Nursing Pathophysiology 2026 Final Exam Questions &
Answers
While viewing the electrocardiogram, the nurse recalls the conducts action
potentials down the atrioventricular septum. - Bundle of His
Which of the following patient would be most prone to metabolic acidosis? A patient with: -
Diabetes whose glucoses are uncontrolled
A 76-year-old patient had the following arterial blood gas sample after his stomach surgery in
which his gastric content and fluid were removed: pH 7.55, PCO2 50, HCO3 35. What acidbase
imbalance is most likely in this patient? - Metabolic alkalosis, compensating
A 50-year-old male visits the cardiologist for an EKG. Results indicate that he has no
PR interval and a variable QRS rate with rhythm irregularity. Which of the following is
the most likely diagnosis to be recorded on the chart? - Atrial fibrillation
A 65-year-old male is transported to the ER for chest pain. An electrocardiogram
reveals a prolonged QRS interval. What is the nurse monitoring when the nurse
observes the QRS complex on the electrocardiogram? The QRS complex reflects: - Ventricular
activity
Which is one of the acid/base conditions that would cause the nurse to monitor for
hyperkalemia? - metabolic acidosis
A 20-year-old male is in acute pain with restlessness and anxiety. An arterial blood gas
reveals decreased carbon dioxide (CO2) levels. Which of the following does the nurse
suspect is the most likely cause? - hyperventilation
A 24-year-old female presents with excessive menstrual bleeding. The physician identified
endometrial changes that are due to hormonal imbalances. These cellular changes would be
referred to as: - Pathologic hyperplasia
A 34-year-old was diagnosed with malignant tumor (cancer). The nurse teaches the patient
about malignant cells. Which of the following is most appropriate explanation when describing
malignant cells? - Malignant cells are dysplastic cells and are irreversible
A characteristic of a malignant tumor includes that it: - can spread far from the tissue of origin
A 25-year-old male develops cancer of the breast glandular tissue. What type of cancer does he
have? - adenocarcinoma
When planning care for a cardiac patient, the nurse knows that in response to an increased
workload, cardiac myocardial cells will: - Increase in size
The term apoptosis is appropriately defined as: - programmed cell death
,A report comes back indicating that muscular atrophy has occurred. A nurse
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
recalls that muscular atrophy involves a decrease in muscle cell - size
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
A nursing student is studying about cancer and the associated risks for cancer. The
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
instructor knows the student understands cancer when which of the following are
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
associated risks for cancer? - -Epstein-Barr virus (EBV)
V3 V3 V3 V3 V3 V3 V3 V3
-hepatitis C virus (HCV) V3 V3 V3
-hepatitis B virus (HBV) V3 V3 V3
-human papillomavirus (HPV) V3 V3
A primary care provider is attempting to diagnose cancer and is looking for a tumor
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
marker. Which of the following could be a possible marker? - Enzymes
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
A 30-year-old homeless was seen in the emergency room with productive cough of
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
bloodtinged sputum. His chest x-ray showed granulomatous disease. Upon further
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
questioning, he
V3 V3
was found to have had tuberculosis (TB) in distant past. TB infections are likely to
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
result in which of the following forms of necrosis? - caseous
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
When discussing body fluid, it is correct to state that: - Two-thirds of the body's water is
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
intracellular.
V3
Rationale: One-third is extracellular. There are two components of the extracellular
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
compartment: interstitial and intravascular. Total body water is about 60% of body
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
weight.
V3
Which of the following statements is TRUE? When discussing body fluid movement, it is
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
correct to state that:
V3 V3 V3 V3
A) Potassium is the most abundant extracellular fluid (ECF) ion.
V3 V3 V3 V3 V3 V3 V3 V3
B) Sodium maintains the osmotic balance of the intracellular fluid (ICF) space.
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
C) Water moves freely across membranes.
V3 V3 V3 V3
D) Aquaporins block water movement across the membrane. - C) Water moves freely
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
across the capillary or cell membrane.
V3 V3 V3 V3 V3 V3
Rationale: Aquaporins are a family of water channel proteins that provide permeability to
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
water at the capillary membrane. Sodium is the major ECF cation, and potassium is
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
the major ICF cation; this is due to the sodium-potassium pump.
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
When discussing aldosterone, it is correct to state that: - It is a hormone that is secreted
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
when sodium levels are depressed.
V3 V3 V3 V3 V3
Rationale: Aldosterone is a minerocorticoid secreted from the adrenal gland that is located
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
on the kidney. Aldosterone is secreted when potassium is increased or sodium is
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
decreased. Therefore, it makes sense that aldosterone increases sodium reabsorption to
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
increase a depleted supply. It also increases potassium secretion.
V3 V3 V3 V3 V3 V3 V3 V3 V3
When discussing hyperchloremia (elevated serum chlorine), it is correct to state that it: -
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
Is a result of an underlying disorder.
V3 V3 V3 V3 V3 V3 V3
, Rationale: Hyperchloremia is usually related to an underlying disorder, and therefore,
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
treatment is centered on the underlying disorder. It usually occurs with an increase in
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
sodium and a deficit of bicarbonate. There are normally no specific symptoms
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
associated with this syndrome.
V3 V3 V3 V3
When discussing hyponatremia (low serum sodium), it is correct to state that it is
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
generally: - An outcome of serious burns, vomiting, or diarrhea.
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
Rationale: Hyponatremia occurs when the serum sodium drops below 135 mEq/L. It can
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
occur due to burns, vomiting, diarrhea, or gastrointestinal suctioning. It can also occur
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
with an increase in TBW. Inadequate sodium intake can cause hyponatremia, but it is
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
uncommon.
V3
Which of the following is a TRUE statement regarding hyperkalemia (elevated
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
serum potassium)? - It often occurs in acidosis.
V3 V3 V3 V3 V3 V3 V3 V3
Rationale: Hyperkalemia (high potassium) often occurs with acidosis. During acidosis,
V3 V3 V3 V3 V3 V3 V3 V3 V3
hydrogen is taken up in the cell. When this occurs, it is exchanged for potassium and
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
serum potassium rises. Dietary excesses are uncommon. An increase in aldosterone
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
would cause hypokalemia, rather than hyperkalemia, because aldosterone increases Na+
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
reabsorption while increasing K+ secretion into the renal tubule.
V3 V3 V3 V3 V3 V3 V3 V3 V3
A patient has deep and rapid respirations. Laboratory tests reveal decreased pH and
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
bicarbonate. This patient is experiencing: - metabolic acidosis.
V3 V3 V3 V3 V3 V3 V3 V3
Rationale: A decrease in pH and bicarbonate occur with metabolic acidosis. Additionally,
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
metabolic acidosis causes deep and rapid breathing, as the body tries to compensate by
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
removing carbon dioxide. Metabolic alkalosis occurs if pH and bicarbonate levels are
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
elevated. Respiratory acidosis occurs when pH is decreased and carbon dioxide is
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
elevated, whereas respiratory alkalosis occurs when pH is elevated and carbon dioxide is
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
decreased.
V3
A common cause of the increased filtration of fluid from capillaries and lymph into
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
surrounding tissues (edema) includes: Select all that apply.
V3 V3 V3 V3 V3 V3 V3 V3
A) Increased hydrostatic pressure. V3 V3
B) Decreased plasma oncotic pressure. V3 V3 V3
C) Increased capillary membrane permeability.
V3 V3 V3
D) Lymphatic obstruction. V3
E) Increased barometric pressure. - A,B,C,&D
V3 V3 V3 V3
Rationale: There are four common causes of increased edema: increased hydrostatic
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
pressure, decreased plasma oncotic pressure, increased capillary membrane permeability,
V3 V3 V3 V3 V3 V3 V3 V3 V3
and lymphatic obstruction. Barometric pressure (Atmospheric pressure) is the force per
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
unit area exerted against a surface by the weight of air above that surface in the Earth's
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
atmosphere
V3
When discussing causes of hypernatremia (elevated serum sodium), it is correct to
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
include: Select all that apply.
V3 V3 V3 V3 V3
A) Excessive free water intake. V3 V3 V3
B) Inappropriate administration of hypertonic saline solution.
V3 V3 V3 V3 V3
C) Oversecretion of the hormone aldosterone. V3 V3 V3 V3
Answers
While viewing the electrocardiogram, the nurse recalls the conducts action
potentials down the atrioventricular septum. - Bundle of His
Which of the following patient would be most prone to metabolic acidosis? A patient with: -
Diabetes whose glucoses are uncontrolled
A 76-year-old patient had the following arterial blood gas sample after his stomach surgery in
which his gastric content and fluid were removed: pH 7.55, PCO2 50, HCO3 35. What acidbase
imbalance is most likely in this patient? - Metabolic alkalosis, compensating
A 50-year-old male visits the cardiologist for an EKG. Results indicate that he has no
PR interval and a variable QRS rate with rhythm irregularity. Which of the following is
the most likely diagnosis to be recorded on the chart? - Atrial fibrillation
A 65-year-old male is transported to the ER for chest pain. An electrocardiogram
reveals a prolonged QRS interval. What is the nurse monitoring when the nurse
observes the QRS complex on the electrocardiogram? The QRS complex reflects: - Ventricular
activity
Which is one of the acid/base conditions that would cause the nurse to monitor for
hyperkalemia? - metabolic acidosis
A 20-year-old male is in acute pain with restlessness and anxiety. An arterial blood gas
reveals decreased carbon dioxide (CO2) levels. Which of the following does the nurse
suspect is the most likely cause? - hyperventilation
A 24-year-old female presents with excessive menstrual bleeding. The physician identified
endometrial changes that are due to hormonal imbalances. These cellular changes would be
referred to as: - Pathologic hyperplasia
A 34-year-old was diagnosed with malignant tumor (cancer). The nurse teaches the patient
about malignant cells. Which of the following is most appropriate explanation when describing
malignant cells? - Malignant cells are dysplastic cells and are irreversible
A characteristic of a malignant tumor includes that it: - can spread far from the tissue of origin
A 25-year-old male develops cancer of the breast glandular tissue. What type of cancer does he
have? - adenocarcinoma
When planning care for a cardiac patient, the nurse knows that in response to an increased
workload, cardiac myocardial cells will: - Increase in size
The term apoptosis is appropriately defined as: - programmed cell death
,A report comes back indicating that muscular atrophy has occurred. A nurse
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
recalls that muscular atrophy involves a decrease in muscle cell - size
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
A nursing student is studying about cancer and the associated risks for cancer. The
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
instructor knows the student understands cancer when which of the following are
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
associated risks for cancer? - -Epstein-Barr virus (EBV)
V3 V3 V3 V3 V3 V3 V3 V3
-hepatitis C virus (HCV) V3 V3 V3
-hepatitis B virus (HBV) V3 V3 V3
-human papillomavirus (HPV) V3 V3
A primary care provider is attempting to diagnose cancer and is looking for a tumor
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
marker. Which of the following could be a possible marker? - Enzymes
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
A 30-year-old homeless was seen in the emergency room with productive cough of
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
bloodtinged sputum. His chest x-ray showed granulomatous disease. Upon further
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
questioning, he
V3 V3
was found to have had tuberculosis (TB) in distant past. TB infections are likely to
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
result in which of the following forms of necrosis? - caseous
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
When discussing body fluid, it is correct to state that: - Two-thirds of the body's water is
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
intracellular.
V3
Rationale: One-third is extracellular. There are two components of the extracellular
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
compartment: interstitial and intravascular. Total body water is about 60% of body
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
weight.
V3
Which of the following statements is TRUE? When discussing body fluid movement, it is
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
correct to state that:
V3 V3 V3 V3
A) Potassium is the most abundant extracellular fluid (ECF) ion.
V3 V3 V3 V3 V3 V3 V3 V3
B) Sodium maintains the osmotic balance of the intracellular fluid (ICF) space.
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
C) Water moves freely across membranes.
V3 V3 V3 V3
D) Aquaporins block water movement across the membrane. - C) Water moves freely
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
across the capillary or cell membrane.
V3 V3 V3 V3 V3 V3
Rationale: Aquaporins are a family of water channel proteins that provide permeability to
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
water at the capillary membrane. Sodium is the major ECF cation, and potassium is
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
the major ICF cation; this is due to the sodium-potassium pump.
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
When discussing aldosterone, it is correct to state that: - It is a hormone that is secreted
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
when sodium levels are depressed.
V3 V3 V3 V3 V3
Rationale: Aldosterone is a minerocorticoid secreted from the adrenal gland that is located
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
on the kidney. Aldosterone is secreted when potassium is increased or sodium is
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
decreased. Therefore, it makes sense that aldosterone increases sodium reabsorption to
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
increase a depleted supply. It also increases potassium secretion.
V3 V3 V3 V3 V3 V3 V3 V3 V3
When discussing hyperchloremia (elevated serum chlorine), it is correct to state that it: -
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
Is a result of an underlying disorder.
V3 V3 V3 V3 V3 V3 V3
, Rationale: Hyperchloremia is usually related to an underlying disorder, and therefore,
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
treatment is centered on the underlying disorder. It usually occurs with an increase in
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
sodium and a deficit of bicarbonate. There are normally no specific symptoms
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
associated with this syndrome.
V3 V3 V3 V3
When discussing hyponatremia (low serum sodium), it is correct to state that it is
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
generally: - An outcome of serious burns, vomiting, or diarrhea.
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
Rationale: Hyponatremia occurs when the serum sodium drops below 135 mEq/L. It can
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
occur due to burns, vomiting, diarrhea, or gastrointestinal suctioning. It can also occur
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
with an increase in TBW. Inadequate sodium intake can cause hyponatremia, but it is
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
uncommon.
V3
Which of the following is a TRUE statement regarding hyperkalemia (elevated
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
serum potassium)? - It often occurs in acidosis.
V3 V3 V3 V3 V3 V3 V3 V3
Rationale: Hyperkalemia (high potassium) often occurs with acidosis. During acidosis,
V3 V3 V3 V3 V3 V3 V3 V3 V3
hydrogen is taken up in the cell. When this occurs, it is exchanged for potassium and
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
serum potassium rises. Dietary excesses are uncommon. An increase in aldosterone
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
would cause hypokalemia, rather than hyperkalemia, because aldosterone increases Na+
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
reabsorption while increasing K+ secretion into the renal tubule.
V3 V3 V3 V3 V3 V3 V3 V3 V3
A patient has deep and rapid respirations. Laboratory tests reveal decreased pH and
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
bicarbonate. This patient is experiencing: - metabolic acidosis.
V3 V3 V3 V3 V3 V3 V3 V3
Rationale: A decrease in pH and bicarbonate occur with metabolic acidosis. Additionally,
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
metabolic acidosis causes deep and rapid breathing, as the body tries to compensate by
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
removing carbon dioxide. Metabolic alkalosis occurs if pH and bicarbonate levels are
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
elevated. Respiratory acidosis occurs when pH is decreased and carbon dioxide is
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
elevated, whereas respiratory alkalosis occurs when pH is elevated and carbon dioxide is
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
decreased.
V3
A common cause of the increased filtration of fluid from capillaries and lymph into
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
surrounding tissues (edema) includes: Select all that apply.
V3 V3 V3 V3 V3 V3 V3 V3
A) Increased hydrostatic pressure. V3 V3
B) Decreased plasma oncotic pressure. V3 V3 V3
C) Increased capillary membrane permeability.
V3 V3 V3
D) Lymphatic obstruction. V3
E) Increased barometric pressure. - A,B,C,&D
V3 V3 V3 V3
Rationale: There are four common causes of increased edema: increased hydrostatic
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
pressure, decreased plasma oncotic pressure, increased capillary membrane permeability,
V3 V3 V3 V3 V3 V3 V3 V3 V3
and lymphatic obstruction. Barometric pressure (Atmospheric pressure) is the force per
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
unit area exerted against a surface by the weight of air above that surface in the Earth's
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
atmosphere
V3
When discussing causes of hypernatremia (elevated serum sodium), it is correct to
V3 V3 V3 V3 V3 V3 V3 V3 V3 V3 V3
include: Select all that apply.
V3 V3 V3 V3 V3
A) Excessive free water intake. V3 V3 V3
B) Inappropriate administration of hypertonic saline solution.
V3 V3 V3 V3 V3
C) Oversecretion of the hormone aldosterone. V3 V3 V3 V3
