NR 507 EDAPT Week 4–8, NR 507, 2026–2027, Complete Exam
Question Bank — Questions with Correct verified Detailed Answers
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Section 1: Endocrine Disorders (Questions 1–30)
1. A patient presents with fatigue, weight gain, cold intolerance, and bradycardia.
Which laboratory finding is most consistent with primary hypothyroidism?
A. Decreased TSH, decreased T4
B. Elevated TSH, decreased T4
C. Decreased TSH, elevated T4
D. Elevated TSH, elevated T4
Correct Answer: B
Rationale: Primary hypothyroidism results from failure of the thyroid
gland itself, leading to decreased T4 production. The pituitary compensates by
increasing TSH secretion in an attempt to stimulate the thyroid. Therefore,
elevated TSH with decreased T4 is the classic pattern. Graves' disease
(hyperthyroidism) would show decreased TSH with elevated T4.
2. A patient with type 1 diabetes mellitus is experiencing diabetic ketoacidosis
(DKA). Which pathophysiologic mechanism best explains the development of
metabolic acidosis?
A. Excessive insulin causing cellular potassium shift
B. Increased lipolysis producing ketone bodies
C. Hyperventilation causing CO2 retention
D. Renal failure causing bicarbonate retention
Correct Answer: B
Rationale: In DKA, absolute insulin deficiency leads to unrestrained
lipolysis, producing large quantities of ketone bodies (acetoacetic acid and β-
hydroxybutyric acid). These are strong acids that accumulate in the bloodstream,
causing high anion gap metabolic acidosis. Hyperventilation (Kussmaul
respirations) is a compensatory mechanism, not the cause.
,3. Which clinical manifestations are most consistent with Cushing's syndrome?
(Select all that apply.)
A. Moon face
B. Weight loss
C. Truncal obesity
D. Hypotension
E. Purple striae
F. Hyperglycemia
Correct Answers: A, C, E, F
Rationale: Cushing's syndrome results from chronic cortisol excess.
Cortisol promotes gluconeogenesis (hyperglycemia), causes fat redistribution to
the trunk and face (truncal obesity, moon face), and weakens dermal connective
tissue (purple striae). Weight loss and hypotension are more consistent with
adrenal insufficiency (Addison's disease).
4. A patient with suspected Cushing's syndrome undergoes a dexamethasone
suppression test. Which finding would be expected in a patient with an ACTH-
secreting pituitary adenoma (Cushing's disease)?
A. Cortisol suppression with low-dose dexamethasone
B. No cortisol suppression with low-dose dexamethasone
C. Complete suppression with both low and high doses
D. No suppression with either low or high doses
Correct Answer: B
Rationale: In Cushing's disease (pituitary adenoma), the feedback
mechanism is impaired, so low-dose dexamethasone does not suppress cortisol
production. However, high-dose dexamethasone typically does suppress cortisol
in Cushing's disease because the pituitary adenoma retains some sensitivity to
negative feedback. Ectopic ACTH production and adrenal tumors do not suppress
with either dose.
5. A patient with Graves' disease is most likely to exhibit which laboratory
pattern?
,A. Elevated TSH, elevated T4, elevated T3
B. Decreased TSH, elevated T4, elevated T3
C. Elevated TSH, decreased T4, decreased T3
D. Decreased TSH, decreased T4, decreased T3
Correct Answer: B
Rationale: Graves' disease is an autoimmune condition in which TSH
receptor antibodies stimulate the thyroid gland to overproduce T4 and T3. The
elevated thyroid hormone levels suppress pituitary TSH production through
negative feedback. Therefore, the pattern is decreased TSH with elevated T4 and
T3.
6. Which electrolyte abnormality is most commonly associated with diabetic
ketoacidosis at presentation?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: A
Rationale: In DKA, insulin deficiency and acidosis cause potassium to shift
from the intracellular to the extracellular space, resulting in hyperkalemia despite
total body potassium depletion. Once insulin therapy is initiated, potassium shifts
back into cells, and hypokalemia can develop if not carefully monitored and
replaced.
7. A patient with Addison's disease (primary adrenal insufficiency) would be
expected to have which of the following? (Select all that apply.)
A. Hyperpigmentation
B. Hypernatremia
C. Hyperkalemia
D. Hypoglycemia
E. Hypertension
F. Hyponatremia
, Correct Answers: A, C, D, F
Rationale: Primary adrenal insufficiency results in deficient cortisol and
aldosterone. Aldosterone deficiency causes sodium loss (hyponatremia) and
potassium retention (hyperkalemia). Cortisol deficiency leads to hypoglycemia.
Increased ACTH production (from loss of negative feedback) causes
hyperpigmentation. Hypotension, not hypertension, is typical due to volume
depletion.
8. What is the primary pathophysiologic mechanism of type 2 diabetes mellitus?
A. Autoimmune destruction of pancreatic beta cells
B. Insulin resistance in peripheral tissues
C. Absolute insulin deficiency
D. Viral destruction of the pancreas
Correct Answer: B
Rationale: Type 2 diabetes is characterized by insulin resistance in target
tissues (muscle, liver, adipose) combined with relative insulin deficiency. The
pancreas initially compensates by producing more insulin, but eventually beta cell
function declines. Autoimmune destruction of beta cells is the mechanism of type
1 diabetes.
9. A patient with a thyroid storm (thyrotoxic crisis) would most likely present with
which clinical findings?
A. Bradycardia, hypothermia, and lethargy
B. Tachycardia, fever, and agitation
C. Hypertension, bradycardia, and weight gain
D. Hypotension, hypothermia, and coma
Correct Answer: B
Rationale: Thyroid storm is a life-threatening exacerbation of
hyperthyroidism characterized by severe tachycardia, hyperthermia, agitation,
delirium, and high-output heart failure. It is a medical emergency requiring
immediate treatment with antithyroid drugs, beta-blockers, and supportive care.
Question Bank — Questions with Correct verified Detailed Answers
Already Graded A+
Section 1: Endocrine Disorders (Questions 1–30)
1. A patient presents with fatigue, weight gain, cold intolerance, and bradycardia.
Which laboratory finding is most consistent with primary hypothyroidism?
A. Decreased TSH, decreased T4
B. Elevated TSH, decreased T4
C. Decreased TSH, elevated T4
D. Elevated TSH, elevated T4
Correct Answer: B
Rationale: Primary hypothyroidism results from failure of the thyroid
gland itself, leading to decreased T4 production. The pituitary compensates by
increasing TSH secretion in an attempt to stimulate the thyroid. Therefore,
elevated TSH with decreased T4 is the classic pattern. Graves' disease
(hyperthyroidism) would show decreased TSH with elevated T4.
2. A patient with type 1 diabetes mellitus is experiencing diabetic ketoacidosis
(DKA). Which pathophysiologic mechanism best explains the development of
metabolic acidosis?
A. Excessive insulin causing cellular potassium shift
B. Increased lipolysis producing ketone bodies
C. Hyperventilation causing CO2 retention
D. Renal failure causing bicarbonate retention
Correct Answer: B
Rationale: In DKA, absolute insulin deficiency leads to unrestrained
lipolysis, producing large quantities of ketone bodies (acetoacetic acid and β-
hydroxybutyric acid). These are strong acids that accumulate in the bloodstream,
causing high anion gap metabolic acidosis. Hyperventilation (Kussmaul
respirations) is a compensatory mechanism, not the cause.
,3. Which clinical manifestations are most consistent with Cushing's syndrome?
(Select all that apply.)
A. Moon face
B. Weight loss
C. Truncal obesity
D. Hypotension
E. Purple striae
F. Hyperglycemia
Correct Answers: A, C, E, F
Rationale: Cushing's syndrome results from chronic cortisol excess.
Cortisol promotes gluconeogenesis (hyperglycemia), causes fat redistribution to
the trunk and face (truncal obesity, moon face), and weakens dermal connective
tissue (purple striae). Weight loss and hypotension are more consistent with
adrenal insufficiency (Addison's disease).
4. A patient with suspected Cushing's syndrome undergoes a dexamethasone
suppression test. Which finding would be expected in a patient with an ACTH-
secreting pituitary adenoma (Cushing's disease)?
A. Cortisol suppression with low-dose dexamethasone
B. No cortisol suppression with low-dose dexamethasone
C. Complete suppression with both low and high doses
D. No suppression with either low or high doses
Correct Answer: B
Rationale: In Cushing's disease (pituitary adenoma), the feedback
mechanism is impaired, so low-dose dexamethasone does not suppress cortisol
production. However, high-dose dexamethasone typically does suppress cortisol
in Cushing's disease because the pituitary adenoma retains some sensitivity to
negative feedback. Ectopic ACTH production and adrenal tumors do not suppress
with either dose.
5. A patient with Graves' disease is most likely to exhibit which laboratory
pattern?
,A. Elevated TSH, elevated T4, elevated T3
B. Decreased TSH, elevated T4, elevated T3
C. Elevated TSH, decreased T4, decreased T3
D. Decreased TSH, decreased T4, decreased T3
Correct Answer: B
Rationale: Graves' disease is an autoimmune condition in which TSH
receptor antibodies stimulate the thyroid gland to overproduce T4 and T3. The
elevated thyroid hormone levels suppress pituitary TSH production through
negative feedback. Therefore, the pattern is decreased TSH with elevated T4 and
T3.
6. Which electrolyte abnormality is most commonly associated with diabetic
ketoacidosis at presentation?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: A
Rationale: In DKA, insulin deficiency and acidosis cause potassium to shift
from the intracellular to the extracellular space, resulting in hyperkalemia despite
total body potassium depletion. Once insulin therapy is initiated, potassium shifts
back into cells, and hypokalemia can develop if not carefully monitored and
replaced.
7. A patient with Addison's disease (primary adrenal insufficiency) would be
expected to have which of the following? (Select all that apply.)
A. Hyperpigmentation
B. Hypernatremia
C. Hyperkalemia
D. Hypoglycemia
E. Hypertension
F. Hyponatremia
, Correct Answers: A, C, D, F
Rationale: Primary adrenal insufficiency results in deficient cortisol and
aldosterone. Aldosterone deficiency causes sodium loss (hyponatremia) and
potassium retention (hyperkalemia). Cortisol deficiency leads to hypoglycemia.
Increased ACTH production (from loss of negative feedback) causes
hyperpigmentation. Hypotension, not hypertension, is typical due to volume
depletion.
8. What is the primary pathophysiologic mechanism of type 2 diabetes mellitus?
A. Autoimmune destruction of pancreatic beta cells
B. Insulin resistance in peripheral tissues
C. Absolute insulin deficiency
D. Viral destruction of the pancreas
Correct Answer: B
Rationale: Type 2 diabetes is characterized by insulin resistance in target
tissues (muscle, liver, adipose) combined with relative insulin deficiency. The
pancreas initially compensates by producing more insulin, but eventually beta cell
function declines. Autoimmune destruction of beta cells is the mechanism of type
1 diabetes.
9. A patient with a thyroid storm (thyrotoxic crisis) would most likely present with
which clinical findings?
A. Bradycardia, hypothermia, and lethargy
B. Tachycardia, fever, and agitation
C. Hypertension, bradycardia, and weight gain
D. Hypotension, hypothermia, and coma
Correct Answer: B
Rationale: Thyroid storm is a life-threatening exacerbation of
hyperthyroidism characterized by severe tachycardia, hyperthermia, agitation,
delirium, and high-output heart failure. It is a medical emergency requiring
immediate treatment with antithyroid drugs, beta-blockers, and supportive care.
