NR-283 Pathophysiology Final Exam Comprehensive
Review Updated and Latest Questions and Correct
Answers with Rationale
1. A patient experiences a decrease in muscle size after being in a cast for six weeks. Which
cellular adaptation has occurred?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Ans: C
Rationale: Atrophy represents a decrease in cell size resulting from a decrease in work demand or
adverse environmental conditions. This physiological change allows the cell to survive by reducing its
metabolic needs. In this case, the lack of mechanical use leads to protein degradation and cellular
shrinkage. Hypertrophy involves an increase in cell size rather than a decrease. Hyperplasia is an
increase in the number of cells within a tissue. Understanding these adaptations is crucial for predicting
clinical outcomes in immobilized patients.
,2. Which electrolyte imbalance is most likely to cause life-threatening cardiac dysrhythmias
and tall, peaked T-waves on an ECG?
A. Hyponatremia
B. Hypocalcemia
C. Hypermagnesemia
D. Hyperkalemia
Ans: D
Rationale: Hyperkalemia is an elevation in serum potassium levels that significantly impacts the resting
membrane potential of cardiac cells. This state leads to increased excitability and characteristic ECG
changes like peaked T-waves. If left untreated, it can progress to ventricular fibrillation or cardiac arrest.
Hyponatremia primarily affects the central nervous system through cerebral edema. Hypocalcemia
usually presents with neuromuscular irritability such as Tetany. Correctly identifying electrolyte shifts is
a priority in acute nursing care.
3. A patient with chronic obstructive pulmonary disease (COPD) is likely to develop which
acid-base imbalance due to CO2 retention?
A. Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Ans: B
,Rationale: Respiratory acidosis occurs when the lungs cannot effectively remove enough of the carbon
dioxide produced by the body. The resulting accumulation of CO2 increases carbonic acid levels and
lowers the blood pH. Patients with COPD often suffer from alveolar hypoventilation leading to this
specific imbalance. Respiratory alkalosis is caused by hyperventilation and excessive CO2 loss. Metabolic
acidosis involves an excess of non-volatile acids or loss of bicarbonate. Monitoring arterial blood gases is
essential for managing chronic respiratory patients.
4. What is the primary characteristic of Type I Hypersensitivity reactions?
A. IgG-mediated cytotoxic response
B. IgE-mediated mast cell degranulation
C. Delayed-type T-cell response
D. Immune complex deposition
Ans: B
Rationale: Type I hypersensitivity involves an immediate allergic reaction triggered by the binding of IgE
antibodies to mast cells. This interaction causes the release of inflammatory mediators like histamine
into the systemic circulation. Common examples include seasonal allergies, asthma, and life-threatening
anaphylaxis. Type II involves antibody-mediated destruction of specific target cells. Type III is
characterized by the formation of antigen-antibody complexes that deposit in tissues. Distinguishing
between hypersensitivity types helps determine the appropriate pharmacological intervention.
, 5. A patient with left-sided heart failure is most likely to exhibit which of the following
clinical manifestations?
A. Peripheral edema
B. Jugular venous distention
C. Splenomegaly
D. Pulmonary crackles
Ans: D
Rationale: Left-sided heart failure occurs when the left ventricle cannot pump blood efficiently, causing
fluid to back up into the lungs. This backup leads to pulmonary congestion and the presence of crackles
during auscultation. Symptoms like shortness of breath and orthopnea are common in these patients.
Peripheral edema is more characteristic of right-sided heart failure due to systemic backup. Jugular
venous distention also suggests right-sided failure or systemic fluid overload. Understanding heart
failure mechanics is vital for differentiating between systemic and pulmonary symptoms.
6. Which type of anemia is caused by a deficiency of intrinsic factor, leading to poor Vitamin
B12 absorption?
A. Pernicious anemia
B. Iron deficiency anemia
C. Aplastic anemia
D. Sickle cell anemia
Ans: A
Review Updated and Latest Questions and Correct
Answers with Rationale
1. A patient experiences a decrease in muscle size after being in a cast for six weeks. Which
cellular adaptation has occurred?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Ans: C
Rationale: Atrophy represents a decrease in cell size resulting from a decrease in work demand or
adverse environmental conditions. This physiological change allows the cell to survive by reducing its
metabolic needs. In this case, the lack of mechanical use leads to protein degradation and cellular
shrinkage. Hypertrophy involves an increase in cell size rather than a decrease. Hyperplasia is an
increase in the number of cells within a tissue. Understanding these adaptations is crucial for predicting
clinical outcomes in immobilized patients.
,2. Which electrolyte imbalance is most likely to cause life-threatening cardiac dysrhythmias
and tall, peaked T-waves on an ECG?
A. Hyponatremia
B. Hypocalcemia
C. Hypermagnesemia
D. Hyperkalemia
Ans: D
Rationale: Hyperkalemia is an elevation in serum potassium levels that significantly impacts the resting
membrane potential of cardiac cells. This state leads to increased excitability and characteristic ECG
changes like peaked T-waves. If left untreated, it can progress to ventricular fibrillation or cardiac arrest.
Hyponatremia primarily affects the central nervous system through cerebral edema. Hypocalcemia
usually presents with neuromuscular irritability such as Tetany. Correctly identifying electrolyte shifts is
a priority in acute nursing care.
3. A patient with chronic obstructive pulmonary disease (COPD) is likely to develop which
acid-base imbalance due to CO2 retention?
A. Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Ans: B
,Rationale: Respiratory acidosis occurs when the lungs cannot effectively remove enough of the carbon
dioxide produced by the body. The resulting accumulation of CO2 increases carbonic acid levels and
lowers the blood pH. Patients with COPD often suffer from alveolar hypoventilation leading to this
specific imbalance. Respiratory alkalosis is caused by hyperventilation and excessive CO2 loss. Metabolic
acidosis involves an excess of non-volatile acids or loss of bicarbonate. Monitoring arterial blood gases is
essential for managing chronic respiratory patients.
4. What is the primary characteristic of Type I Hypersensitivity reactions?
A. IgG-mediated cytotoxic response
B. IgE-mediated mast cell degranulation
C. Delayed-type T-cell response
D. Immune complex deposition
Ans: B
Rationale: Type I hypersensitivity involves an immediate allergic reaction triggered by the binding of IgE
antibodies to mast cells. This interaction causes the release of inflammatory mediators like histamine
into the systemic circulation. Common examples include seasonal allergies, asthma, and life-threatening
anaphylaxis. Type II involves antibody-mediated destruction of specific target cells. Type III is
characterized by the formation of antigen-antibody complexes that deposit in tissues. Distinguishing
between hypersensitivity types helps determine the appropriate pharmacological intervention.
, 5. A patient with left-sided heart failure is most likely to exhibit which of the following
clinical manifestations?
A. Peripheral edema
B. Jugular venous distention
C. Splenomegaly
D. Pulmonary crackles
Ans: D
Rationale: Left-sided heart failure occurs when the left ventricle cannot pump blood efficiently, causing
fluid to back up into the lungs. This backup leads to pulmonary congestion and the presence of crackles
during auscultation. Symptoms like shortness of breath and orthopnea are common in these patients.
Peripheral edema is more characteristic of right-sided heart failure due to systemic backup. Jugular
venous distention also suggests right-sided failure or systemic fluid overload. Understanding heart
failure mechanics is vital for differentiating between systemic and pulmonary symptoms.
6. Which type of anemia is caused by a deficiency of intrinsic factor, leading to poor Vitamin
B12 absorption?
A. Pernicious anemia
B. Iron deficiency anemia
C. Aplastic anemia
D. Sickle cell anemia
Ans: A
