NRS 455 Exam 2 V1 | NRS 455 Pathophysiology |
Actual Q&A with Rationale (NRS455 Exam 2) |
Grand Canyon University
1. A patient presents to the emergency department with a blood glucose level of 650 mg/dL,
arterial pH of 7.1, and positive ketones in the urine. Which clinical manifestations should the
nurse expect to find? (Select all that apply)
A. Kussmaul respirations
B. Fruity breath odor
C. Bradycardia
D. Severe dehydration
E. Weight gain
F. Abdominal pain
Correct Answer: A, B, D, F
Explanation: Diabetic Ketoacidosis (DKA) is characterized by hyperglycemia, metabolic
acidosis, and ketonuria. The respiratory system attempts to compensate for acidosis
through Kussmaul respirations, which are deep and rapid breaths. Dehydration occurs due
to osmotic diuresis, while ketone production leads to a distinct fruity breath odor and GI
distress.
,2. Which of the following pathophysiological processes characterizes Type 1 Diabetes
Mellitus?
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells
C. Excessive glucagon production from alpha cells
D. Decreased glucose uptake by the liver
Correct Answer: B
Explanation: Type 1 Diabetes Mellitus is primarily an autoimmune disorder where the
immune system attacks and destroys the insulin-producing beta cells in the islets of
Langerhans. This leads to an absolute insulin deficiency, requiring exogenous insulin for
survival. In contrast, Type 2 diabetes involves insulin resistance and relative insulin
deficiency.
3. A patient with chronic kidney disease (CKD) is diagnosed with secondary
hyperparathyroidism. What is the primary cause of this condition?
A. Excessive intake of calcium supplements
B. Vitamin D toxicity
C. Pituitary gland dysfunction
D. Hypocalcemia due to phosphorus retention
Correct Answer: D
, Explanation: In CKD, the kidneys fail to excrete phosphorus, leading to
hyperphosphatemia which inversely lowers calcium levels. The kidneys also fail to activate
Vitamin D, further reducing calcium absorption. The parathyroid glands respond to this
chronic hypocalcemia by overproducing parathyroid hormone (PTH) to mobilize calcium
from the bones.
4. A nurse is reviewing the lab results of a patient with suspected Acute Kidney Injury (AKI).
Which of the following findings is most indicative of intrarenal failure?
A. Presence of brown granular casts in the urine
B. BUN to Creatinine ratio of 20:1
C. Specific gravity greater than 1.030
D. Urine sodium level less than 20 mEq/L
Correct Answer: A
Explanation: Intrarenal failure, often caused by Acute Tubular Necrosis (ATN), involves
direct damage to the renal parenchyma. Brown granular casts are formed from dead
tubular epithelial cells sloughing off into the lumen. Prerenal injury typically presents with
low urine sodium and high specific gravity as the kidneys attempt to conserve volume.
5. A patient is diagnosed with Grave’s disease. Which symptoms are consistent with this
hyperthyroid state? (Select all that apply)
A. Exophthalmos
B. Weight gain
Actual Q&A with Rationale (NRS455 Exam 2) |
Grand Canyon University
1. A patient presents to the emergency department with a blood glucose level of 650 mg/dL,
arterial pH of 7.1, and positive ketones in the urine. Which clinical manifestations should the
nurse expect to find? (Select all that apply)
A. Kussmaul respirations
B. Fruity breath odor
C. Bradycardia
D. Severe dehydration
E. Weight gain
F. Abdominal pain
Correct Answer: A, B, D, F
Explanation: Diabetic Ketoacidosis (DKA) is characterized by hyperglycemia, metabolic
acidosis, and ketonuria. The respiratory system attempts to compensate for acidosis
through Kussmaul respirations, which are deep and rapid breaths. Dehydration occurs due
to osmotic diuresis, while ketone production leads to a distinct fruity breath odor and GI
distress.
,2. Which of the following pathophysiological processes characterizes Type 1 Diabetes
Mellitus?
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells
C. Excessive glucagon production from alpha cells
D. Decreased glucose uptake by the liver
Correct Answer: B
Explanation: Type 1 Diabetes Mellitus is primarily an autoimmune disorder where the
immune system attacks and destroys the insulin-producing beta cells in the islets of
Langerhans. This leads to an absolute insulin deficiency, requiring exogenous insulin for
survival. In contrast, Type 2 diabetes involves insulin resistance and relative insulin
deficiency.
3. A patient with chronic kidney disease (CKD) is diagnosed with secondary
hyperparathyroidism. What is the primary cause of this condition?
A. Excessive intake of calcium supplements
B. Vitamin D toxicity
C. Pituitary gland dysfunction
D. Hypocalcemia due to phosphorus retention
Correct Answer: D
, Explanation: In CKD, the kidneys fail to excrete phosphorus, leading to
hyperphosphatemia which inversely lowers calcium levels. The kidneys also fail to activate
Vitamin D, further reducing calcium absorption. The parathyroid glands respond to this
chronic hypocalcemia by overproducing parathyroid hormone (PTH) to mobilize calcium
from the bones.
4. A nurse is reviewing the lab results of a patient with suspected Acute Kidney Injury (AKI).
Which of the following findings is most indicative of intrarenal failure?
A. Presence of brown granular casts in the urine
B. BUN to Creatinine ratio of 20:1
C. Specific gravity greater than 1.030
D. Urine sodium level less than 20 mEq/L
Correct Answer: A
Explanation: Intrarenal failure, often caused by Acute Tubular Necrosis (ATN), involves
direct damage to the renal parenchyma. Brown granular casts are formed from dead
tubular epithelial cells sloughing off into the lumen. Prerenal injury typically presents with
low urine sodium and high specific gravity as the kidneys attempt to conserve volume.
5. A patient is diagnosed with Grave’s disease. Which symptoms are consistent with this
hyperthyroid state? (Select all that apply)
A. Exophthalmos
B. Weight gain
