NRS 455 Final Exam V2 | NRS 455 Pathophysiology
| Actual Q&A with Rationale (NRS455 Final Exam) |
Grand Canyon University
1. A nurse is reviewing cellular adaptation mechanisms. Which of the following conditions are
considered adaptive cellular changes? Select all that apply.
A. Atrophy
B. Hypertrophy
C. Metaplasia
D. Hyperplasia
E. Dysplasia
F. Neoplasia
Correct Answer: A, B, C, D
Explanation: Atrophy, hypertrophy, hyperplasia, and metaplasia are standard adaptive
processes where cells adjust to environmental changes to maintain homeostasis. Dysplasia
is generally considered an abnormal, deranged growth process that is often a precursor to
malignancy rather than a healthy adaptation. Neoplasia represents new, uncontrolled
growth and is pathologically distinct from the adaptive responses of normal tissue.
,2. A patient with Type 1 Diabetes Mellitus presents with extreme thirst and frequent
urination. What is the underlying cause of these symptoms?
A. Insulin resistance in peripheral tissues
B. Excessive glucagon production by the alpha cells
C. Absolute insulin deficiency leading to hyperglycemia
D. The Somogyi effect following nocturnal hypoglycemia
Correct Answer: C
Explanation: Type 1 Diabetes involves the autoimmune destruction of beta cells, resulting
in an absolute lack of insulin production. The resulting hyperglycemia causes glucose to
spill into the urine, which creates an osmotic pull that leads to polyuria. This fluid loss
subsequently triggers polydipsia, or excessive thirst, to compensate for the dehydration.
3. Which clinical manifestations are expected in a patient experiencing Cushing’s Triad due to
increased intracranial pressure? Select all that apply.
A. Bradycardia
B. Tachycardia
C. Irregular respirations
D. Widening pulse pressure
E. Hypotension
F. Systolic hypertension
,Correct Answer: A, C, D, F
Explanation: Cushing’s triad is a late sign of increased intracranial pressure (ICP) that
signals impending brain herniation. It is characterized by systolic hypertension with a
widening pulse pressure, bradycardia, and irregular respiratory patterns such as Cheyne-
Stokes breathing. These physiological changes occur as the body attempts to maintain
cerebral perfusion against high intracranial pressure.
4. A patient is diagnosed with Right-Sided Heart Failure. Which assessment findings should
the nurse anticipate? Select all that apply.
A. Jugular venous distension
B. Pulmonary edema
C. Peripheral edema
D. Hepatomegaly
E. Ascites
F. Crackles in lung bases
Correct Answer: A, C, D, E
Explanation: Right-sided heart failure causes blood to back up into the systemic venous
circulation rather than the lungs. This leads to clinical signs such as jugular venous
distension (JVD), peripheral edema in the lower extremities, and congestion of the liver and
abdominal organs. Pulmonary edema and crackles are typically associated with left-sided
heart failure due to backup into the pulmonary vasculature.
, 5. The nurse is caring for a patient with Chronic Obstructive Pulmonary Disease (COPD).
Which of the following best describes the pathophysiology of emphysema?
A. Excessive mucus production and chronic cough
B. Infection of the lower respiratory tract with purulent exudate
C. Reversible bronchospasm triggered by allergens
D. Destruction of alveolar walls and loss of elastic recoil
Correct Answer: D
Explanation: Emphysema is characterized by the permanent enlargement of gas-exchange
airways and the destruction of alveolar walls. This destruction leads to a loss of elastic
recoil, which causes air trapping and the characteristic ‘barrel chest’ appearance. In
contrast, chronic bronchitis is defined by mucus hypersecretion and a persistent
productive cough.
6. A patient has been diagnosed with Acute Renal Failure of prerenal origin. What is the most
likely cause?
A. Severe dehydration and decreased cardiac output
B. Benign prostatic hyperplasia causing obstruction
C. Nephrotoxic drugs like aminoglycosides
D. Glomerulonephritis following a strep infection
Correct Answer: A
| Actual Q&A with Rationale (NRS455 Final Exam) |
Grand Canyon University
1. A nurse is reviewing cellular adaptation mechanisms. Which of the following conditions are
considered adaptive cellular changes? Select all that apply.
A. Atrophy
B. Hypertrophy
C. Metaplasia
D. Hyperplasia
E. Dysplasia
F. Neoplasia
Correct Answer: A, B, C, D
Explanation: Atrophy, hypertrophy, hyperplasia, and metaplasia are standard adaptive
processes where cells adjust to environmental changes to maintain homeostasis. Dysplasia
is generally considered an abnormal, deranged growth process that is often a precursor to
malignancy rather than a healthy adaptation. Neoplasia represents new, uncontrolled
growth and is pathologically distinct from the adaptive responses of normal tissue.
,2. A patient with Type 1 Diabetes Mellitus presents with extreme thirst and frequent
urination. What is the underlying cause of these symptoms?
A. Insulin resistance in peripheral tissues
B. Excessive glucagon production by the alpha cells
C. Absolute insulin deficiency leading to hyperglycemia
D. The Somogyi effect following nocturnal hypoglycemia
Correct Answer: C
Explanation: Type 1 Diabetes involves the autoimmune destruction of beta cells, resulting
in an absolute lack of insulin production. The resulting hyperglycemia causes glucose to
spill into the urine, which creates an osmotic pull that leads to polyuria. This fluid loss
subsequently triggers polydipsia, or excessive thirst, to compensate for the dehydration.
3. Which clinical manifestations are expected in a patient experiencing Cushing’s Triad due to
increased intracranial pressure? Select all that apply.
A. Bradycardia
B. Tachycardia
C. Irregular respirations
D. Widening pulse pressure
E. Hypotension
F. Systolic hypertension
,Correct Answer: A, C, D, F
Explanation: Cushing’s triad is a late sign of increased intracranial pressure (ICP) that
signals impending brain herniation. It is characterized by systolic hypertension with a
widening pulse pressure, bradycardia, and irregular respiratory patterns such as Cheyne-
Stokes breathing. These physiological changes occur as the body attempts to maintain
cerebral perfusion against high intracranial pressure.
4. A patient is diagnosed with Right-Sided Heart Failure. Which assessment findings should
the nurse anticipate? Select all that apply.
A. Jugular venous distension
B. Pulmonary edema
C. Peripheral edema
D. Hepatomegaly
E. Ascites
F. Crackles in lung bases
Correct Answer: A, C, D, E
Explanation: Right-sided heart failure causes blood to back up into the systemic venous
circulation rather than the lungs. This leads to clinical signs such as jugular venous
distension (JVD), peripheral edema in the lower extremities, and congestion of the liver and
abdominal organs. Pulmonary edema and crackles are typically associated with left-sided
heart failure due to backup into the pulmonary vasculature.
, 5. The nurse is caring for a patient with Chronic Obstructive Pulmonary Disease (COPD).
Which of the following best describes the pathophysiology of emphysema?
A. Excessive mucus production and chronic cough
B. Infection of the lower respiratory tract with purulent exudate
C. Reversible bronchospasm triggered by allergens
D. Destruction of alveolar walls and loss of elastic recoil
Correct Answer: D
Explanation: Emphysema is characterized by the permanent enlargement of gas-exchange
airways and the destruction of alveolar walls. This destruction leads to a loss of elastic
recoil, which causes air trapping and the characteristic ‘barrel chest’ appearance. In
contrast, chronic bronchitis is defined by mucus hypersecretion and a persistent
productive cough.
6. A patient has been diagnosed with Acute Renal Failure of prerenal origin. What is the most
likely cause?
A. Severe dehydration and decreased cardiac output
B. Benign prostatic hyperplasia causing obstruction
C. Nephrotoxic drugs like aminoglycosides
D. Glomerulonephritis following a strep infection
Correct Answer: A
