NURS 8022 -- PATHOPHYSIOLOGY
Exam 3 Study Guide
100% Correct -- Complete Practice Exam
Official Practice Exam | 2026/2027 Edition
75 Questions 90 Minutes 80% Passing 5 Sections
TABLE OF CONTENTS
Section 1: Neurological Disorders (18 Questions 1-18)
Section 2: Endocrine Disorders (16 Questions 19-34)
Section 3: Hematological Disorders (14 Questions 35-48)
Section 4: Cardiovascular Disorders (15 Questions 49-63)
Section 5: Renal & Urinary Disorders (12 Questions 64-75)
INSTRUCTIONS
Read each question carefully. Select the single best answer from the four options provided. A scenario introduces each
question with relevant clinical details. Review the rationale after answering to reinforce your understanding. You have 90
minutes to complete all 75 questions. A score of 80% or higher (60 correct) is required to pass.
This practice exam is for educational purposes only.
NURS 8022 Patho Exam 3 Study Guide | 2026/2027 Edition
NURS 8022 Patho Exam 3 -- 2026/2027 | Passing Score: 80% | Page 1
, Section 1: Neurological Disorders -- 2026/2027
Questions 1 - 18 | 18 Questions
Q1 Question 1 of 75
A 68-year-old retired teacher presents to the emergency department with sudden-onset left-sided weakness,
facial drooping, and slurred speech that began 45 minutes ago while she was eating breakfast. Her blood
pressure is 178/102 mm Hg, and a non-contrast CT scan shows no hemorrhage. Which pathophysiological
mechanism best explains her acute presentation?
A. Hemorrhagic stroke from rupture of a berry aneurysm in the circle of Willis
B. Transient ischemic attack caused by temporary vasospasm of the basilar artery
C. Ischemic stroke due to thrombotic occlusion of the right middle cerebral artery
D. Lacunar infarct resulting from lipohyalinosis of small penetrating arteries
Correct Answer: C
Rationale:
The sudden onset of left-sided weakness with facial drooping and slurred speech in the presence of hypertension
and a CT without hemorrhage is classic for an ischemic stroke, most commonly involving the middle cerebral artery
territory. A hemorrhagic stroke would show blood on CT, and a TIA would resolve within 24 hours.
Q2 Question 2 of 75
A 55-year-old man with a history of hypertension and diabetes mellitus type 2 is brought to the clinic by his wife,
who reports that he has been increasingly confused over the past 2 days and has had a low-grade fever. On
examination, he has neck stiffness and a positive Kernig sign. What is the most likely pathogenic process
occurring in this patient?
A. Bacterial meningitis causing inflammation of the meninges and increased intracranial pressure
B. Subarachnoid hemorrhage leading to chemical irritation of the meningeal surfaces
C. Viral encephalitis producing direct neuronal destruction in the temporal lobes
D. Brain abscess forming a localized collection of pus within the cerebral parenchyma
Correct Answer: A
Rationale:
The triad of fever, neck stiffness, and altered mental status with positive Kernig sign strongly suggests bacterial
meningitis, where bacteria invade the subarachnoid space causing intense inflammation. Viral encephalitis typically
presents with seizures and focal deficits rather than prominent meningeal signs.
NURS 8022 Patho Exam 3 -- 2026/2027 | Passing Score: 80% | Page 2
, Q3 Question 3 of 75
A 72-year-old woman with a 10-year history of Parkinson disease is experiencing increased difficulty with
balance and frequent falls despite being on levodopa-carbidopa therapy. Her tremor is less prominent at rest
but re-emerges with sustained posture. Which neurodegenerative change is the primary driver of her postural
instability?
A. Degeneration of Purkinje cells in the cerebellar cortex causing truncal ataxia and incoordination
B. Progressive loss of dopaminergic neurons in the substantia nigra pars compacta leading to basal ganglia
dysfunction
C. Demyelination of corticospinal tracts resulting in spasticity and impaired voluntary motor control
D. Accumulation of neurofibrillary tangles in the hippocampus producing spatial disorientation
Correct Answer: B
Rationale:
Postural instability in advanced Parkinson disease results from continued degeneration of dopaminergic neurons in
the substantia nigra, which disrupts the basal ganglia circuits responsible for postural reflexes. Cerebellar
degeneration would cause ataxia rather than the classic Parkinsonian gait pattern.
Q4 Question 4 of 75
A 34-year-old woman presents with recurring episodes of unilateral throbbing headache accompanied by
nausea, photophobia, and visual aura lasting 20 minutes before the pain begins. Her neurological examination
between attacks is normal. Which pathophysiological sequence most accurately describes the initiation of her
headache?
A. Cortical spreading depression triggering trigeminal nerve activation and subsequent release of calcitonin
gene-related peptide
B. Dilation of cerebral veins in the sagittal sinus causing increased intracranial pressure and referred pain
C. Autoimmune demyelination of the trigeminal nerve root producing paroxysmal lancinating facial pain
D. Sustained vasoconstriction of the internal carotid artery producing ischemic pain in the ipsilateral
hemisphere
Correct Answer: A
Rationale:
Migraine with aura is initiated by cortical spreading depression, a wave of neuronal depolarization followed by
suppression, which activates the trigeminovascular system and releases CGRP, causing neurogenic inflammation
and pain. Vasoconstriction alone does not explain the full migraine cascade.
NURS 8022 Patho Exam 3 -- 2026/2027 | Passing Score: 80% | Page 3
, Q5 Question 5 of 75
A 60-year-old man undergoes a lumbar puncture that reveals an opening pressure of 280 mm H2O, CSF with
1,200 white blood cells (90% neutrophils), glucose of 28 mg/dL, and protein of 180 mg/dL. Gram stain shows
Gram-positive diplococci. Which inflammatory mechanism best accounts for the severely reduced CSF
glucose?
A. Neutrophilic consumption of glucose in the subarachnoid space and impaired transport across the inflamed
blood-brain barrier
B. Bacterial overgrowth within the CSF directly metabolizing available glucose as a primary energy source
C. Hepatic dysfunction reducing systemic glucose production and therefore decreasing CSF glucose
concentration
D. Rapid diffusion of glucose from the CSF into the cerebral interstitial fluid due to damaged ependymal cells
Correct Answer: A
Rationale:
In bacterial meningitis, the massive neutrophilic response consumes glucose in the subarachnoid space, and the
inflamed meninges impair glucose transport across the blood-brain barrier. The glucose is not primarily consumed
by the bacteria themselves, nor by hepatic or ependymal mechanisms.
Q6 Question 6 of 75
A 45-year-old man with a long history of alcohol abuse is admitted with confusion, ataxia, and nystagmus. MRI
shows symmetric hyperintensities in the mammillary bodies and periaqueductal gray. Which biochemical
deficiency is directly responsible for these neurological findings?
A. Pyridoxine deficiency resulting in GABA depletion and generalized seizure activity
B. Niacin deficiency causing pellagra with dermatitis, diarrhea, and diffuse cortical neuronal loss
C. Vitamin B12 deficiency producing subacute combined degeneration of the posterior and lateral columns
D. Thiamine deficiency leading to impaired glucose metabolism and selective vulnerability of mammillary body
neurons
Correct Answer: D
Rationale:
Wernicke encephalopathy results from thiamine deficiency, which impairs glucose metabolism and causes selective
damage to mammillary bodies and periaqueductal gray. Niacin deficiency causes pellagra, and B12 deficiency
affects spinal cord tracts, not the mammillary bodies.
NURS 8022 Patho Exam 3 -- 2026/2027 | Passing Score: 80% | Page 4
Exam 3 Study Guide
100% Correct -- Complete Practice Exam
Official Practice Exam | 2026/2027 Edition
75 Questions 90 Minutes 80% Passing 5 Sections
TABLE OF CONTENTS
Section 1: Neurological Disorders (18 Questions 1-18)
Section 2: Endocrine Disorders (16 Questions 19-34)
Section 3: Hematological Disorders (14 Questions 35-48)
Section 4: Cardiovascular Disorders (15 Questions 49-63)
Section 5: Renal & Urinary Disorders (12 Questions 64-75)
INSTRUCTIONS
Read each question carefully. Select the single best answer from the four options provided. A scenario introduces each
question with relevant clinical details. Review the rationale after answering to reinforce your understanding. You have 90
minutes to complete all 75 questions. A score of 80% or higher (60 correct) is required to pass.
This practice exam is for educational purposes only.
NURS 8022 Patho Exam 3 Study Guide | 2026/2027 Edition
NURS 8022 Patho Exam 3 -- 2026/2027 | Passing Score: 80% | Page 1
, Section 1: Neurological Disorders -- 2026/2027
Questions 1 - 18 | 18 Questions
Q1 Question 1 of 75
A 68-year-old retired teacher presents to the emergency department with sudden-onset left-sided weakness,
facial drooping, and slurred speech that began 45 minutes ago while she was eating breakfast. Her blood
pressure is 178/102 mm Hg, and a non-contrast CT scan shows no hemorrhage. Which pathophysiological
mechanism best explains her acute presentation?
A. Hemorrhagic stroke from rupture of a berry aneurysm in the circle of Willis
B. Transient ischemic attack caused by temporary vasospasm of the basilar artery
C. Ischemic stroke due to thrombotic occlusion of the right middle cerebral artery
D. Lacunar infarct resulting from lipohyalinosis of small penetrating arteries
Correct Answer: C
Rationale:
The sudden onset of left-sided weakness with facial drooping and slurred speech in the presence of hypertension
and a CT without hemorrhage is classic for an ischemic stroke, most commonly involving the middle cerebral artery
territory. A hemorrhagic stroke would show blood on CT, and a TIA would resolve within 24 hours.
Q2 Question 2 of 75
A 55-year-old man with a history of hypertension and diabetes mellitus type 2 is brought to the clinic by his wife,
who reports that he has been increasingly confused over the past 2 days and has had a low-grade fever. On
examination, he has neck stiffness and a positive Kernig sign. What is the most likely pathogenic process
occurring in this patient?
A. Bacterial meningitis causing inflammation of the meninges and increased intracranial pressure
B. Subarachnoid hemorrhage leading to chemical irritation of the meningeal surfaces
C. Viral encephalitis producing direct neuronal destruction in the temporal lobes
D. Brain abscess forming a localized collection of pus within the cerebral parenchyma
Correct Answer: A
Rationale:
The triad of fever, neck stiffness, and altered mental status with positive Kernig sign strongly suggests bacterial
meningitis, where bacteria invade the subarachnoid space causing intense inflammation. Viral encephalitis typically
presents with seizures and focal deficits rather than prominent meningeal signs.
NURS 8022 Patho Exam 3 -- 2026/2027 | Passing Score: 80% | Page 2
, Q3 Question 3 of 75
A 72-year-old woman with a 10-year history of Parkinson disease is experiencing increased difficulty with
balance and frequent falls despite being on levodopa-carbidopa therapy. Her tremor is less prominent at rest
but re-emerges with sustained posture. Which neurodegenerative change is the primary driver of her postural
instability?
A. Degeneration of Purkinje cells in the cerebellar cortex causing truncal ataxia and incoordination
B. Progressive loss of dopaminergic neurons in the substantia nigra pars compacta leading to basal ganglia
dysfunction
C. Demyelination of corticospinal tracts resulting in spasticity and impaired voluntary motor control
D. Accumulation of neurofibrillary tangles in the hippocampus producing spatial disorientation
Correct Answer: B
Rationale:
Postural instability in advanced Parkinson disease results from continued degeneration of dopaminergic neurons in
the substantia nigra, which disrupts the basal ganglia circuits responsible for postural reflexes. Cerebellar
degeneration would cause ataxia rather than the classic Parkinsonian gait pattern.
Q4 Question 4 of 75
A 34-year-old woman presents with recurring episodes of unilateral throbbing headache accompanied by
nausea, photophobia, and visual aura lasting 20 minutes before the pain begins. Her neurological examination
between attacks is normal. Which pathophysiological sequence most accurately describes the initiation of her
headache?
A. Cortical spreading depression triggering trigeminal nerve activation and subsequent release of calcitonin
gene-related peptide
B. Dilation of cerebral veins in the sagittal sinus causing increased intracranial pressure and referred pain
C. Autoimmune demyelination of the trigeminal nerve root producing paroxysmal lancinating facial pain
D. Sustained vasoconstriction of the internal carotid artery producing ischemic pain in the ipsilateral
hemisphere
Correct Answer: A
Rationale:
Migraine with aura is initiated by cortical spreading depression, a wave of neuronal depolarization followed by
suppression, which activates the trigeminovascular system and releases CGRP, causing neurogenic inflammation
and pain. Vasoconstriction alone does not explain the full migraine cascade.
NURS 8022 Patho Exam 3 -- 2026/2027 | Passing Score: 80% | Page 3
, Q5 Question 5 of 75
A 60-year-old man undergoes a lumbar puncture that reveals an opening pressure of 280 mm H2O, CSF with
1,200 white blood cells (90% neutrophils), glucose of 28 mg/dL, and protein of 180 mg/dL. Gram stain shows
Gram-positive diplococci. Which inflammatory mechanism best accounts for the severely reduced CSF
glucose?
A. Neutrophilic consumption of glucose in the subarachnoid space and impaired transport across the inflamed
blood-brain barrier
B. Bacterial overgrowth within the CSF directly metabolizing available glucose as a primary energy source
C. Hepatic dysfunction reducing systemic glucose production and therefore decreasing CSF glucose
concentration
D. Rapid diffusion of glucose from the CSF into the cerebral interstitial fluid due to damaged ependymal cells
Correct Answer: A
Rationale:
In bacterial meningitis, the massive neutrophilic response consumes glucose in the subarachnoid space, and the
inflamed meninges impair glucose transport across the blood-brain barrier. The glucose is not primarily consumed
by the bacteria themselves, nor by hepatic or ependymal mechanisms.
Q6 Question 6 of 75
A 45-year-old man with a long history of alcohol abuse is admitted with confusion, ataxia, and nystagmus. MRI
shows symmetric hyperintensities in the mammillary bodies and periaqueductal gray. Which biochemical
deficiency is directly responsible for these neurological findings?
A. Pyridoxine deficiency resulting in GABA depletion and generalized seizure activity
B. Niacin deficiency causing pellagra with dermatitis, diarrhea, and diffuse cortical neuronal loss
C. Vitamin B12 deficiency producing subacute combined degeneration of the posterior and lateral columns
D. Thiamine deficiency leading to impaired glucose metabolism and selective vulnerability of mammillary body
neurons
Correct Answer: D
Rationale:
Wernicke encephalopathy results from thiamine deficiency, which impairs glucose metabolism and causes selective
damage to mammillary bodies and periaqueductal gray. Niacin deficiency causes pellagra, and B12 deficiency
affects spinal cord tracts, not the mammillary bodies.
NURS 8022 Patho Exam 3 -- 2026/2027 | Passing Score: 80% | Page 4
