1
NU 110 / NU110 Exam 4 Actual Exam
2026/2027 | Integrated Human
Sciences | Galen | Questions with
Verified Answers | 100% Correct | Pass
Guaranteed
Q001: A 22-year-old patient presents with muscle cramps after running a marathon.
Serum sodium is 128 mEq/L, potassium 3.2 mEq/L, and urine specific gravity
1.005. Which integrated mechanism best explains these findings?
Options:
A. Respiratory acidosis with compensatory renal bicarbonate loss
B. Aldosterone-mediated renal sodium reabsorption and potassium secretion
C. ADH suppression leading to free-water retention and dilutional hyponatremia
with cellular potassium shift
D. Lactic acidosis causing hyperkalemia and hypernatremia
ANSWER: C
Q002: During a blood-transfusion reaction, RBCs lyse and release hemoglobin into
plasma. Which renal tubule segment is most vulnerable to the iron-mediated
oxidative stress and why?
Options:
A. Proximal convoluted tubule—high mitochondrial density for active transport
B. Distal convoluted tubule—aldosterone sensitivity
C. Collecting duct—ADH-dependent water reabsorption
, 2
D. Loop of Henle—counter-current multiplier energy demand
ANSWER: A
Q003: A 30-year-old patient with influenza develops secondary bacterial
pneumonia. Sputum culture grows gram-positive cocci in clusters that are catalase-
positive and coagulase-positive. Which invasin allows this organism to breach
respiratory epithelium?
Options:
A. Pneumolysin of Streptococcus pneumoniae
B. Protein A of Staphylococcus aureus
C. Clumping factor (fibronectin-binding protein) of Staphylococcus aureus
D. M protein of Streptococcus pyogenes
ANSWER: C
Q004: A patient with COPD is prescribed a beta-2 agonist inhaler. Which
intracellular signaling molecule is increased, leading to bronchial smooth-muscle
relaxation?
Options:
A. IP₃ (inositol trisphosphate)
B. cAMP (cyclic adenosine monophosphate)
C. DAG (diacylglycerol)
D. cGMP (cyclic guanosine monophosphate)
ANSWER: B
Q005: A 45-year-old diabetic patient has a blood pH of 7.25, HCO₃⁻ 16 mEq/L,
and anion gap 22 mEq/L. Which chemical process generates the unmeasured
anions driving this gap?
Options:
A. Ketone-body dissociation (acetoacetate and β-hydroxybutyrate)
, 3
B. Lactic-acid deprotonation
C. Phosphate release from ATP hydrolysis
D. Sulfate accumulation from methionine catabolism
ANSWER: A
Q006: A 26-year-old patient receives a tetanus booster. Within the deltoid muscle,
antigen is carried via lymph to a lymph node. Which cell type processes and
presents tetanus toxoid to naïve CD4⁺ T cells in the paracortex?
Options:
A. Plasma cell
B. Follicular dendritic cell
C. Interdigitating dendritic cell
D. Macrophage
ANSWER: C
Q007: A patient with nephrotic syndrome develops spontaneous peritonitis. Which
complement component is most deficient, impairing opsonization and increasing
infection risk?
Options:
A. C3
B. C5
C. C1q
D. Factor B
ANSWER: A
Q008: A 55-year-old patient on furosemide develops muscle cramps and a serum
Na⁺ of 128 mEq/L. Which nephron site is primarily affected by furosemide,
leading to this electrolyte picture?
Options:
NU 110 / NU110 Exam 4 Actual Exam
2026/2027 | Integrated Human
Sciences | Galen | Questions with
Verified Answers | 100% Correct | Pass
Guaranteed
Q001: A 22-year-old patient presents with muscle cramps after running a marathon.
Serum sodium is 128 mEq/L, potassium 3.2 mEq/L, and urine specific gravity
1.005. Which integrated mechanism best explains these findings?
Options:
A. Respiratory acidosis with compensatory renal bicarbonate loss
B. Aldosterone-mediated renal sodium reabsorption and potassium secretion
C. ADH suppression leading to free-water retention and dilutional hyponatremia
with cellular potassium shift
D. Lactic acidosis causing hyperkalemia and hypernatremia
ANSWER: C
Q002: During a blood-transfusion reaction, RBCs lyse and release hemoglobin into
plasma. Which renal tubule segment is most vulnerable to the iron-mediated
oxidative stress and why?
Options:
A. Proximal convoluted tubule—high mitochondrial density for active transport
B. Distal convoluted tubule—aldosterone sensitivity
C. Collecting duct—ADH-dependent water reabsorption
, 2
D. Loop of Henle—counter-current multiplier energy demand
ANSWER: A
Q003: A 30-year-old patient with influenza develops secondary bacterial
pneumonia. Sputum culture grows gram-positive cocci in clusters that are catalase-
positive and coagulase-positive. Which invasin allows this organism to breach
respiratory epithelium?
Options:
A. Pneumolysin of Streptococcus pneumoniae
B. Protein A of Staphylococcus aureus
C. Clumping factor (fibronectin-binding protein) of Staphylococcus aureus
D. M protein of Streptococcus pyogenes
ANSWER: C
Q004: A patient with COPD is prescribed a beta-2 agonist inhaler. Which
intracellular signaling molecule is increased, leading to bronchial smooth-muscle
relaxation?
Options:
A. IP₃ (inositol trisphosphate)
B. cAMP (cyclic adenosine monophosphate)
C. DAG (diacylglycerol)
D. cGMP (cyclic guanosine monophosphate)
ANSWER: B
Q005: A 45-year-old diabetic patient has a blood pH of 7.25, HCO₃⁻ 16 mEq/L,
and anion gap 22 mEq/L. Which chemical process generates the unmeasured
anions driving this gap?
Options:
A. Ketone-body dissociation (acetoacetate and β-hydroxybutyrate)
, 3
B. Lactic-acid deprotonation
C. Phosphate release from ATP hydrolysis
D. Sulfate accumulation from methionine catabolism
ANSWER: A
Q006: A 26-year-old patient receives a tetanus booster. Within the deltoid muscle,
antigen is carried via lymph to a lymph node. Which cell type processes and
presents tetanus toxoid to naïve CD4⁺ T cells in the paracortex?
Options:
A. Plasma cell
B. Follicular dendritic cell
C. Interdigitating dendritic cell
D. Macrophage
ANSWER: C
Q007: A patient with nephrotic syndrome develops spontaneous peritonitis. Which
complement component is most deficient, impairing opsonization and increasing
infection risk?
Options:
A. C3
B. C5
C. C1q
D. Factor B
ANSWER: A
Q008: A 55-year-old patient on furosemide develops muscle cramps and a serum
Na⁺ of 128 mEq/L. Which nephron site is primarily affected by furosemide,
leading to this electrolyte picture?
Options:
