NURS 611 EXAM 3 PATHO ACTUAL EXAM 2023-
2024 150+ QUESTIONS AND ANSWERS WITH
RATIONALES (MARYVILLE UNIVERSITY)
1. What are clinical manifestations of hypothyroidism?
a. Intolerance to heat, tachycardia, and weight loss
b. Oligomenorrhea, fatigue, and warm skin
c. Restlessness, increased appetite, and metrorrhagia
d. Constipation, decreased heat rate, and lethargy
The lower levels of thyroid hormone result in decreased energy metabolism, resulting
in constipation, bradycardia, and lethargy, thus eliminating the remaining options.
2. Thyroid-stimulating hormone (TSH) is released to stimulate thyroid hormone (TH) and is
inhibited when plasma levels of TH are adequate. This is an example of:
a. Positive feedback
b. Neural regulation
c. Negative feedback
d. Physiologic regulation
Negative feedback. Feedback systems provide precise monitoring and control of the
cellular environment. Negative feedback occurs because the changing chemical, neural,
or endocrine response to a stimulus negates the initiating change that triggered the
release of the hormone. Thyrotropin-releasing hormone (TRH) from the hypothalamus
stimulates TSH secretion from the anterior pituitary. Secretion of TSH stimulates the
synthesis and secretion of THs. Increasing levels of T4 and triiodothyronine (T3) then
generate negative feedback on the pituitary and hypothalamus to inhibit TRH and TSH
synthesis.
3. Lipid-soluble hormone receptors are located:
a. Inside the plasma membrane in the cytoplasm
b. On the outer surface of the plasma membrane
c. Inside the mitochondria
d. On the inner surface of the plasma membrane
Inside the plasma membrane in the cytoplasm. Lipid-soluble hormone receptors are
located inside the plasma membrane and easily diffuse across the plasma membrane to
bind to either cytosolic or nuclear receptors.
4. The releasing hormones that are made in the hypothalamus travel to the anterior
pituitary via the:
a. Vessels of the zona fasciculata
b. Hypophyseal stalk
c. Infundibular stem
d. Portal hypophyseal blood vessels
Portal hypophyseal blood vessels. Releasing and inhibitory hormones are synthesized in
the hypothalamus and are secreted into the portal blood vessels through which they
travel to the anterior pituitary hormones.
5. Which mineral is needed for thyroid-stimulating hormone (TSH) to stimulate the
secretion of thyroid hormone (TH)?
a. Iron
b. Iodide
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c. Zinc
d. Copper
Iodide. TSH, which is synthesized and stored in the anterior pituitary, stimulates
secretion of TH by activating intracellular processes, including the uptake of iodine
necessary for the synthesis of TH.
6. What effect does hyperphosphatemia have on other electrolytes?
a. Increases serum calcium
b. Decreases serum magnesium
c. Decreases serum calcium
d. Increases serum magnesium
Decreases serum calcium. Hyperphosphatemia leads to hypocalcemia. Remember that
phos and calcium are inversely related.
7. Insulin transports which electrolyte in the cell?
a. Potassium
b. Sodium
c. Calcium
d. Phosphorus
Potassium. Insulin facilitates the intracellular transport of potassium, phosphate, and
magnesium.
8. Which second messenger is stimulated by epinephrine binding to a β-adrenergic
receptor?
a. Calcium
b. Inositol triphosphate (IP3)
c. Diacylglycerol (DAG)
d. Cyclic adenosine monophosphate (cAMP)
Cyclic adenosine monophosphate (cAMP). Second-messenger molecules are the initial
link between the first signal (hormone) and the inside of the cell. For example, the
binding of epinephrine to a β adrenergic–receptor subtype activates (through a
stimulatory G protein) the enzyme, adenylyl cyclase. Adenylyl cyclase catalyzes the
conversion of adenosine triphosphate (ATP) to the second messenger, 3', and 5'-cAMP.
9. Regulation of the release of catecholamines from the adrenal medulla is an example of
which type of regulation?
a. Negative feedback
b. Neural
c. Positive feedback
d. Physiologic
Neural. The release of hormones occurs either in response to an alteration in the cellular
environment or in the process of maintaining a regulated level of certain hormones or certain
substances. Several different mechanisms, one of which is neural control (e.g., stress-induced
release of catecholamines from the adrenal medulla), regulate the release of hormones.
10. Which hormone does the second messenger calcium (Ca++) bind to activate
phospholipase C through a G protein?
a. Angiotensin II
b. Estrogen
c. Thyroxine
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d. Testosterone
Angiotensin II. Ca++ is considered an important second messenger that facilitates the
binding of a hormone (e.g., norepinephrine, angiotensin II) to a surface receptor,
activating the enzyme phospholipase C through a G protein inside the plasma
membrane.
11. The control of calcium in cells is important because it:
a. Is controlled by the calcium negative-feedback loop.
b. Is continuously synthesized.
c. Acts as a second messenger.
d. Carries lipid-soluble hormones in the bloodstream.
Acts as a second messenger. In addition to being an important ion that participates in a
multitude of cellular actions, Ca++ is considered an important second messenger.
12. Where is antidiuretic hormone (ADH) synthesized, and where does it act?
a. Hypothalamus; renal tubular cells
b. Anterior pituitary; posterior pituitary
c. Renal tubules; renal collecting ducts
d. Posterior pituitary; loop of Henle
Hypothalamus; renal tubular cells. Once synthesized in the hypothalamus, ADH acts on
the vasopressin 2 (V2) receptors of the renal duct cells to increase their permeability.
13. How does a faulty negative-feedback mechanism result in a hormonal imbalance?
a. Hormones are not synthesized in response to cellular and tissue activities.
b. Decreased hormonal secretion is a response to rising hormone levels.
c. Too little hormone production is initiated.
d. Excessive hormone production results from a failure to turn of the system.
Excessive hormone production results from a failure to turn off the system. Negative-
feedback systems are important in maintaining hormones within physiologic ranges. The
lack of negative-feedback inhibition on hormonal release often results in pathologic
conditions. Excessive hormone production, which is the result of the failure to turn of
the system, can cause various hormonal imbalances and related conditions.
14. A deficiency of which chemical may result in hypothyroidism?
a. Iron
b. Zinc
c. Iodine
d. Magnesium
Iodine. The only cause of hypothyroidism from among the provided options is a
deficiency of endemic iodine.
15. What imbalance lessens the rate of secretion of parathyroid hormone
a. Increased serum calcium levels
b. Decreased serum magnesium levels
c. Decreased levels of thyroid-stimulating hormone
d. Increased levels of thyroid-stimulating hormone
The overall effect of parathyroid hormone (PTH)is to increase serum calcium and to
decrease serum phosphate concentration.
16. Which condition may result from pressure exerted by a pituitary tumor?
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a. Hypothyroidism
b. Diabetes insipidus
c. Hypercortisolism
d. Insulin hyposecretion
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.
17. Which substance is a water-soluble protein hormone?
a. Thyroxine
b. Follicle-stimulating hormone
c. Aldosterone
d. Insulin
Insulin. Peptide or protein hormones, such as insulin, pituitary, hypothalamic, and
parathyroid, are water soluble and circulate in free (unbound) forms.
18. Which of the following is a lipid-soluble hormone?
a. Cortisol
b. Epinephrine
c. Oxytocin
d. Growth hormone
Cortisol. Cortisol and adrenal androgens are lipid-soluble hormones and are primarily
bound to a carrier or transport protein in circulation.
19. 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
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.
20. 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
d. Direct
Direct. Direct effects are the obvious changes in cell function that specifically result from
the stimulation by a particular hormone.
21. 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.
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