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HESI RN PATHOPHYSIOLOGY EXAM QUESTIONS AND ANSWERS LATEST 2025
ACTUAL EXAM WITH COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS (100% VERIFIED ANSWERS) |ALREADY GRADED A+| ||PROFESSOR
VERIFIED|| ||BRANDNEW!!!||
Which of the following clinical manifestations following
thyroidectomy would alert the nurse that the client is going into a
life-threatening thyroid storm? Select all that apply.
A) Temperature of 104.2°F
B) Telemetry showing heart rate of 184
C) Unable to close eyelids completely together
D) Extremely agitated
E) Bruising on knees and feet - ANSWER-Ans: A, B, D
Feedback:
Thyroid storm, or crisis, is an extreme and life-threatening
form of thyrotoxicosis, rarely seen today. When it does
occur, it is seen most often in undiagnosed cases or in
person with hyperthyroidism that has not been adequately
treated. It often is precipitated by stress such as an infection,
diabetic ketoacidosis, physical or emotional trauma, or
manipulation of a hyperactive thyroid gland during
thyroidectomy. It is manifested by a very high fever, extreme
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cardiovascular effects (tachycardia, HF, angina), and severe
CNS effects (agitation, restlessness, and delirium)
When educating a client with possible glucocorticoid dysfunction,
the nurse will explain that the CRH controls the release of ACTH.
The best time to perform the blood test to measure peak ACTH
levels would be:
A) 06:00 to 08:00 AM
B) 10:00 to 12:00 AM
C) 04:00 to 6:00 PM
D) 09:00 to 11:00 PM - ANSWER-Ans: A
Feedback:
Levels of cortisol increase as ACTH levels rise and decrease
as ACTH levels fall. There is considerable diurnal variation in
ACTH levels, which reach their peak in the early morning
(around 6 to 8 AM) and decline as the day progresses.
The immune suppressive and anti-inflammatory effects of cortisol
cause:
A) Moderate insulin resistance
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B) Increased capillary permeability
C) Increased cell-mediated immunity
D) Inhibition of prostaglandin synthesis - ANSWER-Ans: D
Feedback:
Large quantities of cortisol are required for an effective anti-
inflammatory action. The increased cortisol blocks
inflammation at an early stage by decreasing capillary
permeability and stabilizing the lysosomal membranes so
that inflammatory mediators are not released. Cortisol
suppresses the immune response by reducing humoral and
cell-mediated immunity. Cortisol also inhibits prostaglandin
synthesis, which may account in large part for its anti-
inflammatory actions. Cortisol stimulates glucose production
by the liver; as glucose production by the liver rises and
peripheral glucose use falls, a moderate resistance to insulin
and hyperglycemia develop.
A client who has been taking 80 mg of prednisone, a
glucocorticoid, each day has been warned by his primary care
provider to carefully follow a plan for the gradual reduction of the
dose rather than stopping the drug suddenly. What is the rationale
for this directive?
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A) Sudden changes in glucocorticoid dosing may reverse the
therapeutic effects of the drug.
B) Stopping the drug suddenly may "shock" the HPA axis into
overactivity.
C) Sudden cessation of a glucocorticoid can result in adrenal
gland necrosis.
D) Stopping the drug suddenly may cause acute adrenal
insufficiency. - ANSWER-Ans: D
Feedback:
Chronic suppression of the HPA system by the use of
steroids causes atrophy of the adrenal gland, and the abrupt
withdrawal of drugs can cause acute adrenal insufficiency.
Activity of the HPA system is consequently insufficient. The
efficacy of the drug is not the primary concern, and necrosis
of the gland itself does not occur.
Primary adrenal insufficiency is manifested by:
A) Truncal obesity and 3+ pitting edema in lower legs
B) Potassium level of 2.8 mEq/L and weight gain of 3 pounds
overnight
HESI RN PATHOPHYSIOLOGY EXAM QUESTIONS AND ANSWERS LATEST 2025
ACTUAL EXAM WITH COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS (100% VERIFIED ANSWERS) |ALREADY GRADED A+| ||PROFESSOR
VERIFIED|| ||BRANDNEW!!!||
Which of the following clinical manifestations following
thyroidectomy would alert the nurse that the client is going into a
life-threatening thyroid storm? Select all that apply.
A) Temperature of 104.2°F
B) Telemetry showing heart rate of 184
C) Unable to close eyelids completely together
D) Extremely agitated
E) Bruising on knees and feet - ANSWER-Ans: A, B, D
Feedback:
Thyroid storm, or crisis, is an extreme and life-threatening
form of thyrotoxicosis, rarely seen today. When it does
occur, it is seen most often in undiagnosed cases or in
person with hyperthyroidism that has not been adequately
treated. It often is precipitated by stress such as an infection,
diabetic ketoacidosis, physical or emotional trauma, or
manipulation of a hyperactive thyroid gland during
thyroidectomy. It is manifested by a very high fever, extreme
,2|Page
cardiovascular effects (tachycardia, HF, angina), and severe
CNS effects (agitation, restlessness, and delirium)
When educating a client with possible glucocorticoid dysfunction,
the nurse will explain that the CRH controls the release of ACTH.
The best time to perform the blood test to measure peak ACTH
levels would be:
A) 06:00 to 08:00 AM
B) 10:00 to 12:00 AM
C) 04:00 to 6:00 PM
D) 09:00 to 11:00 PM - ANSWER-Ans: A
Feedback:
Levels of cortisol increase as ACTH levels rise and decrease
as ACTH levels fall. There is considerable diurnal variation in
ACTH levels, which reach their peak in the early morning
(around 6 to 8 AM) and decline as the day progresses.
The immune suppressive and anti-inflammatory effects of cortisol
cause:
A) Moderate insulin resistance
,3|Page
B) Increased capillary permeability
C) Increased cell-mediated immunity
D) Inhibition of prostaglandin synthesis - ANSWER-Ans: D
Feedback:
Large quantities of cortisol are required for an effective anti-
inflammatory action. The increased cortisol blocks
inflammation at an early stage by decreasing capillary
permeability and stabilizing the lysosomal membranes so
that inflammatory mediators are not released. Cortisol
suppresses the immune response by reducing humoral and
cell-mediated immunity. Cortisol also inhibits prostaglandin
synthesis, which may account in large part for its anti-
inflammatory actions. Cortisol stimulates glucose production
by the liver; as glucose production by the liver rises and
peripheral glucose use falls, a moderate resistance to insulin
and hyperglycemia develop.
A client who has been taking 80 mg of prednisone, a
glucocorticoid, each day has been warned by his primary care
provider to carefully follow a plan for the gradual reduction of the
dose rather than stopping the drug suddenly. What is the rationale
for this directive?
, 4|Page
A) Sudden changes in glucocorticoid dosing may reverse the
therapeutic effects of the drug.
B) Stopping the drug suddenly may "shock" the HPA axis into
overactivity.
C) Sudden cessation of a glucocorticoid can result in adrenal
gland necrosis.
D) Stopping the drug suddenly may cause acute adrenal
insufficiency. - ANSWER-Ans: D
Feedback:
Chronic suppression of the HPA system by the use of
steroids causes atrophy of the adrenal gland, and the abrupt
withdrawal of drugs can cause acute adrenal insufficiency.
Activity of the HPA system is consequently insufficient. The
efficacy of the drug is not the primary concern, and necrosis
of the gland itself does not occur.
Primary adrenal insufficiency is manifested by:
A) Truncal obesity and 3+ pitting edema in lower legs
B) Potassium level of 2.8 mEq/L and weight gain of 3 pounds
overnight
