NR283 Exam 4 Actual Exam Style V2 | NR
283 Pathophysiology | Chamberlain
1. A patient presents with polydipsia, polyuria, and a very low urine specific gravity. Which
condition is the most likely cause of these symptoms?
A. Diabetes Insipidus
B. SIADH
C. Cushing’s Syndrome
D. Diabetes Mellitus Type 2
Answer: A
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH or a decreased renal
response to ADH. This leads to the excretion of large volumes of dilute urine and extreme
thirst. It is distinct from SIADH, which involves excessive water retention and concentrated
urine.
2. Which clinical manifestation is characteristic of a patient diagnosed with Graves’ disease?
A. Weight gain and lethargy
B. Cold intolerance and bradycardia
C. Moon face and buffalo hump
D. Exophthalmos and tachycardia
,Answer: D
Rationale: Graves’ disease is an autoimmune disorder that causes hyperthyroidism.
Patients often exhibit bulging eyes, known as exophthalmos, due to inflammation in the
orbital tissues. They also experience signs of a hypermetabolic state such as a rapid heart
rate and heat intolerance.
3. In the pathophysiology of Type 1 Diabetes Mellitus, what is the primary underlying
mechanism?
A. Autoimmune destruction of pancreatic beta cells
B. Insulin resistance in peripheral tissues
C. Excessive glucagon secretion by alpha cells
D. Decreased glucose absorption in the gut
Answer: A
Rationale: Type 1 Diabetes Mellitus occurs when the immune system attacks and destroys
the insulin-producing beta cells in the Islets of Langerhans. This results in an absolute
insulin deficiency, requiring patients to rely on exogenous insulin. It is typically diagnosed
in childhood or adolescence but can occur at any age.
4. A patient with a history of chronic corticosteroid use is at high risk for developing which of
the following?
A. Addison’s Disease
B. Hashimoto’s Thyroiditis
, C. Cushing’s Syndrome
D. Pheochromocytoma
Answer: C
Rationale: Iatrogenic Cushing’s syndrome is caused by the long-term administration of
glucocorticoid medications. These drugs mimic the effects of excess cortisol, leading to
weight gain and skin thinning. Abrupt withdrawal of these medications can lead to an
adrenal crisis.
5. Which laboratory finding is most consistent with a diagnosis of Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. Serum sodium 120 mEq/L
B. Serum osmolality 310 mOsm/kg
C. Urine specific gravity 1.002
D. Serum potassium 5.5 mEq/L
Answer: A
Rationale: SIADH results in excessive water retention due to high levels of ADH. This
water retention dilutes the blood, leading to dilutional hyponatremia and a serum sodium
below the normal range. Patients will also have highly concentrated urine despite being
fluid overloaded.
283 Pathophysiology | Chamberlain
1. A patient presents with polydipsia, polyuria, and a very low urine specific gravity. Which
condition is the most likely cause of these symptoms?
A. Diabetes Insipidus
B. SIADH
C. Cushing’s Syndrome
D. Diabetes Mellitus Type 2
Answer: A
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH or a decreased renal
response to ADH. This leads to the excretion of large volumes of dilute urine and extreme
thirst. It is distinct from SIADH, which involves excessive water retention and concentrated
urine.
2. Which clinical manifestation is characteristic of a patient diagnosed with Graves’ disease?
A. Weight gain and lethargy
B. Cold intolerance and bradycardia
C. Moon face and buffalo hump
D. Exophthalmos and tachycardia
,Answer: D
Rationale: Graves’ disease is an autoimmune disorder that causes hyperthyroidism.
Patients often exhibit bulging eyes, known as exophthalmos, due to inflammation in the
orbital tissues. They also experience signs of a hypermetabolic state such as a rapid heart
rate and heat intolerance.
3. In the pathophysiology of Type 1 Diabetes Mellitus, what is the primary underlying
mechanism?
A. Autoimmune destruction of pancreatic beta cells
B. Insulin resistance in peripheral tissues
C. Excessive glucagon secretion by alpha cells
D. Decreased glucose absorption in the gut
Answer: A
Rationale: Type 1 Diabetes Mellitus occurs when the immune system attacks and destroys
the insulin-producing beta cells in the Islets of Langerhans. This results in an absolute
insulin deficiency, requiring patients to rely on exogenous insulin. It is typically diagnosed
in childhood or adolescence but can occur at any age.
4. A patient with a history of chronic corticosteroid use is at high risk for developing which of
the following?
A. Addison’s Disease
B. Hashimoto’s Thyroiditis
, C. Cushing’s Syndrome
D. Pheochromocytoma
Answer: C
Rationale: Iatrogenic Cushing’s syndrome is caused by the long-term administration of
glucocorticoid medications. These drugs mimic the effects of excess cortisol, leading to
weight gain and skin thinning. Abrupt withdrawal of these medications can lead to an
adrenal crisis.
5. Which laboratory finding is most consistent with a diagnosis of Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. Serum sodium 120 mEq/L
B. Serum osmolality 310 mOsm/kg
C. Urine specific gravity 1.002
D. Serum potassium 5.5 mEq/L
Answer: A
Rationale: SIADH results in excessive water retention due to high levels of ADH. This
water retention dilutes the blood, leading to dilutional hyponatremia and a serum sodium
below the normal range. Patients will also have highly concentrated urine despite being
fluid overloaded.
