NUR 546/NUR546 Exam 2 V1 | Advanced
Pathophysiology Q&A with Rationale |
William Paterson University
1. Which lab value is the most accurate indicator of overall renal function and glomerular
filtration rate (GFR)?
A. Serum Creatinine
B. Blood Urea Nitrogen (BUN)
C. Creatinine Clearance
D. Urine Specific Gravity
Answer: C
Rationale: Creatinine clearance provides the best estimate of GFR because it compares the
creatinine level in urine with the creatinine level in the blood. Serum creatinine alone is
influenced by muscle mass and hydration, making it less precise than clearance. A 24-hour
urine collection is often used to calculate this value accurately in clinical practice.
2. In a patient with SIADH (Syndrome of Inappropriate Antidiuretic Hormone), what is the
primary electrolyte imbalance expected?
A. Hypernatremia
B. Hypercalcemia
C. Hypokalemia
,D. Hyponatremia
Answer: D
Rationale: SIADH involves the excessive release of antidiuretic hormone, which causes the
kidneys to reabsorb too much water. This excess water dilutes the sodium in the blood,
leading to dilutional hyponatremia. Clinical manifestations often include confusion,
seizures, and fluid overload without edema.
3. Which pathophysiological process occurs in Type 1 Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Excessive glucagon production by the liver
C. Hypersecretion of insulin by the pancreas
D. Autoimmune destruction of pancreatic beta cells
Answer: D
Rationale: Type 1 Diabetes is characterized by an absolute insulin deficiency due to the
destruction of beta cells in the Islets of Langerhans. This is typically a T-cell mediated
autoimmune attack often triggered by environmental factors in genetically susceptible
individuals. Without insulin, the body cannot move glucose into cells, leading to
hyperglycemia and ketoacidosis.
4. A patient presents with exophthalmos, heat intolerance, and tachycardia. Which condition
is most likely?
A. Hashimoto’s Thyroiditis
, B. Cushing’s Syndrome
C. Grave’s Disease
D. Myxedema Coma
Answer: C
Rationale: Grave’s disease is an autoimmune form of hyperthyroidism where antibodies
stimulate the TSH receptors. The resulting overproduction of thyroid hormones increases
the metabolic rate, causing tachycardia and heat intolerance. Exophthalmos, or bulging
eyes, is a unique clinical sign caused by inflammation of the orbital tissues.
5. What is the hallmark clinical manifestation of Nephrotic Syndrome?
A. Massive Proteinuria
B. Hematuria
C. Hypotension
D. Increased GFR
Answer: A
Rationale: Nephrotic syndrome is defined by massive proteinuria, typically exceeding 3.5
grams per day. This loss of protein leads to hypoalbuminemia, which decreases capillary
oncotic pressure and results in generalized edema. In contrast, nephritic syndrome is more
commonly associated with hematuria and hypertension.
Pathophysiology Q&A with Rationale |
William Paterson University
1. Which lab value is the most accurate indicator of overall renal function and glomerular
filtration rate (GFR)?
A. Serum Creatinine
B. Blood Urea Nitrogen (BUN)
C. Creatinine Clearance
D. Urine Specific Gravity
Answer: C
Rationale: Creatinine clearance provides the best estimate of GFR because it compares the
creatinine level in urine with the creatinine level in the blood. Serum creatinine alone is
influenced by muscle mass and hydration, making it less precise than clearance. A 24-hour
urine collection is often used to calculate this value accurately in clinical practice.
2. In a patient with SIADH (Syndrome of Inappropriate Antidiuretic Hormone), what is the
primary electrolyte imbalance expected?
A. Hypernatremia
B. Hypercalcemia
C. Hypokalemia
,D. Hyponatremia
Answer: D
Rationale: SIADH involves the excessive release of antidiuretic hormone, which causes the
kidneys to reabsorb too much water. This excess water dilutes the sodium in the blood,
leading to dilutional hyponatremia. Clinical manifestations often include confusion,
seizures, and fluid overload without edema.
3. Which pathophysiological process occurs in Type 1 Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Excessive glucagon production by the liver
C. Hypersecretion of insulin by the pancreas
D. Autoimmune destruction of pancreatic beta cells
Answer: D
Rationale: Type 1 Diabetes is characterized by an absolute insulin deficiency due to the
destruction of beta cells in the Islets of Langerhans. This is typically a T-cell mediated
autoimmune attack often triggered by environmental factors in genetically susceptible
individuals. Without insulin, the body cannot move glucose into cells, leading to
hyperglycemia and ketoacidosis.
4. A patient presents with exophthalmos, heat intolerance, and tachycardia. Which condition
is most likely?
A. Hashimoto’s Thyroiditis
, B. Cushing’s Syndrome
C. Grave’s Disease
D. Myxedema Coma
Answer: C
Rationale: Grave’s disease is an autoimmune form of hyperthyroidism where antibodies
stimulate the TSH receptors. The resulting overproduction of thyroid hormones increases
the metabolic rate, causing tachycardia and heat intolerance. Exophthalmos, or bulging
eyes, is a unique clinical sign caused by inflammation of the orbital tissues.
5. What is the hallmark clinical manifestation of Nephrotic Syndrome?
A. Massive Proteinuria
B. Hematuria
C. Hypotension
D. Increased GFR
Answer: A
Rationale: Nephrotic syndrome is defined by massive proteinuria, typically exceeding 3.5
grams per day. This loss of protein leads to hypoalbuminemia, which decreases capillary
oncotic pressure and results in generalized edema. In contrast, nephritic syndrome is more
commonly associated with hematuria and hypertension.
