UNIVERSITY OF CENTRAL FLORIDA
NUR 3125 PATHOPHYSIOLOGY FOR NURSING PRACTICE
FINAL EXAM
2026
A 60-year-old patient with chronic obstructive pulmonary disease
(COPD) presents with increased dyspnea and confusion. Arterial
blood gas reveals pH 7.25, PaCO₂ 70 mm Hg, HCO₃⁻ 30 mEq/L.
What is the primary acid-base disturbance?
• A) Metabolic acidosis
• B) Respiratory acidosis with metabolic compensation
• C) Respiratory alkalosis
• D) Metabolic alkalosis
Answer: B) Respiratory acidosis with metabolic compensation
Rationale: Elevated PaCO₂ and low pH indicate respiratory acidosis.
Increased HCO₃⁻ shows kidney compensation. COPD patients often
retain CO₂ causing chronic respiratory acidosis.
A 35-year-old woman has autoimmune thyroiditis leading to
hypothyroidism. Which pathophysiological process best explains her
fatigue and weight gain?
• A) Increased basal metabolic rate
• B) Decreased thyroid hormone production leading to slowed
metabolism
• C) Excess catecholamine production
• D) Hyperplasia of thyroid follicles
Answer: B) Decreased thyroid hormone production leading to
slowed metabolism Rationale: Hypothyroidism reduces thyroid
hormone synthesis, decreasing basal metabolic rates causing fatigue
and weight gain.
True or False: In Type 1 Diabetes Mellitus, autoimmune destruction
of pancreatic beta cells results in an absolute insulin deficiency.
Answer: True Rationale: Type 1 DM is characterized by
autoimmune-mediated beta cell destruction leading to absolute
insulin deficiency.
,True or False: Hyponatremia in patients with Syndrome of
Inappropriate Antidiuretic Hormone Secretion (SIADH) is primarily
due to excessive renal sodium loss. Answer: False Rationale:
Hyponatremia in SIADH is due to water retention (dilutional
hyponatremia), not sodium loss.
Fill in the blank: In shock states, __________ is the pathological
stage where tissue injury becomes irreversible despite restoration of
blood flow. Answer: refractory (irreversible) shock Rationale:
Refractory shock refers to the stage where cellular and organ damage
is irreversible.
Multiple Choice: A patient with congestive heart failure exhibits
peripheral edema and elevated jugular venous pressure. What
pathophysiological mechanism primarily causes these clinical signs?
• A) Decreased oncotic pressure due to hypoalbuminemia
• B) Increased hydrostatic pressure from ventricular failure
• C) Increased capillary permeability
• D) Lymphatic obstruction
Answer: B) Increased hydrostatic pressure from ventricular failure
Rationale: In heart failure, impaired ventricular function causes
blood to back up, elevating hydrostatic pressure leading to edema.
Fill in the blank: The hallmark histopathological feature of
Alzheimer’s disease is the presence of __________ plaques in the
brain. Answer: amyloid-beta Rationale: Amyloid-beta plaques are
extracellular deposits that disrupt neuronal communication in
Alzheimer’s.
Multiple Choice: During compensated metabolic acidosis, the
expected respiratory compensation is:
• A) Hypoventilation to increase CO₂
• B) Hyperventilation to decrease CO₂
• C) No change in ventilation
• D) Apnea
,Answer: B) Hyperventilation to decrease CO₂ Rationale: Metabolic
acidosis triggers hyperventilation (Kussmaul respirations) to blow off
CO₂, reducing acid load.
True or False: In acute pancreatitis, autodigestion of pancreatic tissue
is caused by premature activation of digestive enzymes within the
pancreas. Answer: True Rationale: Premature activation of enzymes
like trypsin leads to pancreatic tissue damage.
Multiple Choice: Which cellular adaptation is most likely in response
to chronic exposure to cigarette smoke in bronchial epithelial cells?
• A) Dysplasia
• B) Metaplasia
• C) Hyperplasia
• D) Atrophy
Answer: B) Metaplasia Rationale: Chronic irritation causes
columnar epithelium to change into squamous epithelium (squamous
metaplasia) as a protective response.
Fill in the blank: The primary mediator responsible for vasodilation
and increased vascular permeability in inflammation is __________.
Answer: histamine Rationale: Histamine released from mast cells
induces vasodilation and permeability.
True or False: In chronic kidney disease, erythropoietin deficiency
leads to normocytic normochromic anemia. Answer: True
Rationale: Reduced erythropoietin causes decreased RBC
production, resulting in anemia with normal RBC size and color.
Multiple Choice: Which of the following best explains hypercalcemia
in hyperparathyroidism?
• A) Increased bone resorption
• B) Decreased intestinal absorption of calcium
• C) Increased renal calcium excretion
• D) Decreased parathyroid hormone levels
, Answer: A) Increased bone resorption Rationale: Excess PTH
increases osteoclastic activity, releasing calcium from bone.
Fill in the blank: __________ edema results from decreased oncotic
pressure, often seen in liver cirrhosis and nephrotic syndrome.
Answer: transudate Rationale: Transudate results from fluid leaking
due to low plasma oncotic pressure, not inflammation.
True or False: The primary cause of vasogenic cerebral edema is
disruption of the blood-brain barrier. Answer: True Rationale:
Vasogenic edema involves leakage of plasma into extracellular space
due to BBB breakdown.
Multiple Choice: Which of the following mechanisms best explains
insulin resistance in Type 2 Diabetes Mellitus?
• A) Autoimmune destruction of pancreatic beta cells
• B) Downregulation of insulin receptor activity in peripheral
tissues
• C) Excess glucagon secretion
• D) Increased adiponectin secretion
Answer: B) Downregulation of insulin receptor activity in peripheral
tissues Rationale: Insulin resistance results from impaired receptor
signaling reducing glucose uptake.
Fill in the blank: The predominant cellular injury mechanism in
ischemia-reperfusion injury involves the generation of excess
__________ species. Answer: reactive oxygen Rationale:
Reperfusion creates reactive oxygen species that damage cell
membranes, proteins, and DNA.
True or False: In metabolic syndrome, central obesity contributes
directly to insulin resistance by releasing pro-inflammatory
adipokines. Answer: True Rationale: Visceral fat secretes cytokines
like TNF-alpha promoting inflammation and insulin resistance.
Multiple Choice: In chronic liver disease, portal hypertension causes
splenomegaly primarily due to:
NUR 3125 PATHOPHYSIOLOGY FOR NURSING PRACTICE
FINAL EXAM
2026
A 60-year-old patient with chronic obstructive pulmonary disease
(COPD) presents with increased dyspnea and confusion. Arterial
blood gas reveals pH 7.25, PaCO₂ 70 mm Hg, HCO₃⁻ 30 mEq/L.
What is the primary acid-base disturbance?
• A) Metabolic acidosis
• B) Respiratory acidosis with metabolic compensation
• C) Respiratory alkalosis
• D) Metabolic alkalosis
Answer: B) Respiratory acidosis with metabolic compensation
Rationale: Elevated PaCO₂ and low pH indicate respiratory acidosis.
Increased HCO₃⁻ shows kidney compensation. COPD patients often
retain CO₂ causing chronic respiratory acidosis.
A 35-year-old woman has autoimmune thyroiditis leading to
hypothyroidism. Which pathophysiological process best explains her
fatigue and weight gain?
• A) Increased basal metabolic rate
• B) Decreased thyroid hormone production leading to slowed
metabolism
• C) Excess catecholamine production
• D) Hyperplasia of thyroid follicles
Answer: B) Decreased thyroid hormone production leading to
slowed metabolism Rationale: Hypothyroidism reduces thyroid
hormone synthesis, decreasing basal metabolic rates causing fatigue
and weight gain.
True or False: In Type 1 Diabetes Mellitus, autoimmune destruction
of pancreatic beta cells results in an absolute insulin deficiency.
Answer: True Rationale: Type 1 DM is characterized by
autoimmune-mediated beta cell destruction leading to absolute
insulin deficiency.
,True or False: Hyponatremia in patients with Syndrome of
Inappropriate Antidiuretic Hormone Secretion (SIADH) is primarily
due to excessive renal sodium loss. Answer: False Rationale:
Hyponatremia in SIADH is due to water retention (dilutional
hyponatremia), not sodium loss.
Fill in the blank: In shock states, __________ is the pathological
stage where tissue injury becomes irreversible despite restoration of
blood flow. Answer: refractory (irreversible) shock Rationale:
Refractory shock refers to the stage where cellular and organ damage
is irreversible.
Multiple Choice: A patient with congestive heart failure exhibits
peripheral edema and elevated jugular venous pressure. What
pathophysiological mechanism primarily causes these clinical signs?
• A) Decreased oncotic pressure due to hypoalbuminemia
• B) Increased hydrostatic pressure from ventricular failure
• C) Increased capillary permeability
• D) Lymphatic obstruction
Answer: B) Increased hydrostatic pressure from ventricular failure
Rationale: In heart failure, impaired ventricular function causes
blood to back up, elevating hydrostatic pressure leading to edema.
Fill in the blank: The hallmark histopathological feature of
Alzheimer’s disease is the presence of __________ plaques in the
brain. Answer: amyloid-beta Rationale: Amyloid-beta plaques are
extracellular deposits that disrupt neuronal communication in
Alzheimer’s.
Multiple Choice: During compensated metabolic acidosis, the
expected respiratory compensation is:
• A) Hypoventilation to increase CO₂
• B) Hyperventilation to decrease CO₂
• C) No change in ventilation
• D) Apnea
,Answer: B) Hyperventilation to decrease CO₂ Rationale: Metabolic
acidosis triggers hyperventilation (Kussmaul respirations) to blow off
CO₂, reducing acid load.
True or False: In acute pancreatitis, autodigestion of pancreatic tissue
is caused by premature activation of digestive enzymes within the
pancreas. Answer: True Rationale: Premature activation of enzymes
like trypsin leads to pancreatic tissue damage.
Multiple Choice: Which cellular adaptation is most likely in response
to chronic exposure to cigarette smoke in bronchial epithelial cells?
• A) Dysplasia
• B) Metaplasia
• C) Hyperplasia
• D) Atrophy
Answer: B) Metaplasia Rationale: Chronic irritation causes
columnar epithelium to change into squamous epithelium (squamous
metaplasia) as a protective response.
Fill in the blank: The primary mediator responsible for vasodilation
and increased vascular permeability in inflammation is __________.
Answer: histamine Rationale: Histamine released from mast cells
induces vasodilation and permeability.
True or False: In chronic kidney disease, erythropoietin deficiency
leads to normocytic normochromic anemia. Answer: True
Rationale: Reduced erythropoietin causes decreased RBC
production, resulting in anemia with normal RBC size and color.
Multiple Choice: Which of the following best explains hypercalcemia
in hyperparathyroidism?
• A) Increased bone resorption
• B) Decreased intestinal absorption of calcium
• C) Increased renal calcium excretion
• D) Decreased parathyroid hormone levels
, Answer: A) Increased bone resorption Rationale: Excess PTH
increases osteoclastic activity, releasing calcium from bone.
Fill in the blank: __________ edema results from decreased oncotic
pressure, often seen in liver cirrhosis and nephrotic syndrome.
Answer: transudate Rationale: Transudate results from fluid leaking
due to low plasma oncotic pressure, not inflammation.
True or False: The primary cause of vasogenic cerebral edema is
disruption of the blood-brain barrier. Answer: True Rationale:
Vasogenic edema involves leakage of plasma into extracellular space
due to BBB breakdown.
Multiple Choice: Which of the following mechanisms best explains
insulin resistance in Type 2 Diabetes Mellitus?
• A) Autoimmune destruction of pancreatic beta cells
• B) Downregulation of insulin receptor activity in peripheral
tissues
• C) Excess glucagon secretion
• D) Increased adiponectin secretion
Answer: B) Downregulation of insulin receptor activity in peripheral
tissues Rationale: Insulin resistance results from impaired receptor
signaling reducing glucose uptake.
Fill in the blank: The predominant cellular injury mechanism in
ischemia-reperfusion injury involves the generation of excess
__________ species. Answer: reactive oxygen Rationale:
Reperfusion creates reactive oxygen species that damage cell
membranes, proteins, and DNA.
True or False: In metabolic syndrome, central obesity contributes
directly to insulin resistance by releasing pro-inflammatory
adipokines. Answer: True Rationale: Visceral fat secretes cytokines
like TNF-alpha promoting inflammation and insulin resistance.
Multiple Choice: In chronic liver disease, portal hypertension causes
splenomegaly primarily due to:
