NUR 631 Exam 3 Review Study Guide | 2026
UPDATE | QUESTIONS AND ANSWERS |
100% CORRECT.- D'Youville College
SECTION 1: ENDOCRINE DISORDERS – PITUITARY
& THYROID (Questions 1-10)
Question 1
A patient with a prolactin-secreting pituitary adenoma (prolactinoma) would
most likely present with which clinical manifestations in females?
A. Hirsutism, weight gain, hypertension
B. Amenorrhea, infertility, and nonpuerperal milk production (galactorrhea)
C. Osteoporosis, renal calculi, and constipation
D. Virilization, deepening voice, and clitoromegaly
Correct Answer: B. Amenorrhea, infertility, and nonpuerperal milk
production
Rationale: Prolactinomas cause hypogonadotropic hypogonadism by
inhibiting GnRH secretion. In women, manifestations include amenorrhea,
infertility, galactorrhea (nonpuerperal milk production), hirsutism, and
osteopenia/osteoporosis . Hyperprolactinemia reduces gonadotropins
(FSH/LH), leading to hypogonadism.
Subtopic: Pituitary Disorders – Prolactinoma
Question 2
Which action correctly describes the mechanism of oxytocin?
,A. It is synthesized and stored in the anterior pituitary
B. It is released in response to elevated blood glucose
C. It is stored in the posterior pituitary and stimulates uterine contractions
and milk ejection
D. It inhibits prolactin release during lactation
Correct Answer: C. It is stored in the posterior pituitary and stimulates
uterine contractions and milk ejection
Rationale: Oxytocin is synthesized in the hypothalamus (supraoptic and
paraventricular nuclei), then transported and stored in the posterior
pituitary for secretion. Its primary effects include uterine contraction during
labor and milk ejection (let-down reflex) in lactating women. Release is
triggered by suckling and uterine distention.
Subtopic: Posterior Pituitary – Oxytocin
Question 3
A patient with suspected syndrome of inappropriate antidiuretic hormone
(SIADH) has serum sodium of 118 mEq/L and concentrated urine despite low
serum osmolality. What is the underlying pathophysiology?
A. Excess ADH secretion causing water retention and dilutional hyponatremia
B. ADH deficiency causing free water loss and hypernatremia
C. Aldosterone excess causing sodium retention
D. Insulin deficiency causing osmotic diuresis
Correct Answer: A. Excess ADH secretion causing water retention and
dilutional hyponatremia
Rationale: SIADH results from excessive ADH release, increasing renal water
reabsorption. This leads to water retention, dilutional hyponatremia (serum
Na <135 mEq/L), and concentrated urine despite low serum osmolality.
Cerebral symptoms (confusion, seizures) occur when Na falls below 120
mEq/L. Treatment includes fluid restriction and careful sodium correction.
Subtopic: Posterior Pituitary – SIADH
, Question 4
A patient with diabetes insipidus would most likely present with which
laboratory finding?
A. Hypernatremia and dilute urine (low specific gravity)
B. Hyponatremia and concentrated urine
C. Hyperkalemia and metabolic acidosis
D. Hypoglycemia and ketonuria
Correct Answer: A. Hypernatremia and dilute urine (low specific gravity)
Rationale: Diabetes insipidus (central or nephrogenic) results from ADH
deficiency or resistance, causing inability to concentrate urine. Patients
excrete large volumes of dilute urine (specific gravity <1.005, osmolality
<300 mOsm/kg), leading to hypernatremia and polydipsia. Central DI is
treated with desmopressin (DDAVP).
Subtopic: Posterior Pituitary – Diabetes Insipidus
Question 5
A patient with hyperthyroidism (Graves' disease) would most likely present
with which clinical manifestations?
A. Weight gain, cold intolerance, bradycardia
B. Weight loss, heat intolerance, tachycardia, exophthalmos
C. Hyperpigmentation, hypotension, hyponatremia
D. Muscle weakness, constipation, hypothermia
Correct Answer: B. Weight loss, heat intolerance, tachycardia, exophthalmos
Rationale: Graves' disease is an autoimmune disorder caused by thyroid-
stimulating immunoglobulins (TSI) that activate TSH receptors.
Manifestations include weight loss despite increased appetite, heat
intolerance, tachycardia, palpitations, exophthalmos (protruding eyes), and
pretibial myxedema. TSH is suppressed; T3/T4 are elevated.
Subtopic: Thyroid Disorders – Hyperthyroidism
UPDATE | QUESTIONS AND ANSWERS |
100% CORRECT.- D'Youville College
SECTION 1: ENDOCRINE DISORDERS – PITUITARY
& THYROID (Questions 1-10)
Question 1
A patient with a prolactin-secreting pituitary adenoma (prolactinoma) would
most likely present with which clinical manifestations in females?
A. Hirsutism, weight gain, hypertension
B. Amenorrhea, infertility, and nonpuerperal milk production (galactorrhea)
C. Osteoporosis, renal calculi, and constipation
D. Virilization, deepening voice, and clitoromegaly
Correct Answer: B. Amenorrhea, infertility, and nonpuerperal milk
production
Rationale: Prolactinomas cause hypogonadotropic hypogonadism by
inhibiting GnRH secretion. In women, manifestations include amenorrhea,
infertility, galactorrhea (nonpuerperal milk production), hirsutism, and
osteopenia/osteoporosis . Hyperprolactinemia reduces gonadotropins
(FSH/LH), leading to hypogonadism.
Subtopic: Pituitary Disorders – Prolactinoma
Question 2
Which action correctly describes the mechanism of oxytocin?
,A. It is synthesized and stored in the anterior pituitary
B. It is released in response to elevated blood glucose
C. It is stored in the posterior pituitary and stimulates uterine contractions
and milk ejection
D. It inhibits prolactin release during lactation
Correct Answer: C. It is stored in the posterior pituitary and stimulates
uterine contractions and milk ejection
Rationale: Oxytocin is synthesized in the hypothalamus (supraoptic and
paraventricular nuclei), then transported and stored in the posterior
pituitary for secretion. Its primary effects include uterine contraction during
labor and milk ejection (let-down reflex) in lactating women. Release is
triggered by suckling and uterine distention.
Subtopic: Posterior Pituitary – Oxytocin
Question 3
A patient with suspected syndrome of inappropriate antidiuretic hormone
(SIADH) has serum sodium of 118 mEq/L and concentrated urine despite low
serum osmolality. What is the underlying pathophysiology?
A. Excess ADH secretion causing water retention and dilutional hyponatremia
B. ADH deficiency causing free water loss and hypernatremia
C. Aldosterone excess causing sodium retention
D. Insulin deficiency causing osmotic diuresis
Correct Answer: A. Excess ADH secretion causing water retention and
dilutional hyponatremia
Rationale: SIADH results from excessive ADH release, increasing renal water
reabsorption. This leads to water retention, dilutional hyponatremia (serum
Na <135 mEq/L), and concentrated urine despite low serum osmolality.
Cerebral symptoms (confusion, seizures) occur when Na falls below 120
mEq/L. Treatment includes fluid restriction and careful sodium correction.
Subtopic: Posterior Pituitary – SIADH
, Question 4
A patient with diabetes insipidus would most likely present with which
laboratory finding?
A. Hypernatremia and dilute urine (low specific gravity)
B. Hyponatremia and concentrated urine
C. Hyperkalemia and metabolic acidosis
D. Hypoglycemia and ketonuria
Correct Answer: A. Hypernatremia and dilute urine (low specific gravity)
Rationale: Diabetes insipidus (central or nephrogenic) results from ADH
deficiency or resistance, causing inability to concentrate urine. Patients
excrete large volumes of dilute urine (specific gravity <1.005, osmolality
<300 mOsm/kg), leading to hypernatremia and polydipsia. Central DI is
treated with desmopressin (DDAVP).
Subtopic: Posterior Pituitary – Diabetes Insipidus
Question 5
A patient with hyperthyroidism (Graves' disease) would most likely present
with which clinical manifestations?
A. Weight gain, cold intolerance, bradycardia
B. Weight loss, heat intolerance, tachycardia, exophthalmos
C. Hyperpigmentation, hypotension, hyponatremia
D. Muscle weakness, constipation, hypothermia
Correct Answer: B. Weight loss, heat intolerance, tachycardia, exophthalmos
Rationale: Graves' disease is an autoimmune disorder caused by thyroid-
stimulating immunoglobulins (TSI) that activate TSH receptors.
Manifestations include weight loss despite increased appetite, heat
intolerance, tachycardia, palpitations, exophthalmos (protruding eyes), and
pretibial myxedema. TSH is suppressed; T3/T4 are elevated.
Subtopic: Thyroid Disorders – Hyperthyroidism
