NR 283 Pathophysiology Exam 3 | Questions and
Answers + Expert Rationales | 2026/27 Updates |
100% correct
1. Which types of muscles make up most of the musculoskeletal system?
A) Striated and involuntary
B) Smooth and voluntary
C) Striated and voluntary
D) Smooth and involuntary
Correct Answer: C. Striated and voluntary
Expert Rationale: Skeletal muscles, which make up the majority of the musculoskeletal system,
are striated (having visible banding patterns) and under voluntary control. Smooth muscle is
involuntary and found in organs like the intestines and blood vessels. Cardiac muscle is striated
but involuntary.
2. Irreversible changes in the distal joints of the fingers caused by osteoarthritis are known as:
A) Bouchard's nodes
B) Lymph nodes
C) Hay Garth’s nodes
D) Heberden's nodes
Correct Answer: D. Heberden's nodes
Expert Rationale: Heberden's nodes are bony enlargements of the distal interphalangeal (DIP)
joints that occur in osteoarthritis. They represent osteophyte formation and are irreversible
changes. Bouchard's nodes affect the proximal interphalangeal (PIP) joints. Lymph nodes are
unrelated to osteoarthritis. Hay Garth’s nodes is not a recognized term for this condition .
3. Osteoporosis is characterized by:
A) Porosity and brittleness
B) Brittleness and swelling of the joints
C) Crystal deposition and brittleness
D) Progressive inflammatory destruction after new bone formation
,Correct Answer: A. Porosity and brittleness
Expert Rationale: Osteoporosis is characterized by decreased bone mass and density, leading to
increased porosity and brittleness. The bones become more porous due to an imbalance where
bone resorption exceeds bone formation. This makes them fragile and susceptible to fractures.
Joint swelling (B) suggests arthritis, crystal deposition (C) suggests gout, and inflammatory
destruction (D) suggests rheumatoid arthritis .
4. Osteoporosis is a condition of:
A) Increased bone density
B) Decreased bone mass and increased fracture risk
C) Excessive bone formation
D) Joint inflammation
Correct Answer: B. Decreased bone mass and increased fracture risk
Expert Rationale: Osteoporosis involves a reduction in bone mineral density and deterioration
of bone microarchitecture, resulting in increased bone fragility and fracture risk. It occurs when
bone resorption outpaces bone formation. The most common fractures occur in the hip, spine,
and wrist. Increased bone density (A) would be osteopetrosis, not osteoporosis .
5. Which patients are at greatest risk for developing osteoporosis? (Select all that apply)
A) An Asian woman
B) A large-boned, dark-skinned woman
C) A client who started menopause early
D) A client with a family history of the disease
E) A client who has a physically active lifestyle
F) A client with an inadequate intake of calcium and vitamin D
Correct Answer: A, C, D, F
Expert Rationale: Risk factors for osteoporosis include: Asian or Caucasian ethnicity (A), early
menopause due to estrogen loss (C), family history (D), and inadequate calcium/vitamin D
intake (F). Large-boned, dark-skinned individuals (B) have lower risk. Physical activity (E) is
protective, not a risk factor .
6. Which treatment is commonly indicated for type 2 diabetes mellitus?
,A) High-fiber, low-fat diet
B) Fluid restriction
C) Insulin injections
D) Oral hypoglycemic agents and lifestyle modifications
Correct Answer: D. Oral hypoglycemic agents and lifestyle modifications
Expert Rationale: Type 2 diabetes is characterized by insulin resistance and relative insulin
deficiency. Treatment typically begins with lifestyle modifications (diet and exercise) and oral
hypoglycemic agents such as metformin. Insulin injections (C) may be needed in advanced cases
but are not the first-line treatment. Fluid restriction (B) is not indicated; hydration is important .
7. A major difference between type 1 and type 2 diabetes is:
A) How the condition is diagnosed
B) How the condition is treated
C) The potential long-term complications
D) The overall goal of treatment
Correct Answer: B. How the condition is treated
Expert Rationale: Type 1 diabetes requires insulin therapy because the body cannot produce
insulin due to autoimmune destruction of beta cells. Type 2 diabetes can often be managed
with lifestyle changes and oral medications that improve insulin sensitivity or increase insulin
secretion. The overall goals and potential complications are similar for both types .
8. Bobby comes into the clinic after 6 months for a follow-up visit. He indicates that his blood
sugars have been around 100 to 120 mg/dL and he has been fully participating in the other
aspects of his diabetes management plan. Which would lead you to believe that he has NOT
been in tight control of his diabetes?
A) A reduced glycosylated hemoglobin level
B) An elevated glycosylated hemoglobin level
C) A random blood sugar of 150 mg/dL performed in the clinic
D) There is no method to determine whether or not he is in tight control
Correct Answer: B. An elevated glycosylated hemoglobin level
Expert Rationale: Hemoglobin A1c (HbA1c) reflects average blood glucose over the previous 8-
12 weeks. An elevated HbA1c level indicates poor glycemic control despite the patient's
, reported blood sugar readings. Fingerstick readings provide only a snapshot, whereas HbA1c
provides a long-term picture of glucose control .
9. Which laboratory test is the best predictor of blood glucose control over the previous few
months?
A) HbA1c (hemoglobin A1c)
B) Fasting blood glucose
C) Urinalysis
D) Postprandial blood glucose
Correct Answer: A. HbA1c (hemoglobin A1c)
Expert Rationale: Hemoglobin A1c reflects the average blood glucose level over the previous 8-
12 weeks because glucose attaches to hemoglobin in red blood cells over their 120-day lifespan.
Fasting and postprandial glucose (B,D) are point-in-time measurements. Urinalysis (C) can
detect glucose in urine but does not reflect long-term control .
10. Neuropathies are a potential complication of diabetes. Why do these occur?
A) Infection in the nerves
B) Thickening and ischemia of the vessels that supply the nerve fibers
C) Inability to provide continuous glucose to the brain and spinal cord
D) Excessive glucose exposure to the brain and spinal cord
Correct Answer: B. Thickening and ischemia of the vessels that supply the nerve fibers
Expert Rationale: Diabetic neuropathy results from microvascular damage causing thickening
and ischemia of the vessels that supply nerve fibers. Chronic hyperglycemia leads to endothelial
dysfunction and microangiopathy, which impairs blood flow to peripheral nerves, causing
ischemic damage. This is a microvascular complication of diabetes .
11. Which of the following is NOT a sign of DKA (diabetic ketoacidosis)?
A) Kussmaul respirations
B) Dehydration
C) Ketonuria
D) Low blood glucose level
Correct Answer: D. Low blood glucose level
Answers + Expert Rationales | 2026/27 Updates |
100% correct
1. Which types of muscles make up most of the musculoskeletal system?
A) Striated and involuntary
B) Smooth and voluntary
C) Striated and voluntary
D) Smooth and involuntary
Correct Answer: C. Striated and voluntary
Expert Rationale: Skeletal muscles, which make up the majority of the musculoskeletal system,
are striated (having visible banding patterns) and under voluntary control. Smooth muscle is
involuntary and found in organs like the intestines and blood vessels. Cardiac muscle is striated
but involuntary.
2. Irreversible changes in the distal joints of the fingers caused by osteoarthritis are known as:
A) Bouchard's nodes
B) Lymph nodes
C) Hay Garth’s nodes
D) Heberden's nodes
Correct Answer: D. Heberden's nodes
Expert Rationale: Heberden's nodes are bony enlargements of the distal interphalangeal (DIP)
joints that occur in osteoarthritis. They represent osteophyte formation and are irreversible
changes. Bouchard's nodes affect the proximal interphalangeal (PIP) joints. Lymph nodes are
unrelated to osteoarthritis. Hay Garth’s nodes is not a recognized term for this condition .
3. Osteoporosis is characterized by:
A) Porosity and brittleness
B) Brittleness and swelling of the joints
C) Crystal deposition and brittleness
D) Progressive inflammatory destruction after new bone formation
,Correct Answer: A. Porosity and brittleness
Expert Rationale: Osteoporosis is characterized by decreased bone mass and density, leading to
increased porosity and brittleness. The bones become more porous due to an imbalance where
bone resorption exceeds bone formation. This makes them fragile and susceptible to fractures.
Joint swelling (B) suggests arthritis, crystal deposition (C) suggests gout, and inflammatory
destruction (D) suggests rheumatoid arthritis .
4. Osteoporosis is a condition of:
A) Increased bone density
B) Decreased bone mass and increased fracture risk
C) Excessive bone formation
D) Joint inflammation
Correct Answer: B. Decreased bone mass and increased fracture risk
Expert Rationale: Osteoporosis involves a reduction in bone mineral density and deterioration
of bone microarchitecture, resulting in increased bone fragility and fracture risk. It occurs when
bone resorption outpaces bone formation. The most common fractures occur in the hip, spine,
and wrist. Increased bone density (A) would be osteopetrosis, not osteoporosis .
5. Which patients are at greatest risk for developing osteoporosis? (Select all that apply)
A) An Asian woman
B) A large-boned, dark-skinned woman
C) A client who started menopause early
D) A client with a family history of the disease
E) A client who has a physically active lifestyle
F) A client with an inadequate intake of calcium and vitamin D
Correct Answer: A, C, D, F
Expert Rationale: Risk factors for osteoporosis include: Asian or Caucasian ethnicity (A), early
menopause due to estrogen loss (C), family history (D), and inadequate calcium/vitamin D
intake (F). Large-boned, dark-skinned individuals (B) have lower risk. Physical activity (E) is
protective, not a risk factor .
6. Which treatment is commonly indicated for type 2 diabetes mellitus?
,A) High-fiber, low-fat diet
B) Fluid restriction
C) Insulin injections
D) Oral hypoglycemic agents and lifestyle modifications
Correct Answer: D. Oral hypoglycemic agents and lifestyle modifications
Expert Rationale: Type 2 diabetes is characterized by insulin resistance and relative insulin
deficiency. Treatment typically begins with lifestyle modifications (diet and exercise) and oral
hypoglycemic agents such as metformin. Insulin injections (C) may be needed in advanced cases
but are not the first-line treatment. Fluid restriction (B) is not indicated; hydration is important .
7. A major difference between type 1 and type 2 diabetes is:
A) How the condition is diagnosed
B) How the condition is treated
C) The potential long-term complications
D) The overall goal of treatment
Correct Answer: B. How the condition is treated
Expert Rationale: Type 1 diabetes requires insulin therapy because the body cannot produce
insulin due to autoimmune destruction of beta cells. Type 2 diabetes can often be managed
with lifestyle changes and oral medications that improve insulin sensitivity or increase insulin
secretion. The overall goals and potential complications are similar for both types .
8. Bobby comes into the clinic after 6 months for a follow-up visit. He indicates that his blood
sugars have been around 100 to 120 mg/dL and he has been fully participating in the other
aspects of his diabetes management plan. Which would lead you to believe that he has NOT
been in tight control of his diabetes?
A) A reduced glycosylated hemoglobin level
B) An elevated glycosylated hemoglobin level
C) A random blood sugar of 150 mg/dL performed in the clinic
D) There is no method to determine whether or not he is in tight control
Correct Answer: B. An elevated glycosylated hemoglobin level
Expert Rationale: Hemoglobin A1c (HbA1c) reflects average blood glucose over the previous 8-
12 weeks. An elevated HbA1c level indicates poor glycemic control despite the patient's
, reported blood sugar readings. Fingerstick readings provide only a snapshot, whereas HbA1c
provides a long-term picture of glucose control .
9. Which laboratory test is the best predictor of blood glucose control over the previous few
months?
A) HbA1c (hemoglobin A1c)
B) Fasting blood glucose
C) Urinalysis
D) Postprandial blood glucose
Correct Answer: A. HbA1c (hemoglobin A1c)
Expert Rationale: Hemoglobin A1c reflects the average blood glucose level over the previous 8-
12 weeks because glucose attaches to hemoglobin in red blood cells over their 120-day lifespan.
Fasting and postprandial glucose (B,D) are point-in-time measurements. Urinalysis (C) can
detect glucose in urine but does not reflect long-term control .
10. Neuropathies are a potential complication of diabetes. Why do these occur?
A) Infection in the nerves
B) Thickening and ischemia of the vessels that supply the nerve fibers
C) Inability to provide continuous glucose to the brain and spinal cord
D) Excessive glucose exposure to the brain and spinal cord
Correct Answer: B. Thickening and ischemia of the vessels that supply the nerve fibers
Expert Rationale: Diabetic neuropathy results from microvascular damage causing thickening
and ischemia of the vessels that supply nerve fibers. Chronic hyperglycemia leads to endothelial
dysfunction and microangiopathy, which impairs blood flow to peripheral nerves, causing
ischemic damage. This is a microvascular complication of diabetes .
11. Which of the following is NOT a sign of DKA (diabetic ketoacidosis)?
A) Kussmaul respirations
B) Dehydration
C) Ketonuria
D) Low blood glucose level
Correct Answer: D. Low blood glucose level
