NUR 546/NUR546 Exam 4 V2 | Advanced
Pathophysiology Q&A with Rationale |
William Paterson University
1. A patient with Type 1 Diabetes Mellitus presents with deep, rapid respirations and a fruity
breath odor. What is the primary mechanism causing these respiratory changes?
A. Compensatory metabolic alkalosis
B. Failure of the renal buffer system
C. Direct irritation of the lungs by high glucose levels
D. Respiratory compensation for metabolic acidosis
Correct Answer: D
Expert Explanation: In diabetic ketoacidosis (DKA), the accumulation of ketone bodies
leads to metabolic acidosis. The body attempts to compensate by increasing the rate and
depth of respirations, known as Kussmaul respirations, to blow off carbon dioxide. This
respiratory compensation helps to slightly increase the pH back toward the normal range.
2. Which laboratory finding is most indicative of Primary Hypothyroidism?
A. Elevated T3 and T4 with low TSH
B. Low TSH and low T4
C. Elevated TSH and elevated T4
D. Elevated TSH and low T4
,Correct Answer: D
Expert Explanation: Primary hypothyroidism occurs when the thyroid gland itself fails to
produce adequate thyroid hormones. Due to the negative feedback loop, the anterior
pituitary increases the secretion of Thyroid Stimulating Hormone (TSH) to stimulate the
failing gland. Therefore, a high TSH level coupled with a low serum T4 level is the classic
diagnostic pattern.
3. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Which electrolyte imbalance should the nurse expect to find?
A. Hypernatremia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
Correct Answer: C
Expert Explanation: SIADH involves the excessive release of ADH, which leads to
significant water retention in the kidneys. This excess water dilutes the sodium in the
extracellular fluid, resulting in dilutional hyponatremia. Patients often present with serum
sodium levels significantly below the normal range of 135-145 mEq/L.
4. What is the pathophysiological hallmark of Nephrotic Syndrome?
A. Glomerular inflammation leading to hematuria
B. Increased glomerular permeability to proteins
, C. Obstruction of the ureters by calcium stones
D. Infection of the renal pelvis by E. coli
Correct Answer: B
Expert Explanation: Nephrotic syndrome is characterized by massive damage to the
glomerular basement membrane. This damage results in increased permeability, allowing
large amounts of protein, primarily albumin, to leak into the urine. This loss leads to the
classic tetrad of proteinuria, hypoalbuminemia, hyperlipidemia, and edema.
5. In the development of Chronic Kidney Disease (CKD), what is the clinical significance of a
GFR of 45 mL/min/1.73m2?
A. Stage 1 CKD with normal function
B. Stage 3 CKD with moderate decrease in GFR
C. Stage 5 CKD requiring dialysis
D. Acute Kidney Injury that is reversible
Correct Answer: B
Expert Explanation: The Glomerular Filtration Rate (GFR) is the gold standard for
assessing kidney function. A GFR between 30 and 59 mL/min/1.73m2 indicates Stage 3
CKD, which represents a moderate decrease in renal function. At this stage, patients may
start to show systemic complications like anemia or bone disease.
Pathophysiology Q&A with Rationale |
William Paterson University
1. A patient with Type 1 Diabetes Mellitus presents with deep, rapid respirations and a fruity
breath odor. What is the primary mechanism causing these respiratory changes?
A. Compensatory metabolic alkalosis
B. Failure of the renal buffer system
C. Direct irritation of the lungs by high glucose levels
D. Respiratory compensation for metabolic acidosis
Correct Answer: D
Expert Explanation: In diabetic ketoacidosis (DKA), the accumulation of ketone bodies
leads to metabolic acidosis. The body attempts to compensate by increasing the rate and
depth of respirations, known as Kussmaul respirations, to blow off carbon dioxide. This
respiratory compensation helps to slightly increase the pH back toward the normal range.
2. Which laboratory finding is most indicative of Primary Hypothyroidism?
A. Elevated T3 and T4 with low TSH
B. Low TSH and low T4
C. Elevated TSH and elevated T4
D. Elevated TSH and low T4
,Correct Answer: D
Expert Explanation: Primary hypothyroidism occurs when the thyroid gland itself fails to
produce adequate thyroid hormones. Due to the negative feedback loop, the anterior
pituitary increases the secretion of Thyroid Stimulating Hormone (TSH) to stimulate the
failing gland. Therefore, a high TSH level coupled with a low serum T4 level is the classic
diagnostic pattern.
3. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Which electrolyte imbalance should the nurse expect to find?
A. Hypernatremia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
Correct Answer: C
Expert Explanation: SIADH involves the excessive release of ADH, which leads to
significant water retention in the kidneys. This excess water dilutes the sodium in the
extracellular fluid, resulting in dilutional hyponatremia. Patients often present with serum
sodium levels significantly below the normal range of 135-145 mEq/L.
4. What is the pathophysiological hallmark of Nephrotic Syndrome?
A. Glomerular inflammation leading to hematuria
B. Increased glomerular permeability to proteins
, C. Obstruction of the ureters by calcium stones
D. Infection of the renal pelvis by E. coli
Correct Answer: B
Expert Explanation: Nephrotic syndrome is characterized by massive damage to the
glomerular basement membrane. This damage results in increased permeability, allowing
large amounts of protein, primarily albumin, to leak into the urine. This loss leads to the
classic tetrad of proteinuria, hypoalbuminemia, hyperlipidemia, and edema.
5. In the development of Chronic Kidney Disease (CKD), what is the clinical significance of a
GFR of 45 mL/min/1.73m2?
A. Stage 1 CKD with normal function
B. Stage 3 CKD with moderate decrease in GFR
C. Stage 5 CKD requiring dialysis
D. Acute Kidney Injury that is reversible
Correct Answer: B
Expert Explanation: The Glomerular Filtration Rate (GFR) is the gold standard for
assessing kidney function. A GFR between 30 and 59 mL/min/1.73m2 indicates Stage 3
CKD, which represents a moderate decrease in renal function. At this stage, patients may
start to show systemic complications like anemia or bone disease.
