NSG 3280 EXAM 3 PRACTICE QUESTIONS &
VERIFIED ANSWERS 2026 | GALEN COLLEGE
OF NURSING PATHOPHYSIOLOGY REVIEW,
DISEASE PROCESSES, CLINICAL
MANIFESTATIONS & NURSING
INTERVENTIONS GUIDE
• This practice exam contains 200 verified multiple-choice questions covering all key
Pathophysiology topics tested in NSG 3280 at Galen College of Nursing — use it by
attempting each question independently before revealing the correct answer and
EXPERT RATIONALE beneath.
• Each question follows a consistent format: bolded stem, five lettered options (A–
E), a highlighted correct answer with EXPERT RATIONALE — ideal for active recall,
timed practice, or final review sessions.
NSG 3280 EXAM 3 PRACTICE QUESTIONS & VERIFIED ANSWERS 2026 GALEN
COLLEGE OF NURSING | PATHOPHYSIOLOGY REVIEW
1. A patient with chronic obstructive pulmonary disease (COPD) presents with
a barrel chest. Which pathophysiological mechanism best explains this
finding?
A. Pulmonary fibrosis causing lung contraction
B. Repeated pneumonia causing pleural thickening
C. Increased mucus production compressing the thorax
D. Lobar consolidation from retained secretions
E. Air trapping due to loss of elastic recoil causing hyperinflation
EXPERT RATIONALE: In COPD, destruction of alveolar walls reduces elastic recoil,
leading to air trapping and hyperinflation. Over time, the chest assumes a fixed, over-
expanded "barrel" shape with increased anteroposterior diameter.
,2. Which arterial blood gas (ABG) pattern is most consistent with acute
respiratory acidosis?
A. pH 7.48, PaCO₂ 30, HCO₃ 22
B. pH 7.44, PaCO₂ 40, HCO₃ 24
C. pH 7.50, PaCO₂ 48, HCO₃ 30
D. pH 7.38, PaCO₂ 42, HCO₃ 25
E. pH 7.28, PaCO₂ 58, HCO₃ 24
EXPERT RATIONALE: Respiratory acidosis is characterized by a low pH and elevated
PaCO₂ due to CO₂ retention from hypoventilation. The HCO₃ is normal in the acute
phase because renal compensation has not yet occurred.
3. A nurse is caring for a patient with asthma in an acute exacerbation. Which
assessment finding requires the most immediate intervention?
A. Expiratory wheezing bilaterally
B. Respiratory rate of 22 breaths/min
C. Mild use of accessory muscles
D. SpO₂ of 93% on room air
E. Absence of breath sounds with silent chest
EXPERT RATIONALE: A silent chest in an asthma patient indicates severe bronchospasm
with minimal air movement — a life-threatening emergency requiring immediate
intervention including high-flow oxygen, bronchodilators, and possible intubation.
4. Which of the following best describes the pathophysiology of Type 1
Diabetes Mellitus?
A. Peripheral insulin resistance with relative insulin deficiency
B. Excess glucagon secretion from alpha cells
,C. Reduced incretin effect in the small intestine
D. Hepatic overproduction of glucose despite normal insulin
E. Autoimmune destruction of pancreatic beta cells leading to absolute
insulin deficiency
EXPERT RATIONALE: Type 1 DM results from autoimmune-mediated destruction of
pancreatic beta cells, resulting in an absolute lack of insulin. Patients require exogenous
insulin for survival and are prone to diabetic ketoacidosis (DKA).
5. A patient presents with polyuria, polydipsia, and a blood glucose of 520
mg/dL with a serum pH of 7.20 and positive urine ketones. Which condition is
most likely?
A. Hyperosmolar Hyperglycemic State (HHS)
B. Type 2 diabetes with hyperglycemia
C. Syndrome of inappropriate ADH (SIADH)
D. Diabetes insipidus
E. Diabetic Ketoacidosis (DKA)
EXPERT RATIONALE: DKA is characterized by hyperglycemia, metabolic acidosis (pH
<7.35), and ketonemia/ketonuria. It occurs predominantly in Type 1 DM due to absolute
insulin deficiency leading to lipolysis and ketone body production.
6. Which electrolyte imbalance is most dangerous in a patient with Addison's
disease?
A. Hypernatremia
B. Hypercalcemia
C. Hypophosphatemia
D. Hypomagnesemia
, E. Hyperkalemia
EXPERT RATIONALE: In Addison's disease, deficient aldosterone causes sodium loss and
potassium retention. Hyperkalemia can lead to life-threatening cardiac dysrhythmias
and must be corrected promptly.
7. A patient with heart failure has an ejection fraction of 35%. Which of the
following best describes this finding?
A. Normal systolic function with diastolic dysfunction
B. Preserved ejection fraction heart failure
C. Right-sided heart failure only
D. Mild systolic dysfunction requiring no intervention
E. Reduced ejection fraction indicating systolic dysfunction
EXPERT RATIONALE: Normal ejection fraction is 55–70%. An EF of 35% indicates the
heart is pumping less than half its volume with each contraction, consistent with systolic
heart failure (HFrEF), requiring aggressive pharmacological management.
8. Which of the following is a classic early sign of left-sided heart failure?
A. Peripheral edema
B. Jugular vein distension
C. Hepatomegaly
D. Ascites
E. Dyspnea on exertion and orthopnea
EXPERT RATIONALE: Left-sided heart failure causes pulmonary congestion. The earliest
symptoms include dyspnea on exertion and orthopnea (difficulty breathing when lying
flat) due to fluid redistribution into the pulmonary vasculature.
VERIFIED ANSWERS 2026 | GALEN COLLEGE
OF NURSING PATHOPHYSIOLOGY REVIEW,
DISEASE PROCESSES, CLINICAL
MANIFESTATIONS & NURSING
INTERVENTIONS GUIDE
• This practice exam contains 200 verified multiple-choice questions covering all key
Pathophysiology topics tested in NSG 3280 at Galen College of Nursing — use it by
attempting each question independently before revealing the correct answer and
EXPERT RATIONALE beneath.
• Each question follows a consistent format: bolded stem, five lettered options (A–
E), a highlighted correct answer with EXPERT RATIONALE — ideal for active recall,
timed practice, or final review sessions.
NSG 3280 EXAM 3 PRACTICE QUESTIONS & VERIFIED ANSWERS 2026 GALEN
COLLEGE OF NURSING | PATHOPHYSIOLOGY REVIEW
1. A patient with chronic obstructive pulmonary disease (COPD) presents with
a barrel chest. Which pathophysiological mechanism best explains this
finding?
A. Pulmonary fibrosis causing lung contraction
B. Repeated pneumonia causing pleural thickening
C. Increased mucus production compressing the thorax
D. Lobar consolidation from retained secretions
E. Air trapping due to loss of elastic recoil causing hyperinflation
EXPERT RATIONALE: In COPD, destruction of alveolar walls reduces elastic recoil,
leading to air trapping and hyperinflation. Over time, the chest assumes a fixed, over-
expanded "barrel" shape with increased anteroposterior diameter.
,2. Which arterial blood gas (ABG) pattern is most consistent with acute
respiratory acidosis?
A. pH 7.48, PaCO₂ 30, HCO₃ 22
B. pH 7.44, PaCO₂ 40, HCO₃ 24
C. pH 7.50, PaCO₂ 48, HCO₃ 30
D. pH 7.38, PaCO₂ 42, HCO₃ 25
E. pH 7.28, PaCO₂ 58, HCO₃ 24
EXPERT RATIONALE: Respiratory acidosis is characterized by a low pH and elevated
PaCO₂ due to CO₂ retention from hypoventilation. The HCO₃ is normal in the acute
phase because renal compensation has not yet occurred.
3. A nurse is caring for a patient with asthma in an acute exacerbation. Which
assessment finding requires the most immediate intervention?
A. Expiratory wheezing bilaterally
B. Respiratory rate of 22 breaths/min
C. Mild use of accessory muscles
D. SpO₂ of 93% on room air
E. Absence of breath sounds with silent chest
EXPERT RATIONALE: A silent chest in an asthma patient indicates severe bronchospasm
with minimal air movement — a life-threatening emergency requiring immediate
intervention including high-flow oxygen, bronchodilators, and possible intubation.
4. Which of the following best describes the pathophysiology of Type 1
Diabetes Mellitus?
A. Peripheral insulin resistance with relative insulin deficiency
B. Excess glucagon secretion from alpha cells
,C. Reduced incretin effect in the small intestine
D. Hepatic overproduction of glucose despite normal insulin
E. Autoimmune destruction of pancreatic beta cells leading to absolute
insulin deficiency
EXPERT RATIONALE: Type 1 DM results from autoimmune-mediated destruction of
pancreatic beta cells, resulting in an absolute lack of insulin. Patients require exogenous
insulin for survival and are prone to diabetic ketoacidosis (DKA).
5. A patient presents with polyuria, polydipsia, and a blood glucose of 520
mg/dL with a serum pH of 7.20 and positive urine ketones. Which condition is
most likely?
A. Hyperosmolar Hyperglycemic State (HHS)
B. Type 2 diabetes with hyperglycemia
C. Syndrome of inappropriate ADH (SIADH)
D. Diabetes insipidus
E. Diabetic Ketoacidosis (DKA)
EXPERT RATIONALE: DKA is characterized by hyperglycemia, metabolic acidosis (pH
<7.35), and ketonemia/ketonuria. It occurs predominantly in Type 1 DM due to absolute
insulin deficiency leading to lipolysis and ketone body production.
6. Which electrolyte imbalance is most dangerous in a patient with Addison's
disease?
A. Hypernatremia
B. Hypercalcemia
C. Hypophosphatemia
D. Hypomagnesemia
, E. Hyperkalemia
EXPERT RATIONALE: In Addison's disease, deficient aldosterone causes sodium loss and
potassium retention. Hyperkalemia can lead to life-threatening cardiac dysrhythmias
and must be corrected promptly.
7. A patient with heart failure has an ejection fraction of 35%. Which of the
following best describes this finding?
A. Normal systolic function with diastolic dysfunction
B. Preserved ejection fraction heart failure
C. Right-sided heart failure only
D. Mild systolic dysfunction requiring no intervention
E. Reduced ejection fraction indicating systolic dysfunction
EXPERT RATIONALE: Normal ejection fraction is 55–70%. An EF of 35% indicates the
heart is pumping less than half its volume with each contraction, consistent with systolic
heart failure (HFrEF), requiring aggressive pharmacological management.
8. Which of the following is a classic early sign of left-sided heart failure?
A. Peripheral edema
B. Jugular vein distension
C. Hepatomegaly
D. Ascites
E. Dyspnea on exertion and orthopnea
EXPERT RATIONALE: Left-sided heart failure causes pulmonary congestion. The earliest
symptoms include dyspnea on exertion and orthopnea (difficulty breathing when lying
flat) due to fluid redistribution into the pulmonary vasculature.
