1
NR 507 Week 6 Study Guide Alterations in the
Endocrine System Actual Exam 2026/2027 – Complete
Exam-Style Questions with Detailed Rationales | 100%
Verified – Pass Guaranteed – A+ Graded
Section 1: Diabetes Mellitus (Type 1, Type 2, Gestational) (Questions 1-20)
Q1: A 12-year-old male is diagnosed with Type 1 Diabetes Mellitus. The nurse practitioner
explains that the primary pathophysiological process involves:
A. Peripheral insulin resistance coupled with relative insulin deficiency.
B. Autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency.
[CORRECT]
C. Genetic defects in insulin receptor signaling.
D. Gestational hormonal changes causing insulin resistance.
Correct Answer: B
Rationale: Type 1 Diabetes Mellitus is characterized by an autoimmune reaction (often
associated with HLA-DR3/DR4 and autoantibodies like GAD65) that destroys the beta cells in
the pancreas, resulting in an absolute deficiency of insulin. Type 2 involves insulin resistance.
Genetic defects are MODY (Maturity Onset Diabetes of the Young).
Q2: Which laboratory result confirms the diagnosis of diabetes mellitus in a symptomatic
patient?
A. Fasting plasma glucose (FPG) of 110 mg/dL.
B. Hemoglobin A1c (HbA1c) of 6.0%.
C. Random plasma glucose of 210 mg/dL with classic symptoms. [CORRECT]
D. 2-hour Oral Glucose Tolerance Test (OGTT) of 160 mg/dL.
Correct Answer: C
Rationale: Diagnostic criteria include random plasma glucose ≥200 mg/dL with classic
symptoms (polyuria, polydipsia, weight loss). FPG ≥126 mg/dL, HbA1c ≥6.5%, and 2-hour
,2
OGTT ≥200 mg/dL are also diagnostic, but the values in A, B, and D fall within prediabetic or
normal ranges.
Q3: A patient presents to the emergency department with polyuria, polydipsia, nausea, vomiting,
and abdominal pain. Blood glucose is 450 mg/dL, and urinalysis is positive for ketones. Arterial
blood gas shows a pH of 7.25. Which acute complication of diabetes is this patient most likely
experiencing?
A. Hyperosmolar Hyperglycemic State (HHS)
B. Diabetic Ketoacidosis (DKA) [CORRECT]
C. Hypoglycemia unawareness
D. Lactic Acidosis
Correct Answer: B
Rationale: The presence of ketones, metabolic acidosis (pH 7.25), and hyperglycemia (>250
mg/dL) are classic signs of DKA, which is more common in Type 1 diabetes. HHS typically
presents with extreme hyperglycemia (>600 mg/dL) but without significant ketosis or acidosis.
Q4: In the pathophysiology of Diabetic Ketoacidosis (DKA), the absence of insulin leads to the
breakdown of fatty acids into which byproducts?
A. Triglycerides and glycerol.
B. Ketones (acetoacetate, beta-hydroxybutyrate, acetone). [CORRECT]
C. Lactic acid and pyruvate.
D. Glucose and glycogen.
Correct Answer: B
Rationale: Insulin deficiency promotes lipolysis. Free fatty acids are released and converted by
the liver into ketone bodies (acetoacetate, beta-hydroxybutyrate, acetone), which are acidic and
cause metabolic acidosis.
, 3
Q5: A patient with Type 2 Diabetes Mellitus is prescribed Metformin. What is the primary
mechanism of action of this medication?
A. Stimulates the pancreas to release more insulin.
B. Inhibits the reabsorption of glucose in the renal tubules.
C. Decreases hepatic glucose production and increases peripheral insulin sensitivity.
[CORRECT]
D. Delays gastric emptying to slow glucose absorption.
Correct Answer: C
Rationale: Metformin is a biguanide that primarily works by suppressing gluconeogenesis in the
liver and increasing insulin sensitivity in peripheral tissues. Sulfonylureas stimulate insulin
release. SGLT2 inhibitors inhibit renal reabsorption. GLP-1 agonists delay gastric emptying.
Q6: The nurse practitioner is educating a patient about "Dawn Phenomenon." What causes this
early morning hyperglycemia?
A. Nocturnal hypoglycemia followed by rebound hyperglycemia (Somogyi effect).
B. The release of counter-regulatory hormones (growth hormone, cortisol) in the early morning.
[CORRECT]
C. Inadequate long-acting insulin dose the previous evening.
D. Consuming a high-carbohydrate snack before bed.
Correct Answer: B
Rationale: The Dawn Phenomenon results from the normal release of growth hormone and
cortisol in the early morning hours, which stimulates hepatic glucose production. The Somogyi
effect is caused by nocturnal hypoglycemia triggering a rebound hyperglycemia.
Q7: Which of the following findings is most characteristic of Hyperosmolar Hyperglycemic
State (HHS) compared to Diabetic Ketoacidosis (DKA)?
A. Presence of severe metabolic acidosis (pH < 7.3).
B. Serum ketones are significantly elevated.
NR 507 Week 6 Study Guide Alterations in the
Endocrine System Actual Exam 2026/2027 – Complete
Exam-Style Questions with Detailed Rationales | 100%
Verified – Pass Guaranteed – A+ Graded
Section 1: Diabetes Mellitus (Type 1, Type 2, Gestational) (Questions 1-20)
Q1: A 12-year-old male is diagnosed with Type 1 Diabetes Mellitus. The nurse practitioner
explains that the primary pathophysiological process involves:
A. Peripheral insulin resistance coupled with relative insulin deficiency.
B. Autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency.
[CORRECT]
C. Genetic defects in insulin receptor signaling.
D. Gestational hormonal changes causing insulin resistance.
Correct Answer: B
Rationale: Type 1 Diabetes Mellitus is characterized by an autoimmune reaction (often
associated with HLA-DR3/DR4 and autoantibodies like GAD65) that destroys the beta cells in
the pancreas, resulting in an absolute deficiency of insulin. Type 2 involves insulin resistance.
Genetic defects are MODY (Maturity Onset Diabetes of the Young).
Q2: Which laboratory result confirms the diagnosis of diabetes mellitus in a symptomatic
patient?
A. Fasting plasma glucose (FPG) of 110 mg/dL.
B. Hemoglobin A1c (HbA1c) of 6.0%.
C. Random plasma glucose of 210 mg/dL with classic symptoms. [CORRECT]
D. 2-hour Oral Glucose Tolerance Test (OGTT) of 160 mg/dL.
Correct Answer: C
Rationale: Diagnostic criteria include random plasma glucose ≥200 mg/dL with classic
symptoms (polyuria, polydipsia, weight loss). FPG ≥126 mg/dL, HbA1c ≥6.5%, and 2-hour
,2
OGTT ≥200 mg/dL are also diagnostic, but the values in A, B, and D fall within prediabetic or
normal ranges.
Q3: A patient presents to the emergency department with polyuria, polydipsia, nausea, vomiting,
and abdominal pain. Blood glucose is 450 mg/dL, and urinalysis is positive for ketones. Arterial
blood gas shows a pH of 7.25. Which acute complication of diabetes is this patient most likely
experiencing?
A. Hyperosmolar Hyperglycemic State (HHS)
B. Diabetic Ketoacidosis (DKA) [CORRECT]
C. Hypoglycemia unawareness
D. Lactic Acidosis
Correct Answer: B
Rationale: The presence of ketones, metabolic acidosis (pH 7.25), and hyperglycemia (>250
mg/dL) are classic signs of DKA, which is more common in Type 1 diabetes. HHS typically
presents with extreme hyperglycemia (>600 mg/dL) but without significant ketosis or acidosis.
Q4: In the pathophysiology of Diabetic Ketoacidosis (DKA), the absence of insulin leads to the
breakdown of fatty acids into which byproducts?
A. Triglycerides and glycerol.
B. Ketones (acetoacetate, beta-hydroxybutyrate, acetone). [CORRECT]
C. Lactic acid and pyruvate.
D. Glucose and glycogen.
Correct Answer: B
Rationale: Insulin deficiency promotes lipolysis. Free fatty acids are released and converted by
the liver into ketone bodies (acetoacetate, beta-hydroxybutyrate, acetone), which are acidic and
cause metabolic acidosis.
, 3
Q5: A patient with Type 2 Diabetes Mellitus is prescribed Metformin. What is the primary
mechanism of action of this medication?
A. Stimulates the pancreas to release more insulin.
B. Inhibits the reabsorption of glucose in the renal tubules.
C. Decreases hepatic glucose production and increases peripheral insulin sensitivity.
[CORRECT]
D. Delays gastric emptying to slow glucose absorption.
Correct Answer: C
Rationale: Metformin is a biguanide that primarily works by suppressing gluconeogenesis in the
liver and increasing insulin sensitivity in peripheral tissues. Sulfonylureas stimulate insulin
release. SGLT2 inhibitors inhibit renal reabsorption. GLP-1 agonists delay gastric emptying.
Q6: The nurse practitioner is educating a patient about "Dawn Phenomenon." What causes this
early morning hyperglycemia?
A. Nocturnal hypoglycemia followed by rebound hyperglycemia (Somogyi effect).
B. The release of counter-regulatory hormones (growth hormone, cortisol) in the early morning.
[CORRECT]
C. Inadequate long-acting insulin dose the previous evening.
D. Consuming a high-carbohydrate snack before bed.
Correct Answer: B
Rationale: The Dawn Phenomenon results from the normal release of growth hormone and
cortisol in the early morning hours, which stimulates hepatic glucose production. The Somogyi
effect is caused by nocturnal hypoglycemia triggering a rebound hyperglycemia.
Q7: Which of the following findings is most characteristic of Hyperosmolar Hyperglycemic
State (HHS) compared to Diabetic Ketoacidosis (DKA)?
A. Presence of severe metabolic acidosis (pH < 7.3).
B. Serum ketones are significantly elevated.
