NUR 641EA Exam 4 V3 | NUR 641EA Advanced
Pathophysiology and Pharmacology for Nurse
Educators | Actual Q&A with Rationale (NUR641EA
Exam 4) | Grand Canyon University
1. A nurse educator is discussing the risk factors for Type 2 Diabetes Mellitus with a group of
students. Which of the following factors should be identified as increasing a patient’s risk?
(Select All That Apply)
A. Body Mass Index (BMI) greater than 25 kg/m2
B. First-degree relative with diabetes
C. History of gestational diabetes mellitus
D. High-density lipoprotein (HDL) cholesterol level > 50 mg/dL
E. Physically inactive lifestyle
Correct Answer: A, B, C, E
Explanation: Type 2 Diabetes risk is significantly heightened by obesity and a sedentary
lifestyle which contribute to insulin resistance. Genetic predisposition through first-degree
relatives and a history of gestational diabetes are also primary clinical indicators for
screening. Conversely, a high HDL level is considered protective, whereas an HDL level less
than 35 mg/dL is a known risk factor.
2. Which pathophysiological mechanism best describes the development of Grave’s disease?
A. Autoimmune destruction of thyroid follicular cells
,B. Production of antibodies that mimic thyroid-stimulating hormone (TSH)
C. Increased production of thyrotropin-releasing hormone by the hypothalamus
D. Iodine deficiency leading to compensatory thyroid hypertrophy
Correct Answer: B
Explanation: Grave’s disease is characterized by the production of thyroid-stimulating
immunoglobulins (TSI) that bind to TSH receptors. This binding triggers the continuous
release of thyroid hormones regardless of the actual metabolic need. This process results in
hyperthyroidism and the characteristic goiter associated with the condition.
3. A patient presents with a ‘moon face,’ buffalo hump, and purple striae on the abdomen.
Which laboratory finding would the nurse educator expect to see in this patient?
A. Elevated serum cortisol
B. Hyperkalemia
C. Hypoglycemia
D. Decreased serum sodium
Correct Answer: A
Explanation: The clinical presentation described is consistent with Cushing’s Syndrome,
which results from prolonged exposure to high levels of glucocorticoids. Elevated serum
cortisol is the definitive diagnostic marker for this hypercortisolemic state. Patients
, typically also exhibit hyperglycemia and hypokalemia rather than the options listed in A
and B.
4. Which statement by a patient indicates an understanding of the management of
Levothyroxine therapy for hypothyroidism?
A. I should take this medication with my evening meal to improve absorption.
B. If I feel energetic, I can skip a few doses to prevent heart palpitations.
C. I will need to take this medication for the rest of my life.
D. I can stop the medication once my TSH levels return to normal.
Correct Answer: C
Explanation: Hypothyroidism usually requires lifelong replacement therapy with
Levothyroxine because the thyroid gland cannot produce sufficient hormones. The
medication must be taken on an empty stomach, usually 30-60 minutes before breakfast, to
ensure optimal absorption. Patients must never adjust or stop the dosage without
consulting a healthcare provider due to the risk of myxedema coma.
5. A patient is diagnosed with Primary Adrenal Insufficiency (Addison’s Disease). Which
clinical manifestations should the nurse expect to find? (Select All That Apply)
A. Hyperpigmentation of the skin
B. Hypertension
C. Hyperkalemia
Pathophysiology and Pharmacology for Nurse
Educators | Actual Q&A with Rationale (NUR641EA
Exam 4) | Grand Canyon University
1. A nurse educator is discussing the risk factors for Type 2 Diabetes Mellitus with a group of
students. Which of the following factors should be identified as increasing a patient’s risk?
(Select All That Apply)
A. Body Mass Index (BMI) greater than 25 kg/m2
B. First-degree relative with diabetes
C. History of gestational diabetes mellitus
D. High-density lipoprotein (HDL) cholesterol level > 50 mg/dL
E. Physically inactive lifestyle
Correct Answer: A, B, C, E
Explanation: Type 2 Diabetes risk is significantly heightened by obesity and a sedentary
lifestyle which contribute to insulin resistance. Genetic predisposition through first-degree
relatives and a history of gestational diabetes are also primary clinical indicators for
screening. Conversely, a high HDL level is considered protective, whereas an HDL level less
than 35 mg/dL is a known risk factor.
2. Which pathophysiological mechanism best describes the development of Grave’s disease?
A. Autoimmune destruction of thyroid follicular cells
,B. Production of antibodies that mimic thyroid-stimulating hormone (TSH)
C. Increased production of thyrotropin-releasing hormone by the hypothalamus
D. Iodine deficiency leading to compensatory thyroid hypertrophy
Correct Answer: B
Explanation: Grave’s disease is characterized by the production of thyroid-stimulating
immunoglobulins (TSI) that bind to TSH receptors. This binding triggers the continuous
release of thyroid hormones regardless of the actual metabolic need. This process results in
hyperthyroidism and the characteristic goiter associated with the condition.
3. A patient presents with a ‘moon face,’ buffalo hump, and purple striae on the abdomen.
Which laboratory finding would the nurse educator expect to see in this patient?
A. Elevated serum cortisol
B. Hyperkalemia
C. Hypoglycemia
D. Decreased serum sodium
Correct Answer: A
Explanation: The clinical presentation described is consistent with Cushing’s Syndrome,
which results from prolonged exposure to high levels of glucocorticoids. Elevated serum
cortisol is the definitive diagnostic marker for this hypercortisolemic state. Patients
, typically also exhibit hyperglycemia and hypokalemia rather than the options listed in A
and B.
4. Which statement by a patient indicates an understanding of the management of
Levothyroxine therapy for hypothyroidism?
A. I should take this medication with my evening meal to improve absorption.
B. If I feel energetic, I can skip a few doses to prevent heart palpitations.
C. I will need to take this medication for the rest of my life.
D. I can stop the medication once my TSH levels return to normal.
Correct Answer: C
Explanation: Hypothyroidism usually requires lifelong replacement therapy with
Levothyroxine because the thyroid gland cannot produce sufficient hormones. The
medication must be taken on an empty stomach, usually 30-60 minutes before breakfast, to
ensure optimal absorption. Patients must never adjust or stop the dosage without
consulting a healthcare provider due to the risk of myxedema coma.
5. A patient is diagnosed with Primary Adrenal Insufficiency (Addison’s Disease). Which
clinical manifestations should the nurse expect to find? (Select All That Apply)
A. Hyperpigmentation of the skin
B. Hypertension
C. Hyperkalemia
