidneys
D. Increased destruction of red blood cells by uremic toxins
Correct Answer: C
Explanation: In patients with CKD, the kidneys are unable to produce adequate amounts of
erythropoietin, the hormone responsible for stimulating red blood cell production in the
bone marrow. This deficiency is the hallmark cause of anemia in renal failure patients.
While uremic toxins can shorten the lifespan of existing RBCs, the fundamental problem is
the lack of production. Therefore, synthetic erythropoietin (Epogen) is commonly
administered to manage this condition.
3. A nurse is reviewing the lab results of a patient in the oliguric phase of Acute Kidney Injury
(AKI). Which findings are consistent with this diagnosis?
A. Urine output greater than 400 mL/day
B. Hypokalemia and respiratory alkalosis
C. Low BUN and creatinine levels
,D. Hyperkalemia and metabolic acidosis
Correct Answer: D
Explanation: During the oliguric phase of AKI, the kidneys fail to excrete potassium and
hydrogen ions, leading to hyperkalemia and metabolic acidosis. The inability to filter
metabolic waste results in elevated blood urea nitrogen (BUN) and creatinine levels. The
urine output in this phase is strictly defined as less than 400 mL per day. Monitoring for
cardiac arrhythmias is critical because the rising potassium levels can interfere with
myocardial conduction.
4. Which of the following hormones is responsible for increasing blood calcium levels by
stimulating bone resorption?
A. Calcitonin
B. Parathyroid Hormone (PTH)
C. Aldosterone
D. Cortisol
Correct Answer: B
Explanation: Parathyroid Hormone (PTH) is secreted by the parathyroid glands in
response to low serum calcium levels. It acts by stimulating osteoclasts to break down bone
matrix, which releases calcium into the bloodstream. Calcitonin, on the other hand, works
to lower calcium levels by inhibiting osteoclasts. This delicate balance is essential for
maintaining neuromuscular stability and skeletal integrity.
, 5. A patient is experiencing an acute exacerbation of Crohn’s disease. Which of the following
clinical manifestations are characteristic of this disorder? (Select All That Apply)
A. Transmural inflammation
B. Skip lesions throughout the GI tract
C. Bloody stools with mucus (hematochezia)
D. Cobblestone appearance of the mucosa
E. Fistula and abscess formation
Correct Answer: A, B, D, E
Explanation: Crohn’s disease is characterized by transmural inflammation, meaning it
affects all layers of the intestinal wall. It typically presents with ‘skip lesions’ where healthy
tissue is interspersed with diseased tissue, creating a cobblestone appearance. Because it
affects the full thickness of the wall, fistulas and abscesses are common complications. In
contrast, bloody stools are more frequently associated with Ulcerative Colitis, which is
confined to the mucosal layer of the colon.
6. A patient presents with tremors, exophthalmos, and heat intolerance. Which laboratory
finding would support a diagnosis of Graves’ disease?
A. Elevated TSH and low T3/T4
B. Low TSH and elevated T3/T4
C. Elevated TSH and elevated T3/T4
