NUR 6111 / NUR6111 (2025/2026) Advanced Practice Nursing I Exam 3 – Third Comprehensive
Question Bank: 150 Additional Questions with Multiple Answers, Case-Based Scenarios, and
Evidence-Based Rationales – A Complete A+ Guide for Clinical Mastery (Maryville University &
William Paterson University)
Below is a third complete set of 150 exam-style questions with verified answers and detailed
rationales, compiled from the latest 2025/2026 NUR 6111 Exam 3 resources . This bank
integrates pathophysiology, pharmacology, clinical assessment, and diagnostic reasoning across the
core domains of advanced primary care.
Section 1: Endocrine & Metabolic Disorders (Questions 1–30)
1. Clinical manifestations of hypothyroidism include: (Select all that apply)
A) Constipation
B) Increased heart rate
C) Lethargy
D) Weight gain
Correct Answers: A, C, D – Hypothyroidism slows metabolism, causing constipation, fatigue, and
weight gain; bradycardia occurs, not tachycardia .
2. Thyroid-stimulating hormone (TSH) release is inhibited when plasma TH levels rise. This is an
example of:
A) Positive feedback
B) Negative feedback
C) Autocrine regulation
D) Paracrine signaling
Correct Answer: B – Negative feedback maintains homeostasis by suppressing further hormone
release when target levels are adequate .
3. Lipid-soluble hormone receptors are located:
A) On the cell surface membrane
B) Inside the plasma membrane in the cytoplasm
C) Exclusively in the nucleus
D) Within mitochondrial membranes
Correct Answer: B – Lipid-soluble hormones cross cell membranes and bind intracellular receptors in
the cytoplasm .
4. Releasing hormones from the hypothalamus reach the anterior pituitary via:
A) Direct neural connections
B) Portal hypophyseal blood vessels
C) Systemic arterial circulation
D) Lymphatic vessels
,Correct Answer: B – The hypothalamic-pituitary portal system delivers releasing hormones directly to
the anterior pituitary .
5. Which mineral is essential for TSH to stimulate thyroid hormone secretion?
A) Iron
B) Iodide
C) Zinc
D) Selenium
Correct Answer: B – Iodide is required for thyroid hormone synthesis; deficiency leads to
hypothyroidism .
6. Hyperphosphatemia has what effect on serum calcium?
A) Increases calcium
B) Decreases calcium
C) No effect on calcium
D) Converts calcium to phosphate
Correct Answer: B – Hyperphosphatemia decreases serum calcium due to reciprocal relationship .
7. Insulin transports which electrolyte into cells?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Correct Answer: B – Insulin promotes intracellular potassium uptake; this is important in DKA
management .
8. Which second messenger is stimulated by epinephrine binding to β-adrenergic receptor?
A) Cyclic AMP (cAMP)
B) Cyclic GMP (cGMP)
C) Inositol trisphosphate (IP3)
D) Diacylglycerol (DAG)
Correct Answer: A – Epinephrine binding to β-adrenergic receptors activates adenylyl cyclase,
converting ATP to cAMP .
9. Regulation of catecholamine release from the adrenal medulla is an example of:
A) Hormonal regulation
B) Neural regulation
C) Humoral regulation
D) Autocrine regulation
Correct Answer: B – Adrenal medulla releases catecholamines in response to direct sympathetic
nervous system stimulation .
10. A deficiency of which chemical may result in hypothyroidism?
A) Selenium
B) Iodine
C) Zinc
D) Copper
Correct Answer: B – Endemic iodine deficiency is a classic cause of hypothyroidism and goiter .
, 11. TSH levels in individuals with Graves' disease are usually:
A) Elevated
B) Suppressed (low)
C) Normal
D) Unmeasurable
Correct Answer: B – Hyperfunction of the thyroid gland suppresses TSH via normal negative
feedback .
12. Palpation of the neck in Graves' disease would detect a thyroid that is:
A) Atrophic
B) Diffusely enlarged (goiter)
C) Nodular
D) Unpalpable
Correct Answer: B – Graves' disease typically presents with diffuse, nontender goiter .
13. The effects of syndrome of inappropriate antidiuretic hormone (SIADH) include solute:
A) Dilution and water retention
B) Concentration and water loss
C) Dilution and water loss
D) Concentration and water retention
Correct Answer: A – SIADH causes solute dilution and water retention, leading to hyponatremia .
14. Common cause of elevated ADH secretion is:
A) Dehydration
B) Ectopically produced ADH
C) Overhydration
D) Renal failure
Correct Answer: B – Ectopic ADH production (e.g., small cell lung cancer) is a common cause of
SIADH .
15. Which lab value is expected in SIADH?
A) Serum Na 150 mEq/L
B) Serum Na 120 mEq/L with serum hypo-osmolality
C) Serum K 5.5 mEq/L
D) Serum osmolality 310 mOsm/kg
Correct Answer: B – SIADH diagnosis requires serum sodium <135 mEq/L and serum hypo-osmolality
<280 mOsm/kg .
16. A patient with closed head injury has urine output 6-8 L/day, normal electrolytes, and low ADH.
Diagnosis:
A) SIADH
B) Neurogenic diabetes insipidus
C) Psychogenic polydipsia
D) Nephrogenic DI
Correct Answer: B – Head trauma can damage posterior pituitary, causing neurogenic DI from ADH
deficiency .
Question Bank: 150 Additional Questions with Multiple Answers, Case-Based Scenarios, and
Evidence-Based Rationales – A Complete A+ Guide for Clinical Mastery (Maryville University &
William Paterson University)
Below is a third complete set of 150 exam-style questions with verified answers and detailed
rationales, compiled from the latest 2025/2026 NUR 6111 Exam 3 resources . This bank
integrates pathophysiology, pharmacology, clinical assessment, and diagnostic reasoning across the
core domains of advanced primary care.
Section 1: Endocrine & Metabolic Disorders (Questions 1–30)
1. Clinical manifestations of hypothyroidism include: (Select all that apply)
A) Constipation
B) Increased heart rate
C) Lethargy
D) Weight gain
Correct Answers: A, C, D – Hypothyroidism slows metabolism, causing constipation, fatigue, and
weight gain; bradycardia occurs, not tachycardia .
2. Thyroid-stimulating hormone (TSH) release is inhibited when plasma TH levels rise. This is an
example of:
A) Positive feedback
B) Negative feedback
C) Autocrine regulation
D) Paracrine signaling
Correct Answer: B – Negative feedback maintains homeostasis by suppressing further hormone
release when target levels are adequate .
3. Lipid-soluble hormone receptors are located:
A) On the cell surface membrane
B) Inside the plasma membrane in the cytoplasm
C) Exclusively in the nucleus
D) Within mitochondrial membranes
Correct Answer: B – Lipid-soluble hormones cross cell membranes and bind intracellular receptors in
the cytoplasm .
4. Releasing hormones from the hypothalamus reach the anterior pituitary via:
A) Direct neural connections
B) Portal hypophyseal blood vessels
C) Systemic arterial circulation
D) Lymphatic vessels
,Correct Answer: B – The hypothalamic-pituitary portal system delivers releasing hormones directly to
the anterior pituitary .
5. Which mineral is essential for TSH to stimulate thyroid hormone secretion?
A) Iron
B) Iodide
C) Zinc
D) Selenium
Correct Answer: B – Iodide is required for thyroid hormone synthesis; deficiency leads to
hypothyroidism .
6. Hyperphosphatemia has what effect on serum calcium?
A) Increases calcium
B) Decreases calcium
C) No effect on calcium
D) Converts calcium to phosphate
Correct Answer: B – Hyperphosphatemia decreases serum calcium due to reciprocal relationship .
7. Insulin transports which electrolyte into cells?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Correct Answer: B – Insulin promotes intracellular potassium uptake; this is important in DKA
management .
8. Which second messenger is stimulated by epinephrine binding to β-adrenergic receptor?
A) Cyclic AMP (cAMP)
B) Cyclic GMP (cGMP)
C) Inositol trisphosphate (IP3)
D) Diacylglycerol (DAG)
Correct Answer: A – Epinephrine binding to β-adrenergic receptors activates adenylyl cyclase,
converting ATP to cAMP .
9. Regulation of catecholamine release from the adrenal medulla is an example of:
A) Hormonal regulation
B) Neural regulation
C) Humoral regulation
D) Autocrine regulation
Correct Answer: B – Adrenal medulla releases catecholamines in response to direct sympathetic
nervous system stimulation .
10. A deficiency of which chemical may result in hypothyroidism?
A) Selenium
B) Iodine
C) Zinc
D) Copper
Correct Answer: B – Endemic iodine deficiency is a classic cause of hypothyroidism and goiter .
, 11. TSH levels in individuals with Graves' disease are usually:
A) Elevated
B) Suppressed (low)
C) Normal
D) Unmeasurable
Correct Answer: B – Hyperfunction of the thyroid gland suppresses TSH via normal negative
feedback .
12. Palpation of the neck in Graves' disease would detect a thyroid that is:
A) Atrophic
B) Diffusely enlarged (goiter)
C) Nodular
D) Unpalpable
Correct Answer: B – Graves' disease typically presents with diffuse, nontender goiter .
13. The effects of syndrome of inappropriate antidiuretic hormone (SIADH) include solute:
A) Dilution and water retention
B) Concentration and water loss
C) Dilution and water loss
D) Concentration and water retention
Correct Answer: A – SIADH causes solute dilution and water retention, leading to hyponatremia .
14. Common cause of elevated ADH secretion is:
A) Dehydration
B) Ectopically produced ADH
C) Overhydration
D) Renal failure
Correct Answer: B – Ectopic ADH production (e.g., small cell lung cancer) is a common cause of
SIADH .
15. Which lab value is expected in SIADH?
A) Serum Na 150 mEq/L
B) Serum Na 120 mEq/L with serum hypo-osmolality
C) Serum K 5.5 mEq/L
D) Serum osmolality 310 mOsm/kg
Correct Answer: B – SIADH diagnosis requires serum sodium <135 mEq/L and serum hypo-osmolality
<280 mOsm/kg .
16. A patient with closed head injury has urine output 6-8 L/day, normal electrolytes, and low ADH.
Diagnosis:
A) SIADH
B) Neurogenic diabetes insipidus
C) Psychogenic polydipsia
D) Nephrogenic DI
Correct Answer: B – Head trauma can damage posterior pituitary, causing neurogenic DI from ADH
deficiency .
