1
NURS 611(ADVANCED PATHOPHYSIOLOGY) EXAM 3
ACTUAL EXAM WITH 100 QUESTIONS& 100%
CORRECT ANSWERS WITH RATIONALES| A+ GRADE
(MARYVILLE UNIVERSITY)
1. What are clinical manifestations of hypothyroidism?
a. Intolerance to heat, tachycardia, and weight loss
b. Oligomenorrhea, fatigue, and warm skin
c. Restlessness, increased appetite, and metrorrhagia
d. Constipation, decreased heat rate, and lethargy
The lower levels of thyroid hormone result in decreased energy metabolism,
resulting in constipation, bradycardia, and lethargy, thus eliminating the
remaining options.
2. Thyroid-stimulating hormone (TSH) is released to stimulate thyroid
hormone (TH) and is inhibited when plasma levels of TH are adequate. This
is an example of:
a. Positive feedback
b. Neural regulation
c. Negative feedback
d. Physiologic regulation
Negative feedback. Feedback systems provide precise monitoring and control
of the cellular environment. Negative feedback occurs because the changing
chemical, neural, or endocrine response to a stimulus negates the initiating
change that triggered the release of the hormone. Thyrotropin-releasing
hormone (TRH) from the hypothalamus stimulates TSH secretion from the
anterior pituitary. Secretion of TSH stimulates the synthesis and secretion of
THs. Increasing levels of T4 and triiodothyronine (T3) then generate negative
feedback on the pituitary and hypothalamus to inhibit TRH and TSH synthesis.
3. Lipid-soluble hormone receptors are located:
a. Inside the plasma membrane in the cytoplasm
b. On the outer surface of the plasma membrane
c. Inside the mitochondria
d. On the inner surface of the plasma membrane
Inside the plasma membrane in the cytoplasm. Lipid-soluble hormone
receptors are located inside the plasma membrane and easily diffuse across the
plasma membrane to bind to either cytosolic or nuclear receptors.
4. The releasing hormones that are made in the hypothalamus travel to
the anterior pituitary via the:
a. Vessels of the zona fasciculata
b. Hypophyseal stalk
c. Infundibular stem
d. Portal hypophyseal blood vessels
Portal hypophyseal blood vessels. Releasing and inhibitory hormones are
synthesized in the hypothalamus and are secreted into the portal blood vessels
through which they travel to the anterior pituitary hormones.
5. Which mineral is needed for thyroid-stimulating hormone (TSH) to
stimulate the secretion of thyroid hormone (TH)?
, 2
a. Iron
b. Iodide
c. Zinc
d. Copper
Iodide. TSH, which is synthesized and stored in the anterior pituitary,
stimulates secretion of TH by activating intracellular processes, including the
uptake of iodine necessary for the synthesis of TH.
6. What effect does hyperphosphatemia have on other electrolytes?
a. Increases serum calcium
b. Decreases serum magnesium
c. Decreases serum calcium
d. Increases serum magnesium
Decreases serum calcium. Hyperphosphatemia leads to hypocalcemia.
Remember that phos and calcium are inversely related.
7. Insulin transports which electrolyte in the cell?
a. Potassium
b. Sodium
c. Calcium
d. Phosphorus
Potassium. Insulin facilitates the intracellular transport of potassium,
phosphate, and magnesium.
8. Which second messenger is stimulated by epinephrine binding to a β-
adrenergic receptor?
a. Calcium
b. Inositol triphosphate (IP3)
c. Diacylglycerol (DAG)
d. Cyclic adenosine monophosphate (cAMP)
Cyclic adenosine monophosphate (cAMP). Second-messenger molecules are the
initial link between the first signal (hormone) and the inside of the cell. For
example, the binding of epinephrine to a β adrenergic–receptor subtype
activates (through a stimulatory G protein) the enzyme, adenylyl cyclase.
Adenylyl cyclase catalyzes the conversion of adenosine triphosphate (ATP) to
the second messenger, 3', and 5'-cAMP.
9. Regulation of the release of catecholamines from the adrenal medulla is an
example of which type of regulation?
a. Negative feedback
b. Neural
c. Positive feedback
d. Physiologic
Neural. The release of hormones occurs either in response to an alteration in
the cellular environment or in the process of maintaining a regulated level of certain
hormones or certain substances. Several different mechanisms, one of which is neural
control (e.g., stress-induced release of catecholamines from the adrenal
medulla),regulate the release of hormones.
10. Which hormone does the second messenger calcium (Ca++) bind to activate
phospholipase C through a G protein?
a. Angiotensin II
b. Estrogen
c. Thyroxine
, 3
d. Testosterone
Angiotensin II. Ca++ is considered an important second messenger that
facilitates the binding of a hormone (e.g., norepinephrine, angiotensin II) to a
surface receptor, activating the enzyme phospholipase C through a G protein
inside the plasma membrane.
11. The control of calcium in cells is important because it:
a. Is controlled by the calcium negative-feedback loop.
b. Is continuously synthesized.
c. Acts as a second messenger.
d. Carries lipid-soluble hormones in the bloodstream.
Acts as a second messenger. In addition to being an important ion that
participates in a multitude of cellular actions, Ca++ is considered an important
second messenger.
12. Where is antidiuretic hormone (ADH) synthesized, and where does it act?
a. Hypothalamus; renal tubular cells
b. Anterior pituitary; posterior pituitary
c. Renal tubules; renal collecting ducts
d. Posterior pituitary; loop of Henle
Hypothalamus; renal tubular cells. Once synthesized in the hypothalamus, ADH
acts on the vasopressin 2 (V2) receptors of the renal duct cells to increase their
permeability.
13. How does a faulty negative-feedback mechanism result in a hormonal
imbalance?
a. Hormones are not synthesized in response to cellular and tissue activities.
b. Decreased hormonal secretion is a response to rising hormone levels.
c. Too little hormone production is initiated.
d. Excessive hormone production results from a failure to turn of the
system.
Excessive hormone production results from a failure to turn off the system.
Negative- feedback systems are important in maintaining hormones within
physiologic ranges. The lack of negative-feedback inhibition on hormonal
release often results in pathologic conditions. Excessive hormone
production, which is the result of the failure to turn of the system, can
cause various hormonal imbalances and related conditions.
14. A deficiency of which chemical may result in hypothyroidism?
a. Iron
b. Zinc
c. Iodine
d. Magnesium
Zinc. The only cause of hypothyroidism from among the provided options is a
deficiency of endemic iodine.
15. What imbalance lessens the rate of secretion of parathyroid hormone
a. Increased serum calcium levels
b. Decreased serum magnesium levels
c. Decreased levels of thyroid-stimulating hormone
d. Increased levels of thyroid-stimulating hormone
The overall effect of parathyroid hormone (PTH)is to increase serum calcium
and to decrease serum phosphate concentration.
16. Which condition may result from pressure exerted by a pituitary tumor?
, 4
a. Hypothyroidism
b. Diabetes insipidus
c. Hypercortisolism
d. Insulin hyposecretion
Hypothyroidism. If the tumor exerts sufficient pressure, then thyroid and
adrenal hypofunction may occur because of lack of thyroid-stimulating
hormone (TSH) and adrenocorticotropic hormone (ACTH). These result in the
symptoms of hypothyroidism and hypocortisolism.
17. Which substance is a water-soluble protein hormone?
a. Thyroxine
b. Follicle-stimulating hormone
c. Aldosterone
d. Insulin
Insulin. Peptide or protein hormones, such as insulin, pituitary, hypothalamic,
and parathyroid, are water soluble and circulate in free (unbound) forms.
18. Which of the following is a lipid-soluble hormone?
a. Cortisol
b. Epinephrine
c. Oxytocin
d. Growth hormone
Cortisol. Cortisol and adrenal androgens are lipid-soluble hormones and are
primarily bound to a carrier or transport protein in circulation.
19. Most protein hormones are transported in the bloodstream and are:
a. Bound to a lipid-soluble carrier
b. Free in an unbound, water-soluble form
c. Bound to a water soluble–binding protein
d. Free because of their lipid-soluble chemistry
Free in an unbound, water-soluble form. Peptide or protein hormones, such as
insulin, pituitary, hypothalamic, and parathyroid, are water soluble and
circulate in free (unbound) forms.
20. When insulin binds its receptors on muscle cells, an increase in glucose
uptake by the muscle cells is the result. This is an example of what type
of effect by a hormone?
a. Pharmacologic
b. Synergistic
c. Permissive
d. Direct
Direct. Direct effects are the obvious changes in cell function that specifically
result from the stimulation by a particular hormone.
21. Graves disease develops from a(n):
a. Viral infection of the thyroid gland that causes overproduction of
thyroid hormone.
b. Autoimmune process during which lymphocytes and fibrous tissue
replace thyroid tissue.
NURS 611(ADVANCED PATHOPHYSIOLOGY) EXAM 3
ACTUAL EXAM WITH 100 QUESTIONS& 100%
CORRECT ANSWERS WITH RATIONALES| A+ GRADE
(MARYVILLE UNIVERSITY)
1. What are clinical manifestations of hypothyroidism?
a. Intolerance to heat, tachycardia, and weight loss
b. Oligomenorrhea, fatigue, and warm skin
c. Restlessness, increased appetite, and metrorrhagia
d. Constipation, decreased heat rate, and lethargy
The lower levels of thyroid hormone result in decreased energy metabolism,
resulting in constipation, bradycardia, and lethargy, thus eliminating the
remaining options.
2. Thyroid-stimulating hormone (TSH) is released to stimulate thyroid
hormone (TH) and is inhibited when plasma levels of TH are adequate. This
is an example of:
a. Positive feedback
b. Neural regulation
c. Negative feedback
d. Physiologic regulation
Negative feedback. Feedback systems provide precise monitoring and control
of the cellular environment. Negative feedback occurs because the changing
chemical, neural, or endocrine response to a stimulus negates the initiating
change that triggered the release of the hormone. Thyrotropin-releasing
hormone (TRH) from the hypothalamus stimulates TSH secretion from the
anterior pituitary. Secretion of TSH stimulates the synthesis and secretion of
THs. Increasing levels of T4 and triiodothyronine (T3) then generate negative
feedback on the pituitary and hypothalamus to inhibit TRH and TSH synthesis.
3. Lipid-soluble hormone receptors are located:
a. Inside the plasma membrane in the cytoplasm
b. On the outer surface of the plasma membrane
c. Inside the mitochondria
d. On the inner surface of the plasma membrane
Inside the plasma membrane in the cytoplasm. Lipid-soluble hormone
receptors are located inside the plasma membrane and easily diffuse across the
plasma membrane to bind to either cytosolic or nuclear receptors.
4. The releasing hormones that are made in the hypothalamus travel to
the anterior pituitary via the:
a. Vessels of the zona fasciculata
b. Hypophyseal stalk
c. Infundibular stem
d. Portal hypophyseal blood vessels
Portal hypophyseal blood vessels. Releasing and inhibitory hormones are
synthesized in the hypothalamus and are secreted into the portal blood vessels
through which they travel to the anterior pituitary hormones.
5. Which mineral is needed for thyroid-stimulating hormone (TSH) to
stimulate the secretion of thyroid hormone (TH)?
, 2
a. Iron
b. Iodide
c. Zinc
d. Copper
Iodide. TSH, which is synthesized and stored in the anterior pituitary,
stimulates secretion of TH by activating intracellular processes, including the
uptake of iodine necessary for the synthesis of TH.
6. What effect does hyperphosphatemia have on other electrolytes?
a. Increases serum calcium
b. Decreases serum magnesium
c. Decreases serum calcium
d. Increases serum magnesium
Decreases serum calcium. Hyperphosphatemia leads to hypocalcemia.
Remember that phos and calcium are inversely related.
7. Insulin transports which electrolyte in the cell?
a. Potassium
b. Sodium
c. Calcium
d. Phosphorus
Potassium. Insulin facilitates the intracellular transport of potassium,
phosphate, and magnesium.
8. Which second messenger is stimulated by epinephrine binding to a β-
adrenergic receptor?
a. Calcium
b. Inositol triphosphate (IP3)
c. Diacylglycerol (DAG)
d. Cyclic adenosine monophosphate (cAMP)
Cyclic adenosine monophosphate (cAMP). Second-messenger molecules are the
initial link between the first signal (hormone) and the inside of the cell. For
example, the binding of epinephrine to a β adrenergic–receptor subtype
activates (through a stimulatory G protein) the enzyme, adenylyl cyclase.
Adenylyl cyclase catalyzes the conversion of adenosine triphosphate (ATP) to
the second messenger, 3', and 5'-cAMP.
9. Regulation of the release of catecholamines from the adrenal medulla is an
example of which type of regulation?
a. Negative feedback
b. Neural
c. Positive feedback
d. Physiologic
Neural. The release of hormones occurs either in response to an alteration in
the cellular environment or in the process of maintaining a regulated level of certain
hormones or certain substances. Several different mechanisms, one of which is neural
control (e.g., stress-induced release of catecholamines from the adrenal
medulla),regulate the release of hormones.
10. Which hormone does the second messenger calcium (Ca++) bind to activate
phospholipase C through a G protein?
a. Angiotensin II
b. Estrogen
c. Thyroxine
, 3
d. Testosterone
Angiotensin II. Ca++ is considered an important second messenger that
facilitates the binding of a hormone (e.g., norepinephrine, angiotensin II) to a
surface receptor, activating the enzyme phospholipase C through a G protein
inside the plasma membrane.
11. The control of calcium in cells is important because it:
a. Is controlled by the calcium negative-feedback loop.
b. Is continuously synthesized.
c. Acts as a second messenger.
d. Carries lipid-soluble hormones in the bloodstream.
Acts as a second messenger. In addition to being an important ion that
participates in a multitude of cellular actions, Ca++ is considered an important
second messenger.
12. Where is antidiuretic hormone (ADH) synthesized, and where does it act?
a. Hypothalamus; renal tubular cells
b. Anterior pituitary; posterior pituitary
c. Renal tubules; renal collecting ducts
d. Posterior pituitary; loop of Henle
Hypothalamus; renal tubular cells. Once synthesized in the hypothalamus, ADH
acts on the vasopressin 2 (V2) receptors of the renal duct cells to increase their
permeability.
13. How does a faulty negative-feedback mechanism result in a hormonal
imbalance?
a. Hormones are not synthesized in response to cellular and tissue activities.
b. Decreased hormonal secretion is a response to rising hormone levels.
c. Too little hormone production is initiated.
d. Excessive hormone production results from a failure to turn of the
system.
Excessive hormone production results from a failure to turn off the system.
Negative- feedback systems are important in maintaining hormones within
physiologic ranges. The lack of negative-feedback inhibition on hormonal
release often results in pathologic conditions. Excessive hormone
production, which is the result of the failure to turn of the system, can
cause various hormonal imbalances and related conditions.
14. A deficiency of which chemical may result in hypothyroidism?
a. Iron
b. Zinc
c. Iodine
d. Magnesium
Zinc. The only cause of hypothyroidism from among the provided options is a
deficiency of endemic iodine.
15. What imbalance lessens the rate of secretion of parathyroid hormone
a. Increased serum calcium levels
b. Decreased serum magnesium levels
c. Decreased levels of thyroid-stimulating hormone
d. Increased levels of thyroid-stimulating hormone
The overall effect of parathyroid hormone (PTH)is to increase serum calcium
and to decrease serum phosphate concentration.
16. Which condition may result from pressure exerted by a pituitary tumor?
, 4
a. Hypothyroidism
b. Diabetes insipidus
c. Hypercortisolism
d. Insulin hyposecretion
Hypothyroidism. If the tumor exerts sufficient pressure, then thyroid and
adrenal hypofunction may occur because of lack of thyroid-stimulating
hormone (TSH) and adrenocorticotropic hormone (ACTH). These result in the
symptoms of hypothyroidism and hypocortisolism.
17. Which substance is a water-soluble protein hormone?
a. Thyroxine
b. Follicle-stimulating hormone
c. Aldosterone
d. Insulin
Insulin. Peptide or protein hormones, such as insulin, pituitary, hypothalamic,
and parathyroid, are water soluble and circulate in free (unbound) forms.
18. Which of the following is a lipid-soluble hormone?
a. Cortisol
b. Epinephrine
c. Oxytocin
d. Growth hormone
Cortisol. Cortisol and adrenal androgens are lipid-soluble hormones and are
primarily bound to a carrier or transport protein in circulation.
19. Most protein hormones are transported in the bloodstream and are:
a. Bound to a lipid-soluble carrier
b. Free in an unbound, water-soluble form
c. Bound to a water soluble–binding protein
d. Free because of their lipid-soluble chemistry
Free in an unbound, water-soluble form. Peptide or protein hormones, such as
insulin, pituitary, hypothalamic, and parathyroid, are water soluble and
circulate in free (unbound) forms.
20. When insulin binds its receptors on muscle cells, an increase in glucose
uptake by the muscle cells is the result. This is an example of what type
of effect by a hormone?
a. Pharmacologic
b. Synergistic
c. Permissive
d. Direct
Direct. Direct effects are the obvious changes in cell function that specifically
result from the stimulation by a particular hormone.
21. Graves disease develops from a(n):
a. Viral infection of the thyroid gland that causes overproduction of
thyroid hormone.
b. Autoimmune process during which lymphocytes and fibrous tissue
replace thyroid tissue.
