NR283 Exam 3 Actual Exam Style V2 | NR
283 Pathophysiology | Chamberlain
1. A patient with Type 1 Diabetes Mellitus presents with Kussmaul respirations and a fruity
breath odor. Which physiological process is primarily responsible for these symptoms?
A. Breakdown of fats resulting in the production of ketones
B. Excessive insulin production leading to hypoglycemia
C. Retention of carbon dioxide due to hypoventilation
D. Decreased glucose production by the liver
Answer: A
Rationale: In Type 1 Diabetes, the lack of insulin prevents glucose from entering cells,
forcing the body to burn fat for energy. This lipid metabolism produces ketones, which are
acidic and lead to metabolic acidosis. The body attempts to compensate for this acidity
through Kussmaul respirations to blow off carbon dioxide and reduce acid levels.
2. Which clinical manifestation is a hallmark sign of Nephrotic Syndrome?
A. Massive proteinuria and generalized edema
B. Gross hematuria and hypertension
C. Oliguria and flank pain
D. Urethral discharge and dysuria
,Answer: A
Rationale: Nephrotic syndrome is characterized by increased glomerular permeability,
which allows large amounts of protein to escape into the urine. The resulting
hypoalbuminemia decreases oncotic pressure, leading to significant fluid shifts and
generalized edema (anasarca). This condition is distinct from nephritic syndrome, which is
more commonly associated with hematuria.
3. A patient is diagnosed with Graves’ disease. Which finding would the nurse expect to see in
the laboratory results?
A. Elevated TSH and decreased T3/T4
B. Normal TSH and elevated T3/T4
C. Decreased TSH and decreased T3/T4
D. Decreased TSH and elevated T3/T4
Answer: D
Rationale: Graves’ disease is a form of primary hyperthyroidism caused by autoimmune
stimulation of the thyroid gland. Because the thyroid is overproducing hormones (T3 and
T4), the negative feedback loop causes the anterior pituitary to stop secreting Thyroid
Stimulating Hormone (TSH). Therefore, a low TSH level combined with high thyroid
hormone levels confirms the diagnosis.
4. What is the primary underlying cause of Type 2 Diabetes Mellitus?
A. Autoimmune destruction of pancreatic beta cells
, B. Absolute deficiency of insulin production
C. Insulin resistance and relative insulin deficiency
D. Excessive glucagon secretion by alpha cells
Answer: C
Rationale: Type 2 Diabetes involves a progressive condition where body cells become less
responsive to insulin, known as insulin resistance. Initially, the pancreas compensates by
producing more insulin, but eventually, it cannot keep up, leading to relative deficiency.
This differs from Type 1 Diabetes, which is characterized by an absolute lack of insulin due
to autoimmune destruction.
5. Which electrolyte imbalance is most commonly associated with the oliguric phase of Acute
Kidney Injury (AKI)?
A. Hypokalemia
B. Hypernatremia
C. Hypophosphatemia
D. Hyperkalemia
Answer: D
Rationale: During the oliguric phase of AKI, the kidneys are unable to effectively excrete
metabolic wastes or electrolytes. Potassium remains in the bloodstream rather than being
filtered into the urine, leading to potentially life-threatening hyperkalemia. Monitoring
283 Pathophysiology | Chamberlain
1. A patient with Type 1 Diabetes Mellitus presents with Kussmaul respirations and a fruity
breath odor. Which physiological process is primarily responsible for these symptoms?
A. Breakdown of fats resulting in the production of ketones
B. Excessive insulin production leading to hypoglycemia
C. Retention of carbon dioxide due to hypoventilation
D. Decreased glucose production by the liver
Answer: A
Rationale: In Type 1 Diabetes, the lack of insulin prevents glucose from entering cells,
forcing the body to burn fat for energy. This lipid metabolism produces ketones, which are
acidic and lead to metabolic acidosis. The body attempts to compensate for this acidity
through Kussmaul respirations to blow off carbon dioxide and reduce acid levels.
2. Which clinical manifestation is a hallmark sign of Nephrotic Syndrome?
A. Massive proteinuria and generalized edema
B. Gross hematuria and hypertension
C. Oliguria and flank pain
D. Urethral discharge and dysuria
,Answer: A
Rationale: Nephrotic syndrome is characterized by increased glomerular permeability,
which allows large amounts of protein to escape into the urine. The resulting
hypoalbuminemia decreases oncotic pressure, leading to significant fluid shifts and
generalized edema (anasarca). This condition is distinct from nephritic syndrome, which is
more commonly associated with hematuria.
3. A patient is diagnosed with Graves’ disease. Which finding would the nurse expect to see in
the laboratory results?
A. Elevated TSH and decreased T3/T4
B. Normal TSH and elevated T3/T4
C. Decreased TSH and decreased T3/T4
D. Decreased TSH and elevated T3/T4
Answer: D
Rationale: Graves’ disease is a form of primary hyperthyroidism caused by autoimmune
stimulation of the thyroid gland. Because the thyroid is overproducing hormones (T3 and
T4), the negative feedback loop causes the anterior pituitary to stop secreting Thyroid
Stimulating Hormone (TSH). Therefore, a low TSH level combined with high thyroid
hormone levels confirms the diagnosis.
4. What is the primary underlying cause of Type 2 Diabetes Mellitus?
A. Autoimmune destruction of pancreatic beta cells
, B. Absolute deficiency of insulin production
C. Insulin resistance and relative insulin deficiency
D. Excessive glucagon secretion by alpha cells
Answer: C
Rationale: Type 2 Diabetes involves a progressive condition where body cells become less
responsive to insulin, known as insulin resistance. Initially, the pancreas compensates by
producing more insulin, but eventually, it cannot keep up, leading to relative deficiency.
This differs from Type 1 Diabetes, which is characterized by an absolute lack of insulin due
to autoimmune destruction.
5. Which electrolyte imbalance is most commonly associated with the oliguric phase of Acute
Kidney Injury (AKI)?
A. Hypokalemia
B. Hypernatremia
C. Hypophosphatemia
D. Hyperkalemia
Answer: D
Rationale: During the oliguric phase of AKI, the kidneys are unable to effectively excrete
metabolic wastes or electrolytes. Potassium remains in the bloodstream rather than being
filtered into the urine, leading to potentially life-threatening hyperkalemia. Monitoring
