,NSG 530 Exam 4 | Advanced
Pathophysiology (2026) Actual Q&A PDF |
Wilkes
1. In the context of endocrine pathophysiology, which mechanism best
explains the polydipsia and polyuria observed in a patient with untreated
diabetes insipidus?
A) Osmotic diuresis from hyperglycemia
B) Failure of antidiuretic hormone secretion or action
C) Excessive aldosterone production
D) Increased atrial natriuretic peptide release
Correct Answer: Failure of antidiuretic hormone secretion or action
Rationale: Diabetes insipidus is characterized by a deficiency of
antidiuretic hormone (central) or renal resistance to antidiuretic hormone
(nephrogenic). This leads to an inability to reabsorb water in the collecting
ducts, resulting in the excretion of large volumes of dilute urine (polyuria)
and compensatory excessive thirst (polydipsia). Osmotic diuresis from
hyperglycemia is the mechanism in diabetes mellitus.
2. A 45-year-old female presents with weight gain, easy bruising, and a
buffalo hump. Which laboratory finding would most likely be elevated?
A) Serum cortisol
B) Serum aldosterone
C) Serum thyroxine
D) Serum parathyroid hormone
Correct Answer: Serum cortisol
,Rationale: The clinical presentation of weight gain, easy bruising, and a
buffalo hump is characteristic of Cushing's syndrome, which results from
chronic excess of cortisol. Serum cortisol levels would be elevated.
Aldosterone excess would cause hypertension and hypokalemia, while
thyroid and parathyroid abnormalities present with different clinical
features.
3. What is the primary mechanism of insulin resistance in type 2 diabetes
mellitus?
A) Autoimmune destruction of pancreatic beta cells
B) Impaired post-receptor signaling and reduced GLUT-4 translocation
C) Absolute deficiency of insulin production
D) Excessive glucagon secretion from pancreatic alpha cells
Correct Answer: Impaired post-receptor signaling and reduced GLUT-
4 translocation
Rationale: Type 2 diabetes mellitus is characterized by insulin
resistance, primarily due to impaired post-receptor signaling and reduced
translocation of GLUT-4 transporters to the cell membrane. This impairs
glucose uptake into skeletal muscle and adipose tissue. Autoimmune
destruction of beta cells is the mechanism in type 1 diabetes.
4. Which electrolyte abnormality is most commonly associated with
primary hyperaldosteronism?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
Correct Answer: Hypokalemia
, Rationale: Primary hyperaldosteronism, such as from an adrenal
adenoma, leads to excessive aldosterone secretion. Aldosterone increases
sodium reabsorption and potassium excretion in the distal tubule,
resulting in hypokalemia and hypertension. Hyperkalemia is typically seen
in adrenal insufficiency.
5. A patient with Graves' disease is likely to exhibit which of the following
clinical manifestations?
A) Weight gain and bradycardia
B) Cold intolerance and constipation
C) Weight loss and heat intolerance
D) Hypotension and hyperpigmentation
Correct Answer: Weight loss and heat intolerance
Rationale: Graves' disease is the most common cause of
hyperthyroidism. Excess thyroid hormones increase the basal metabolic
rate, leading to weight loss despite increased appetite, heat intolerance,
tachycardia, and nervousness. Weight gain and cold intolerance are seen
in hypothyroidism.
6. In the pathophysiology of diabetic ketoacidosis, which of the following is
the primary cause of metabolic acidosis?
A) Excessive bicarbonate retention
B) Accumulation of ketone bodies (beta-hydroxybutyrate and
acetoacetate)
C) Lactic acid production from anaerobic metabolism
D) Renal failure with inability to excrete hydrogen ions
Correct Answer: Accumulation of ketone bodies (beta-
hydroxybutyrate and acetoacetate)
Pathophysiology (2026) Actual Q&A PDF |
Wilkes
1. In the context of endocrine pathophysiology, which mechanism best
explains the polydipsia and polyuria observed in a patient with untreated
diabetes insipidus?
A) Osmotic diuresis from hyperglycemia
B) Failure of antidiuretic hormone secretion or action
C) Excessive aldosterone production
D) Increased atrial natriuretic peptide release
Correct Answer: Failure of antidiuretic hormone secretion or action
Rationale: Diabetes insipidus is characterized by a deficiency of
antidiuretic hormone (central) or renal resistance to antidiuretic hormone
(nephrogenic). This leads to an inability to reabsorb water in the collecting
ducts, resulting in the excretion of large volumes of dilute urine (polyuria)
and compensatory excessive thirst (polydipsia). Osmotic diuresis from
hyperglycemia is the mechanism in diabetes mellitus.
2. A 45-year-old female presents with weight gain, easy bruising, and a
buffalo hump. Which laboratory finding would most likely be elevated?
A) Serum cortisol
B) Serum aldosterone
C) Serum thyroxine
D) Serum parathyroid hormone
Correct Answer: Serum cortisol
,Rationale: The clinical presentation of weight gain, easy bruising, and a
buffalo hump is characteristic of Cushing's syndrome, which results from
chronic excess of cortisol. Serum cortisol levels would be elevated.
Aldosterone excess would cause hypertension and hypokalemia, while
thyroid and parathyroid abnormalities present with different clinical
features.
3. What is the primary mechanism of insulin resistance in type 2 diabetes
mellitus?
A) Autoimmune destruction of pancreatic beta cells
B) Impaired post-receptor signaling and reduced GLUT-4 translocation
C) Absolute deficiency of insulin production
D) Excessive glucagon secretion from pancreatic alpha cells
Correct Answer: Impaired post-receptor signaling and reduced GLUT-
4 translocation
Rationale: Type 2 diabetes mellitus is characterized by insulin
resistance, primarily due to impaired post-receptor signaling and reduced
translocation of GLUT-4 transporters to the cell membrane. This impairs
glucose uptake into skeletal muscle and adipose tissue. Autoimmune
destruction of beta cells is the mechanism in type 1 diabetes.
4. Which electrolyte abnormality is most commonly associated with
primary hyperaldosteronism?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
Correct Answer: Hypokalemia
, Rationale: Primary hyperaldosteronism, such as from an adrenal
adenoma, leads to excessive aldosterone secretion. Aldosterone increases
sodium reabsorption and potassium excretion in the distal tubule,
resulting in hypokalemia and hypertension. Hyperkalemia is typically seen
in adrenal insufficiency.
5. A patient with Graves' disease is likely to exhibit which of the following
clinical manifestations?
A) Weight gain and bradycardia
B) Cold intolerance and constipation
C) Weight loss and heat intolerance
D) Hypotension and hyperpigmentation
Correct Answer: Weight loss and heat intolerance
Rationale: Graves' disease is the most common cause of
hyperthyroidism. Excess thyroid hormones increase the basal metabolic
rate, leading to weight loss despite increased appetite, heat intolerance,
tachycardia, and nervousness. Weight gain and cold intolerance are seen
in hypothyroidism.
6. In the pathophysiology of diabetic ketoacidosis, which of the following is
the primary cause of metabolic acidosis?
A) Excessive bicarbonate retention
B) Accumulation of ketone bodies (beta-hydroxybutyrate and
acetoacetate)
C) Lactic acid production from anaerobic metabolism
D) Renal failure with inability to excrete hydrogen ions
Correct Answer: Accumulation of ketone bodies (beta-
hydroxybutyrate and acetoacetate)
