NRS 455 Exam 4 V3 | NRS 455 Pathophysiology |
Actual Q&A with Rationale (NRS455 Exam 4) |
Grand Canyon University
1. A patient with Type 1 Diabetes Mellitus presents with extreme thirst, frequent urination,
and weight loss. Which of the following best describes the underlying pathophysiology of this
condition?
A. Insulin resistance in peripheral tissues combined with beta-cell exhaustion.
B. Autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency.
C. Excessive production of glucagon by alpha cells despite normal insulin levels.
D. Decreased glucose absorption in the small intestine leading to starvation.
Correct Answer: B
Explanation: Type 1 Diabetes Mellitus is characterized by an absolute insulin deficiency.
This occurs because the body’s immune system mistakenly attacks and destroys the
insulin-producing beta cells in the pancreas. Without insulin, glucose cannot enter cells,
leading to hyperglycemia and the classic symptoms of polyuria and polydipsia.
2. A nurse is caring for a patient diagnosed with SIADH. Which laboratory finding should the
nurse expect to see? (Select all that apply)
A. Serum sodium 120 mEq/L
,B. Serum osmolality 310 mOsm/kg
C. Urine specific gravity 1.030
D. Low serum uric acid
E. Hypokalemia
Correct Answer: A, C, D
Explanation: SIADH involves the excessive release of antidiuretic hormone, which causes
the kidneys to reabsorb too much water. This results in dilutional hyponatremia and
concentrated urine with a high specific gravity. Low serum uric acid is also a clinical
indicator of the fluid volume expansion seen in SIADH.
3. Which of the following conditions is most likely to cause prerenal acute kidney injury (AKI)?
A. Acute tubular necrosis from nephrotoxic antibiotics
B. Benign prostatic hyperplasia causing urinary retention
C. Kidney stones lodged in the bilateral ureters
D. Severe dehydration and hypovolemic shock
Correct Answer: D
Explanation: Prerenal AKI is caused by factors that reduce systemic blood flow to the
kidneys, decreasing glomerular perfusion. Hypovolemic shock and dehydration reduce the
effective circulating volume, leading to decreased renal blood flow. This is distinct from
intrarenal causes like toxins or postrenal causes like obstructions.
, 4. A patient is admitted with a diagnosis of Chronic Kidney Disease (CKD) Stage 4. Which of
the following clinical manifestations should the nurse monitor for? (Select all that apply)
A. Metabolic alkalosis
B. Hyperkalemia
C. Hypophosphatemia
D. Anemia
E. Pruritus
F. Hypertension
Correct Answer: B, D, E, F
Explanation: As renal function declines, the kidneys lose the ability to excrete potassium
and phosphate, leading to hyperkalemia and hyperphosphatemia. Anemia occurs due to
decreased erythropoietin production by the failing kidneys. Uremic waste buildup causes
pruritus, and fluid retention contributes to hypertension.
5. A patient presents with a ‘buffalo hump’, moon face, and purple striae on the abdomen.
Which hormone imbalance is most likely responsible?
A. Deficiency of aldosterone
B. Overproduction of growth hormone
C. Excessive secretion of cortisol
D. Deficiency of thyroid-stimulating hormone
Actual Q&A with Rationale (NRS455 Exam 4) |
Grand Canyon University
1. A patient with Type 1 Diabetes Mellitus presents with extreme thirst, frequent urination,
and weight loss. Which of the following best describes the underlying pathophysiology of this
condition?
A. Insulin resistance in peripheral tissues combined with beta-cell exhaustion.
B. Autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency.
C. Excessive production of glucagon by alpha cells despite normal insulin levels.
D. Decreased glucose absorption in the small intestine leading to starvation.
Correct Answer: B
Explanation: Type 1 Diabetes Mellitus is characterized by an absolute insulin deficiency.
This occurs because the body’s immune system mistakenly attacks and destroys the
insulin-producing beta cells in the pancreas. Without insulin, glucose cannot enter cells,
leading to hyperglycemia and the classic symptoms of polyuria and polydipsia.
2. A nurse is caring for a patient diagnosed with SIADH. Which laboratory finding should the
nurse expect to see? (Select all that apply)
A. Serum sodium 120 mEq/L
,B. Serum osmolality 310 mOsm/kg
C. Urine specific gravity 1.030
D. Low serum uric acid
E. Hypokalemia
Correct Answer: A, C, D
Explanation: SIADH involves the excessive release of antidiuretic hormone, which causes
the kidneys to reabsorb too much water. This results in dilutional hyponatremia and
concentrated urine with a high specific gravity. Low serum uric acid is also a clinical
indicator of the fluid volume expansion seen in SIADH.
3. Which of the following conditions is most likely to cause prerenal acute kidney injury (AKI)?
A. Acute tubular necrosis from nephrotoxic antibiotics
B. Benign prostatic hyperplasia causing urinary retention
C. Kidney stones lodged in the bilateral ureters
D. Severe dehydration and hypovolemic shock
Correct Answer: D
Explanation: Prerenal AKI is caused by factors that reduce systemic blood flow to the
kidneys, decreasing glomerular perfusion. Hypovolemic shock and dehydration reduce the
effective circulating volume, leading to decreased renal blood flow. This is distinct from
intrarenal causes like toxins or postrenal causes like obstructions.
, 4. A patient is admitted with a diagnosis of Chronic Kidney Disease (CKD) Stage 4. Which of
the following clinical manifestations should the nurse monitor for? (Select all that apply)
A. Metabolic alkalosis
B. Hyperkalemia
C. Hypophosphatemia
D. Anemia
E. Pruritus
F. Hypertension
Correct Answer: B, D, E, F
Explanation: As renal function declines, the kidneys lose the ability to excrete potassium
and phosphate, leading to hyperkalemia and hyperphosphatemia. Anemia occurs due to
decreased erythropoietin production by the failing kidneys. Uremic waste buildup causes
pruritus, and fluid retention contributes to hypertension.
5. A patient presents with a ‘buffalo hump’, moon face, and purple striae on the abdomen.
Which hormone imbalance is most likely responsible?
A. Deficiency of aldosterone
B. Overproduction of growth hormone
C. Excessive secretion of cortisol
D. Deficiency of thyroid-stimulating hormone
