NRS 455 Exam 4 V2 | NRS 455 Pathophysiology |
Actual Q&A with Rationale (NRS455 Exam 4) |
Grand Canyon University
1. A patient is suspected of having Multiple Sclerosis (MS). Which of the following clinical
manifestations should the nurse expect to find during the assessment? (Select All That Apply)
A. Fatigue and muscle weakness
B. Visual disturbances such as diplopia
C. Ataxia and loss of balance
D. Heat sensitivity (Uhthoff’s phenomenon)
E. Paresthesia and numbness
F. Bradycardia and hypotension
Correct Answer: A, B, C, D, E
Explanation: Multiple Sclerosis is a chronic, progressive autoimmune disease
characterized by the demyelination of nerve fibers in the brain and spinal cord. The
destruction of myelin leads to a wide range of neurological symptoms including motor
weakness, sensory changes, and visual impairment. Bradycardia and hypotension are
generally not characteristic of MS and are more likely related to cardiac or autonomic
shock issues.
,2. Which pathophysiology best describes the development of Type 1 Diabetes Mellitus?
A. Increased hepatic glucose production
B. Insulin resistance in peripheral tissues
C. Hypersecretion of glucagon by alpha cells
D. Autoimmune destruction of pancreatic beta cells
Correct Answer: D
Explanation: Type 1 Diabetes Mellitus is primarily an autoimmune disorder where the
body’s T-cells attack and destroy the insulin-producing beta cells in the Islets of
Langerhans. This leads to an absolute deficiency of insulin, requiring patients to rely on
exogenous insulin for survival. In contrast, insulin resistance is the hallmark of Type 2
Diabetes Mellitus.
3. A nurse is caring for a patient in the oliguric phase of Acute Kidney Injury (AKI). Which
clinical finding is most expected during this phase?
A. Hypokalemia and dehydration
B. Metabolic alkalosis and hypovolemia
C. Increased glomerular filtration rate (GFR)
D. Fluid volume excess and hyperkalemia
Correct Answer: D
,Explanation: The oliguric phase of AKI is characterized by a significant decrease in urine
output, typically less than 400 mL per day. Because the kidneys cannot effectively excrete
waste or fluid, the patient develops fluid volume overload and electrolyte imbalances like
hyperkalemia and hypermagnesemia. Metabolic acidosis also occurs because the kidneys
are unable to excrete hydrogen ions or regenerate bicarbonate.
4. In Graves’ Disease, the pathophysiology of hyperthyroidism is caused by:
A. A pituitary adenoma secreting excessive TSH
B. Thyroid-stimulating immunoglobulins (TSI) mimicking TSH
C. Destruction of thyroid tissue leading to leakage of stored hormones
D. Iodine deficiency leading to goiter formation
Correct Answer: B
Explanation: Graves’ Disease is an autoimmune disorder where the body produces
antibodies known as thyroid-stimulating immunoglobulins (TSI). These antibodies bind to
the TSH receptors on the thyroid gland and stimulate the continuous production and
release of thyroid hormones (T3 and T4). This results in a hypermetabolic state and the
characteristic clinical features of hyperthyroidism.
5. A patient with a traumatic brain injury (TBI) is showing signs of increased intracranial
pressure (ICP). Which findings represent Cushing’s Triad? (Select All That Apply)
A. Widening pulse pressure
B. Tachycardia
, C. Bradycardia
D. Irregular respirations (Cheyne-Stokes)
E. Hypotension
F. Systolic hypertension
Correct Answer: A, C, D, F
Explanation: Cushing’s Triad is a critical late sign of increased intracranial pressure that
indicates impending brain herniation. It consists of systolic hypertension with a widening
pulse pressure, bradycardia, and irregular respiratory patterns. These physiological
changes are a compensatory response by the body to maintain cerebral perfusion pressure
in the face of rising intracranial volume.
6. A patient is admitted with suspected bacterial meningitis. Which clinical manifestations are
classic markers of this condition? (Select All That Apply)
A. Nuchal rigidity
B. Photophobia
C. Severe headache
D. Fever and chills
E. Projectile vomiting
F. Kernig’s and Brudzinski’s signs
Correct Answer: A, B, C, D, F
Actual Q&A with Rationale (NRS455 Exam 4) |
Grand Canyon University
1. A patient is suspected of having Multiple Sclerosis (MS). Which of the following clinical
manifestations should the nurse expect to find during the assessment? (Select All That Apply)
A. Fatigue and muscle weakness
B. Visual disturbances such as diplopia
C. Ataxia and loss of balance
D. Heat sensitivity (Uhthoff’s phenomenon)
E. Paresthesia and numbness
F. Bradycardia and hypotension
Correct Answer: A, B, C, D, E
Explanation: Multiple Sclerosis is a chronic, progressive autoimmune disease
characterized by the demyelination of nerve fibers in the brain and spinal cord. The
destruction of myelin leads to a wide range of neurological symptoms including motor
weakness, sensory changes, and visual impairment. Bradycardia and hypotension are
generally not characteristic of MS and are more likely related to cardiac or autonomic
shock issues.
,2. Which pathophysiology best describes the development of Type 1 Diabetes Mellitus?
A. Increased hepatic glucose production
B. Insulin resistance in peripheral tissues
C. Hypersecretion of glucagon by alpha cells
D. Autoimmune destruction of pancreatic beta cells
Correct Answer: D
Explanation: Type 1 Diabetes Mellitus is primarily an autoimmune disorder where the
body’s T-cells attack and destroy the insulin-producing beta cells in the Islets of
Langerhans. This leads to an absolute deficiency of insulin, requiring patients to rely on
exogenous insulin for survival. In contrast, insulin resistance is the hallmark of Type 2
Diabetes Mellitus.
3. A nurse is caring for a patient in the oliguric phase of Acute Kidney Injury (AKI). Which
clinical finding is most expected during this phase?
A. Hypokalemia and dehydration
B. Metabolic alkalosis and hypovolemia
C. Increased glomerular filtration rate (GFR)
D. Fluid volume excess and hyperkalemia
Correct Answer: D
,Explanation: The oliguric phase of AKI is characterized by a significant decrease in urine
output, typically less than 400 mL per day. Because the kidneys cannot effectively excrete
waste or fluid, the patient develops fluid volume overload and electrolyte imbalances like
hyperkalemia and hypermagnesemia. Metabolic acidosis also occurs because the kidneys
are unable to excrete hydrogen ions or regenerate bicarbonate.
4. In Graves’ Disease, the pathophysiology of hyperthyroidism is caused by:
A. A pituitary adenoma secreting excessive TSH
B. Thyroid-stimulating immunoglobulins (TSI) mimicking TSH
C. Destruction of thyroid tissue leading to leakage of stored hormones
D. Iodine deficiency leading to goiter formation
Correct Answer: B
Explanation: Graves’ Disease is an autoimmune disorder where the body produces
antibodies known as thyroid-stimulating immunoglobulins (TSI). These antibodies bind to
the TSH receptors on the thyroid gland and stimulate the continuous production and
release of thyroid hormones (T3 and T4). This results in a hypermetabolic state and the
characteristic clinical features of hyperthyroidism.
5. A patient with a traumatic brain injury (TBI) is showing signs of increased intracranial
pressure (ICP). Which findings represent Cushing’s Triad? (Select All That Apply)
A. Widening pulse pressure
B. Tachycardia
, C. Bradycardia
D. Irregular respirations (Cheyne-Stokes)
E. Hypotension
F. Systolic hypertension
Correct Answer: A, C, D, F
Explanation: Cushing’s Triad is a critical late sign of increased intracranial pressure that
indicates impending brain herniation. It consists of systolic hypertension with a widening
pulse pressure, bradycardia, and irregular respiratory patterns. These physiological
changes are a compensatory response by the body to maintain cerebral perfusion pressure
in the face of rising intracranial volume.
6. A patient is admitted with suspected bacterial meningitis. Which clinical manifestations are
classic markers of this condition? (Select All That Apply)
A. Nuchal rigidity
B. Photophobia
C. Severe headache
D. Fever and chills
E. Projectile vomiting
F. Kernig’s and Brudzinski’s signs
Correct Answer: A, B, C, D, F
