NR-283 Exam 2: Pathophysiology V3 Updated and Latest
Questions and Correct Answers with Rationale -
Chamberlain University
1. Which electrolyte imbalance is most likely to cause tall, peaked T waves on an EKG?
A. Hypokalemia
B. Hyponatremia
C. Hyperkalemia
D. Hypocalcemia
Ans: C
Rationale: Hyperkalemia involves an elevation of serum potassium levels above the normal range. This
condition directly impacts the repolarization phase of the cardiac action potential. Peaked T waves are a
classic early sign of potassium toxicity in the heart. If left untreated, it can progress to QRS widening and
cardiac arrest. Monitoring electrolyte levels is crucial for patients with renal failure. This
pathophysiology explains why nurses prioritize EKG monitoring in hyperkalemic patients.
,2. A patient presents with a pH of 7.25, a pCO2 of 55, and a HCO3 of 24. What is the
interpretation?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Ans: B
Rationale: Respiratory acidosis is characterized by a low pH and an elevated carbon dioxide level. In this
scenario, the pH is below 7.35, indicating a state of acidosis. The pCO2 is above 45, which shows that the
lungs are retaining too much acid. Since the bicarbonate level is within the normal range, there is no
compensation yet. This condition is often caused by hypoventilation or obstructive lung diseases. Nurses
must address the underlying respiratory cause to restore acid-base balance.
3. Which type of hypersensitivity reaction is mediated by IgE antibodies and involves mast
cell degranulation?
A. Type III
B. Type II
C. Type I
D. Type IV
Ans: C
,Rationale: Type I hypersensitivity is also known as an immediate or allergic reaction. It occurs when an
allergen binds to IgE antibodies already attached to mast cells. This binding triggers the release of
histamine and other inflammatory mediators. Common examples include hay fever, asthma, and life-
threatening systemic anaphylaxis. The reaction happens very rapidly, often within minutes of exposure to
the allergen. Understanding this mechanism helps clinicians manage allergic triggers and administer
epinephrine when necessary.
4. What is the primary mechanism behind the development of edema in a patient with liver
failure and low albumin?
A. Increased capillary hydrostatic pressure
B. Increased capillary permeability
C. Decreased capillary oncotic pressure
D. Lymphatic obstruction
Ans: C
Rationale: Albumin is the primary protein responsible for maintaining oncotic pressure in the blood.
When the liver fails, it produces significantly less albumin for the circulatory system. Lower oncotic
pressure means the blood cannot effectively pull fluid back from the tissues. Consequently, fluid leaks out
of the capillaries and accumulates in the interstitial spaces. This specific process leads to the generalized
swelling and ascites seen in liver patients. Replacing protein or using diuretics are common strategies to
manage this fluid shift.
, 5. Which sign is a classic clinical manifestation of hypocalcemia?
A. Chvostek sign
B. Negative Trousseau sign
C. Polyuria
D. Muscle weakness
Ans: A
Rationale: Hypocalcemia increases neuromuscular excitability because of the low calcium levels around
nerve cells. The Chvostek sign is elicited by tapping the facial nerve in front of the ear. A positive
response consists of a twitch of the facial muscles on that side. This indicates that the nerves are
hypersensitive to stimuli due to the electrolyte deficit. Trousseau sign is another common indicator
involving carpal spasms with blood pressure cuff inflation. Early detection of these signs prevents severe
complications like tetany or seizures.
6. Which of the following describes the ‘alarm stage’ of the General Adaptation Syndrome?
A. The body begins to repair damage and return to normal.
B. The hypothalamus activates the sympathetic nervous system.
C. Resources are depleted and the body can no longer fight stress.
D. Chronic hormone release leads to organ system failure.
Ans: B
Rationale: The alarm stage is the initial response to a perceived stressor or threat. It involves the
activation of the hypothalamus-pituitary-adrenal axis and the sympathetic system. Epinephrine and
Questions and Correct Answers with Rationale -
Chamberlain University
1. Which electrolyte imbalance is most likely to cause tall, peaked T waves on an EKG?
A. Hypokalemia
B. Hyponatremia
C. Hyperkalemia
D. Hypocalcemia
Ans: C
Rationale: Hyperkalemia involves an elevation of serum potassium levels above the normal range. This
condition directly impacts the repolarization phase of the cardiac action potential. Peaked T waves are a
classic early sign of potassium toxicity in the heart. If left untreated, it can progress to QRS widening and
cardiac arrest. Monitoring electrolyte levels is crucial for patients with renal failure. This
pathophysiology explains why nurses prioritize EKG monitoring in hyperkalemic patients.
,2. A patient presents with a pH of 7.25, a pCO2 of 55, and a HCO3 of 24. What is the
interpretation?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Ans: B
Rationale: Respiratory acidosis is characterized by a low pH and an elevated carbon dioxide level. In this
scenario, the pH is below 7.35, indicating a state of acidosis. The pCO2 is above 45, which shows that the
lungs are retaining too much acid. Since the bicarbonate level is within the normal range, there is no
compensation yet. This condition is often caused by hypoventilation or obstructive lung diseases. Nurses
must address the underlying respiratory cause to restore acid-base balance.
3. Which type of hypersensitivity reaction is mediated by IgE antibodies and involves mast
cell degranulation?
A. Type III
B. Type II
C. Type I
D. Type IV
Ans: C
,Rationale: Type I hypersensitivity is also known as an immediate or allergic reaction. It occurs when an
allergen binds to IgE antibodies already attached to mast cells. This binding triggers the release of
histamine and other inflammatory mediators. Common examples include hay fever, asthma, and life-
threatening systemic anaphylaxis. The reaction happens very rapidly, often within minutes of exposure to
the allergen. Understanding this mechanism helps clinicians manage allergic triggers and administer
epinephrine when necessary.
4. What is the primary mechanism behind the development of edema in a patient with liver
failure and low albumin?
A. Increased capillary hydrostatic pressure
B. Increased capillary permeability
C. Decreased capillary oncotic pressure
D. Lymphatic obstruction
Ans: C
Rationale: Albumin is the primary protein responsible for maintaining oncotic pressure in the blood.
When the liver fails, it produces significantly less albumin for the circulatory system. Lower oncotic
pressure means the blood cannot effectively pull fluid back from the tissues. Consequently, fluid leaks out
of the capillaries and accumulates in the interstitial spaces. This specific process leads to the generalized
swelling and ascites seen in liver patients. Replacing protein or using diuretics are common strategies to
manage this fluid shift.
, 5. Which sign is a classic clinical manifestation of hypocalcemia?
A. Chvostek sign
B. Negative Trousseau sign
C. Polyuria
D. Muscle weakness
Ans: A
Rationale: Hypocalcemia increases neuromuscular excitability because of the low calcium levels around
nerve cells. The Chvostek sign is elicited by tapping the facial nerve in front of the ear. A positive
response consists of a twitch of the facial muscles on that side. This indicates that the nerves are
hypersensitive to stimuli due to the electrolyte deficit. Trousseau sign is another common indicator
involving carpal spasms with blood pressure cuff inflation. Early detection of these signs prevents severe
complications like tetany or seizures.
6. Which of the following describes the ‘alarm stage’ of the General Adaptation Syndrome?
A. The body begins to repair damage and return to normal.
B. The hypothalamus activates the sympathetic nervous system.
C. Resources are depleted and the body can no longer fight stress.
D. Chronic hormone release leads to organ system failure.
Ans: B
Rationale: The alarm stage is the initial response to a perceived stressor or threat. It involves the
activation of the hypothalamus-pituitary-adrenal axis and the sympathetic system. Epinephrine and
