1
NURSING 2451
PATHOPHYSIOLOGY
EXAM Q & A
2024
1. A patient with chronic obstructive pulmonary disease (COPD) presents
with dyspnea, wheezes, and productive cough. The nurse suspects that
the patient has developed a respiratory infection. Which of the
following laboratory tests would be most useful to confirm this
diagnosis?
A) Arterial blood gas (ABG) analysis
B) Chest x-ray
C) Sputum culture*
D) Pulmonary function test
Rationale: A sputum culture can identify the causative organism of a
respiratory infection and guide the appropriate antibiotic therapy. ABG
, 2
analysis can assess the gas exchange and acid-base balance of the
patient, but it cannot diagnose an infection. Chest x-ray can show the
presence of consolidation, atelectasis, or pleural effusion, but it cannot
differentiate between bacterial, viral, or fungal infections. Pulmonary
function test can measure the lung volumes and capacities, but it
cannot detect an infection.
2. A patient with type 1 diabetes mellitus is admitted to the hospital with
diabetic ketoacidosis (DKA). The patient reports that he forgot to take
his insulin for the past two days due to stress. Which of the following
signs and symptoms would the nurse expect to find in this patient?
A) Hypoglycemia, hypotension, and bradycardia
B) Hyperglycemia, dehydration, and Kussmaul respirations*
C) Hypoglycemia, edema, and crackles
D) Hyperglycemia, hypokalemia, and muscle weakness
Rationale: DKA is a life-threatening complication of type 1 diabetes mellitus
that occurs when the body breaks down fat for energy due to insulin
deficiency. This results in the production of ketones, which are acidic
byproducts that cause metabolic acidosis. The signs and symptoms of
DKA include hyperglycemia (blood glucose > 250 mg/dL), dehydration
(due to osmotic diuresis and fluid loss), and Kussmaul respirations
(deep and rapid breathing to compensate for acidosis). Hypoglycemia,
hypotension, and bradycardia are signs of insulin overdose or
hypoglycemic shock. Hypoglycemia, edema, and crackles are signs of
heart failure or fluid overload. Hyperglycemia, hypokalemia, and
, 3
muscle weakness are signs of hyperosmolar hyperglycemic state (HHS),
which is another complication of diabetes mellitus that occurs mainly in
type 2 diabetes.
3. A patient with chronic kidney disease (CKD) is scheduled for
hemodialysis. The nurse reviews the patient's laboratory results and
notes that the patient has a serum calcium level of 7.8 mg/dL (normal
range: 8.5-10.5 mg/dL) and a serum phosphorus level of 6.2 mg/dL
(normal range: 2.5-4.5 mg/dL). Which of the following interventions
would be most appropriate for this patient?
A) Administer calcium carbonate tablets before meals*
B) Restrict dietary intake of calcium-rich foods
C) Increase fluid intake to promote diuresis
D) Administer sodium phosphate enema as ordered
Rationale: CKD can cause mineral and bone disorders due to impaired renal
excretion of phosphorus and reduced production of active vitamin D,
which is needed for calcium absorption. This leads to hypocalcemia and
hyperphosphatemia, which stimulate the parathyroid gland to secrete
parathyroid hormone (PTH). PTH increases bone resorption and
releases calcium and phosphorus into the bloodstream, further
worsening the condition. The goal of treatment is to lower serum
phosphorus and increase serum calcium levels. Calcium carbonate
tablets are phosphate binders that prevent phosphorus absorption
from the gastrointestinal tract and also provide supplemental calcium.
Dietary restriction of phosphorus-rich foods (such as dairy products,
, 4
nuts, beans, and cola drinks) is also recommended. Increasing fluid
intake or administering sodium phosphate enema would not help lower
serum phosphorus levels and may cause fluid overload or electrolyte
imbalance.
4. A patient with systemic lupus erythematosus (SLE) is prescribed
prednisone, a corticosteroid medication, to reduce inflammation and
suppress immune system activity. The nurse instructs the patient about
the potential adverse effects of long-term corticosteroid therapy.
Which of the following statements by the patient indicates a need for
further teaching?
A) "I should avoid contact with people who are sick or have infections."
B) "I should take my medication with food or milk to prevent stomach
upset."
C) "I should report any signs of bleeding, bruising, or petechiae to my
doctor."
D) "I should stop taking my medication if I experience weight gain or mood
changes."*
Rationale: Corticosteroids have anti-inflammatory and immunosuppressive
effects, but they also have many adverse effects, such as increased risk
of infection, gastrointestinal ulceration, bleeding, osteoporosis,
hyperglycemia, fluid retention, weight gain, mood changes, and adrenal
insufficiency. Patients who are taking corticosteroids should avoid
contact with people who are sick or have infections, take their
medication with food or milk to prevent stomach upset, and report any
NURSING 2451
PATHOPHYSIOLOGY
EXAM Q & A
2024
1. A patient with chronic obstructive pulmonary disease (COPD) presents
with dyspnea, wheezes, and productive cough. The nurse suspects that
the patient has developed a respiratory infection. Which of the
following laboratory tests would be most useful to confirm this
diagnosis?
A) Arterial blood gas (ABG) analysis
B) Chest x-ray
C) Sputum culture*
D) Pulmonary function test
Rationale: A sputum culture can identify the causative organism of a
respiratory infection and guide the appropriate antibiotic therapy. ABG
, 2
analysis can assess the gas exchange and acid-base balance of the
patient, but it cannot diagnose an infection. Chest x-ray can show the
presence of consolidation, atelectasis, or pleural effusion, but it cannot
differentiate between bacterial, viral, or fungal infections. Pulmonary
function test can measure the lung volumes and capacities, but it
cannot detect an infection.
2. A patient with type 1 diabetes mellitus is admitted to the hospital with
diabetic ketoacidosis (DKA). The patient reports that he forgot to take
his insulin for the past two days due to stress. Which of the following
signs and symptoms would the nurse expect to find in this patient?
A) Hypoglycemia, hypotension, and bradycardia
B) Hyperglycemia, dehydration, and Kussmaul respirations*
C) Hypoglycemia, edema, and crackles
D) Hyperglycemia, hypokalemia, and muscle weakness
Rationale: DKA is a life-threatening complication of type 1 diabetes mellitus
that occurs when the body breaks down fat for energy due to insulin
deficiency. This results in the production of ketones, which are acidic
byproducts that cause metabolic acidosis. The signs and symptoms of
DKA include hyperglycemia (blood glucose > 250 mg/dL), dehydration
(due to osmotic diuresis and fluid loss), and Kussmaul respirations
(deep and rapid breathing to compensate for acidosis). Hypoglycemia,
hypotension, and bradycardia are signs of insulin overdose or
hypoglycemic shock. Hypoglycemia, edema, and crackles are signs of
heart failure or fluid overload. Hyperglycemia, hypokalemia, and
, 3
muscle weakness are signs of hyperosmolar hyperglycemic state (HHS),
which is another complication of diabetes mellitus that occurs mainly in
type 2 diabetes.
3. A patient with chronic kidney disease (CKD) is scheduled for
hemodialysis. The nurse reviews the patient's laboratory results and
notes that the patient has a serum calcium level of 7.8 mg/dL (normal
range: 8.5-10.5 mg/dL) and a serum phosphorus level of 6.2 mg/dL
(normal range: 2.5-4.5 mg/dL). Which of the following interventions
would be most appropriate for this patient?
A) Administer calcium carbonate tablets before meals*
B) Restrict dietary intake of calcium-rich foods
C) Increase fluid intake to promote diuresis
D) Administer sodium phosphate enema as ordered
Rationale: CKD can cause mineral and bone disorders due to impaired renal
excretion of phosphorus and reduced production of active vitamin D,
which is needed for calcium absorption. This leads to hypocalcemia and
hyperphosphatemia, which stimulate the parathyroid gland to secrete
parathyroid hormone (PTH). PTH increases bone resorption and
releases calcium and phosphorus into the bloodstream, further
worsening the condition. The goal of treatment is to lower serum
phosphorus and increase serum calcium levels. Calcium carbonate
tablets are phosphate binders that prevent phosphorus absorption
from the gastrointestinal tract and also provide supplemental calcium.
Dietary restriction of phosphorus-rich foods (such as dairy products,
, 4
nuts, beans, and cola drinks) is also recommended. Increasing fluid
intake or administering sodium phosphate enema would not help lower
serum phosphorus levels and may cause fluid overload or electrolyte
imbalance.
4. A patient with systemic lupus erythematosus (SLE) is prescribed
prednisone, a corticosteroid medication, to reduce inflammation and
suppress immune system activity. The nurse instructs the patient about
the potential adverse effects of long-term corticosteroid therapy.
Which of the following statements by the patient indicates a need for
further teaching?
A) "I should avoid contact with people who are sick or have infections."
B) "I should take my medication with food or milk to prevent stomach
upset."
C) "I should report any signs of bleeding, bruising, or petechiae to my
doctor."
D) "I should stop taking my medication if I experience weight gain or mood
changes."*
Rationale: Corticosteroids have anti-inflammatory and immunosuppressive
effects, but they also have many adverse effects, such as increased risk
of infection, gastrointestinal ulceration, bleeding, osteoporosis,
hyperglycemia, fluid retention, weight gain, mood changes, and adrenal
insufficiency. Patients who are taking corticosteroids should avoid
contact with people who are sick or have infections, take their
medication with food or milk to prevent stomach upset, and report any
