NRS 455 Exam 4 V2 | NRS 455
Pathophysiology | Actual Q&A with
Rationale (NRS455 Exam 4) | Grand
Canyon University
1. A patient is diagnosed with Type 1 Diabetes Mellitus. Which statement best describes the
underlying pathophysiology of this condition?
A. Insulin resistance in peripheral tissues combined with a relative insulin deficiency.
B. A decrease in the number of insulin receptors on the surface of target cells.
C. Overproduction of glucagon by alpha cells causing chronic hyperglycemia.
D. Autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency.
Correct Answer: D
Rationale: Type 1 Diabetes Mellitus is characterized by the immune-mediated destruction
of beta cells in the Islets of Langerhans. This leads to a complete lack of insulin production,
requiring lifelong exogenous insulin administration. This distinguishes it from Type 2,
which primarily involves insulin resistance and secretory dysfunction.
2. A nurse is evaluating a client with Graves’ disease. Which clinical manifestations should the
nurse expect to find? (Select All That Apply)
A. Exophthalmos
B. Weight gain
,C. Tachycardia
D. Heat intolerance
E. Bradycardia
F. Fine muscle tremors
Correct Answer: A, C, D, F
Rationale: Graves’ disease is an autoimmune form of hyperthyroidism resulting in
hypermetabolism. Common symptoms include bulging eyes (exophthalmos), increased
heart rate, and an inability to tolerate warm environments. These signs reflect the
overstimulation of the sympathetic nervous system and metabolic rate by excess thyroid
hormones.
3. Which electrolyte imbalance is most commonly associated with Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. Hyponatremia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Correct Answer: A
Rationale: SIADH involves the excessive release of ADH, leading to water retention and
expansion of intravascular volume. This excess water dilutes the serum sodium
, concentration, resulting in dilutional hyponatremia. Patients must be monitored closely for
neurological changes due to the potential for cerebral edema.
4. A patient presents with ‘moon face,’ ‘buffalo hump,’ and abdominal striae. Which
condition does the nurse suspect?
A. Addison’s Disease
B. Hashimoto’s Thyroiditis
C. Cushing’s Syndrome
D. Pheochromocytoma
Correct Answer: C
Rationale: Cushing’s syndrome results from chronic exposure to excessive levels of
cortisol, whether endogenous or exogenous. The classic physical signs include central
obesity, a fatty hump between the shoulders, and a rounded face. These changes occur due
to altered fat distribution and protein wasting caused by glucocorticoid excess.
5. What is the primary cause of esophageal varices in a patient with cirrhosis?
A. Direct irritation from gastric acid reflux.
B. Decreased production of clotting factors by the liver.
C. Portal hypertension causing blood to shunt into collateral vessels.
D. Chronic inflammation of the esophagus due to alcohol consumption.
Correct Answer: C
Pathophysiology | Actual Q&A with
Rationale (NRS455 Exam 4) | Grand
Canyon University
1. A patient is diagnosed with Type 1 Diabetes Mellitus. Which statement best describes the
underlying pathophysiology of this condition?
A. Insulin resistance in peripheral tissues combined with a relative insulin deficiency.
B. A decrease in the number of insulin receptors on the surface of target cells.
C. Overproduction of glucagon by alpha cells causing chronic hyperglycemia.
D. Autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency.
Correct Answer: D
Rationale: Type 1 Diabetes Mellitus is characterized by the immune-mediated destruction
of beta cells in the Islets of Langerhans. This leads to a complete lack of insulin production,
requiring lifelong exogenous insulin administration. This distinguishes it from Type 2,
which primarily involves insulin resistance and secretory dysfunction.
2. A nurse is evaluating a client with Graves’ disease. Which clinical manifestations should the
nurse expect to find? (Select All That Apply)
A. Exophthalmos
B. Weight gain
,C. Tachycardia
D. Heat intolerance
E. Bradycardia
F. Fine muscle tremors
Correct Answer: A, C, D, F
Rationale: Graves’ disease is an autoimmune form of hyperthyroidism resulting in
hypermetabolism. Common symptoms include bulging eyes (exophthalmos), increased
heart rate, and an inability to tolerate warm environments. These signs reflect the
overstimulation of the sympathetic nervous system and metabolic rate by excess thyroid
hormones.
3. Which electrolyte imbalance is most commonly associated with Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. Hyponatremia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Correct Answer: A
Rationale: SIADH involves the excessive release of ADH, leading to water retention and
expansion of intravascular volume. This excess water dilutes the serum sodium
, concentration, resulting in dilutional hyponatremia. Patients must be monitored closely for
neurological changes due to the potential for cerebral edema.
4. A patient presents with ‘moon face,’ ‘buffalo hump,’ and abdominal striae. Which
condition does the nurse suspect?
A. Addison’s Disease
B. Hashimoto’s Thyroiditis
C. Cushing’s Syndrome
D. Pheochromocytoma
Correct Answer: C
Rationale: Cushing’s syndrome results from chronic exposure to excessive levels of
cortisol, whether endogenous or exogenous. The classic physical signs include central
obesity, a fatty hump between the shoulders, and a rounded face. These changes occur due
to altered fat distribution and protein wasting caused by glucocorticoid excess.
5. What is the primary cause of esophageal varices in a patient with cirrhosis?
A. Direct irritation from gastric acid reflux.
B. Decreased production of clotting factors by the liver.
C. Portal hypertension causing blood to shunt into collateral vessels.
D. Chronic inflammation of the esophagus due to alcohol consumption.
Correct Answer: C
