WGU | D236
OBJECTIVE ASSESSMENT REVIEW
WGU D236
Pathophysiology Review
100 Original Study Questions with Answers and Rationales
| 2026/2027
Independent educational review; not official WGU content, not verified OA questions, and not a
guarantee of passing.
100 100 2026/2027
QUESTIONS ORIGINAL ITEMS EDITION
TOPICS COVERED
Homeostasis and cellular injury Cardiopulmonary and renal disease
Fluid, electrolyte, and acid-base Neuro, skin, bone, and joint disease
Immune and hematologic disorders Endocrine, GI, genetic disorders
COVER PAGE - 1
WGU D236 Pathophysiology Review - 2026/2027 | Passing Score: 80% | Page 1 of 43
,WGU D236 Pathophysiology Review
100 Original Study Questions with Answers and Rationales | 2026/2027
Independent educational review; not official WGU content, not verified OA questions, and not a guarantee of passing.
Section Questions High-yield focus
Homeostasis and Cellular Responses Q1-Q20 homeostasis, cellular adaptation, acid-base imbalance, fluid and electrolytes
Immune, Hematologic, and Oncologic Disorders
Q21-Q40 immune responses, hypersensitivity, anemias, coagulation disorders
Cardiovascular, Pulmonary, and Renal Disorders
Q41-Q60 hypertension, heart failure, thromboembolism, gas exchange
Neurologic, Musculoskeletal, and Integumentary
Q61-Q80
Disorders stroke, increased intracranial pressure, neuromuscular disorders, bone and joint dise
Endocrine, Gastrointestinal, Reproductive, and
Q81-Q100
Genetic Disordersdiabetes, thyroid and adrenal disorders, pancreatic and liver disease, GI inflammatio
WGU D236 Pathophysiology Review - 2026/2027 | Passing Score: 80% | Page 2 of 43
, SECTION 1 | Homeostasis and Cellular Responses | Q1-Q20 | WGU D236 Pathophysiology Review
2026/2027
Q1 Question 1 of 100
DKA Pattern
Glucose Ketones HCO3 pH
Measure
A 22-year-old client with type 1 diabetes arrives with fruity breath, abdominal pain, and deep
rapid respirations. Laboratory results show glucose 486 mg/dL, low bicarbonate, and a high
anion gap.
A. Metabolic acidosis caused by ketoacid accumulation.
B. Respiratory alkalosis caused by excessive carbon dioxide retention.
C. Metabolic alkalosis caused by prolonged gastric acid loss.
D. Normal acid-base balance with compensatory bicarbonate retention.
Correct Answer: A
Rationale:
Diabetic ketoacidosis produces ketoacids that lower bicarbonate and increase the anion gap. Kussmaul respirations
are compensation for metabolic acidosis, not primary respiratory alkalosis.
Q2 Question 2 of 100
A 68-year-old client with severe COPD is increasingly drowsy and has shallow respirations.
Arterial blood gas results show pH 7.29 and PaCO2 62 mm Hg.
A. Metabolic acidosis from renal bicarbonate wasting.
B. Respiratory acidosis from hypoventilation and carbon dioxide retention.
C. Respiratory alkalosis from excessive carbon dioxide elimination.
D. Metabolic alkalosis from chloride depletion after vomiting.
Correct Answer: B
Rationale:
Hypoventilation causes carbon dioxide retention, which forms carbonic acid and lowers pH. COPD exacerbations
commonly produce respiratory acidosis when ventilation is inadequate.
WGU D236 Pathophysiology Review - 2026/2027 | Passing Score: 80% | Page 3 of 43
, Q3 Question 3 of 100
A 47-year-old client has had persistent vomiting for two days and now reports weakness and
dizziness. The provider suspects an acid-base disturbance related to loss of gastric secretions.
A. Respiratory acidosis from carbon dioxide retention.
B. Metabolic acidosis from excess lactic acid production.
C. Metabolic alkalosis from loss of hydrogen and chloride ions.
D. Respiratory alkalosis from inadequate ventilation.
Correct Answer: C
Rationale:
Vomiting removes gastric acid, producing alkalosis and often chloride depletion. The primary problem is metabolic
because bicarbonate becomes relatively elevated.
Q4 Question 4 of 100
A 73-year-old client with a small-cell lung tumor has confusion, serum sodium 118 mEq/L, low
serum osmolality, and concentrated urine. The nurse connects these findings to inappropriate
antidiuretic hormone release.
A. Sodium retention raises serum sodium and causes severe hypertonicity.
B. Osmotic diuresis removes water and causes hypernatremia.
C. Aldosterone deficiency directly causes concentrated urine and high sodium.
D. Water retention dilutes serum sodium and causes hypo-osmolality.
Correct Answer: D
Rationale:
SIADH causes excess water reabsorption, diluting serum sodium while urine remains concentrated. The problem is
water excess relative to sodium rather than sodium overload.
Q5 Question 5 of 100
A 35-year-old client develops extreme thirst and large volumes of dilute urine after head trauma.
Serum sodium is 154 mEq/L, and urine specific gravity is very low.
A. Diabetes insipidus from inadequate antidiuretic hormone effect.
B. Syndrome of inappropriate antidiuretic hormone from excess water retention.
C. Primary adrenal insufficiency from low cortisol and aldosterone.
D. Hyperaldosteronism from excessive sodium and water loss.
Correct Answer: A
Rationale:
Diabetes insipidus causes inability to concentrate urine, producing polyuria and hypernatremia. SIADH would instead
cause water retention and hyponatremia.
WGU D236 Pathophysiology Review - 2026/2027 | Passing Score: 80% | Page 4 of 43
OBJECTIVE ASSESSMENT REVIEW
WGU D236
Pathophysiology Review
100 Original Study Questions with Answers and Rationales
| 2026/2027
Independent educational review; not official WGU content, not verified OA questions, and not a
guarantee of passing.
100 100 2026/2027
QUESTIONS ORIGINAL ITEMS EDITION
TOPICS COVERED
Homeostasis and cellular injury Cardiopulmonary and renal disease
Fluid, electrolyte, and acid-base Neuro, skin, bone, and joint disease
Immune and hematologic disorders Endocrine, GI, genetic disorders
COVER PAGE - 1
WGU D236 Pathophysiology Review - 2026/2027 | Passing Score: 80% | Page 1 of 43
,WGU D236 Pathophysiology Review
100 Original Study Questions with Answers and Rationales | 2026/2027
Independent educational review; not official WGU content, not verified OA questions, and not a guarantee of passing.
Section Questions High-yield focus
Homeostasis and Cellular Responses Q1-Q20 homeostasis, cellular adaptation, acid-base imbalance, fluid and electrolytes
Immune, Hematologic, and Oncologic Disorders
Q21-Q40 immune responses, hypersensitivity, anemias, coagulation disorders
Cardiovascular, Pulmonary, and Renal Disorders
Q41-Q60 hypertension, heart failure, thromboembolism, gas exchange
Neurologic, Musculoskeletal, and Integumentary
Q61-Q80
Disorders stroke, increased intracranial pressure, neuromuscular disorders, bone and joint dise
Endocrine, Gastrointestinal, Reproductive, and
Q81-Q100
Genetic Disordersdiabetes, thyroid and adrenal disorders, pancreatic and liver disease, GI inflammatio
WGU D236 Pathophysiology Review - 2026/2027 | Passing Score: 80% | Page 2 of 43
, SECTION 1 | Homeostasis and Cellular Responses | Q1-Q20 | WGU D236 Pathophysiology Review
2026/2027
Q1 Question 1 of 100
DKA Pattern
Glucose Ketones HCO3 pH
Measure
A 22-year-old client with type 1 diabetes arrives with fruity breath, abdominal pain, and deep
rapid respirations. Laboratory results show glucose 486 mg/dL, low bicarbonate, and a high
anion gap.
A. Metabolic acidosis caused by ketoacid accumulation.
B. Respiratory alkalosis caused by excessive carbon dioxide retention.
C. Metabolic alkalosis caused by prolonged gastric acid loss.
D. Normal acid-base balance with compensatory bicarbonate retention.
Correct Answer: A
Rationale:
Diabetic ketoacidosis produces ketoacids that lower bicarbonate and increase the anion gap. Kussmaul respirations
are compensation for metabolic acidosis, not primary respiratory alkalosis.
Q2 Question 2 of 100
A 68-year-old client with severe COPD is increasingly drowsy and has shallow respirations.
Arterial blood gas results show pH 7.29 and PaCO2 62 mm Hg.
A. Metabolic acidosis from renal bicarbonate wasting.
B. Respiratory acidosis from hypoventilation and carbon dioxide retention.
C. Respiratory alkalosis from excessive carbon dioxide elimination.
D. Metabolic alkalosis from chloride depletion after vomiting.
Correct Answer: B
Rationale:
Hypoventilation causes carbon dioxide retention, which forms carbonic acid and lowers pH. COPD exacerbations
commonly produce respiratory acidosis when ventilation is inadequate.
WGU D236 Pathophysiology Review - 2026/2027 | Passing Score: 80% | Page 3 of 43
, Q3 Question 3 of 100
A 47-year-old client has had persistent vomiting for two days and now reports weakness and
dizziness. The provider suspects an acid-base disturbance related to loss of gastric secretions.
A. Respiratory acidosis from carbon dioxide retention.
B. Metabolic acidosis from excess lactic acid production.
C. Metabolic alkalosis from loss of hydrogen and chloride ions.
D. Respiratory alkalosis from inadequate ventilation.
Correct Answer: C
Rationale:
Vomiting removes gastric acid, producing alkalosis and often chloride depletion. The primary problem is metabolic
because bicarbonate becomes relatively elevated.
Q4 Question 4 of 100
A 73-year-old client with a small-cell lung tumor has confusion, serum sodium 118 mEq/L, low
serum osmolality, and concentrated urine. The nurse connects these findings to inappropriate
antidiuretic hormone release.
A. Sodium retention raises serum sodium and causes severe hypertonicity.
B. Osmotic diuresis removes water and causes hypernatremia.
C. Aldosterone deficiency directly causes concentrated urine and high sodium.
D. Water retention dilutes serum sodium and causes hypo-osmolality.
Correct Answer: D
Rationale:
SIADH causes excess water reabsorption, diluting serum sodium while urine remains concentrated. The problem is
water excess relative to sodium rather than sodium overload.
Q5 Question 5 of 100
A 35-year-old client develops extreme thirst and large volumes of dilute urine after head trauma.
Serum sodium is 154 mEq/L, and urine specific gravity is very low.
A. Diabetes insipidus from inadequate antidiuretic hormone effect.
B. Syndrome of inappropriate antidiuretic hormone from excess water retention.
C. Primary adrenal insufficiency from low cortisol and aldosterone.
D. Hyperaldosteronism from excessive sodium and water loss.
Correct Answer: A
Rationale:
Diabetes insipidus causes inability to concentrate urine, producing polyuria and hypernatremia. SIADH would instead
cause water retention and hyponatremia.
WGU D236 Pathophysiology Review - 2026/2027 | Passing Score: 80% | Page 4 of 43
