ADVANCED PATHOPHYSIOLOGY EXAM 2.WITH
VERIFIED QUESTIONS AND ANSWERS.A+
GRADED.2024/2025.
1. Which condition may result from pressure exerted by a pituitary tumor?
a. Hypothyroidism
b. Diabetes insipidus
c. Hypercortisolism
d. Insulin hyposecretion ------CORRECT ANSWER-----Hypothyroidism. If the tumor exerts
sufficient pressure, then thyroid and adrenal hypofunction may occur because of lack of
thyroid-stimulating hormone (TSH) and adrenocorticotropic hormone (ACTH). These result in
the symptoms of hypothyroidism and hypocortisolism.
1. Which substance is a water-soluble protein hormone?
a. Thyroxine
b. Follicle-stimulating hormone
c. Aldosterone
d. Insulin ------CORRECT ANSWER-----Insulin. Peptide or protein hormones, such as insulin,
pituitary, hypothalamic, and parathyroid, are water soluble and circulate in free (unbound)
forms.
1. Which of the following is a lipid-soluble hormone?
a. Cortisol
b. Epinephrine
c. Oxytocin
d. Growth hormone ------CORRECT ANSWER-----Cortisol. Cortisol and adrenal androgens are
lipid-soluble hormones and are primarily bound to a carrier or transport protein in circulation.
1. Most protein hormones are transported in the bloodstream and are:
a. Bound to a lipid-soluble carrier
b. Free in an unbound, water-soluble form
c. Bound to a water soluble-binding protein
d. Free because of their lipid-soluble chemistry ------CORRECT ANSWER-----Free in an unbound,
water-soluble form. Peptide or protein hormones, such as insulin, pituitary, hypothalamic, and
parathyroid, are water soluble and circulate in free (unbound) forms.
1. When insulin binds its receptors on muscle cells, an increase in glucose uptake by the muscle
cells is the result. This is an example of what type of effect by a hormone?
a. Pharmacologic
b. Synergistic
c. Permissive
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d. Direct
Direct. ------CORRECT ANSWER-----Direct effects are the obvious changes in cell function that
specifically result from the stimulation by a particular hormone.
1. Graves disease develops from a(n):
a. Viral infection of the thyroid gland that causes overproduction of thyroid hormone.
b. Autoimmune process during which lymphocytes and fibrous tissue replace thyroid tissue.
c. Thyroid-stimulating immunoglobulin that causes overproduction of thyroid hormones.
d. Ingestion of goitrogens that inhibits the synthesis of the thyroid hormones, causing a goiter. -
-----CORRECT ANSWER-----Thyroid-stimulating immunoglobulin that causes the overproduction
of thyroid hormones. The pathologic features of Graves disease indicates that normal
regulatory mechanisms are overridden by abnormal immunologic mechanisms that result in the
stimulation of excessive TH.
1. Pathologic changes associated with Graves disease include:
a. High levels of circulating thyroid-stimulating immunoglobulins
b. Diminished levels of thyrotropin-releasing hormone
c. High levels of thyroid-stimulating hormone
d. Diminished levels of thyroid-binding globulin ------CORRECT ANSWER-----High levels of
circulating thyroid-stimulating immunoglobulins. The only option that correctly describes the
changes associated with Graves disease identifies high levels of circulating thyroid -stimulating
immunoglobulins that are found in more than 95% of individuals diagnosed with the disease.
1. The signs of thyrotoxic crisis include:
a. Constipation with gastric distention
b. Hyperthermia and tachycardia
c. Bradycardia and bradypnea
d. Constipation and lethargy ------CORRECT ANSWER-----Hyperthermia and tachycardia
1. The level of thyroid-stimulating hormone (TSH) in individuals with Graves disease is usually:
a. High
b. Normal
c. Low
d. In constant flux
Low. ------CORRECT ANSWER-----The hyperfunction of the thyroid gland leads to suppression of
TSH because of the normal negative feedback mechanism.
1. Palpation of the neck of a person diagnosed with Graves disease would detect a thyroid that
is:
a. Left of midline
b. Normal in size
c. Small with discrete nodules
d. Diffusely enlarged ------CORRECT ANSWER-----Diffusely enlarged.
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1. The effects of the syndrome of inappropriate antidiuretic hormone (SIADH) secretion include
solute:
a. Retention and water retention
b. Dilution and water retention
c. Retention and water loss
d. Dilution and water loss ------CORRECT ANSWER-----Dilution & water retention
1. The common cause of elevated levels of antidiuretic hormone (ADH) secretion is:
a. Ectopically produced ADH
b. Posterior pituitary tumor
c. Inflammation of the hypothalamus
d. Inflammation of the nephrons ------CORRECT ANSWER-----Ectopically produced ADH
1. Which laboratory value would the nurse expect to find if a person is experiencing syndrome
of inappropriate antidiuretic hormone (SIADH)?
a. Hypernatremia and urine hypo-osmolality
b. Serum potassium (K+) level of 5 mEq/L and urine hyper-osmolality
c. Serum sodium (Na+) level of 120 mEq/L and serum hypo-osmolality
d. Hypokalemia and serum hyper-osmolality ------CORRECT ANSWER-----Serum Na level of 120
and serum hypo-osmolatlity. A diagnosis of SIADH requires a serum sodium level of less than
135 mEq/L, serum hypo-osmolality less than 280 mOsm/kg, and urine hyper-osmolarity.
Potassium levels are not considered a factor.
1. A patient who is diagnosed with a closed head injury has a urine output of 6 to 8 L/day.
Electrolytes are within normal limits, but his antidiuretic hormone (ADH) level is low. Although
he has had no intake for 4 hours, no change in his polyuria level has occurred. These symptoms
support a diagnosis of:
a. Neurogenic diabetes insipidus
b. Syndrome of inappropriate antidiuretic hormone
c. Psychogenic polydipsia
d. Osmotically induced diuresis ------CORRECT ANSWER-----Neurogenic diabetes insipidus.
Remember, sodium has to be below 135 to meet the requirement for SIADH.
1. Diabetes insipidus, diabetes mellitus, and syndrome of inappropriate antidiuretic hormone all
exhibit which symptom?
a. Polyuria
b. Vomiting
c. Edema
d. Thirst ------CORRECT ANSWER-----Thirst, is the only symptom in common.
1. The cause of neurogenic diabetes insipidus (DI) is related to an organic
a. Anterior pituitary
b. Posterior pituitary
c. Thalamus
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d. Renal tubules ------CORRECT ANSWER-----Posterior pituitary. Neurogenic DI is a result of
dysfunctional antidiuretic hormone synthesis, caused by a lesion of the posterior pituitary,
hypothalamus, or pituitary stalk.
1. Which form of diabetic insipidus (DI) will result if the target cells for antidiuretic hormone
(ADH) in the renal collecting tubules demonstrate insensitivity?
a. Neurogenic
b. Nephrogenic
c. Psychogenic
d. Ischemic ------CORRECT ANSWER-----Nephrogenic. Only nephrogenic DI is associated with an
insensitivity of the renal collecting tubules to ADH.
1. Which laboratory value is consistently low in a patient with diabetes insipidus (DI)?
a. Urine-specific gravity
b. Urine protein
c. Serum sodium
d. Serum total protein ------CORRECT ANSWER-----Urine-specific gravity. The basic criteria for
diagnosing DI include a low urine-specific gravity while sodium levels are high. Protein levels are
not considered.
1. Which form of diabetes insipidus (DI) is treatable with exogenous antidiuretic hormone
(ADH)?
a. Neurogenic
b. Nephrogenic
c. Psychogenic
d. Ischemic ------CORRECT ANSWER-----Neurogenic DI is treated with ADH replacement therapy.
1. The term used to describe a person who experiences a lack of all hormones associated with
the anterior pituitary is:
a. Panhypopituitarism
b. Hypopituitarism
c. Adrenocorticotropic hormone deficiency ------CORRECT ANSWER-----Panhypopituitarism is
the only available term that is correctly associated with the lack of all anterior pituitary
hormones.
1. Diabetes insipidus is a result of:
a. Antidiuretic hormone hyposecretion
b. Insulin hyposecretion
c. Antidiuretic hormone hypersecretion
d. Insulin hypersecretion ------CORRECT ANSWER-----ADH hyposecretion
1. Visual disturbances are a result of a pituitary adenoma because of the:
a. Liberation of anterior pituitary hormones into the optic chiasm
b. Pituitary hormones clouding the lens of the eyes
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