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NR 546 / FINAL EXAM 2026–2027 | 200 VERIFIED ANSWERS & DETAILED
RATIONALES,100% CORRECT ALREADY GRADED A+
1.
Which of the following is the primary pathophysiological mechanism in Type 2
Diabetes Mellitus?
A. Absolute insulin deficiency
B. Insulin resistance with relative insulin deficiency
C. Autoimmune destruction of beta cells
D. Excess glucagon production
Answer: B
Rationale: Type 2 diabetes is primarily caused by insulin resistance in peripheral
tissues combined with a relative deficiency of insulin secretion, unlike Type 1,
which is autoimmune-mediated.
2.
A patient presents with hyperglycemia, polyuria, and polydipsia. Which lab value
confirms diabetes mellitus?
A. Fasting plasma glucose 105 mg/dL
B. Random glucose 180 mg/dL
C. HbA1c 7.2%
D. Serum sodium 140 mEq/L
Answer: C
Rationale: HbA1c ≥6.5% confirms diabetes. Fasting glucose ≥126 mg/dL or
random glucose ≥200 mg/dL with symptoms also support diagnosis.
3.
Which electrolyte imbalance is most commonly associated with diabetic
ketoacidosis (DKA)?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: B
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Rationale: In DKA, total body potassium is depleted due to osmotic diuresis,
though serum potassium may initially appear normal or elevated.
4.
What is the primary cause of microvascular complications in chronic
hyperglycemia?
A. Autoimmune attack on small vessels
B. Accumulation of advanced glycation end-products (AGEs)
C. Dehydration
D. Hypoglycemia
Answer: B
Rationale: AGEs accumulate during chronic hyperglycemia, causing endothelial
damage, basement membrane thickening, and microvascular complications such
as nephropathy and retinopathy.
5.
Which hormone is released in response to hypoglycemia to increase blood
glucose?
A. Insulin
B. Glucagon
C. Somatostatin
D. Amylin
Answer: B
Rationale: Glucagon stimulates hepatic glycogenolysis and gluconeogenesis to
raise blood glucose levels during hypoglycemia.
6.
Which type of shock is characterized by widespread vasodilation, warm skin, and
low systemic vascular resistance?
A. Hypovolemic shock
B. Cardiogenic shock
C. Septic shock
D. Neurogenic shock
Answer: C
Rationale: Septic shock produces vasodilation, warm peripheries initially,
hypotension, and low SVR due to systemic inflammatory response.
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7.
A patient with heart failure develops pulmonary edema. The pathophysiology is
primarily due to:
A. Increased capillary hydrostatic pressure
B. Decreased plasma oncotic pressure
C. Increased alveolar permeability
D. Decreased lymphatic drainage
Answer: A
Rationale: Left-sided heart failure leads to elevated pulmonary capillary
hydrostatic pressure, causing fluid to transudate into alveoli, resulting in
pulmonary edema.
8.
Which lipoprotein is primarily responsible for transporting cholesterol from
tissues to the liver?
A. LDL
B. HDL
C. VLDL
D. Chylomicrons
Answer: B
Rationale: High-density lipoprotein (HDL) mediates reverse cholesterol
transport, removing cholesterol from tissues and delivering it to the liver for
excretion.
9.
Which cardiac biomarker is most sensitive and specific for acute myocardial
infarction (AMI)?
A. CK-MB
B. Troponin I/T
C. Myoglobin
D. BNP
Answer: B
Rationale: Troponin I/T is highly sensitive and specific for myocardial injury and
remains elevated for 7–10 days after infarction.
10.
Which mechanism is responsible for hyperkalemia in renal failure?
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A. Increased potassium excretion
B. Decreased aldosterone secretion
C. Increased sodium reabsorption
D. Hyperinsulinemia
Answer: B
Rationale: In renal failure, aldosterone secretion decreases, reducing potassium
excretion, resulting in hyperkalemia.
11.
A patient with COPD has a PaCO₂ of 60 mmHg and pH of 7.32. What acid-base
imbalance is present?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Answer: B
Rationale: Elevated PaCO₂ and low pH indicate respiratory acidosis, commonly
due to CO₂ retention in COPD.
12
Which type of cell injury is reversible?
A. Apoptosis
B. Necrosis
C. Hydropic swelling
D. Gangrene
Answer: C
Rationale: Hydropic swelling due to ATP depletion is a reversible injury, whereas
necrosis and gangrene are irreversible.
13.
Which of the following is a compensatory mechanism in hypovolemic shock?
A. Decreased heart rate
B. Peripheral vasodilation
C. Increased renin-angiotensin activation
D. Decreased respiratory rate
Answer: C
Rationale: Renin-angiotensin-aldosterone system (RAAS) activation increases
NR 546 / FINAL EXAM 2026–2027 | 200 VERIFIED ANSWERS & DETAILED
RATIONALES,100% CORRECT ALREADY GRADED A+
1.
Which of the following is the primary pathophysiological mechanism in Type 2
Diabetes Mellitus?
A. Absolute insulin deficiency
B. Insulin resistance with relative insulin deficiency
C. Autoimmune destruction of beta cells
D. Excess glucagon production
Answer: B
Rationale: Type 2 diabetes is primarily caused by insulin resistance in peripheral
tissues combined with a relative deficiency of insulin secretion, unlike Type 1,
which is autoimmune-mediated.
2.
A patient presents with hyperglycemia, polyuria, and polydipsia. Which lab value
confirms diabetes mellitus?
A. Fasting plasma glucose 105 mg/dL
B. Random glucose 180 mg/dL
C. HbA1c 7.2%
D. Serum sodium 140 mEq/L
Answer: C
Rationale: HbA1c ≥6.5% confirms diabetes. Fasting glucose ≥126 mg/dL or
random glucose ≥200 mg/dL with symptoms also support diagnosis.
3.
Which electrolyte imbalance is most commonly associated with diabetic
ketoacidosis (DKA)?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: B
,2|Page
Rationale: In DKA, total body potassium is depleted due to osmotic diuresis,
though serum potassium may initially appear normal or elevated.
4.
What is the primary cause of microvascular complications in chronic
hyperglycemia?
A. Autoimmune attack on small vessels
B. Accumulation of advanced glycation end-products (AGEs)
C. Dehydration
D. Hypoglycemia
Answer: B
Rationale: AGEs accumulate during chronic hyperglycemia, causing endothelial
damage, basement membrane thickening, and microvascular complications such
as nephropathy and retinopathy.
5.
Which hormone is released in response to hypoglycemia to increase blood
glucose?
A. Insulin
B. Glucagon
C. Somatostatin
D. Amylin
Answer: B
Rationale: Glucagon stimulates hepatic glycogenolysis and gluconeogenesis to
raise blood glucose levels during hypoglycemia.
6.
Which type of shock is characterized by widespread vasodilation, warm skin, and
low systemic vascular resistance?
A. Hypovolemic shock
B. Cardiogenic shock
C. Septic shock
D. Neurogenic shock
Answer: C
Rationale: Septic shock produces vasodilation, warm peripheries initially,
hypotension, and low SVR due to systemic inflammatory response.
,3|Page
7.
A patient with heart failure develops pulmonary edema. The pathophysiology is
primarily due to:
A. Increased capillary hydrostatic pressure
B. Decreased plasma oncotic pressure
C. Increased alveolar permeability
D. Decreased lymphatic drainage
Answer: A
Rationale: Left-sided heart failure leads to elevated pulmonary capillary
hydrostatic pressure, causing fluid to transudate into alveoli, resulting in
pulmonary edema.
8.
Which lipoprotein is primarily responsible for transporting cholesterol from
tissues to the liver?
A. LDL
B. HDL
C. VLDL
D. Chylomicrons
Answer: B
Rationale: High-density lipoprotein (HDL) mediates reverse cholesterol
transport, removing cholesterol from tissues and delivering it to the liver for
excretion.
9.
Which cardiac biomarker is most sensitive and specific for acute myocardial
infarction (AMI)?
A. CK-MB
B. Troponin I/T
C. Myoglobin
D. BNP
Answer: B
Rationale: Troponin I/T is highly sensitive and specific for myocardial injury and
remains elevated for 7–10 days after infarction.
10.
Which mechanism is responsible for hyperkalemia in renal failure?
, 4|Page
A. Increased potassium excretion
B. Decreased aldosterone secretion
C. Increased sodium reabsorption
D. Hyperinsulinemia
Answer: B
Rationale: In renal failure, aldosterone secretion decreases, reducing potassium
excretion, resulting in hyperkalemia.
11.
A patient with COPD has a PaCO₂ of 60 mmHg and pH of 7.32. What acid-base
imbalance is present?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Answer: B
Rationale: Elevated PaCO₂ and low pH indicate respiratory acidosis, commonly
due to CO₂ retention in COPD.
12
Which type of cell injury is reversible?
A. Apoptosis
B. Necrosis
C. Hydropic swelling
D. Gangrene
Answer: C
Rationale: Hydropic swelling due to ATP depletion is a reversible injury, whereas
necrosis and gangrene are irreversible.
13.
Which of the following is a compensatory mechanism in hypovolemic shock?
A. Decreased heart rate
B. Peripheral vasodilation
C. Increased renin-angiotensin activation
D. Decreased respiratory rate
Answer: C
Rationale: Renin-angiotensin-aldosterone system (RAAS) activation increases
