NUR 641EA Exam 2 V3 | NUR 641EA Advanced
Pathophysiology and Pharmacology for Nurse
Educators | Actual Q&A with Rationale (NUR641EA
Exam 2) | Grand Canyon University
1. A patient with type 2 diabetes is prescribed metformin. Which of the following is the
primary mechanism of action for this medication?
A. Increasing insulin secretion from the pancreatic beta cells
B. Delaying the absorption of carbohydrates in the small intestine
C. Decreasing hepatic glucose production and improving insulin sensitivity
D. Increasing the renal excretion of glucose through SGLT2 inhibition
Correct Answer: C
Explanation: Metformin is a biguanide that primarily works by decreasing
gluconeogenesis in the liver. It also enhances insulin sensitivity in peripheral tissues, which
increases glucose uptake. Unlike sulfonylureas, it does not stimulate the release of insulin,
thus minimizing the risk of hypoglycemia.
2. When evaluating a patient with Chronic Kidney Disease (CKD), the nurse educator should
identify which of the following as common systemic complications? (Select all that apply)
A. Anemia due to reduced erythropoietin production
B. Secondary hyperparathyroidism and renal osteodystrophy
C. Hyperkalemia and metabolic acidosis
,D. Respiratory alkalosis due to fluid overload
E. Hypertension related to sodium and water retention
F. Hypophosphatemia due to increased renal clearance
Correct Answer: A,B,C,E
Explanation: CKD leads to multi-system failure including decreased erythropoietin, which
causes anemia. The kidneys’ inability to excrete phosphate and activate vitamin D leads to
hyperphosphatemia and secondary hyperparathyroidism. Furthermore, the loss of
nephron function results in impaired potassium excretion and acid-base imbalances,
typically manifesting as metabolic acidosis rather than alkalosis.
3. A patient is diagnosed with Graves’ Disease. Which pathophysiological process best
describes this condition?
A. Autoimmune destruction of the thyroid follicles
B. Type IV hypersensitivity involving T-cell mediated follicular death
C. Type II hypersensitivity where antibodies stimulate TSH receptors
D. Iodine deficiency leading to compensatory thyroid hypertrophy
Correct Answer: C
Explanation: Graves’ disease is an autoimmune disorder characterized by the production
of thyroid-stimulating immunoglobulins (TSI). These antibodies bind to and activate the
TSH receptors on the thyroid gland, leading to autonomous overproduction of thyroid
, hormones. This mechanism is categorized as a Type II hypersensitivity reaction where the
antibody stimulates rather than destroys the target cell.
4. Which pharmacological agent is considered the first-line therapy for a patient experiencing
an acute exacerbation of asthma symptoms?
A. Salmeterol (Long-acting beta agonist)
B. Albuterol (Short-acting beta agonist)
C. Fluticasone (Inhaled corticosteroid)
D. Tiotropium (Long-acting muscarinic antagonist)
Correct Answer: B
Explanation: Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid
bronchodilation by relaxing smooth muscle. It is the drug of choice for acute symptoms or
‘rescue’ therapy during an asthma attack. Long-acting agents and corticosteroids are used
for maintenance and do not provide the immediate relief required during an acute event.
5. The nurse is reviewing the pathophysiology of Parkinson’s disease. Which of the following
changes in the brain is characteristic of this disorder?
A. Loss of cholinergic neurons in the nucleus basalis of Meynert
B. Accumulation of amyloid-beta plaques in the cerebral cortex
C. Demyelination of neurons in the central nervous system
D. Degeneration of dopaminergic neurons in the substantia nigra
Pathophysiology and Pharmacology for Nurse
Educators | Actual Q&A with Rationale (NUR641EA
Exam 2) | Grand Canyon University
1. A patient with type 2 diabetes is prescribed metformin. Which of the following is the
primary mechanism of action for this medication?
A. Increasing insulin secretion from the pancreatic beta cells
B. Delaying the absorption of carbohydrates in the small intestine
C. Decreasing hepatic glucose production and improving insulin sensitivity
D. Increasing the renal excretion of glucose through SGLT2 inhibition
Correct Answer: C
Explanation: Metformin is a biguanide that primarily works by decreasing
gluconeogenesis in the liver. It also enhances insulin sensitivity in peripheral tissues, which
increases glucose uptake. Unlike sulfonylureas, it does not stimulate the release of insulin,
thus minimizing the risk of hypoglycemia.
2. When evaluating a patient with Chronic Kidney Disease (CKD), the nurse educator should
identify which of the following as common systemic complications? (Select all that apply)
A. Anemia due to reduced erythropoietin production
B. Secondary hyperparathyroidism and renal osteodystrophy
C. Hyperkalemia and metabolic acidosis
,D. Respiratory alkalosis due to fluid overload
E. Hypertension related to sodium and water retention
F. Hypophosphatemia due to increased renal clearance
Correct Answer: A,B,C,E
Explanation: CKD leads to multi-system failure including decreased erythropoietin, which
causes anemia. The kidneys’ inability to excrete phosphate and activate vitamin D leads to
hyperphosphatemia and secondary hyperparathyroidism. Furthermore, the loss of
nephron function results in impaired potassium excretion and acid-base imbalances,
typically manifesting as metabolic acidosis rather than alkalosis.
3. A patient is diagnosed with Graves’ Disease. Which pathophysiological process best
describes this condition?
A. Autoimmune destruction of the thyroid follicles
B. Type IV hypersensitivity involving T-cell mediated follicular death
C. Type II hypersensitivity where antibodies stimulate TSH receptors
D. Iodine deficiency leading to compensatory thyroid hypertrophy
Correct Answer: C
Explanation: Graves’ disease is an autoimmune disorder characterized by the production
of thyroid-stimulating immunoglobulins (TSI). These antibodies bind to and activate the
TSH receptors on the thyroid gland, leading to autonomous overproduction of thyroid
, hormones. This mechanism is categorized as a Type II hypersensitivity reaction where the
antibody stimulates rather than destroys the target cell.
4. Which pharmacological agent is considered the first-line therapy for a patient experiencing
an acute exacerbation of asthma symptoms?
A. Salmeterol (Long-acting beta agonist)
B. Albuterol (Short-acting beta agonist)
C. Fluticasone (Inhaled corticosteroid)
D. Tiotropium (Long-acting muscarinic antagonist)
Correct Answer: B
Explanation: Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid
bronchodilation by relaxing smooth muscle. It is the drug of choice for acute symptoms or
‘rescue’ therapy during an asthma attack. Long-acting agents and corticosteroids are used
for maintenance and do not provide the immediate relief required during an acute event.
5. The nurse is reviewing the pathophysiology of Parkinson’s disease. Which of the following
changes in the brain is characteristic of this disorder?
A. Loss of cholinergic neurons in the nucleus basalis of Meynert
B. Accumulation of amyloid-beta plaques in the cerebral cortex
C. Demyelination of neurons in the central nervous system
D. Degeneration of dopaminergic neurons in the substantia nigra
