NR283 EXAM 3 PATHOPHYSIOLOGY
COMPREHENSIVE PRACTICE EXAM
QUESTIONS AND ANSWERS
1. A patient presents with extreme thirst, frequent urination, and a blood glucose level of 650
mg/dL. The nurse notes the absence of ketones in the urine. Which condition is most likely
occurring?
A. Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
B. Diabetic Ketoacidosis (DKA)
C. Somogyi Effect
D. Diabetes Insipidus
Answer: A
Conceptual Explanation: HHNS is characterized by extreme hyperglycemia and
dehydration without the significant ketosis seen in DKA, typically occurring in Type 2
diabetics.
2. Which pathophysiological mechanism best explains the development of exophthalmos in
Graves’ disease?
A. Destruction of the optic nerve by autoantibodies
,B. Increased sympathetic nervous system stimulation of the eyelid muscles
C. Excessive production of thyroid hormones causing systemic edema
D. Accumulation of glycosaminoglycans and inflammation in the retro-orbital tissues
Answer: D
Conceptual Explanation: In Graves’ disease, fibroblasts in the eye muscles and fat are
stimulated by autoantibodies, leading to the accumulation of glycosaminoglycans and fluid,
causing the eyes to bulge.
3. A patient with chronic kidney disease (CKD) presents with a high serum phosphorus level
and a low serum calcium level. What is the primary cause of this low calcium?
A. Failure of the kidneys to activate Vitamin D
B. Excessive calcium excretion in the urine
C. Decreased secretion of Parathyroid Hormone (PTH)
D. High levels of aluminum in the blood binding to calcium
Answer: A
Conceptual Explanation: The kidneys are responsible for converting Vitamin D to its
active form (calcitriol), which is necessary for calcium absorption in the GI tract. In CKD,
this process fails.
, 4. Which type of acute kidney injury (AKI) would be caused by a massive hemorrhage
resulting in severe hypotension?
A. Intrarenal AKI
B. Prerenal AKI
C. Postrenal AKI
D. Acute Tubular Necrosis
Answer: B
Conceptual Explanation: Prerenal AKI is caused by factors that decrease blood flow to the
kidney (hypoperfusion) before it reaches the renal parenchyma, such as hemorrhage or
dehydration.
5. A patient with SIADH (Syndrome of Inappropriate Antidiuretic Hormone) is likely to exhibit
which electrolyte abnormality?
A. Hypernatremia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
Answer: C
Conceptual Explanation: SIADH causes excessive water retention, which dilutes the
sodium in the blood, leading to dilutional hyponatremia.
COMPREHENSIVE PRACTICE EXAM
QUESTIONS AND ANSWERS
1. A patient presents with extreme thirst, frequent urination, and a blood glucose level of 650
mg/dL. The nurse notes the absence of ketones in the urine. Which condition is most likely
occurring?
A. Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
B. Diabetic Ketoacidosis (DKA)
C. Somogyi Effect
D. Diabetes Insipidus
Answer: A
Conceptual Explanation: HHNS is characterized by extreme hyperglycemia and
dehydration without the significant ketosis seen in DKA, typically occurring in Type 2
diabetics.
2. Which pathophysiological mechanism best explains the development of exophthalmos in
Graves’ disease?
A. Destruction of the optic nerve by autoantibodies
,B. Increased sympathetic nervous system stimulation of the eyelid muscles
C. Excessive production of thyroid hormones causing systemic edema
D. Accumulation of glycosaminoglycans and inflammation in the retro-orbital tissues
Answer: D
Conceptual Explanation: In Graves’ disease, fibroblasts in the eye muscles and fat are
stimulated by autoantibodies, leading to the accumulation of glycosaminoglycans and fluid,
causing the eyes to bulge.
3. A patient with chronic kidney disease (CKD) presents with a high serum phosphorus level
and a low serum calcium level. What is the primary cause of this low calcium?
A. Failure of the kidneys to activate Vitamin D
B. Excessive calcium excretion in the urine
C. Decreased secretion of Parathyroid Hormone (PTH)
D. High levels of aluminum in the blood binding to calcium
Answer: A
Conceptual Explanation: The kidneys are responsible for converting Vitamin D to its
active form (calcitriol), which is necessary for calcium absorption in the GI tract. In CKD,
this process fails.
, 4. Which type of acute kidney injury (AKI) would be caused by a massive hemorrhage
resulting in severe hypotension?
A. Intrarenal AKI
B. Prerenal AKI
C. Postrenal AKI
D. Acute Tubular Necrosis
Answer: B
Conceptual Explanation: Prerenal AKI is caused by factors that decrease blood flow to the
kidney (hypoperfusion) before it reaches the renal parenchyma, such as hemorrhage or
dehydration.
5. A patient with SIADH (Syndrome of Inappropriate Antidiuretic Hormone) is likely to exhibit
which electrolyte abnormality?
A. Hypernatremia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
Answer: C
Conceptual Explanation: SIADH causes excessive water retention, which dilutes the
sodium in the blood, leading to dilutional hyponatremia.
