NRS 455 Exam 4 V1 | NRS 455
Pathophysiology | Actual Q&A with
Rationale (NRS455 Exam 4) | Grand
Canyon University
1. A patient with a traumatic brain injury is producing large amounts of clear, dilute urine and
reports extreme thirst. The laboratory results indicate a high serum sodium level and a low
urine specific gravity. Which pathophysiology does the nurse suspect?
A. Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
B. Diabetes Mellitus Type 1
C. Diabetes Insipidus (DI)
D. Adrenal Insufficiency
Correct Answer: C
Rationale: Diabetes Insipidus (DI) is characterized by a deficiency of ADH or a decreased
renal response to ADH, leading to excessive water loss. This condition results in polyuria,
polydipsia, and significant dehydration if fluids are not replaced. The nurse should focus on
monitoring fluid balance and administering synthetic vasopressin as ordered.
2. Which electrolyte imbalance is most commonly associated with the early stage of Acute
Kidney Injury (AKI) caused by rhabdomyolysis?
A. Hypocalcemia
,B. Hyperkalemia
C. Hyponatremia
D. Hypophosphatemia
Correct Answer: B
Rationale: Hyperkalemia occurs in AKI because the kidneys are unable to effectively
excrete potassium from the blood. In the case of rhabdomyolysis, the breakdown of muscle
tissue releases large amounts of intracellular potassium into the systemic circulation.
Immediate nursing intervention is required to prevent life-threatening cardiac
dysrhythmias.
3. A patient is admitted with suspected Chronic Kidney Disease (CKD). Which of the following
clinical manifestations are typical for Stage 4 or 5 CKD? (Select All That Apply)
A. Pruritus
B. Uremic frost
C. Respiratory alkalosis
D. Hypokalemia
E. Anemia
F. Osteodystrophy
Correct Answer: A, B, E, F
, Rationale: Pruritus and uremic frost result from the accumulation of urea and other toxins
that deposit in the skin. Anemia occurs because the failing kidneys produce less
erythropoietin, which is necessary for red blood cell production. Osteodystrophy is caused
by the imbalance of calcium and phosphate levels, which triggers secondary
hyperparathyroidism.
4. Which hormone is primarily responsible for the pathophysiology of Graves’ disease?
A. Thyroid-stimulating immunoglobulins (TSI)
B. Thyroxine (T4)
C. Thyroid Stimulating Hormone (TSH)
D. Cortisol
Correct Answer: A
Rationale: Graves’ disease is an autoimmune disorder where thyroid-stimulating
immunoglobulins act as antibodies that mimic TSH. These antibodies bind to and activate
TSH receptors, causing the thyroid gland to grow and overproduce thyroid hormones. This
leads to the clinical state of hyperthyroidism, including symptoms like exophthalmos and
goiter.
5. A patient presents with ‘moon face,’ truncal obesity, and purple striae on the abdomen.
Which diagnostic finding would most likely confirm Cushing’s Syndrome?
A. Decreased serum ACTH
B. Increased serum cortisol
Pathophysiology | Actual Q&A with
Rationale (NRS455 Exam 4) | Grand
Canyon University
1. A patient with a traumatic brain injury is producing large amounts of clear, dilute urine and
reports extreme thirst. The laboratory results indicate a high serum sodium level and a low
urine specific gravity. Which pathophysiology does the nurse suspect?
A. Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
B. Diabetes Mellitus Type 1
C. Diabetes Insipidus (DI)
D. Adrenal Insufficiency
Correct Answer: C
Rationale: Diabetes Insipidus (DI) is characterized by a deficiency of ADH or a decreased
renal response to ADH, leading to excessive water loss. This condition results in polyuria,
polydipsia, and significant dehydration if fluids are not replaced. The nurse should focus on
monitoring fluid balance and administering synthetic vasopressin as ordered.
2. Which electrolyte imbalance is most commonly associated with the early stage of Acute
Kidney Injury (AKI) caused by rhabdomyolysis?
A. Hypocalcemia
,B. Hyperkalemia
C. Hyponatremia
D. Hypophosphatemia
Correct Answer: B
Rationale: Hyperkalemia occurs in AKI because the kidneys are unable to effectively
excrete potassium from the blood. In the case of rhabdomyolysis, the breakdown of muscle
tissue releases large amounts of intracellular potassium into the systemic circulation.
Immediate nursing intervention is required to prevent life-threatening cardiac
dysrhythmias.
3. A patient is admitted with suspected Chronic Kidney Disease (CKD). Which of the following
clinical manifestations are typical for Stage 4 or 5 CKD? (Select All That Apply)
A. Pruritus
B. Uremic frost
C. Respiratory alkalosis
D. Hypokalemia
E. Anemia
F. Osteodystrophy
Correct Answer: A, B, E, F
, Rationale: Pruritus and uremic frost result from the accumulation of urea and other toxins
that deposit in the skin. Anemia occurs because the failing kidneys produce less
erythropoietin, which is necessary for red blood cell production. Osteodystrophy is caused
by the imbalance of calcium and phosphate levels, which triggers secondary
hyperparathyroidism.
4. Which hormone is primarily responsible for the pathophysiology of Graves’ disease?
A. Thyroid-stimulating immunoglobulins (TSI)
B. Thyroxine (T4)
C. Thyroid Stimulating Hormone (TSH)
D. Cortisol
Correct Answer: A
Rationale: Graves’ disease is an autoimmune disorder where thyroid-stimulating
immunoglobulins act as antibodies that mimic TSH. These antibodies bind to and activate
TSH receptors, causing the thyroid gland to grow and overproduce thyroid hormones. This
leads to the clinical state of hyperthyroidism, including symptoms like exophthalmos and
goiter.
5. A patient presents with ‘moon face,’ truncal obesity, and purple striae on the abdomen.
Which diagnostic finding would most likely confirm Cushing’s Syndrome?
A. Decreased serum ACTH
B. Increased serum cortisol
