Updated NU551 Unit 4 exam
questions with correct
answers.
-ol hormones? - CORRECT ANSWER✅✅Alcohols
-one homrones? - CORRECT ANSWER✅✅Ketones
1st and 2nd messenger for water soluble hormones? - CORRECT ANSWER✅✅1st =
Water soluble hormone that initiates the cascade when it binds to the membrane and
the second messenger
2nd = Small molecules inside the cell produced by the 1st messenger interaction. The
chemical signal generated within a cell that mediates the action of the water-soluble
hormone or other chemicals. (CAMP, CGMP) [hormones that bind to receptors that
activate adenylyl cyclase us CAMP as a second messenger]
A 12-year-old female is newly diagnosed with type 1 DM. When the parents ask what
causes this, what is the nurse's best response?
a. A familial, autosomal dominant gene defect
b. Obesity and lack of exercise
c. Immune destruction of the pancreas
d. Hyperglycemia from eating too many sweets - CORRECT ANSWER✅✅c. Immune
destruction of the pancreas
Rationale: The most common cause of type 1 DM is a slowly progressive autoimmune T
cell-mediated disease that destroys the beta cells of the pancreas.
A 12-year-old male is newly diagnosed with type 1 DM. Which of the following tests
should the nurse prepare the patient to best confirm the diagnosis?
a. Fasting plasma glucose levels
b. Random serum glucose levels
c. Genetic testing
d. Glycosylated hemoglobin measurements - CORRECT ANSWER✅✅a. Fasting
plasma glucose levels
,Rationale: Fasting blood glucose levels are most beneficial in confirming the diagnosis
of diabetes.
Random serum levels are not as accurate as fasting.
Genetic testing may be important for future determination, but it does not confirm the
diagnosis.
Glycosylated testing measures glucose control over time.
A 13-year-old male who uses insulin to control his type 1 diabetes experiences hunger,
lightheadedness, tachycardia, pallor, headache, and confusion during gym class. The
most probable cause of these symptoms is:
a. Hyperglycemia resulting from incorrect insulin administration
b. Dawn phenomenon caused by eating a snack before gym class
c. Hypoglycemia caused by increased exercise
d. Somogyi effect caused by insulin sensitivity - CORRECT ANSWER✅✅c.
Hypoglycemia caused by increased exercise
A 15-year-old female presents with breast discharge, dysmenorrhea, and excessive
excitability. Tests reveal that all her pituitary hormones are elevated. What does the
nurse suspect as the most likely cause for these assessment findings?
a. A pituitary adenoma
b. Hypothalamic hyposecretion
c. Hypothalamic inflammation
d. Pheochromocytoma - CORRECT ANSWER✅✅a. A pituitary adenoma
Rationale: Hormonal effects of pituitary adenomas include hypersecretion from the
adenoma, itself, and hyposecretion from surrounding pituitary cells; in this case
prolactin would be elevated with the manifestation of menstrual irregularities and
secretion from the breast.
A 19-year-old female with type 1 DM was admitted to the hospital with altered
consciousness and the following lab values: serum glucose 500 mg/dl (high) and serum
K+ 2 (low). Her parents state that she has been sick with the "flu" for a week. The
diagnosis is hyperosmolar hyperglycemia nonketotic syndrome (HHNKS). What
relationship do these values have with her insulin deficiency?
a. Increased glucose utilization causes the shift of fluid from the intravascular to the
intracellular space.
b. Decreased insulin causes hyperglycemia and osmotic diuresis.
c. Increased glucose and fatty acid metabolism stimulates renal diuresis and electrolyte
loss.
, d. Increased insulin use results in protein catabolism, tissue wasting, and electrolyte
loss. - CORRECT ANSWER✅✅b. Decreased insulin causes hyperglycemia and
osmotic diuresis.
Rationale: Because the amount of insulin required to inhibit fat breakdown is less than
that needed for effective glucose transport, insulin levels are sufficient to prevent
excessive lipolysis and ketosis.
Volume is depleted, not increased.
Electrolyte loss does occur, but it is not due to fatty acids and glucose metabolism, it is
due to insufficient insulin.
Insulin is decreased, not increased.
A 19-year-old female with type 1 DM was admitted to the hospital with the following lab
values: serum glucose 500 mg/dl (high), urine glucose and ketones 4+ (high), and
arterial pH 7.20 (low). Her parents state that she has been sick with the "flu" for a week.
Which of the following statements best explains her acidotic state?
a. Increased insulin levels promote protein breakdown and ketone formation.
b. Her uncontrolled diabetes has led to renal failure.
c. Low serum insulin promotes lipid storage and a corresponding release of ketones.
d. Insulin deficiency promotes lipid metabolism and ketone formation. - CORRECT
ANSWER✅✅d. Insulin deficiency promotes lipid metabolism and ketone formation.
Rationale: With insulin deficiency, lipolysis is enhanced, and there is an increase in the
amount of nonesterified fatty acids delivered to the liver. The consequence is increased
glyconeogenesis contributing to hyperglycemia and production of ketone bodies
(acetoacetate, hydroxybutyrate, and acetone) by the mitochondria of the liver at a rate
that exceeds peripheral use.
A 22-year-old female has a low level of TSH. What condition does the nurse expect the
patient is experiencing?
a. Primary hypothyroidism
b. Secondary hypothyroidism
c. Autoimmune hypothyroidism
d. Atypical hypothyroidism - CORRECT ANSWER✅✅b. Secondary hypothyroidism
Rationale: Causes of secondary hypothyroidism are related to either pituitary or
hypothalamic failure, which would be evident by low levels of TSH.
Primary hypothyroidism would be evident by elevated levels of TSH.
Autoimmune hypothyroidism would be evident by elevated TSH.
questions with correct
answers.
-ol hormones? - CORRECT ANSWER✅✅Alcohols
-one homrones? - CORRECT ANSWER✅✅Ketones
1st and 2nd messenger for water soluble hormones? - CORRECT ANSWER✅✅1st =
Water soluble hormone that initiates the cascade when it binds to the membrane and
the second messenger
2nd = Small molecules inside the cell produced by the 1st messenger interaction. The
chemical signal generated within a cell that mediates the action of the water-soluble
hormone or other chemicals. (CAMP, CGMP) [hormones that bind to receptors that
activate adenylyl cyclase us CAMP as a second messenger]
A 12-year-old female is newly diagnosed with type 1 DM. When the parents ask what
causes this, what is the nurse's best response?
a. A familial, autosomal dominant gene defect
b. Obesity and lack of exercise
c. Immune destruction of the pancreas
d. Hyperglycemia from eating too many sweets - CORRECT ANSWER✅✅c. Immune
destruction of the pancreas
Rationale: The most common cause of type 1 DM is a slowly progressive autoimmune T
cell-mediated disease that destroys the beta cells of the pancreas.
A 12-year-old male is newly diagnosed with type 1 DM. Which of the following tests
should the nurse prepare the patient to best confirm the diagnosis?
a. Fasting plasma glucose levels
b. Random serum glucose levels
c. Genetic testing
d. Glycosylated hemoglobin measurements - CORRECT ANSWER✅✅a. Fasting
plasma glucose levels
,Rationale: Fasting blood glucose levels are most beneficial in confirming the diagnosis
of diabetes.
Random serum levels are not as accurate as fasting.
Genetic testing may be important for future determination, but it does not confirm the
diagnosis.
Glycosylated testing measures glucose control over time.
A 13-year-old male who uses insulin to control his type 1 diabetes experiences hunger,
lightheadedness, tachycardia, pallor, headache, and confusion during gym class. The
most probable cause of these symptoms is:
a. Hyperglycemia resulting from incorrect insulin administration
b. Dawn phenomenon caused by eating a snack before gym class
c. Hypoglycemia caused by increased exercise
d. Somogyi effect caused by insulin sensitivity - CORRECT ANSWER✅✅c.
Hypoglycemia caused by increased exercise
A 15-year-old female presents with breast discharge, dysmenorrhea, and excessive
excitability. Tests reveal that all her pituitary hormones are elevated. What does the
nurse suspect as the most likely cause for these assessment findings?
a. A pituitary adenoma
b. Hypothalamic hyposecretion
c. Hypothalamic inflammation
d. Pheochromocytoma - CORRECT ANSWER✅✅a. A pituitary adenoma
Rationale: Hormonal effects of pituitary adenomas include hypersecretion from the
adenoma, itself, and hyposecretion from surrounding pituitary cells; in this case
prolactin would be elevated with the manifestation of menstrual irregularities and
secretion from the breast.
A 19-year-old female with type 1 DM was admitted to the hospital with altered
consciousness and the following lab values: serum glucose 500 mg/dl (high) and serum
K+ 2 (low). Her parents state that she has been sick with the "flu" for a week. The
diagnosis is hyperosmolar hyperglycemia nonketotic syndrome (HHNKS). What
relationship do these values have with her insulin deficiency?
a. Increased glucose utilization causes the shift of fluid from the intravascular to the
intracellular space.
b. Decreased insulin causes hyperglycemia and osmotic diuresis.
c. Increased glucose and fatty acid metabolism stimulates renal diuresis and electrolyte
loss.
, d. Increased insulin use results in protein catabolism, tissue wasting, and electrolyte
loss. - CORRECT ANSWER✅✅b. Decreased insulin causes hyperglycemia and
osmotic diuresis.
Rationale: Because the amount of insulin required to inhibit fat breakdown is less than
that needed for effective glucose transport, insulin levels are sufficient to prevent
excessive lipolysis and ketosis.
Volume is depleted, not increased.
Electrolyte loss does occur, but it is not due to fatty acids and glucose metabolism, it is
due to insufficient insulin.
Insulin is decreased, not increased.
A 19-year-old female with type 1 DM was admitted to the hospital with the following lab
values: serum glucose 500 mg/dl (high), urine glucose and ketones 4+ (high), and
arterial pH 7.20 (low). Her parents state that she has been sick with the "flu" for a week.
Which of the following statements best explains her acidotic state?
a. Increased insulin levels promote protein breakdown and ketone formation.
b. Her uncontrolled diabetes has led to renal failure.
c. Low serum insulin promotes lipid storage and a corresponding release of ketones.
d. Insulin deficiency promotes lipid metabolism and ketone formation. - CORRECT
ANSWER✅✅d. Insulin deficiency promotes lipid metabolism and ketone formation.
Rationale: With insulin deficiency, lipolysis is enhanced, and there is an increase in the
amount of nonesterified fatty acids delivered to the liver. The consequence is increased
glyconeogenesis contributing to hyperglycemia and production of ketone bodies
(acetoacetate, hydroxybutyrate, and acetone) by the mitochondria of the liver at a rate
that exceeds peripheral use.
A 22-year-old female has a low level of TSH. What condition does the nurse expect the
patient is experiencing?
a. Primary hypothyroidism
b. Secondary hypothyroidism
c. Autoimmune hypothyroidism
d. Atypical hypothyroidism - CORRECT ANSWER✅✅b. Secondary hypothyroidism
Rationale: Causes of secondary hypothyroidism are related to either pituitary or
hypothalamic failure, which would be evident by low levels of TSH.
Primary hypothyroidism would be evident by elevated levels of TSH.
Autoimmune hypothyroidism would be evident by elevated TSH.
