NR507 Final Exam 2026 / NR 507 Week 8
Exam Advanced Pathophysiology
Expected Questions and Answers –
Chamberlain.
**1. Which process results in the movement of water between the ICF
and ECF compartments?**
A. Active transport
B. Facilitated diffusion
C. **Osmosis**
D. Endocytosis
**Rationale:** Osmosis is the movement of water across a
semipermeable membrane from an area of low solute concentration to
high solute concentration. While active transport and diffusion move
solutes, only osmosis specifically governs water distribution to maintain
osmotic equilibrium between intracellular fluid (ICF) and extracellular
fluid (ECF) .
**2. A patient has a pH of 7.22 and a PaCO2 of 60. This is characteristic
of:**
A. Metabolic Acidosis
B. **Respiratory Acidosis**
C. Metabolic Alkalosis
,D. Respiratory Alkalosis
**Rationale:** A pH below 7.35 indicates acidosis. The elevated PaCO2
(normal is 35-45) indicates that hypoventilation is the cause, making
this a primary respiratory acidosis. In metabolic acidosis, the bicarb
(HCO3) would be low, not the CO2 high .
**3. Which type of cell adaptation occurs when the lining of the
esophagus changes from squamous to columnar cells due to chronic
acid reflux?**
A. Atrophy
B. Hyperplasia
C. **Metaplasia**
D. Dysplasia
**Rationale:** Metaplasia is the reversible replacement of one
differentiated cell type with another. In Barrett's esophagus, the
squamous epithelium converts to columnar epithelium to better handle
the chronic acid stress, though this increases cancer risk .
**4. What is the primary mechanism of cellular injury during a
myocardial infarction?**
A. Calcium accumulation
B. **Hypoxic injury due to ischemia**
C. Free radical formation
,D. Chemical toxicity
**Rationale:** Ischemia halts aerobic metabolism, stopping ATP
production. This causes the sodium-potassium pump to fail, leading to
cellular swelling, calcium influx, and eventually cell death if perfusion is
not restored .
### Fluid & Electrolytes
**5. Which electrolyte imbalance is a common cause of flattened T-
waves and the presence of U-waves on an EKG?**
A. Hyperkalemia
B. **Hypokalemia**
C. Hypercalcemia
D. Hyponatremia
**Rationale:** Hypokalemia (low potassium) delays ventricular
repolarization. This results in specific ECG changes including ST
depression, T wave flattening/inversion, and the appearance of a
prominent U wave .
**6. Which type of shock is caused by a massive loss of blood or
fluids?**
A. Cardiogenic
, B. Distributive
C. **Hypovolemic**
D. Obstructive
**Rationale:** Hypovolemic shock occurs when intravascular volume is
depleted (hemorrhage, burns, dehydration) to the point that the heart
cannot pump enough blood to the body. Cardiogenic is pump failure,
while distributive involves severe vasodilation .
**7. What is the physiological effect of Aldosterone?**
A. Excretion of sodium and water
B. **Retention of sodium and water; excretion of potassium**
C. Retention of potassium; excretion of sodium
D. Vasodilation
**Rationale:** Aldosterone acts on the distal tubules of the kidney to
increase sodium reabsorption and potassium excretion. "Water follows
sodium," so this also increases blood volume and blood pressure .
### Immunology & Inflammation
**8. In the inflammatory response, which cells are the "first
responders" that arrive at the site of injury?**
A. Macrophages
Exam Advanced Pathophysiology
Expected Questions and Answers –
Chamberlain.
**1. Which process results in the movement of water between the ICF
and ECF compartments?**
A. Active transport
B. Facilitated diffusion
C. **Osmosis**
D. Endocytosis
**Rationale:** Osmosis is the movement of water across a
semipermeable membrane from an area of low solute concentration to
high solute concentration. While active transport and diffusion move
solutes, only osmosis specifically governs water distribution to maintain
osmotic equilibrium between intracellular fluid (ICF) and extracellular
fluid (ECF) .
**2. A patient has a pH of 7.22 and a PaCO2 of 60. This is characteristic
of:**
A. Metabolic Acidosis
B. **Respiratory Acidosis**
C. Metabolic Alkalosis
,D. Respiratory Alkalosis
**Rationale:** A pH below 7.35 indicates acidosis. The elevated PaCO2
(normal is 35-45) indicates that hypoventilation is the cause, making
this a primary respiratory acidosis. In metabolic acidosis, the bicarb
(HCO3) would be low, not the CO2 high .
**3. Which type of cell adaptation occurs when the lining of the
esophagus changes from squamous to columnar cells due to chronic
acid reflux?**
A. Atrophy
B. Hyperplasia
C. **Metaplasia**
D. Dysplasia
**Rationale:** Metaplasia is the reversible replacement of one
differentiated cell type with another. In Barrett's esophagus, the
squamous epithelium converts to columnar epithelium to better handle
the chronic acid stress, though this increases cancer risk .
**4. What is the primary mechanism of cellular injury during a
myocardial infarction?**
A. Calcium accumulation
B. **Hypoxic injury due to ischemia**
C. Free radical formation
,D. Chemical toxicity
**Rationale:** Ischemia halts aerobic metabolism, stopping ATP
production. This causes the sodium-potassium pump to fail, leading to
cellular swelling, calcium influx, and eventually cell death if perfusion is
not restored .
### Fluid & Electrolytes
**5. Which electrolyte imbalance is a common cause of flattened T-
waves and the presence of U-waves on an EKG?**
A. Hyperkalemia
B. **Hypokalemia**
C. Hypercalcemia
D. Hyponatremia
**Rationale:** Hypokalemia (low potassium) delays ventricular
repolarization. This results in specific ECG changes including ST
depression, T wave flattening/inversion, and the appearance of a
prominent U wave .
**6. Which type of shock is caused by a massive loss of blood or
fluids?**
A. Cardiogenic
, B. Distributive
C. **Hypovolemic**
D. Obstructive
**Rationale:** Hypovolemic shock occurs when intravascular volume is
depleted (hemorrhage, burns, dehydration) to the point that the heart
cannot pump enough blood to the body. Cardiogenic is pump failure,
while distributive involves severe vasodilation .
**7. What is the physiological effect of Aldosterone?**
A. Excretion of sodium and water
B. **Retention of sodium and water; excretion of potassium**
C. Retention of potassium; excretion of sodium
D. Vasodilation
**Rationale:** Aldosterone acts on the distal tubules of the kidney to
increase sodium reabsorption and potassium excretion. "Water follows
sodium," so this also increases blood volume and blood pressure .
### Immunology & Inflammation
**8. In the inflammatory response, which cells are the "first
responders" that arrive at the site of injury?**
A. Macrophages
