NUR612/NUR 612 Exam 3 V2 | Advanced
Nursing II Q&A with Rationale | William
Paterson University
1. A 55-year-old patient with Stage 4 Chronic Kidney Disease (CKD) presents with a
hemoglobin of 8.5 g/dL. Which of the following is the primary cause of anemia in this patient?
A. Iron deficiency due to poor dietary intake
B. Shortened life span of red blood cells
C. Decreased production of erythropoietin
D. Vitamin B12 malabsorption in the ileum
Answer: C
Rationale: In advanced CKD, the kidneys fail to produce sufficient erythropoietin, which is
the primary hormone stimulating red blood cell production. This leads to a normocytic,
normochromic anemia as the bone marrow lacks the signal to generate new cells.
Treatment often involves administering synthetic erythropoietin-stimulating agents to
maintain target hemoglobin levels.
2. Which electrolyte abnormality is most commonly associated with the early stages of
Chronic Kidney Disease?
A. Hypokalemia
B. Hyperkalemia
,C. Hypercalcemia
D. Hyponatremia
Answer: B
Rationale: Hyperkalemia occurs because the kidneys lose their ability to effectively
excrete potassium as the glomerular filtration rate declines. This condition is dangerous
because elevated potassium levels can lead to life-threatening cardiac arrhythmias.
Patients are often placed on a low-potassium diet to manage this risk in the clinical setting.
3. A patient with Grave’s disease is prescribed Methimazole. What is the primary mechanism
of action for this medication?
A. Destruction of thyroid tissue via radiation
B. Blocking the peripheral conversion of T4 to T3
C. Inhibition of thyroid hormone synthesis
D. Antagonism of beta-adrenergic receptors
Answer: C
Rationale: Methimazole works by inhibiting the enzyme thyroperoxidase, which is
necessary for the synthesis of thyroid hormones T3 and T4. It does not destroy the gland
itself but rather prevents the production of new hormone over time. This is a common first-
line treatment for hyperthyroidism to achieve a euthyroid state.
, 4. Which of the following is a classic symptom of Diabetes Insipidus?
A. High urine specific gravity
B. Elevated blood glucose levels
C. Fluid volume excess and peripheral edema
D. Excessive thirst and large volumes of dilute urine
Answer: D
Rationale: Diabetes Insipidus is characterized by a deficiency in Antidiuretic Hormone
(ADH) or a lack of response to it, leading to polyuria. This results in the excretion of large
amounts of very dilute urine, which subsequently triggers intense polydipsia (thirst).
Monitoring urine specific gravity is crucial, as it will typically remain very low despite
dehydration.
5. A patient is diagnosed with Cushing’s Syndrome. Which clinical finding is most consistent
with this diagnosis?
A. Hyperpigmentation of the skin
B. Weight loss and hypotension
C. Hyperkalemia and metabolic acidosis
D. Central obesity and purple striae
Answer: D
Nursing II Q&A with Rationale | William
Paterson University
1. A 55-year-old patient with Stage 4 Chronic Kidney Disease (CKD) presents with a
hemoglobin of 8.5 g/dL. Which of the following is the primary cause of anemia in this patient?
A. Iron deficiency due to poor dietary intake
B. Shortened life span of red blood cells
C. Decreased production of erythropoietin
D. Vitamin B12 malabsorption in the ileum
Answer: C
Rationale: In advanced CKD, the kidneys fail to produce sufficient erythropoietin, which is
the primary hormone stimulating red blood cell production. This leads to a normocytic,
normochromic anemia as the bone marrow lacks the signal to generate new cells.
Treatment often involves administering synthetic erythropoietin-stimulating agents to
maintain target hemoglobin levels.
2. Which electrolyte abnormality is most commonly associated with the early stages of
Chronic Kidney Disease?
A. Hypokalemia
B. Hyperkalemia
,C. Hypercalcemia
D. Hyponatremia
Answer: B
Rationale: Hyperkalemia occurs because the kidneys lose their ability to effectively
excrete potassium as the glomerular filtration rate declines. This condition is dangerous
because elevated potassium levels can lead to life-threatening cardiac arrhythmias.
Patients are often placed on a low-potassium diet to manage this risk in the clinical setting.
3. A patient with Grave’s disease is prescribed Methimazole. What is the primary mechanism
of action for this medication?
A. Destruction of thyroid tissue via radiation
B. Blocking the peripheral conversion of T4 to T3
C. Inhibition of thyroid hormone synthesis
D. Antagonism of beta-adrenergic receptors
Answer: C
Rationale: Methimazole works by inhibiting the enzyme thyroperoxidase, which is
necessary for the synthesis of thyroid hormones T3 and T4. It does not destroy the gland
itself but rather prevents the production of new hormone over time. This is a common first-
line treatment for hyperthyroidism to achieve a euthyroid state.
, 4. Which of the following is a classic symptom of Diabetes Insipidus?
A. High urine specific gravity
B. Elevated blood glucose levels
C. Fluid volume excess and peripheral edema
D. Excessive thirst and large volumes of dilute urine
Answer: D
Rationale: Diabetes Insipidus is characterized by a deficiency in Antidiuretic Hormone
(ADH) or a lack of response to it, leading to polyuria. This results in the excretion of large
amounts of very dilute urine, which subsequently triggers intense polydipsia (thirst).
Monitoring urine specific gravity is crucial, as it will typically remain very low despite
dehydration.
5. A patient is diagnosed with Cushing’s Syndrome. Which clinical finding is most consistent
with this diagnosis?
A. Hyperpigmentation of the skin
B. Weight loss and hypotension
C. Hyperkalemia and metabolic acidosis
D. Central obesity and purple striae
Answer: D
