NR283 Exam 3 Actual Exam Style V2 | NR
283 Pathophysiology | Chamberlain
NR 283 Pathophysiology – Exam 3 (Actual Exam Style V2)
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1. A patient has a serum sodium level of 128 mEq/L. Which clinical manifestation would the
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nurse expect?
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a) Muscle cramps and hyperreflexia
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b) Thirst and dry mucous membranes
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c) Lethargy and confusion
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d) Tetany and positive Chvostek’s sign
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Correct Answer: c – jh jh jh
Hyponatremia (↓Na) causes cerebral edema, leading to lethargy, confusion, seizures.
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2. Which acid-base imbalance is most likely to occur from prolonged vomiting?
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a) Metabolic acidosis
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b) Metabolic alkalosis
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c) Respiratory acidosis
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d) Respiratory alkalosis
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Correct Answer: b – Loss of gastric acid (HCl) → ↑ bicarbonate → metabolic alkalosis.
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3. A patient with diabetic ketoacidosis (DKA) has deep, rapid respirations. This is best descr
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ibed as: jh
a) Cheyne-Stokes
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b) Biot’s breathing
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,c) Kussmaul breathing
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d) Apneustic breathing
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Correct Answer: c – Kussmaul breathing is compensatory for metabolic acidosis (blows off CO₂).
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4. Which finding is characteristic of Cushing’s syndrome?
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a) Weight loss and heat intolerance
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b) Hyperpigmentation and hypotension
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c) Moon face and buffalo hump
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d) Exophthalmos and pretibial myxedema
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Correct Answer: c – Cortisol excess → central obesity, moon facies, buffalo hump, striae.
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5. A patient with type 1 diabetes mellitus misses an insulin dose. Which lab value would be
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most consistent with this scenario?
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a) Serum pH 7.45
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b) Serum bicarbonate 22 mEq/L
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c) Serum ketones positive
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d) Serum glucose 120 mg/dL
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Correct Answer: c – Insulin deficiency → lipolysis → ketone production (DKA).
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6. The most life-threatening complication of hyperkalemia is:
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a) Muscle weakness
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b) Cardiac dysrhythmias
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c) Metabolic alkalosis
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d) Polyuria
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Correct Answer: b – Hyperkalemia → peaked T waves, widened QRS, risk of V-fib/cardiac arrest.
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7. Which hormone is deficient in diabetes insipidus?
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a) Aldosterone
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b) Cortisol
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c) ADH (vasopressin)
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d) Insulin
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Correct Answer: c – ADH deficiency → inability to concentrate urine → polyuria, polydipsia.
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,8. A patient with cirrhosis has ascites and esophageal varices. These are primarily due to:
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a) Decreased albumin and portal hypertension
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b) Increased aldosterone and hyperglycemia
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c) Bile duct obstruction and steatorrhea
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d) Vitamin K deficiency and thrombocytopenia
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Correct Answer: a – jh jh jh
Portal hypertension → varices; low albumin → decreased oncotic pressure → ascites.
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9. In acute pancreatitis, which lab finding is most specific?
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a) Elevated ALT
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b) Elevated lipase
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c) Elevated ammonia
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d) Elevated creatinine
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Correct Answer: b – Lipase is more specific and sensitive for acute pancreatitis than amylase.
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10. Which condition is most likely to cause hypercalcemia?
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a) Chronic kidney disease
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b) Hypoparathyroidism
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c) Malignancy (e.g., breast, lung cancer)
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d) Rhabdomyolysis
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Correct Answer: c – Malignancy can cause PTHrP secretion, bone metastases → hypercalcemia.
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11. A patient has an ABG: pH 7.30, PaCO₂ 50 mm Hg, HCO₃ 24 mEq/L. This indicates:
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a) Metabolic acidosis
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b) Metabolic alkalosis
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c) Respiratory acidosis
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d) Respiratory alkalosis
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Correct Answer: c – ↓pH, ↑PaCO₂, normal HCO₃ → acute respiratory acidosis.
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12. Which manifestation is common in both hyperthyroidism and hypothyroidism?
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a) Weight gain
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b) Goiter
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c) Heat intolerance
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d) Bradycardia
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, Correct Answer: b – jh jh jh
Goiter can occur in both (due to TSH stimulation in hypothyroid; autoimmune stimulation in hype
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rthyroid).
13. In syndrome of inappropriate antidiuretic hormone (SIADH), which lab abnormality is e
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xpected?
a) Hypernatremia
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b) Hyponatremia
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c) Hyperkalemia
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d) Hypoglycemia
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Correct Answer: b – Excess ADH → water retention → dilutional hyponatremia.
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14. A classic sign of hypoparathyroidism is:
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a) Positive Trousseau’s sign
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b) Bone pain and kidney stones
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c) Polyuria and polydipsia
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d) Thyroid bruit
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Correct Answer: a – jh jh jh
Hypocalcemia from hypoparathyroidism → neuromuscular irritability → Trousseau’s/Chvostek’s.
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15. Which statement best describes the pathophysiology of type 2 diabetes?
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a) Autoimmune destruction of pancreatic beta cells
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b) Insulin resistance and relative insulin deficiency
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c) Absolute deficiency of ADH
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d) Excess cortisol secretion
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Correct Answer: b – jh jh jh
Type 2 DM is characterized by insulin resistance + eventual beta cell dysfunction.
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16. A patient with chronic kidney disease (CKD) develops metabolic acidosis. This is primari
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ly due to:
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a) Inability to excrete H⁺ and regenerate HCO₃⁻
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b) Increased aldosterone secretion
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c) Respiratory muscle weakness
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d) Excessive vomiting
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Correct Answer: a – Kidneys fail to excrete acid or make new bicarbonate → metabolic acidosis.
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283 Pathophysiology | Chamberlain
NR 283 Pathophysiology – Exam 3 (Actual Exam Style V2)
jh jh jh jh jh jh jh jh jh
1. A patient has a serum sodium level of 128 mEq/L. Which clinical manifestation would the
jh jh jh jh jh jh jh jh jh jh jh jh jh jh jh j
nurse expect?
h jh
a) Muscle cramps and hyperreflexia
jh jh jh jh
b) Thirst and dry mucous membranes
jh jh jh jh jh
c) Lethargy and confusion
jh jh jh
d) Tetany and positive Chvostek’s sign
jh jh jh jh jh
Correct Answer: c – jh jh jh
Hyponatremia (↓Na) causes cerebral edema, leading to lethargy, confusion, seizures.
jh jh jh jh jh jh jh jh jh jh
2. Which acid-base imbalance is most likely to occur from prolonged vomiting?
jh jh jh jh jh jh jh jh jh jh jh
a) Metabolic acidosis
jh jh
b) Metabolic alkalosis
jh jh
c) Respiratory acidosis
jh jh
d) Respiratory alkalosis
jh jh
Correct Answer: b – Loss of gastric acid (HCl) → ↑ bicarbonate → metabolic alkalosis.
jh jh jh jh jh jh jh jh jh jh jh jh jh jh
3. A patient with diabetic ketoacidosis (DKA) has deep, rapid respirations. This is best descr
jh jh jh jh jh jh jh jh jh jh jh jh jh jh
ibed as: jh
a) Cheyne-Stokes
jh
b) Biot’s breathing
jh jh
,c) Kussmaul breathing
jh jh
d) Apneustic breathing
jh jh
Correct Answer: c – Kussmaul breathing is compensatory for metabolic acidosis (blows off CO₂).
jh jh jh jh jh jh jh jh jh jh jh jh jh
4. Which finding is characteristic of Cushing’s syndrome?
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a) Weight loss and heat intolerance
jh jh jh jh jh
b) Hyperpigmentation and hypotension
jh jh jh
c) Moon face and buffalo hump
jh jh jh jh jh
d) Exophthalmos and pretibial myxedema
jh jh jh jh
Correct Answer: c – Cortisol excess → central obesity, moon facies, buffalo hump, striae.
jh jh jh jh jh jh jh jh jh jh jh jh jh
5. A patient with type 1 diabetes mellitus misses an insulin dose. Which lab value would be
jh jh jh jh jh jh jh jh jh jh jh jh jh jh jh jh jh
most consistent with this scenario?
jh jh jh jh
a) Serum pH 7.45
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b) Serum bicarbonate 22 mEq/L
jh jh jh jh
c) Serum ketones positive
jh jh jh
d) Serum glucose 120 mg/dL
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Correct Answer: c – Insulin deficiency → lipolysis → ketone production (DKA).
jh jh jh jh jh jh jh jh jh jh jh
6. The most life-threatening complication of hyperkalemia is:
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a) Muscle weakness
jh jh
b) Cardiac dysrhythmias
jh jh
c) Metabolic alkalosis
jh jh
d) Polyuria
jh
Correct Answer: b – Hyperkalemia → peaked T waves, widened QRS, risk of V-fib/cardiac arrest.
jh jh jh jh jh jh jh jh jh jh jh jh jh jh
7. Which hormone is deficient in diabetes insipidus?
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a) Aldosterone
jh
b) Cortisol
jh
c) ADH (vasopressin)
jh jh
d) Insulin
jh
Correct Answer: c – ADH deficiency → inability to concentrate urine → polyuria, polydipsia.
jh jh jh jh jh jh jh jh jh jh jh jh jh
,8. A patient with cirrhosis has ascites and esophageal varices. These are primarily due to:
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a) Decreased albumin and portal hypertension
jh jh jh jh jh
b) Increased aldosterone and hyperglycemia
jh jh jh jh
c) Bile duct obstruction and steatorrhea
jh jh jh jh jh
d) Vitamin K deficiency and thrombocytopenia
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Correct Answer: a – jh jh jh
Portal hypertension → varices; low albumin → decreased oncotic pressure → ascites.
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9. In acute pancreatitis, which lab finding is most specific?
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a) Elevated ALT
jh jh
b) Elevated lipase
jh jh
c) Elevated ammonia
jh jh
d) Elevated creatinine
jh jh
Correct Answer: b – Lipase is more specific and sensitive for acute pancreatitis than amylase.
jh jh jh jh jh jh jh jh jh jh jh jh jh jh
10. Which condition is most likely to cause hypercalcemia?
jh jh jh jh jh jh jh jh
a) Chronic kidney disease
jh jh jh
b) Hypoparathyroidism
jh
c) Malignancy (e.g., breast, lung cancer)
jh jh jh jh jh
d) Rhabdomyolysis
jh
Correct Answer: c – Malignancy can cause PTHrP secretion, bone metastases → hypercalcemia.
jh jh jh jh jh jh jh jh jh jh jh jh
11. A patient has an ABG: pH 7.30, PaCO₂ 50 mm Hg, HCO₃ 24 mEq/L. This indicates:
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a) Metabolic acidosis
jh jh
b) Metabolic alkalosis
jh jh
c) Respiratory acidosis
jh jh
d) Respiratory alkalosis
jh jh
Correct Answer: c – ↓pH, ↑PaCO₂, normal HCO₃ → acute respiratory acidosis.
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12. Which manifestation is common in both hyperthyroidism and hypothyroidism?
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a) Weight gain
jh jh
b) Goiter
jh
c) Heat intolerance
jh jh
d) Bradycardia
jh
, Correct Answer: b – jh jh jh
Goiter can occur in both (due to TSH stimulation in hypothyroid; autoimmune stimulation in hype
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rthyroid).
13. In syndrome of inappropriate antidiuretic hormone (SIADH), which lab abnormality is e
jh jh jh jh jh jh jh jh jh jh jh jh
xpected?
a) Hypernatremia
jh
b) Hyponatremia
jh
c) Hyperkalemia
jh
d) Hypoglycemia
jh
Correct Answer: b – Excess ADH → water retention → dilutional hyponatremia.
jh jh jh jh jh jh jh jh jh jh jh
14. A classic sign of hypoparathyroidism is:
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a) Positive Trousseau’s sign
jh jh jh
b) Bone pain and kidney stones
jh jh jh jh jh
c) Polyuria and polydipsia
jh jh jh
d) Thyroid bruit
jh jh
Correct Answer: a – jh jh jh
Hypocalcemia from hypoparathyroidism → neuromuscular irritability → Trousseau’s/Chvostek’s.
jh jh jh jh jh jh jh jh
15. Which statement best describes the pathophysiology of type 2 diabetes?
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a) Autoimmune destruction of pancreatic beta cells
jh jh jh jh jh jh
b) Insulin resistance and relative insulin deficiency
jh jh jh jh jh jh
c) Absolute deficiency of ADH
jh jh jh jh
d) Excess cortisol secretion
jh jh jh
Correct Answer: b – jh jh jh
Type 2 DM is characterized by insulin resistance + eventual beta cell dysfunction.
jh jh jh jh jh jh jh jh jh jh jh jh jh
16. A patient with chronic kidney disease (CKD) develops metabolic acidosis. This is primari
jh jh jh jh jh jh jh jh jh jh jh jh jh
ly due to:
jh jh
a) Inability to excrete H⁺ and regenerate HCO₃⁻
jh jh jh jh jh jh jh
b) Increased aldosterone secretion
jh jh jh
c) Respiratory muscle weakness
jh jh jh
d) Excessive vomiting
jh jh
Correct Answer: a – Kidneys fail to excrete acid or make new bicarbonate → metabolic acidosis.
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