Pathophysiology Final Exam Version 3 Questions & Answers| Grade A| 100%
Correct (Verified Solutions)Newest Update 2026
Question 1
Which physiological mechanism is primarily responsible for the development of allergic asthma?
A) Type IV delayed hypersensitivity mediated by T-cells
B) Type II cytotoxic reaction involving IgG and IgM
C) Type 1 Hypersensitivity; IgE mediated
D) Chronic destructive changes to the alveolar walls
E) Autosomal recessive mutation of the CFTR gene
Correct Answer: C) Type 1 Hypersensitivity; IgE mediated
Rationale: Allergic asthma is a Type 1 hypersensitivity reaction. Upon exposure to an
allergen, B-lymphocytes produce IgE antibodies that bind to mast cells. Re-exposure causes
mast cell degranulation, releasing inflammatory mediators like histamine and leukotrienes,
leading to bronchoconstriction and airway edema.
Question 2
A patient presents with acute respiratory distress syndrome (ARDS). Which of the following sets
of clinical manifestations should the nurse expect to find?
A) Bradycardia, hypertension, and increased lung compliance
B) SOB, shallow rapid breathing, and inspiratory crackles
C) Productive cough with green sputum and a high fever
D) Paradoxical chest wall movement and localized chest pain
E) Hyperinflation of the lungs and a flat diaphragm on X-ray
Correct Answer: B) SOB, shallow rapid breathing, and inspiratory crackles
Rationale: ARDS is characterized by a massive inflammatory response that damages the
alveolar-capillary membrane. This leads to the movement of fluid into the alveoli
(pulmonary edema), resulting in dyspnea (SOB), tachypnea, crackles due to fluid, and
decreased lung compliance (stiff lungs).
Question 3
In the event of a tension pneumothorax, what is the classic hallmark sign observed during a
physical assessment?
A) Tracheal deviation toward the affected side
B) Tracheal deviation toward the unaffected side
C) Presence of hyperactive bowel sounds in the thoracic cavity
D) Excessive purulent sputum production
E) Resonance upon percussion of the unaffected lung
Correct Answer: B) Pressure that builds up and pushes the trachea towards the unaffected
side
Rationale: In a tension pneumothorax, air enters the pleural space but cannot escape. The
, 2
accumulating pressure causes a mediastinal shift, compressing the heart and great vessels,
and physically pushing the trachea toward the opposite (unaffected) side. This is a life-
threatening emergency.
Question 4
Which statement accurately describes the underlying pathophysiology and genetics of Cystic
Fibrosis?
A) It is an autosomal dominant disorder causing thinning of mucosal linings.
B) It is a Type III hypersensitivity reaction causing lung scarring.
C) It is a genetic disorder (Autosomal Recessive) causing excessive mucus in lungs and
pancreas.
D) It is caused by a viral infection during early childhood.
E) It results in the overproduction of surfactant leading to alveolar collapse.
Correct Answer: C) Genetic Disorder (Autosomal Recessive); excessive mucous coating in
the lungs and pancreas
Rationale: Cystic Fibrosis results from a mutation in the CFTR gene. Because it is
autosomal recessive, a child must inherit two copies of the defective gene. The defect results
in abnormal chloride transport, leading to thick, dehydrated, and tenacious mucus that
obstructs the airways and the pancreatic ducts.
Question 5
During an acute asthma attack, which physiological changes are occurring within the patient's
respiratory system?
A) Bronchodilation and decreased respiratory rate
B) Alveolar destruction and permanent air trapping
C) Wheezing, SOB, and bronchoconstriction
D) Increased oxygen saturation and bradycardia
E) Thinning of the bronchial basement membrane
Correct Answer: C) Wheezing, SOB, Bronchoconstriction, Dyspnea, Tachypnea (rapid
breathing)
Rationale: During an asthma attack, the smooth muscles of the bronchi contract
(bronchoconstriction) in response to inflammatory triggers. This narrows the airway,
causing the characteristic wheezing sound. The body compensates for the lack of oxygen by
increasing the rate of breathing (tachypnea).
Question 6
A patient’s ABG results are: pH 7.28, CO2 52, HCO3 24. How should the nurse interpret this
primary disorder?
A) Metabolic Acidosis
B) Metabolic Alkalosis
, 3
C) Respiratory Acidosis
D) Respiratory Alkalosis
E) Fully Compensated Respiratory Acidosis
Correct Answer: C) Respiratory Acidosis
Rationale: The pH is low (7.28), indicating acidosis. The CO2 is high (52), which is an acidic
indicator (normal is 35-45). Since the CO2 direction matches the pH direction (both
indicate acidosis), the primary disorder is respiratory. The HCO3 is normal, meaning no
compensation has occurred yet.
Question 7
Which of the following describes the ABG changes seen in a patient with Respiratory Alkalosis?
A) pH 7.30 and CO2 50
B) pH 7.40 and HCO3 24
C) Increased pH and decreased pCO2
D) Decreased pH and decreased HCO3
E) pH 7.50 and HCO3 35
Correct Answer: C) Increased pH (alkalosis) -- Depression (decrease) of pCO2
Rationale: Respiratory alkalosis occurs when a patient hyperventilates, "blowing off" too
much CO2. Because CO2 is an acid, losing it makes the blood more basic, resulting in an
elevated pH (above 7.45).
Question 8
In Metabolic Acidosis, what are the characteristic changes to the pH and the bicarbonate (HCO3)
levels?
A) Increased pH and increased HCO3
B) Decreased pH and decreased HCO3
C) Increased pH and decreased CO2
D) Decreased pH and increased CO2
E) Normal pH and decreased HCO3
Correct Answer: B) Decreased pH (acidosis) -- Depression (decrease) of HCO3
Rationale: Metabolic acidosis is characterized by a primary decrease in bicarbonate (a base)
or an increase in non-volatile acids. This loss of base results in a drop in pH below 7.35.
Question 9
A patient is diagnosed with Metabolic Alkalosis. Which set of laboratory values is consistent
with this diagnosis?
A) pH 7.20, HCO3 15
B) pH 7.48, CO2 30
C) pH 7.52, HCO3 36
, 4
D) pH 7.35, CO2 45
E) pH 7.10, HCO3 22
Correct Answer: C) Increased pH (alkalosis) -- Elevation (increase) of HCO3
Rationale: Metabolic alkalosis involves a primary gain in bicarbonate or a loss of metabolic
acids (like through vomiting). This excess base raises the pH above 7.45.
Question 10
What is the first step in the systematic interpretation of Arterial Blood Gases (ABGs)?
A) Determine if the patient needs oxygen.
B) Check the HCO3 level to see if the kidneys are working.
C) Look at the pH to determine if it is acidosis or alkalosis.
D) Assess the PaO2 to determine the level of hypoxemia.
E) Calculate the anion gap.
Correct Answer: C) Look at pH (acidosis - low or alkalosis - high)
Rationale: The pH is the definitive indicator of the body's acid-base balance. You must first
determine if the blood is acidic (<7.35) or alkaline (>7.45) before you can use the CO2 and
HCO3 values to determine the cause.
Question 11
Which clinical finding is most frequently associated with the early stages of renal cancer?
A) Severe, colicky flank pain
B) High fever and chills
C) Painless hematuria
D) Acute onset of hypertension
E) Sudden weight gain and edema
Correct Answer: C) No pain! Hematuria (Blood in the Urine)
Rationale: Renal cell carcinoma is often called a "silent" killer because it rarely produces
symptoms in the early stages. When symptoms do appear, the most common sign is painless
hematuria (blood in the urine). Pain only occurs if the tumor becomes large enough to
press on other structures.
Question 12
Which of the following is a priority intervention for the long-term management of End-Stage
Renal Disease (ESRD)?
A) High protein diet to promote muscle healing
B) Increased fluid intake to flush the kidneys
C) Erythropoietin injections and fluid restriction
D) Increasing the dosage of all home medications
E) High sodium diet to maintain blood pressure
Correct (Verified Solutions)Newest Update 2026
Question 1
Which physiological mechanism is primarily responsible for the development of allergic asthma?
A) Type IV delayed hypersensitivity mediated by T-cells
B) Type II cytotoxic reaction involving IgG and IgM
C) Type 1 Hypersensitivity; IgE mediated
D) Chronic destructive changes to the alveolar walls
E) Autosomal recessive mutation of the CFTR gene
Correct Answer: C) Type 1 Hypersensitivity; IgE mediated
Rationale: Allergic asthma is a Type 1 hypersensitivity reaction. Upon exposure to an
allergen, B-lymphocytes produce IgE antibodies that bind to mast cells. Re-exposure causes
mast cell degranulation, releasing inflammatory mediators like histamine and leukotrienes,
leading to bronchoconstriction and airway edema.
Question 2
A patient presents with acute respiratory distress syndrome (ARDS). Which of the following sets
of clinical manifestations should the nurse expect to find?
A) Bradycardia, hypertension, and increased lung compliance
B) SOB, shallow rapid breathing, and inspiratory crackles
C) Productive cough with green sputum and a high fever
D) Paradoxical chest wall movement and localized chest pain
E) Hyperinflation of the lungs and a flat diaphragm on X-ray
Correct Answer: B) SOB, shallow rapid breathing, and inspiratory crackles
Rationale: ARDS is characterized by a massive inflammatory response that damages the
alveolar-capillary membrane. This leads to the movement of fluid into the alveoli
(pulmonary edema), resulting in dyspnea (SOB), tachypnea, crackles due to fluid, and
decreased lung compliance (stiff lungs).
Question 3
In the event of a tension pneumothorax, what is the classic hallmark sign observed during a
physical assessment?
A) Tracheal deviation toward the affected side
B) Tracheal deviation toward the unaffected side
C) Presence of hyperactive bowel sounds in the thoracic cavity
D) Excessive purulent sputum production
E) Resonance upon percussion of the unaffected lung
Correct Answer: B) Pressure that builds up and pushes the trachea towards the unaffected
side
Rationale: In a tension pneumothorax, air enters the pleural space but cannot escape. The
, 2
accumulating pressure causes a mediastinal shift, compressing the heart and great vessels,
and physically pushing the trachea toward the opposite (unaffected) side. This is a life-
threatening emergency.
Question 4
Which statement accurately describes the underlying pathophysiology and genetics of Cystic
Fibrosis?
A) It is an autosomal dominant disorder causing thinning of mucosal linings.
B) It is a Type III hypersensitivity reaction causing lung scarring.
C) It is a genetic disorder (Autosomal Recessive) causing excessive mucus in lungs and
pancreas.
D) It is caused by a viral infection during early childhood.
E) It results in the overproduction of surfactant leading to alveolar collapse.
Correct Answer: C) Genetic Disorder (Autosomal Recessive); excessive mucous coating in
the lungs and pancreas
Rationale: Cystic Fibrosis results from a mutation in the CFTR gene. Because it is
autosomal recessive, a child must inherit two copies of the defective gene. The defect results
in abnormal chloride transport, leading to thick, dehydrated, and tenacious mucus that
obstructs the airways and the pancreatic ducts.
Question 5
During an acute asthma attack, which physiological changes are occurring within the patient's
respiratory system?
A) Bronchodilation and decreased respiratory rate
B) Alveolar destruction and permanent air trapping
C) Wheezing, SOB, and bronchoconstriction
D) Increased oxygen saturation and bradycardia
E) Thinning of the bronchial basement membrane
Correct Answer: C) Wheezing, SOB, Bronchoconstriction, Dyspnea, Tachypnea (rapid
breathing)
Rationale: During an asthma attack, the smooth muscles of the bronchi contract
(bronchoconstriction) in response to inflammatory triggers. This narrows the airway,
causing the characteristic wheezing sound. The body compensates for the lack of oxygen by
increasing the rate of breathing (tachypnea).
Question 6
A patient’s ABG results are: pH 7.28, CO2 52, HCO3 24. How should the nurse interpret this
primary disorder?
A) Metabolic Acidosis
B) Metabolic Alkalosis
, 3
C) Respiratory Acidosis
D) Respiratory Alkalosis
E) Fully Compensated Respiratory Acidosis
Correct Answer: C) Respiratory Acidosis
Rationale: The pH is low (7.28), indicating acidosis. The CO2 is high (52), which is an acidic
indicator (normal is 35-45). Since the CO2 direction matches the pH direction (both
indicate acidosis), the primary disorder is respiratory. The HCO3 is normal, meaning no
compensation has occurred yet.
Question 7
Which of the following describes the ABG changes seen in a patient with Respiratory Alkalosis?
A) pH 7.30 and CO2 50
B) pH 7.40 and HCO3 24
C) Increased pH and decreased pCO2
D) Decreased pH and decreased HCO3
E) pH 7.50 and HCO3 35
Correct Answer: C) Increased pH (alkalosis) -- Depression (decrease) of pCO2
Rationale: Respiratory alkalosis occurs when a patient hyperventilates, "blowing off" too
much CO2. Because CO2 is an acid, losing it makes the blood more basic, resulting in an
elevated pH (above 7.45).
Question 8
In Metabolic Acidosis, what are the characteristic changes to the pH and the bicarbonate (HCO3)
levels?
A) Increased pH and increased HCO3
B) Decreased pH and decreased HCO3
C) Increased pH and decreased CO2
D) Decreased pH and increased CO2
E) Normal pH and decreased HCO3
Correct Answer: B) Decreased pH (acidosis) -- Depression (decrease) of HCO3
Rationale: Metabolic acidosis is characterized by a primary decrease in bicarbonate (a base)
or an increase in non-volatile acids. This loss of base results in a drop in pH below 7.35.
Question 9
A patient is diagnosed with Metabolic Alkalosis. Which set of laboratory values is consistent
with this diagnosis?
A) pH 7.20, HCO3 15
B) pH 7.48, CO2 30
C) pH 7.52, HCO3 36
, 4
D) pH 7.35, CO2 45
E) pH 7.10, HCO3 22
Correct Answer: C) Increased pH (alkalosis) -- Elevation (increase) of HCO3
Rationale: Metabolic alkalosis involves a primary gain in bicarbonate or a loss of metabolic
acids (like through vomiting). This excess base raises the pH above 7.45.
Question 10
What is the first step in the systematic interpretation of Arterial Blood Gases (ABGs)?
A) Determine if the patient needs oxygen.
B) Check the HCO3 level to see if the kidneys are working.
C) Look at the pH to determine if it is acidosis or alkalosis.
D) Assess the PaO2 to determine the level of hypoxemia.
E) Calculate the anion gap.
Correct Answer: C) Look at pH (acidosis - low or alkalosis - high)
Rationale: The pH is the definitive indicator of the body's acid-base balance. You must first
determine if the blood is acidic (<7.35) or alkaline (>7.45) before you can use the CO2 and
HCO3 values to determine the cause.
Question 11
Which clinical finding is most frequently associated with the early stages of renal cancer?
A) Severe, colicky flank pain
B) High fever and chills
C) Painless hematuria
D) Acute onset of hypertension
E) Sudden weight gain and edema
Correct Answer: C) No pain! Hematuria (Blood in the Urine)
Rationale: Renal cell carcinoma is often called a "silent" killer because it rarely produces
symptoms in the early stages. When symptoms do appear, the most common sign is painless
hematuria (blood in the urine). Pain only occurs if the tumor becomes large enough to
press on other structures.
Question 12
Which of the following is a priority intervention for the long-term management of End-Stage
Renal Disease (ESRD)?
A) High protein diet to promote muscle healing
B) Increased fluid intake to flush the kidneys
C) Erythropoietin injections and fluid restriction
D) Increasing the dosage of all home medications
E) High sodium diet to maintain blood pressure
