NURS 231/NURS231 Module 7 V3 |
Pathophysiology Q&A with Rationale |
Portage Learning
1. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Which laboratory finding should the nurse expect?
A. Hematocrit 55%
B. Serum osmolality 310 mOsm/kg
C. Urine specific gravity 1.002
D. Serum sodium 120 mEq/L
Correct Answer: D
Rationale: SIADH is characterized by the excessive release of antidiuretic hormone, which
leads to significant water retention and dilutional hyponatremia. The serum sodium level
of 120 mEq/L is a classic finding because the kidneys reabsorb too much water, diluting the
sodium in the intravascular space. This condition typically results in low serum osmolality
and high urine concentration, which is the opposite of the other provided options.
2. Which clinical manifestation is most characteristic of a patient experiencing Diabetes
Insipidus (DI)?
A. Extreme polyuria and polydipsia
B. High urine specific gravity
,C. Peripheral edema and weight gain
D. Hypervolemia and hypertension
Correct Answer: A
Rationale: Diabetes Insipidus results from a deficiency of ADH or a decreased renal
response to ADH, leading to the inability to concentrate urine. Patients typically present
with extreme polyuria, often excreting up to 20 liters of dilute urine per day, and
compensatory polydipsia. This massive loss of fluid leads to dehydration and high serum
osmolality rather than the fluid overload seen in SIADH.
3. A 45-year-old male presents with enlarged hands, a protruding jaw, and a deepening voice.
The nurse suspects which endocrine disorder?
A. Gigantism
B. Acromegaly
C. Cushing Syndrome
D. Myxedema
Correct Answer: B
Rationale: Acromegaly occurs due to the hypersecretion of growth hormone (GH) during
adulthood after the epiphyseal plates have closed. This results in the thickening of bones
and soft tissues, specifically in the face, hands, and feet, rather than an increase in height.
Gigantism occurs when GH excess happens in childhood before the growth plates close,
leading to excessive height.
, 4. What is the primary pathophysiology behind Type 1 Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Downregulation of insulin receptors
C. Hypersecretion of glucagon from alpha cells
D. Autoimmune destruction of pancreatic beta cells
Correct Answer: D
Rationale: Type 1 Diabetes Mellitus is an autoimmune condition where the body’s immune
system attacks and destroys the insulin-producing beta cells in the Islets of Langerhans.
This leads to an absolute insulin deficiency, meaning the patient must rely on exogenous
insulin for survival. This is distinct from Type 2 DM, which is primarily characterized by
insulin resistance and relative insulin deficiency.
5. A patient with Grave’s disease is admitted to the ICU with hyperthermia, tachycardia, and
agitation. What complication is most likely occurring?
A. Myxedema Coma
B. Thyroid Storm
C. Addisonian Crisis
D. Pheochromocytoma crisis
Correct Answer: B
Pathophysiology Q&A with Rationale |
Portage Learning
1. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Which laboratory finding should the nurse expect?
A. Hematocrit 55%
B. Serum osmolality 310 mOsm/kg
C. Urine specific gravity 1.002
D. Serum sodium 120 mEq/L
Correct Answer: D
Rationale: SIADH is characterized by the excessive release of antidiuretic hormone, which
leads to significant water retention and dilutional hyponatremia. The serum sodium level
of 120 mEq/L is a classic finding because the kidneys reabsorb too much water, diluting the
sodium in the intravascular space. This condition typically results in low serum osmolality
and high urine concentration, which is the opposite of the other provided options.
2. Which clinical manifestation is most characteristic of a patient experiencing Diabetes
Insipidus (DI)?
A. Extreme polyuria and polydipsia
B. High urine specific gravity
,C. Peripheral edema and weight gain
D. Hypervolemia and hypertension
Correct Answer: A
Rationale: Diabetes Insipidus results from a deficiency of ADH or a decreased renal
response to ADH, leading to the inability to concentrate urine. Patients typically present
with extreme polyuria, often excreting up to 20 liters of dilute urine per day, and
compensatory polydipsia. This massive loss of fluid leads to dehydration and high serum
osmolality rather than the fluid overload seen in SIADH.
3. A 45-year-old male presents with enlarged hands, a protruding jaw, and a deepening voice.
The nurse suspects which endocrine disorder?
A. Gigantism
B. Acromegaly
C. Cushing Syndrome
D. Myxedema
Correct Answer: B
Rationale: Acromegaly occurs due to the hypersecretion of growth hormone (GH) during
adulthood after the epiphyseal plates have closed. This results in the thickening of bones
and soft tissues, specifically in the face, hands, and feet, rather than an increase in height.
Gigantism occurs when GH excess happens in childhood before the growth plates close,
leading to excessive height.
, 4. What is the primary pathophysiology behind Type 1 Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Downregulation of insulin receptors
C. Hypersecretion of glucagon from alpha cells
D. Autoimmune destruction of pancreatic beta cells
Correct Answer: D
Rationale: Type 1 Diabetes Mellitus is an autoimmune condition where the body’s immune
system attacks and destroys the insulin-producing beta cells in the Islets of Langerhans.
This leads to an absolute insulin deficiency, meaning the patient must rely on exogenous
insulin for survival. This is distinct from Type 2 DM, which is primarily characterized by
insulin resistance and relative insulin deficiency.
5. A patient with Grave’s disease is admitted to the ICU with hyperthermia, tachycardia, and
agitation. What complication is most likely occurring?
A. Myxedema Coma
B. Thyroid Storm
C. Addisonian Crisis
D. Pheochromocytoma crisis
Correct Answer: B
