HSC 4558 Exam 4 V1 | HSC 4558
Pathophysiology II | Actual Q&A with
Rationale (HSC4558 Exam 4) | University
of Central Florida
1. A patient is diagnosed with Type 1 Diabetes Mellitus. What is the primary
pathophysiological mechanism behind this condition?
A. Insulin resistance in peripheral tissues
B. Excessive glucagon production by alpha cells
C. Decreased glucose absorption in the small intestine
D. Autoimmune destruction of pancreatic beta cells
Answer: D
Rationale: Type 1 Diabetes Mellitus is characterized by an absolute deficiency of insulin
due to the immune system attacking the beta cells in the Islets of Langerhans. This leads to
a total loss of endogenous insulin production, necessitating lifelong exogenous insulin
therapy. The absence of insulin prevents glucose from entering cells, resulting in
hyperglycemia and the breakdown of fats for energy.
2. Which of the following clinical manifestations is most indicative of Graves’ disease?
A. Weight gain and bradycardia
B. Exophthalmos and heat intolerance
,C. Cold intolerance and dry skin
D. Hypotension and lethargy
Answer: B
Rationale: Graves’ disease is a form of hyperthyroidism caused by thyroid-stimulating
immunoglobulins that bind to TSH receptors. This results in the overproduction of thyroid
hormones, leading to a hypermetabolic state characterized by heat intolerance and
tachycardia. Exophthalmos, or bulging eyes, is a specific sign caused by inflammation and
tissue accumulation behind the orbits.
3. A patient presents with a ‘moon face,’ buffalo hump, and central obesity. Which condition
should the nurse suspect?
A. Addison’s disease
B. Pheochromocytoma
C. Cushing’s syndrome
D. Hypoparathyroidism
Answer: C
Rationale: Cushing’s syndrome occurs when there is a chronic excess of glucocorticoids,
particularly cortisol, in the body. This excess leads to characteristic fat redistribution,
including a rounded face and a fat pad on the upper back. The catabolic effects of cortisol
also cause skin thinning, purple striae, and muscle wasting in the extremities.
, 4. What is the primary cause of Diabetes Insipidus (DI)?
A. Deficiency of or decreased response to Antidiuretic Hormone (ADH)
B. Insulin deficiency in the pancreas
C. Excessive secretion of aldosterone
D. Hypersecretion of cortisol from the adrenal cortex
Answer: A
Rationale: Diabetes Insipidus results from a lack of ADH (Central DI) or a failure of the
kidneys to respond to ADH (Nephrogenic DI). ADH is responsible for water reabsorption in
the distal tubules and collecting ducts of the kidney. Without sufficient ADH activity, the
body cannot concentrate urine, leading to massive polyuria and extreme thirst.
5. A patient in the ER has a fruity breath odor, Kussmaul respirations, and a blood glucose of
550 mg/dL. What is the likely diagnosis?
A. Diabetic Ketoacidosis (DKA)
B. Hyperosmolar Hyperglycemic State (HHS)
C. Hypoglycemic shock
D. Myxedema coma
Answer: A
Rationale: Diabetic Ketoacidosis (DKA) is a life-threatening complication of diabetes,
usually Type 1, where lack of insulin leads to ketone production. The fruity breath odor is
Pathophysiology II | Actual Q&A with
Rationale (HSC4558 Exam 4) | University
of Central Florida
1. A patient is diagnosed with Type 1 Diabetes Mellitus. What is the primary
pathophysiological mechanism behind this condition?
A. Insulin resistance in peripheral tissues
B. Excessive glucagon production by alpha cells
C. Decreased glucose absorption in the small intestine
D. Autoimmune destruction of pancreatic beta cells
Answer: D
Rationale: Type 1 Diabetes Mellitus is characterized by an absolute deficiency of insulin
due to the immune system attacking the beta cells in the Islets of Langerhans. This leads to
a total loss of endogenous insulin production, necessitating lifelong exogenous insulin
therapy. The absence of insulin prevents glucose from entering cells, resulting in
hyperglycemia and the breakdown of fats for energy.
2. Which of the following clinical manifestations is most indicative of Graves’ disease?
A. Weight gain and bradycardia
B. Exophthalmos and heat intolerance
,C. Cold intolerance and dry skin
D. Hypotension and lethargy
Answer: B
Rationale: Graves’ disease is a form of hyperthyroidism caused by thyroid-stimulating
immunoglobulins that bind to TSH receptors. This results in the overproduction of thyroid
hormones, leading to a hypermetabolic state characterized by heat intolerance and
tachycardia. Exophthalmos, or bulging eyes, is a specific sign caused by inflammation and
tissue accumulation behind the orbits.
3. A patient presents with a ‘moon face,’ buffalo hump, and central obesity. Which condition
should the nurse suspect?
A. Addison’s disease
B. Pheochromocytoma
C. Cushing’s syndrome
D. Hypoparathyroidism
Answer: C
Rationale: Cushing’s syndrome occurs when there is a chronic excess of glucocorticoids,
particularly cortisol, in the body. This excess leads to characteristic fat redistribution,
including a rounded face and a fat pad on the upper back. The catabolic effects of cortisol
also cause skin thinning, purple striae, and muscle wasting in the extremities.
, 4. What is the primary cause of Diabetes Insipidus (DI)?
A. Deficiency of or decreased response to Antidiuretic Hormone (ADH)
B. Insulin deficiency in the pancreas
C. Excessive secretion of aldosterone
D. Hypersecretion of cortisol from the adrenal cortex
Answer: A
Rationale: Diabetes Insipidus results from a lack of ADH (Central DI) or a failure of the
kidneys to respond to ADH (Nephrogenic DI). ADH is responsible for water reabsorption in
the distal tubules and collecting ducts of the kidney. Without sufficient ADH activity, the
body cannot concentrate urine, leading to massive polyuria and extreme thirst.
5. A patient in the ER has a fruity breath odor, Kussmaul respirations, and a blood glucose of
550 mg/dL. What is the likely diagnosis?
A. Diabetic Ketoacidosis (DKA)
B. Hyperosmolar Hyperglycemic State (HHS)
C. Hypoglycemic shock
D. Myxedema coma
Answer: A
Rationale: Diabetic Ketoacidosis (DKA) is a life-threatening complication of diabetes,
usually Type 1, where lack of insulin leads to ketone production. The fruity breath odor is
