NSG 3280 EXAM 2 PATHOPHYSIOLOGY —
COMPLETE 150-QUESTION PRACTICE
EXAM Galen College of Nursing | 2026/2027 |
Questions with Answers & Rationales
SECTION 1: IMMUNITY & INFLAMMATION (Questions 1-35)
1. The nurse is administering a childhood vaccine to a pediatric client. The mother
asks the nurse why the child needs so many vaccinations. How should the nurse
respond?
A. "Immunization is an important means of inhibiting the spread of infection by
decreasing your child's susceptibility to the infection."
B. "Vaccines prevent all infections completely for life."
C. "The more vaccines a child gets, the stronger their immune system becomes
overall."
D. "Vaccines are mainly required for school paperwork."
Correct Answer: A
Rationale: Vaccines induce active immunity and herd protection by reducing
susceptibility and transmission of specific pathogens .
2. The nurse is reviewing assessment documentation of a client's wound and notes
"purulent drainage." The nurse would interpret this as:
A. Exudate containing clear fluid only
B. Exudate containing white blood cells, protein, and tissue debris
C. Exudate consisting primarily of blood
D. Exudate with high fibrin content but no cells
Correct Answer: B
Rationale: Purulent (suppurative) exudate is thick, cloudy, and often yellow/green
due to pus—primarily neutrophils, necrotic cells, and protein .
,3. A newborn has been lethargic and is not nursing well. Testing of cord blood
done at birth reveals the presence of IgM. How should the nurse interpret this
finding?
A. IgM is normally transferred from the mother in utero
B. The presence of IgM suggests the newborn has an infection
C. IgM indicates adequate maternal immunity
D. IgM indicates a normal newborn immune response to breast milk
Correct Answer: B
Rationale: Maternal IgM does not cross the placenta. IgM in cord blood suggests
fetal/neonatal synthesis in response to in utero infection .
4. The nurse is caring for a client who has experienced hypovolemic shock
secondary to penetrating multiple trauma. When caring for the client
postoperatively, which of these factors does the nurse recognize places the client at
risk for poor wound healing?
A. Tissue hypoxia
B. Hyperglycemia only
C. Hypervolemia
D. Excessive protein intake
Correct Answer: A
Rationale: Adequate oxygen is essential for collagen synthesis and bacterial
killing. Hypovolemia and shock reduce perfusion, causing tissue hypoxia and
delayed healing .
5. Stem cells in the bone marrow produce T lymphocytes or T cells and release
them into the vascular system. The T cells then migrate where to mature?
A. Spleen
B. Lymph nodes
C. Thymus
D. Liver
Correct Answer: C
Rationale: T cells mature in the thymus, where they undergo selection to ensure
appropriate antigen recognition and self-tolerance .
,6. A client who has a history of intravenous drug use is diagnosed with hepatitis C.
Which portal of entry likely led to the client's infection?
A. Inhalation
B. Ingestion
C. Penetration
D. Direct contact through intact skin
Correct Answer: C
Rationale: Sharing needles bypasses skin barriers and introduces the virus directly
into the bloodstream—this is infection via penetration through disrupted skin .
7. The first physical line of defense in innate immunity is:
A. Neutrophils and macrophages
B. T and B lymphocytes
C. Skin and mucous membranes
D. Complement proteins
Correct Answer: C
Rationale: Intact skin and mucosal surfaces provide mechanical and chemical
barriers (e.g., acidic pH, mucus, cilia) to prevent pathogen entry before cellular
immune responses are triggered .
8. Which description does the nurse recognize fits a client in the prodromal stage
of an infection?
A. Client has no symptoms but is infected
B. Client is experiencing vague symptoms of fatigue and low-grade fever
C. Client has maximum specific signs and symptoms of the illness
D. Client is recovering and symptoms are resolved
Correct Answer: B
Rationale: The prodromal stage is characterized by nonspecific, mild symptoms
before the full-blown illness phase (e.g., low-grade fever, malaise) .
9. A client is being treated for a pressure injury and the care team has observed that
the wound is healing. Which activity will take place during the proliferative phase?
A. Hemostasis and clot formation
B. Fibroblasts secrete collagen to promote wound healing
, C. Wound contraction by myofibroblasts only
D. Scar remodeling and collagen reorganization
Correct Answer: B
Rationale: During the proliferative phase, fibroblasts produce collagen and
extracellular matrix, new capillaries grow, and granulation tissue fills the wound .
10. A client has developed a skin infection linked to receiving pedicures in a
commercial salon. Which term for the source of transmission will the nurse use
when explaining the source of the client's infection?
A. Vector-borne transmission
B. Transmission via fomites
C. Airborne transmission
D. Vertical transmission
Correct Answer: B
Rationale: Fomites are inanimate objects (e.g., instruments, surfaces) that harbor
pathogens and transmit infection when contaminated .
11. A client underwent an open cholecystectomy 2 days ago, and the incision is
now in the proliferative phase of healing. What is the dominant cellular process
that characterizes this phase of the client's healing?
A. Neutrophil infiltration and clot formation
B. Collagen secretion by fibroblasts
C. Apoptosis of inflammatory cells
D. Scar tissue remodeling
Correct Answer: B
Rationale: The hallmark of the proliferative phase is fibroblast migration and
collagen deposition to rebuild the tissue framework .
12. A client is brought to the physician's office with a raised, red macular rash on
the trunk and arms accompanied by a fever. A diagnosis of measles is made.
Which type of immunity does this disease process provide?
A. Active natural immunity
B. Passive natural immunity
C. Active artificial immunity
D. Passive artificial immunity
COMPLETE 150-QUESTION PRACTICE
EXAM Galen College of Nursing | 2026/2027 |
Questions with Answers & Rationales
SECTION 1: IMMUNITY & INFLAMMATION (Questions 1-35)
1. The nurse is administering a childhood vaccine to a pediatric client. The mother
asks the nurse why the child needs so many vaccinations. How should the nurse
respond?
A. "Immunization is an important means of inhibiting the spread of infection by
decreasing your child's susceptibility to the infection."
B. "Vaccines prevent all infections completely for life."
C. "The more vaccines a child gets, the stronger their immune system becomes
overall."
D. "Vaccines are mainly required for school paperwork."
Correct Answer: A
Rationale: Vaccines induce active immunity and herd protection by reducing
susceptibility and transmission of specific pathogens .
2. The nurse is reviewing assessment documentation of a client's wound and notes
"purulent drainage." The nurse would interpret this as:
A. Exudate containing clear fluid only
B. Exudate containing white blood cells, protein, and tissue debris
C. Exudate consisting primarily of blood
D. Exudate with high fibrin content but no cells
Correct Answer: B
Rationale: Purulent (suppurative) exudate is thick, cloudy, and often yellow/green
due to pus—primarily neutrophils, necrotic cells, and protein .
,3. A newborn has been lethargic and is not nursing well. Testing of cord blood
done at birth reveals the presence of IgM. How should the nurse interpret this
finding?
A. IgM is normally transferred from the mother in utero
B. The presence of IgM suggests the newborn has an infection
C. IgM indicates adequate maternal immunity
D. IgM indicates a normal newborn immune response to breast milk
Correct Answer: B
Rationale: Maternal IgM does not cross the placenta. IgM in cord blood suggests
fetal/neonatal synthesis in response to in utero infection .
4. The nurse is caring for a client who has experienced hypovolemic shock
secondary to penetrating multiple trauma. When caring for the client
postoperatively, which of these factors does the nurse recognize places the client at
risk for poor wound healing?
A. Tissue hypoxia
B. Hyperglycemia only
C. Hypervolemia
D. Excessive protein intake
Correct Answer: A
Rationale: Adequate oxygen is essential for collagen synthesis and bacterial
killing. Hypovolemia and shock reduce perfusion, causing tissue hypoxia and
delayed healing .
5. Stem cells in the bone marrow produce T lymphocytes or T cells and release
them into the vascular system. The T cells then migrate where to mature?
A. Spleen
B. Lymph nodes
C. Thymus
D. Liver
Correct Answer: C
Rationale: T cells mature in the thymus, where they undergo selection to ensure
appropriate antigen recognition and self-tolerance .
,6. A client who has a history of intravenous drug use is diagnosed with hepatitis C.
Which portal of entry likely led to the client's infection?
A. Inhalation
B. Ingestion
C. Penetration
D. Direct contact through intact skin
Correct Answer: C
Rationale: Sharing needles bypasses skin barriers and introduces the virus directly
into the bloodstream—this is infection via penetration through disrupted skin .
7. The first physical line of defense in innate immunity is:
A. Neutrophils and macrophages
B. T and B lymphocytes
C. Skin and mucous membranes
D. Complement proteins
Correct Answer: C
Rationale: Intact skin and mucosal surfaces provide mechanical and chemical
barriers (e.g., acidic pH, mucus, cilia) to prevent pathogen entry before cellular
immune responses are triggered .
8. Which description does the nurse recognize fits a client in the prodromal stage
of an infection?
A. Client has no symptoms but is infected
B. Client is experiencing vague symptoms of fatigue and low-grade fever
C. Client has maximum specific signs and symptoms of the illness
D. Client is recovering and symptoms are resolved
Correct Answer: B
Rationale: The prodromal stage is characterized by nonspecific, mild symptoms
before the full-blown illness phase (e.g., low-grade fever, malaise) .
9. A client is being treated for a pressure injury and the care team has observed that
the wound is healing. Which activity will take place during the proliferative phase?
A. Hemostasis and clot formation
B. Fibroblasts secrete collagen to promote wound healing
, C. Wound contraction by myofibroblasts only
D. Scar remodeling and collagen reorganization
Correct Answer: B
Rationale: During the proliferative phase, fibroblasts produce collagen and
extracellular matrix, new capillaries grow, and granulation tissue fills the wound .
10. A client has developed a skin infection linked to receiving pedicures in a
commercial salon. Which term for the source of transmission will the nurse use
when explaining the source of the client's infection?
A. Vector-borne transmission
B. Transmission via fomites
C. Airborne transmission
D. Vertical transmission
Correct Answer: B
Rationale: Fomites are inanimate objects (e.g., instruments, surfaces) that harbor
pathogens and transmit infection when contaminated .
11. A client underwent an open cholecystectomy 2 days ago, and the incision is
now in the proliferative phase of healing. What is the dominant cellular process
that characterizes this phase of the client's healing?
A. Neutrophil infiltration and clot formation
B. Collagen secretion by fibroblasts
C. Apoptosis of inflammatory cells
D. Scar tissue remodeling
Correct Answer: B
Rationale: The hallmark of the proliferative phase is fibroblast migration and
collagen deposition to rebuild the tissue framework .
12. A client is brought to the physician's office with a raised, red macular rash on
the trunk and arms accompanied by a fever. A diagnosis of measles is made.
Which type of immunity does this disease process provide?
A. Active natural immunity
B. Passive natural immunity
C. Active artificial immunity
D. Passive artificial immunity
