NURS 753 EXAM / ACTUAL NURS 753 MIDTERM AND FINAL
EXAM EACH EXAM CONTAINS COMPLETE ACCURATE
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES (100% CORRECT VERIFIED SOLUTIONS) LATEST
UPDATED VERSIONS 2026 EDITION |GUARANTEED PASS A+
(BRAND NEW!) FULL REVISED EXAMS
NURS 753 MIDTERM EXAM
1. A 45-year-old male presents with fatigue, weight gain, cold intolerance, and bradycardia. Laboratory
findings show elevated TSH and low free T4. Which cellular mechanism best explains his symptoms?
A) Decreased mitochondrial uncoupling proteins in brown adipose tissue
B) Increased sodium-potassium ATPase activity in skeletal muscle
C) Enhanced beta-adrenergic receptor sensitivity
D) Upregulation of thyroid hormone nuclear receptors
CORRECT ANSWER: A
Rationale: Hypothyroidism reduces metabolic rate. Thyroid hormone normally increases mitochondrial
uncoupling proteins (UCPs) that generate heat. Decreased UCP activity leads to reduced
thermogenesis, contributing to cold intolerance and fatigue.
2. A patient with chronic heart failure has elevated B-type natriuretic peptide (BNP). BNP is primarily
released from which cardiac structure in response to?
A) Atria – increased atrial pressure
B) Ventricles – increased wall tension
C) Pericardium – inflammation
D) Coronary arteries – shear stress
CORRECT ANSWER: B
Rationale: BNP is synthesized and secreted mainly by ventricular myocytes in response to increased
wall tension (stretch). Atrial natriuretic peptide (ANP) is released from atria.
,3. A 60-year-old with cirrhosis develops ascites. The primary pathophysiologic mechanism is:
A) Decreased plasma oncotic pressure due to hypoalbuminemia
B) Increased hepatic lymph production exceeding thoracic duct drainage
C) Sodium and water retention secondary to hyperaldosteronism
D) All of the above
CORRECT ANSWER: D
Rationale: Ascites in cirrhosis is multifactorial: hypoalbuminemia reduces oncotic pressure; increased
hepatic lymph production overwhelms drainage; and aldosterone excess (due to decreased liver
metabolism) causes sodium/water retention.
4. A child presents with acute post-streptococcal glomerulonephritis. The glomerular lesion is best
described as:
A) Anti-GBM antibody deposition along the basement membrane
B) Immune complex deposition with sub epithelial “humps”
C) Paucity-immune crescentic glomerulonephritis
D) Nodular glomerulosclerosis
CORRECT ANSWER: B
Rationale: Post-streptococcal glomerulonephritis is caused by immune complex deposition (antigen-
antibody) that forms sub epithelial electron-dense “humps” on electron microscopy.
5. Which of the following best characterizes the pain of acute myocardial infarction?
A) Sharp, pleuritic, relieved by leaning forward
B) Substernal pressure radiating to the jaw or left arm, unrelieved by rest
C) Burning epigastric pain relieved by antacids
D) Sharp, localized pain reproduced by chest wall palpation
CORRECT ANSWER: B
,Rationale: Classic ischemic chest pain is substernal pressure or heaviness with radiation to the jaw,
shoulder, or left arm. It is not positional or pleuritic.
6. A patient with septic shock has a cardiac output that is initially increased. This hyper dynamic state is
primarily due to:
A) Myocardial depression from endotoxins
B) Peripheral vasodilation and compensatory tachycardia
C) Direct beta-1 receptor stimulation by bacterial antigens
D) Increased preload from fluid resuscitation
CORRECT ANSWER: B
Rationale: Early septic shock causes vasodilation (decreased afterload). The heart compensates with
tachycardia, resulting in increased cardiac output. Myocardial depression occurs later.
7. A patient with type 1 diabetes mellitus develops nausea, vomiting, deep rapid breathing (Kussmaul
respirations), and a fruity breath odor. The most likely acid-base disturbance is:
A) Metabolic alkalosis
B) Respiratory acidosis
C) Metabolic acidosis with high anion gap
D) Respiratory alkalosis
CORRECT ANSWER: C
Rationale: Diabetic ketoacidosis causes accumulation of ketone bodies (acetoacetate, beta-
hydroxybutyrate), resulting in a high anion gap metabolic acidosis. Kussmaul respirations are
compensatory.
8. A 30-year-old woman presents with episodic headaches, palpitations, and diaphoresis. Her blood
pressure is 180/110 mmHg. A CT scan shows a 3 cm adrenal mass. The most likely diagnosis is:
A) Cushing’s syndrome
B) Primary hyperaldosteronism
C) Pheochromocytoma
, D) Adrenal carcinoma
CORRECT ANSWER: C
Rationale: The classic triad of episodic headache, palpitations, and diaphoresis with hypertension is
characteristic of pheochromocytoma, a catecholamine-secreting tumor.
9. A patient with chronic obstructive pulmonary disease (COPD) has a Pac₂ of 65 mmHg. Which
compensatory mechanism is expected?
A) Increased renal bicarbonate reabsorption
B) Hyperventilation with decreased Pac₂
C) Decreased renal hydrogen ion excretion
D) Metabolic alkalosis from vomiting
CORRECT ANSWER: A
Rationale: Chronic respiratory acidosis leads to renal compensation: the kidneys increase bicarbonate
reabsorption and hydrogen ion excretion, raising serum HCO₃⁻.
10. A 55-year-old male with a history of alcohol use disorder presents with jaundice, ascites, and
asterisks. Liver biopsy shows micro nodular cirrhosis. The most common cause of death in such patients
is:
A) Hepatic encephalopathy
B) Esophageal varietal hemorrhage
C) Hepatocellular carcinoma
D) Spontaneous bacterial peritonitis
CORRECT ANSWER: B
Rationale: In cirrhosis, the most common cause of death is varietal hemorrhage (bleeding from
esophageal varices) due to portal hypertension.
11. A patient with acute pancreatitis develops retroperitoneal hemorrhage. Which enzyme is
responsible for the hemorrhagic complication?
EXAM EACH EXAM CONTAINS COMPLETE ACCURATE
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES (100% CORRECT VERIFIED SOLUTIONS) LATEST
UPDATED VERSIONS 2026 EDITION |GUARANTEED PASS A+
(BRAND NEW!) FULL REVISED EXAMS
NURS 753 MIDTERM EXAM
1. A 45-year-old male presents with fatigue, weight gain, cold intolerance, and bradycardia. Laboratory
findings show elevated TSH and low free T4. Which cellular mechanism best explains his symptoms?
A) Decreased mitochondrial uncoupling proteins in brown adipose tissue
B) Increased sodium-potassium ATPase activity in skeletal muscle
C) Enhanced beta-adrenergic receptor sensitivity
D) Upregulation of thyroid hormone nuclear receptors
CORRECT ANSWER: A
Rationale: Hypothyroidism reduces metabolic rate. Thyroid hormone normally increases mitochondrial
uncoupling proteins (UCPs) that generate heat. Decreased UCP activity leads to reduced
thermogenesis, contributing to cold intolerance and fatigue.
2. A patient with chronic heart failure has elevated B-type natriuretic peptide (BNP). BNP is primarily
released from which cardiac structure in response to?
A) Atria – increased atrial pressure
B) Ventricles – increased wall tension
C) Pericardium – inflammation
D) Coronary arteries – shear stress
CORRECT ANSWER: B
Rationale: BNP is synthesized and secreted mainly by ventricular myocytes in response to increased
wall tension (stretch). Atrial natriuretic peptide (ANP) is released from atria.
,3. A 60-year-old with cirrhosis develops ascites. The primary pathophysiologic mechanism is:
A) Decreased plasma oncotic pressure due to hypoalbuminemia
B) Increased hepatic lymph production exceeding thoracic duct drainage
C) Sodium and water retention secondary to hyperaldosteronism
D) All of the above
CORRECT ANSWER: D
Rationale: Ascites in cirrhosis is multifactorial: hypoalbuminemia reduces oncotic pressure; increased
hepatic lymph production overwhelms drainage; and aldosterone excess (due to decreased liver
metabolism) causes sodium/water retention.
4. A child presents with acute post-streptococcal glomerulonephritis. The glomerular lesion is best
described as:
A) Anti-GBM antibody deposition along the basement membrane
B) Immune complex deposition with sub epithelial “humps”
C) Paucity-immune crescentic glomerulonephritis
D) Nodular glomerulosclerosis
CORRECT ANSWER: B
Rationale: Post-streptococcal glomerulonephritis is caused by immune complex deposition (antigen-
antibody) that forms sub epithelial electron-dense “humps” on electron microscopy.
5. Which of the following best characterizes the pain of acute myocardial infarction?
A) Sharp, pleuritic, relieved by leaning forward
B) Substernal pressure radiating to the jaw or left arm, unrelieved by rest
C) Burning epigastric pain relieved by antacids
D) Sharp, localized pain reproduced by chest wall palpation
CORRECT ANSWER: B
,Rationale: Classic ischemic chest pain is substernal pressure or heaviness with radiation to the jaw,
shoulder, or left arm. It is not positional or pleuritic.
6. A patient with septic shock has a cardiac output that is initially increased. This hyper dynamic state is
primarily due to:
A) Myocardial depression from endotoxins
B) Peripheral vasodilation and compensatory tachycardia
C) Direct beta-1 receptor stimulation by bacterial antigens
D) Increased preload from fluid resuscitation
CORRECT ANSWER: B
Rationale: Early septic shock causes vasodilation (decreased afterload). The heart compensates with
tachycardia, resulting in increased cardiac output. Myocardial depression occurs later.
7. A patient with type 1 diabetes mellitus develops nausea, vomiting, deep rapid breathing (Kussmaul
respirations), and a fruity breath odor. The most likely acid-base disturbance is:
A) Metabolic alkalosis
B) Respiratory acidosis
C) Metabolic acidosis with high anion gap
D) Respiratory alkalosis
CORRECT ANSWER: C
Rationale: Diabetic ketoacidosis causes accumulation of ketone bodies (acetoacetate, beta-
hydroxybutyrate), resulting in a high anion gap metabolic acidosis. Kussmaul respirations are
compensatory.
8. A 30-year-old woman presents with episodic headaches, palpitations, and diaphoresis. Her blood
pressure is 180/110 mmHg. A CT scan shows a 3 cm adrenal mass. The most likely diagnosis is:
A) Cushing’s syndrome
B) Primary hyperaldosteronism
C) Pheochromocytoma
, D) Adrenal carcinoma
CORRECT ANSWER: C
Rationale: The classic triad of episodic headache, palpitations, and diaphoresis with hypertension is
characteristic of pheochromocytoma, a catecholamine-secreting tumor.
9. A patient with chronic obstructive pulmonary disease (COPD) has a Pac₂ of 65 mmHg. Which
compensatory mechanism is expected?
A) Increased renal bicarbonate reabsorption
B) Hyperventilation with decreased Pac₂
C) Decreased renal hydrogen ion excretion
D) Metabolic alkalosis from vomiting
CORRECT ANSWER: A
Rationale: Chronic respiratory acidosis leads to renal compensation: the kidneys increase bicarbonate
reabsorption and hydrogen ion excretion, raising serum HCO₃⁻.
10. A 55-year-old male with a history of alcohol use disorder presents with jaundice, ascites, and
asterisks. Liver biopsy shows micro nodular cirrhosis. The most common cause of death in such patients
is:
A) Hepatic encephalopathy
B) Esophageal varietal hemorrhage
C) Hepatocellular carcinoma
D) Spontaneous bacterial peritonitis
CORRECT ANSWER: B
Rationale: In cirrhosis, the most common cause of death is varietal hemorrhage (bleeding from
esophageal varices) due to portal hypertension.
11. A patient with acute pancreatitis develops retroperitoneal hemorrhage. Which enzyme is
responsible for the hemorrhagic complication?
