NUR 546/NUR546 Exam 2 V2 | Advanced
Pathophysiology Q&A with Rationale |
William Paterson University
1. A patient with chronic kidney disease (CKD) presents with an ECG showing peaked T waves.
Which electrolyte imbalance should the nurse suspect?
A. Hypocalcemia
B. Hypomagnesemia
C. Hyponatremia
D. Hyperkalemia
Correct Answer: D
Expert Explanation: Hyperkalemia is a common complication in CKD due to the kidney’s
inability to excrete potassium effectively. Peaked T waves are a classic early
electrocardiographic manifestation of elevated serum potassium levels. This condition
requires immediate intervention to prevent progression to ventricular fibrillation or
cardiac arrest.
2. Which mechanism is primarily responsible for the development of pulmonary edema in a
patient with left-sided heart failure?
A. Decreased capillary oncotic pressure
B. Increased systemic vascular resistance
,C. Increased pulmonary capillary hydrostatic pressure
D. Decreased lymphatic drainage
Correct Answer: C
Expert Explanation: In left-sided heart failure, the left ventricle fails to pump blood
efficiently, leading to a backup of blood into the pulmonary circulation. This backup
increases the hydrostatic pressure within the pulmonary capillaries, forcing fluid into the
interstitial spaces and alveoli. This process impairs gas exchange and leads to the clinical
presentation of dyspnea and crackles.
3. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
What is the expected finding regarding serum sodium and osmolarity?
A. Hypernatremia and high serum osmolarity
B. Hyponatremia and low serum osmolarity
C. Hypernatremia and low serum osmolarity
D. Hyponatremia and high serum osmolarity
Correct Answer: B
Expert Explanation: SIADH involves the excessive release of ADH, which causes the
kidneys to reabsorb water regardless of the body’s needs. This excess water dilutes the
blood, resulting in dilutional hyponatremia and a decrease in serum osmolarity.
Understanding the relationship between water retention and solute concentration is
essential for diagnosing this endocrine disorder.
, 4. In the pathogenesis of atherosclerosis, which cell type is responsible for the formation of
‘foam cells’ after ingesting oxidized LDL?
A. Endothelial cells
B. Platelets
C. Smooth muscle cells
D. Macrophages
Correct Answer: D
Expert Explanation: Macrophages migrate into the subendothelial space of the arterial
wall and engulf oxidized low-density lipoproteins (LDL). Once they become overloaded
with lipids, they transform into foam cells, which are a hallmark of early atherosclerotic
plaques. The accumulation of these cells contributes to the inflammatory progression of the
lesion.
5. A patient has a arterial blood gas (ABG) result of pH 7.30, PaCO2 55 mmHg, and HCO3 26
mEq/L. How should the nurse interpret this acid-base imbalance?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Correct Answer: A
Pathophysiology Q&A with Rationale |
William Paterson University
1. A patient with chronic kidney disease (CKD) presents with an ECG showing peaked T waves.
Which electrolyte imbalance should the nurse suspect?
A. Hypocalcemia
B. Hypomagnesemia
C. Hyponatremia
D. Hyperkalemia
Correct Answer: D
Expert Explanation: Hyperkalemia is a common complication in CKD due to the kidney’s
inability to excrete potassium effectively. Peaked T waves are a classic early
electrocardiographic manifestation of elevated serum potassium levels. This condition
requires immediate intervention to prevent progression to ventricular fibrillation or
cardiac arrest.
2. Which mechanism is primarily responsible for the development of pulmonary edema in a
patient with left-sided heart failure?
A. Decreased capillary oncotic pressure
B. Increased systemic vascular resistance
,C. Increased pulmonary capillary hydrostatic pressure
D. Decreased lymphatic drainage
Correct Answer: C
Expert Explanation: In left-sided heart failure, the left ventricle fails to pump blood
efficiently, leading to a backup of blood into the pulmonary circulation. This backup
increases the hydrostatic pressure within the pulmonary capillaries, forcing fluid into the
interstitial spaces and alveoli. This process impairs gas exchange and leads to the clinical
presentation of dyspnea and crackles.
3. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
What is the expected finding regarding serum sodium and osmolarity?
A. Hypernatremia and high serum osmolarity
B. Hyponatremia and low serum osmolarity
C. Hypernatremia and low serum osmolarity
D. Hyponatremia and high serum osmolarity
Correct Answer: B
Expert Explanation: SIADH involves the excessive release of ADH, which causes the
kidneys to reabsorb water regardless of the body’s needs. This excess water dilutes the
blood, resulting in dilutional hyponatremia and a decrease in serum osmolarity.
Understanding the relationship between water retention and solute concentration is
essential for diagnosing this endocrine disorder.
, 4. In the pathogenesis of atherosclerosis, which cell type is responsible for the formation of
‘foam cells’ after ingesting oxidized LDL?
A. Endothelial cells
B. Platelets
C. Smooth muscle cells
D. Macrophages
Correct Answer: D
Expert Explanation: Macrophages migrate into the subendothelial space of the arterial
wall and engulf oxidized low-density lipoproteins (LDL). Once they become overloaded
with lipids, they transform into foam cells, which are a hallmark of early atherosclerotic
plaques. The accumulation of these cells contributes to the inflammatory progression of the
lesion.
5. A patient has a arterial blood gas (ABG) result of pH 7.30, PaCO2 55 mmHg, and HCO3 26
mEq/L. How should the nurse interpret this acid-base imbalance?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Correct Answer: A
