NR283 Exam 2 Actual Exam Style V2 | NR
283 Pathophysiology | Chamberlain
1. A patient is admitted with a pH of 7.25, PaCO2 of 50 mmHg, and HCO3 of 26 mEq/L. Which
acid-base imbalance does this represent?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Respiratory Acidosis
Correct Answer: D
Expert Explanation: The pH level is below 7.35, indicating an acidic state in the blood. The
PaCO2 is elevated above 45 mmHg, which suggests a respiratory cause for the acidity. This
condition occurs when the lungs fail to adequately eliminate carbon dioxide from the body.
2. Which clinical manifestation is most characteristic of left-sided heart failure?
A. Crackles in the lungs
B. Peripheral Edema
C. Jugular Venous Distention (JVD)
D. Hepatomegaly
Correct Answer: A
,Expert Explanation: Left-sided heart failure causes blood to back up into the pulmonary
circulation. This leads to increased hydrostatic pressure in the pulmonary capillaries and
fluid leaking into the alveoli. Consequently, patients often present with shortness of breath
and crackles upon auscultation.
3. A patient presents with a serum potassium level of 6.5 mEq/L. Which ECG change should
the nurse monitor for?
A. U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Prominent P waves
Correct Answer: C
Expert Explanation: Hyperkalemia is defined as a serum potassium level greater than 5.0
mEq/L. Elevated potassium levels affect the repolarization phase of the cardiac action
potential. This typically manifests as tall, peaked T waves on a 12-lead ECG.
4. What is the primary underlying pathophysiology of emphysema?
A. Destruction of the alveolar walls
B. Infection and inflammation of the bronchi
C. Reversible bronchospasm
D. Excessive mucus production in the airway
, Correct Answer: A
Expert Explanation: Emphysema is characterized by the permanent enlargement of gas-
exchange airways. It involves the destruction of alveolar walls and loss of elastic recoil in
the lung tissue. This leads to air trapping and difficulty with expiration.
5. A patient with a positive Chvostek sign most likely has which electrolyte imbalance?
A. Hypercalcemia
B. Hyponatremia
C. Hyperkalemia
D. Hypocalcemia
Correct Answer: D
Expert Explanation: Chvostek sign is an abnormal reaction to the stimulation of the facial
nerve. It is a classic clinical indicator of hypocalcemia or hypomagnesemia. The lack of
calcium increases neuromuscular excitability, causing the facial muscle to twitch.
6. Which type of shock is caused by a severe allergic reaction?
A. Septic shock
B. Anaphylactic shock
C. Hypovolemic shock
D. Neurogenic shock
Correct Answer: B
283 Pathophysiology | Chamberlain
1. A patient is admitted with a pH of 7.25, PaCO2 of 50 mmHg, and HCO3 of 26 mEq/L. Which
acid-base imbalance does this represent?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Respiratory Acidosis
Correct Answer: D
Expert Explanation: The pH level is below 7.35, indicating an acidic state in the blood. The
PaCO2 is elevated above 45 mmHg, which suggests a respiratory cause for the acidity. This
condition occurs when the lungs fail to adequately eliminate carbon dioxide from the body.
2. Which clinical manifestation is most characteristic of left-sided heart failure?
A. Crackles in the lungs
B. Peripheral Edema
C. Jugular Venous Distention (JVD)
D. Hepatomegaly
Correct Answer: A
,Expert Explanation: Left-sided heart failure causes blood to back up into the pulmonary
circulation. This leads to increased hydrostatic pressure in the pulmonary capillaries and
fluid leaking into the alveoli. Consequently, patients often present with shortness of breath
and crackles upon auscultation.
3. A patient presents with a serum potassium level of 6.5 mEq/L. Which ECG change should
the nurse monitor for?
A. U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Prominent P waves
Correct Answer: C
Expert Explanation: Hyperkalemia is defined as a serum potassium level greater than 5.0
mEq/L. Elevated potassium levels affect the repolarization phase of the cardiac action
potential. This typically manifests as tall, peaked T waves on a 12-lead ECG.
4. What is the primary underlying pathophysiology of emphysema?
A. Destruction of the alveolar walls
B. Infection and inflammation of the bronchi
C. Reversible bronchospasm
D. Excessive mucus production in the airway
, Correct Answer: A
Expert Explanation: Emphysema is characterized by the permanent enlargement of gas-
exchange airways. It involves the destruction of alveolar walls and loss of elastic recoil in
the lung tissue. This leads to air trapping and difficulty with expiration.
5. A patient with a positive Chvostek sign most likely has which electrolyte imbalance?
A. Hypercalcemia
B. Hyponatremia
C. Hyperkalemia
D. Hypocalcemia
Correct Answer: D
Expert Explanation: Chvostek sign is an abnormal reaction to the stimulation of the facial
nerve. It is a classic clinical indicator of hypocalcemia or hypomagnesemia. The lack of
calcium increases neuromuscular excitability, causing the facial muscle to twitch.
6. Which type of shock is caused by a severe allergic reaction?
A. Septic shock
B. Anaphylactic shock
C. Hypovolemic shock
D. Neurogenic shock
Correct Answer: B
