NR283 Pathophysiology Final Exam Prep –
Chamberlain University NR 283 Questions
and Well Graded Solutions with Rationales
Updated 2026-2027
Master your Chamberlain University NR283 Pathophysiology course with this comprehensive
final exam study guide. Covers high-yield nursing exam questions, answers, and detailed
rationales tracing complex disease mechanisms. Perfect prep for cellular adaptations, fluid and
electrolyte shifts, acid-base balance, cardiovascular disorders, renal failure, and endocrine
pathology. Align your weekly EdDapt modules and prep directly for your NR 283 milestone
testing to pass your BSN filter class.
1|Page
,1. A patient experiences myocardial infarction due to arterial occlusion. Which type of
cellular necrosis occurs in the myocardial tissue?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
A. Coagulative necrosis
Rationale: Coagulative necrosis typically occurs in solid organs like the heart,
kidneys, and adrenal glands following severe ischemia, preserving the basic
structural outline of the tissue for several days.
2. A 45-year-old female presents with enlargement of her thyroid gland due to
increased cellular workload and stimulation. This adaptive cellular change is known
as:
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
C. Hyperplasia
Rationale: Hyperplasia is an increase in the number of cells in an organ or tissue,
which often occurs alongside hypertrophy in response to hormonal stimulation or
increased functional demand.
3. A chronic smoker undergoes a bronchoscopy, which reveals that the normal ciliated
columnar epithelium of the airways has been replaced by stratified squamous
epithelium. What is this cellular adaptation called?
A. Anaplasia
B. Dysplasia
C. Metaplasia
D. Hyperplasia
C. Metaplasia
Rationale: Metaplasia is a reversible change in which one adult cell type is replaced
by another adult cell type better able to withstand the chronic irritation or stress.
4. Which of the following cells are the first responders to migrate to the site of an acute
inflammatory injury?
A. Macrophages
B. Neutrophils
C. Lymphocytes
D. Eosinophils
B. Neutrophils
Rationale: Neutrophils, also known as polymorphonuclear leukocytes, are the
primary and earliest cellular responders in acute inflammation, arriving within 6 to 24
hours.
5. A patient with a severe bacterial infection exhibits a shift to the left on their complete
blood count (CBC). What does this term indicate?
A. An increase in mature lymphocytes
2|Page
, B. An increase in immature neutrophils (bands)
C. A decrease in total white blood cells
D. An elevation in platelet production
B. An increase in immature neutrophils (bands)
Rationale: A "shift to the left" refers to an increase in the percentage of immature
neutrophils (band cells) released from the bone marrow during an acute, severe
infection.
6. What is the primary cause of edema in a patient diagnosed with severe liver failure
and protein malnutrition?
A. Increased capillary hydrostatic pressure
B. Decreased capillary oncotic pressure
C. Increased capillary permeability
D. Lymphatic obstruction
B. Decreased capillary oncotic pressure
Rationale: The liver synthesizes albumin, the primary protein responsible for
maintaining capillary oncotic (colloid) pressure. Liver failure leads to
hypoalbuminemia, causing fluid to leak into the interstitial spaces.
7. A patient has a serum sodium level of 118 mEq/L. Which clinical manifestation is the
priority concern for the nurse due to intracellular fluid shifts?
A. Muscle cramping
B. Confusion and seizures
C. Postural hypotension
D. Dry mucous membranes
B. Confusion and seizures
Rationale: Severe hyponatremia causes an osmotic fluid shift from the extracellular
space into the brain cells, leading to cerebral edema, which presents as confusion,
lethargy, seizures, and potential coma.
8. An arterial blood gas (ABG) report shows pH 7.28, PaCO2 55 mmHg, and HCO3 24
mEq/L. Which acid-base imbalance is present?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
B. Respiratory acidosis
Rationale: The pH is below 7.35 (acidosis) and the PaCO2 is elevated above 45
mmHg (respiratory source), while the bicarbonate is normal, indicating an
uncompensated respiratory acidosis.
9. A patient with an elevated serum potassium level of 6.8 mEq/L is at high risk for
which dangerous physiological complication?
A. Skeletal muscle tetany
B. Cardiac dysrhythmias
C. Paralytic ileus
D. Prolonged bleeding times
B. Cardiac dysrhythmias
Rationale: Hyperkalemia alters the resting membrane potential of cardiac myocytes,
which can lead to life-threatening dysrhythmias, characteristically presenting with
peaked T waves and prolonged PR intervals.
10. Which hormone is released by the posterior pituitary gland in response to high serum
osmolality or decreased circulating blood volume to cause water reabsorption?
A. Aldosterone
3|Page
, B. Antidiuretic hormone (ADH)
C. Atrial natriuretic peptide (ANP)
D. Cortisol
B. Antidiuretic hormone (ADH)
Rationale: Antidiuretic hormone (ADH) increases the water permeability of the renal
collecting ducts, causing water retention to lower serum osmolality and expand
intravascular volume.
11. A patient presents to the emergency department with an anaphylactic reaction to
penicillin. Which type of hypersensitivity reaction is occurring?
A. Type I (Immediate)
B. Type II (Cytotoxic)
C. Type III (Immune complex)
D. Type IV (Delayed)
A. Type I (Immediate)
Rationale: Anaphylaxis is a classic Type I hypersensitivity reaction mediated by IgE
antibodies, which trigger immediate mast cell degranulation and systemic histamine
release.
12. A blood transfusion reaction involving ABO incompatibility, where host antibodies
destroy donor red blood cells, is an example of which hypersensitivity type?
A. Type I
B. Type II
C. Type III
D. Type IV
B. Type II
Rationale: Type II hypersensitivity reactions are tissue-specific or cytotoxic reactions
where antibodies (IgG or IgM) bind to antigens on cell surfaces, activating the
complement cascade and causing cell lysis.
13. Which of the following conditions represents a classic Type III hypersensitivity
reaction characterized by the systemic deposition of antigen-antibody complexes in
tissues?
A. Allergic rhinitis
B. Systemic lupus erythematosus (SLE)
C. Poison ivy dermatitis
D. Graft-versus-host disease
B. Systemic lupus erythematosus (SLE)
Rationale: SLE is an autoimmune disorder where immune complexes deposit in
various tissues (such as joints, skin, and kidneys), causing complement activation
and widespread inflammatory damage.
14. A positive tuberculin (PPD) skin test reading 48 hours after injection is mediated by
which of the following immune components?
A. IgE antibodies and mast cells
B. Immune complexes and neutrophils
C. T lymphocytes and macrophages
D. IgG antibodies and complement
C. T lymphocytes and macrophages
Rationale: The PPD skin test is a classic example of a Type IV cell-mediated
(delayed) hypersensitivity reaction, which relies on sensitized T lymphocytes reacting
to the antigen over 24 to 72 hours.
15. What is the fundamental pathophysiological mechanism underlying all autoimmune
diseases?
4|Page
Chamberlain University NR 283 Questions
and Well Graded Solutions with Rationales
Updated 2026-2027
Master your Chamberlain University NR283 Pathophysiology course with this comprehensive
final exam study guide. Covers high-yield nursing exam questions, answers, and detailed
rationales tracing complex disease mechanisms. Perfect prep for cellular adaptations, fluid and
electrolyte shifts, acid-base balance, cardiovascular disorders, renal failure, and endocrine
pathology. Align your weekly EdDapt modules and prep directly for your NR 283 milestone
testing to pass your BSN filter class.
1|Page
,1. A patient experiences myocardial infarction due to arterial occlusion. Which type of
cellular necrosis occurs in the myocardial tissue?
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis
A. Coagulative necrosis
Rationale: Coagulative necrosis typically occurs in solid organs like the heart,
kidneys, and adrenal glands following severe ischemia, preserving the basic
structural outline of the tissue for several days.
2. A 45-year-old female presents with enlargement of her thyroid gland due to
increased cellular workload and stimulation. This adaptive cellular change is known
as:
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
C. Hyperplasia
Rationale: Hyperplasia is an increase in the number of cells in an organ or tissue,
which often occurs alongside hypertrophy in response to hormonal stimulation or
increased functional demand.
3. A chronic smoker undergoes a bronchoscopy, which reveals that the normal ciliated
columnar epithelium of the airways has been replaced by stratified squamous
epithelium. What is this cellular adaptation called?
A. Anaplasia
B. Dysplasia
C. Metaplasia
D. Hyperplasia
C. Metaplasia
Rationale: Metaplasia is a reversible change in which one adult cell type is replaced
by another adult cell type better able to withstand the chronic irritation or stress.
4. Which of the following cells are the first responders to migrate to the site of an acute
inflammatory injury?
A. Macrophages
B. Neutrophils
C. Lymphocytes
D. Eosinophils
B. Neutrophils
Rationale: Neutrophils, also known as polymorphonuclear leukocytes, are the
primary and earliest cellular responders in acute inflammation, arriving within 6 to 24
hours.
5. A patient with a severe bacterial infection exhibits a shift to the left on their complete
blood count (CBC). What does this term indicate?
A. An increase in mature lymphocytes
2|Page
, B. An increase in immature neutrophils (bands)
C. A decrease in total white blood cells
D. An elevation in platelet production
B. An increase in immature neutrophils (bands)
Rationale: A "shift to the left" refers to an increase in the percentage of immature
neutrophils (band cells) released from the bone marrow during an acute, severe
infection.
6. What is the primary cause of edema in a patient diagnosed with severe liver failure
and protein malnutrition?
A. Increased capillary hydrostatic pressure
B. Decreased capillary oncotic pressure
C. Increased capillary permeability
D. Lymphatic obstruction
B. Decreased capillary oncotic pressure
Rationale: The liver synthesizes albumin, the primary protein responsible for
maintaining capillary oncotic (colloid) pressure. Liver failure leads to
hypoalbuminemia, causing fluid to leak into the interstitial spaces.
7. A patient has a serum sodium level of 118 mEq/L. Which clinical manifestation is the
priority concern for the nurse due to intracellular fluid shifts?
A. Muscle cramping
B. Confusion and seizures
C. Postural hypotension
D. Dry mucous membranes
B. Confusion and seizures
Rationale: Severe hyponatremia causes an osmotic fluid shift from the extracellular
space into the brain cells, leading to cerebral edema, which presents as confusion,
lethargy, seizures, and potential coma.
8. An arterial blood gas (ABG) report shows pH 7.28, PaCO2 55 mmHg, and HCO3 24
mEq/L. Which acid-base imbalance is present?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
B. Respiratory acidosis
Rationale: The pH is below 7.35 (acidosis) and the PaCO2 is elevated above 45
mmHg (respiratory source), while the bicarbonate is normal, indicating an
uncompensated respiratory acidosis.
9. A patient with an elevated serum potassium level of 6.8 mEq/L is at high risk for
which dangerous physiological complication?
A. Skeletal muscle tetany
B. Cardiac dysrhythmias
C. Paralytic ileus
D. Prolonged bleeding times
B. Cardiac dysrhythmias
Rationale: Hyperkalemia alters the resting membrane potential of cardiac myocytes,
which can lead to life-threatening dysrhythmias, characteristically presenting with
peaked T waves and prolonged PR intervals.
10. Which hormone is released by the posterior pituitary gland in response to high serum
osmolality or decreased circulating blood volume to cause water reabsorption?
A. Aldosterone
3|Page
, B. Antidiuretic hormone (ADH)
C. Atrial natriuretic peptide (ANP)
D. Cortisol
B. Antidiuretic hormone (ADH)
Rationale: Antidiuretic hormone (ADH) increases the water permeability of the renal
collecting ducts, causing water retention to lower serum osmolality and expand
intravascular volume.
11. A patient presents to the emergency department with an anaphylactic reaction to
penicillin. Which type of hypersensitivity reaction is occurring?
A. Type I (Immediate)
B. Type II (Cytotoxic)
C. Type III (Immune complex)
D. Type IV (Delayed)
A. Type I (Immediate)
Rationale: Anaphylaxis is a classic Type I hypersensitivity reaction mediated by IgE
antibodies, which trigger immediate mast cell degranulation and systemic histamine
release.
12. A blood transfusion reaction involving ABO incompatibility, where host antibodies
destroy donor red blood cells, is an example of which hypersensitivity type?
A. Type I
B. Type II
C. Type III
D. Type IV
B. Type II
Rationale: Type II hypersensitivity reactions are tissue-specific or cytotoxic reactions
where antibodies (IgG or IgM) bind to antigens on cell surfaces, activating the
complement cascade and causing cell lysis.
13. Which of the following conditions represents a classic Type III hypersensitivity
reaction characterized by the systemic deposition of antigen-antibody complexes in
tissues?
A. Allergic rhinitis
B. Systemic lupus erythematosus (SLE)
C. Poison ivy dermatitis
D. Graft-versus-host disease
B. Systemic lupus erythematosus (SLE)
Rationale: SLE is an autoimmune disorder where immune complexes deposit in
various tissues (such as joints, skin, and kidneys), causing complement activation
and widespread inflammatory damage.
14. A positive tuberculin (PPD) skin test reading 48 hours after injection is mediated by
which of the following immune components?
A. IgE antibodies and mast cells
B. Immune complexes and neutrophils
C. T lymphocytes and macrophages
D. IgG antibodies and complement
C. T lymphocytes and macrophages
Rationale: The PPD skin test is a classic example of a Type IV cell-mediated
(delayed) hypersensitivity reaction, which relies on sensitized T lymphocytes reacting
to the antigen over 24 to 72 hours.
15. What is the fundamental pathophysiological mechanism underlying all autoimmune
diseases?
4|Page
