Pathophysiology (NR 283) Final Exam – Chamberlain University
Study Guide, Practice Questions & Comprehensive Exam Review 3
versions
Comprehensive study resource for NR 283 Pathophysiology at Chamberlain University. This
guide covers major pathophysiology concepts across all course units, including cellular
adaptation and injury, inflammation, immunity, fluid and electrolyte balance, acid-base
disorders, cardiovascular, respiratory, hematologic, endocrine, neurological, gastrointestinal,
renal, urinary, and reproductive system disorders. Includes practice questions, answer
explanations, concept summaries, and exam-focused review material designed to help nursing
students reinforce key concepts, strengthen clinical reasoning, and prepare effectively for the
final exam.
Question 1
A patient with chronic hypertension develops left ventricular hypertrophy. This cellular
change is best described as:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Rationale: Hypertrophy is an increase in cell size due to increased workload. Chronic
hypertension increases afterload, causing cardiac myocytes to enlarge. Hyperplasia is
increased cell number. Atrophy is decreased cell size. Metaplasia is one cell type replacing
another.
Question 2
Which type of necrosis is most commonly seen in the brain following a stroke?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
,Rationale: The brain has high lipid content and few connective tissue cells. Ischemic injury
triggers enzymatic digestion, turning tissue into liquid (liquefactive necrosis). Coagulative
necrosis occurs in heart, kidney, liver. Caseous occurs in TB. Fat necrosis occurs in pancreas
or breast.
Question 3
A patient with a bacterial infection has a fever. Which cytokines act as endogenous
pyrogens?
A) Interferons and colony-stimulating factors
B) Interleukin-1, interleukin-6, and tumor necrosis factor
C) Complement proteins C3a and C5a
D) Histamine and bradykinin
*Rationale: Endogenous pyrogens (IL-1, IL-6, TNF) are released from macrophages and
act on the hypothalamus to raise the temperature set point, causing fever. Interferons
are antiviral. Complement and histamine/bradykinin are inflammatory mediators but not
primary pyrogens.*
Question 4
A patient with heart failure has pitting edema in the lower extremities. The primary
mechanism is:
A) Decreased capillary hydrostatic pressure
B) Increased capillary hydrostatic pressure
C) Decreased capillary permeability
D) Increased plasma oncotic pressure
Rationale: Heart failure increases venous pressure, which increases capillary hydrostatic
pressure, forcing fluid into interstitial space, causing edema. Decreased oncotic pressure
(nephrotic syndrome) also causes edema but is not the primary mechanism in heart
failure.
,Question 5
A patient has a serum sodium of 125 mEq/L (hyponatremia). Which neurologic finding is
most concerning?
A) Thirst
B) Seizures and altered mental status
C) Dry mucous membranes
D) Muscle cramps
Rationale: Severe hyponatremia causes cerebral edema as water shifts into brain cells,
leading to confusion, seizures, coma, and respiratory arrest. Thirst and dry mucous
membranes suggest hypernatremia. Muscle cramps can occur but are less immediately
life-threatening.
Question 6
A patient with vomiting and nasogastric suction develops metabolic alkalosis. Which
electrolyte imbalance commonly accompanies this?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
Rationale: Loss of gastric acid (HCl) causes metabolic alkalosis. Hypokalemia often
accompanies metabolic alkalosis because kidneys excrete potassium to retain hydrogen
ions. Vomiting also directly loses potassium from gastric fluid.
Question 7
A patient with chronic kidney disease has anemia. The primary cause is:
, A) Iron deficiency
B) Decreased erythropoietin production
C) Hemolysis
D) Folate deficiency
Rationale: Kidneys produce erythropoietin (EPO), which stimulates RBC production.
Chronic kidney disease damages EPO-producing cells, leading to normocytic
normochromic anemia. Iron and folate deficiencies may coexist but are not primary
causes.
Question 8
A patient with sickle cell disease has a vaso-occlusive crisis. Which condition is most
likely to trigger this crisis?
A) High oxygen tension
B) Dehydration
C) Alkalosis
D) Increased blood viscosity from polycythemia
Rationale: Vaso-occlusive crisis occurs when sickle hemoglobin polymerizes under low
oxygen, dehydration, acidosis, or cold. Dehydration increases blood viscosity and promotes
sickling. High oxygen and alkalosis reduce sickling.
Question 9
A patient has immune thrombocytopenic purpura (ITP). The nurse expects which
laboratory finding?
A) Elevated platelet count
B) Decreased platelet count
C) Elevated PT/INR
D) Decreased bleeding time
Study Guide, Practice Questions & Comprehensive Exam Review 3
versions
Comprehensive study resource for NR 283 Pathophysiology at Chamberlain University. This
guide covers major pathophysiology concepts across all course units, including cellular
adaptation and injury, inflammation, immunity, fluid and electrolyte balance, acid-base
disorders, cardiovascular, respiratory, hematologic, endocrine, neurological, gastrointestinal,
renal, urinary, and reproductive system disorders. Includes practice questions, answer
explanations, concept summaries, and exam-focused review material designed to help nursing
students reinforce key concepts, strengthen clinical reasoning, and prepare effectively for the
final exam.
Question 1
A patient with chronic hypertension develops left ventricular hypertrophy. This cellular
change is best described as:
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Rationale: Hypertrophy is an increase in cell size due to increased workload. Chronic
hypertension increases afterload, causing cardiac myocytes to enlarge. Hyperplasia is
increased cell number. Atrophy is decreased cell size. Metaplasia is one cell type replacing
another.
Question 2
Which type of necrosis is most commonly seen in the brain following a stroke?
A) Coagulative necrosis
B) Liquefactive necrosis
C) Caseous necrosis
D) Fat necrosis
,Rationale: The brain has high lipid content and few connective tissue cells. Ischemic injury
triggers enzymatic digestion, turning tissue into liquid (liquefactive necrosis). Coagulative
necrosis occurs in heart, kidney, liver. Caseous occurs in TB. Fat necrosis occurs in pancreas
or breast.
Question 3
A patient with a bacterial infection has a fever. Which cytokines act as endogenous
pyrogens?
A) Interferons and colony-stimulating factors
B) Interleukin-1, interleukin-6, and tumor necrosis factor
C) Complement proteins C3a and C5a
D) Histamine and bradykinin
*Rationale: Endogenous pyrogens (IL-1, IL-6, TNF) are released from macrophages and
act on the hypothalamus to raise the temperature set point, causing fever. Interferons
are antiviral. Complement and histamine/bradykinin are inflammatory mediators but not
primary pyrogens.*
Question 4
A patient with heart failure has pitting edema in the lower extremities. The primary
mechanism is:
A) Decreased capillary hydrostatic pressure
B) Increased capillary hydrostatic pressure
C) Decreased capillary permeability
D) Increased plasma oncotic pressure
Rationale: Heart failure increases venous pressure, which increases capillary hydrostatic
pressure, forcing fluid into interstitial space, causing edema. Decreased oncotic pressure
(nephrotic syndrome) also causes edema but is not the primary mechanism in heart
failure.
,Question 5
A patient has a serum sodium of 125 mEq/L (hyponatremia). Which neurologic finding is
most concerning?
A) Thirst
B) Seizures and altered mental status
C) Dry mucous membranes
D) Muscle cramps
Rationale: Severe hyponatremia causes cerebral edema as water shifts into brain cells,
leading to confusion, seizures, coma, and respiratory arrest. Thirst and dry mucous
membranes suggest hypernatremia. Muscle cramps can occur but are less immediately
life-threatening.
Question 6
A patient with vomiting and nasogastric suction develops metabolic alkalosis. Which
electrolyte imbalance commonly accompanies this?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
Rationale: Loss of gastric acid (HCl) causes metabolic alkalosis. Hypokalemia often
accompanies metabolic alkalosis because kidneys excrete potassium to retain hydrogen
ions. Vomiting also directly loses potassium from gastric fluid.
Question 7
A patient with chronic kidney disease has anemia. The primary cause is:
, A) Iron deficiency
B) Decreased erythropoietin production
C) Hemolysis
D) Folate deficiency
Rationale: Kidneys produce erythropoietin (EPO), which stimulates RBC production.
Chronic kidney disease damages EPO-producing cells, leading to normocytic
normochromic anemia. Iron and folate deficiencies may coexist but are not primary
causes.
Question 8
A patient with sickle cell disease has a vaso-occlusive crisis. Which condition is most
likely to trigger this crisis?
A) High oxygen tension
B) Dehydration
C) Alkalosis
D) Increased blood viscosity from polycythemia
Rationale: Vaso-occlusive crisis occurs when sickle hemoglobin polymerizes under low
oxygen, dehydration, acidosis, or cold. Dehydration increases blood viscosity and promotes
sickling. High oxygen and alkalosis reduce sickling.
Question 9
A patient has immune thrombocytopenic purpura (ITP). The nurse expects which
laboratory finding?
A) Elevated platelet count
B) Decreased platelet count
C) Elevated PT/INR
D) Decreased bleeding time
