Pathophysiology (NR 283) Exam 1 – Chamberlain University Study
Guide, Practice Questions & Exam Review
Comprehensive study resource for NR 283 Pathophysiology Exam 1 at Chamberlain
University. Covers foundational concepts including cellular adaptation, cellular injury,
inflammation, immunity, genetics, stress responses, fluid and electrolyte balance, acid-base
regulation, and mechanisms of disease. Includes practice questions, answer explanations, concept
reviews, and exam-focused study material designed to help nursing students strengthen critical-
thinking skills and prepare for success on Exam 1.
Question 1:
A patient with long-standing, untreated hypertension shows significant concentric
thickening of the left ventricular wall on an echocardiogram. The nurse recognizes this
adaptive structural change as:
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Atrophy
Answer: C) Hypertrophy
Rationale: Hypertrophy is an increase in the size of individual cells, leading to an
increase in the overall size of the tissue or organ. Because permanent myocardial cells
cannot divide to replicate, they adapt to the increased workload of pumping against
systemic resistance by increasing their cell size.
Question 2:
A tissue biopsy report from a patient with chronic gastroesophageal reflux disease
(GERD) indicates that the normal ciliated columnar epithelium of the lower esophagus
has been replaced by stratified squamous epithelium. The nurse identifies this
reversible cellular change as:
A) Dysplasia
B) Metaplasia
C) Anaplasia
D) Hyperplasia
Answer: B) Metaplasia
,Rationale: Metaplasia is a reversible cellular adaptation where one mature, adult cell
type is replaced by another mature cell type that is better suited to withstand chronic
irritation, stress, or inflammation, such as exposure to gastric acid.
Question 3:
A pathology report shows that a patient's tissue sample contains cellular injury
characterized by the activation of digestive lipases, which break down intracellular
triglycerides into free fatty acids that combine with calcium to form chalky white
deposits. The nurse knows this describes:
A) Coagulative necrosis
B) Caseous necrosis
C) Liquefactive necrosis
D) Fat necrosis [1]
Answer: D) Fat necrosis [1]
Rationale: Fat necrosis occurs specifically in adipose tissue when damaged cells
release active lipases (frequently seen in acute pancreatitis or breast tissue trauma).
The released fatty acids undergo saponification by binding with calcium ions, appearing
as chalky, soap-like deposits.
Question 4:
A patient is admitted to the medical unit with a serum potassium level of 6.5 mEq/L.
Which of the following alterations should the nurse expect to observe first on the
patient's continuous ECG monitor?
A) Prominent, distinct U waves
B) Prolonged QT intervals
C) Tall, peaked, tented T waves
D) Flattened ST segments
Answer: C) Tall, peaked, tented T waves
Rationale: Hyperkalemia (potassium level > 5.0 mEq/L) changes cell membrane
potentials and speeds up repolarization. The earliest diagnostic cardiotoxic sign of an
elevated serum potassium level on an ECG is the development of narrow, tall, peaked T
waves.
,Question 5:
Widespread edema and ascites develop in a patient with end-stage liver cirrhosis. Lab
values reveal a serum albumin level of 1.9 g/dL. The nurse understands that this fluid
accumulation is driven by which primary pathophysiological mechanism?
A) Increased capillary hydrostatic pressure
B) Decreased capillary oncotic pressure
C) Increased interstitial hydrostatic pressure
D) Lymphatic obstruction
Answer: B) Decreased capillary oncotic pressure
Rationale: Albumin is the primary plasma protein responsible for maintaining capillary
oncotic (colloid) pressure, which pulls interstitial fluid back into the blood vessels. When
the liver cannot synthesize albumin, oncotic pressure drops, causing fluid to leak into
tissue spaces.
Question 6:
An arterial blood gas (ABG) sample drawn from a patient in acute respiratory distress
reveals the following values: pH 7.28, PaCO2 54 mmHg, and HCO3 24 mEq/L. How
should the nurse interpret this imbalance?
A) Uncompensated metabolic acidosis
B) Fully compensated respiratory alkalosis
C) Uncompensated respiratory acidosis
D) Partially compensated metabolic alkalosis
Answer: C) Uncompensated respiratory acidosis
Rationale: The pH is low (< 7.35), indicating acidosis. The PaCO2 is high (> 45 mmHg),
matching the acidotic state (respiratory origin). Because the HCO3 is normal (22–26
mEq/L), the kidneys have not yet compensated for the respiratory retention of carbon
dioxide.
Question 7:
During an acute inflammatory response, which chemical mediator is stored in mast cells
and released immediately to cause localized vasodilation and increased capillary
permeability?
A) Leukotrienes
B) Histamine
, C) Interleukins
D) Prostaglandins
Answer: B) Histamine
Rationale: Histamine is a preformed vasoactive amine stored within mast cell granules.
Upon tissue injury or IgE cross-linking, it degranulates instantly to cause endothelial cell
contraction, leading to local vasodilation and fluid leakage.
Question 8:
A patient presents to the emergency department experiencing a severe type I
hypersensitivity anaphylactic reaction to a bee sting. The nurse knows that this
immediate immune response is mediated by which antibody?
A) IgG
B) IgM
C) IgA
D) IgE
Answer: D) IgE
Rationale: Type I hypersensitivity reactions are immediate allergic responses mediated
by IgE antibodies. Upon re-exposure, allergens bind to IgE molecules already attached
to mast cells, triggering mass chemical mediator release.
Question 9:
A nurse is reviewing the lab results for a patient with a severe wound infection and
notes a "shift to the left" on the white blood cell differential report. The nurse
understands that a shift to the left indicates:
A) An increase in mature lymphocytes
B) An elevated number of circulating eosinophils
C) An increased percentage of immature neutrophils (band cells) in response to acute
infection
D) A reduction in the overall absolute leukocyte count
Answer: C) An increased percentage of immature neutrophils (band cells) in
response to acute infection
Rationale: A "shift to the left" means the bone marrow is rapidly producing and releasing
immature neutrophils (known as bands) into systemic circulation because the body's
store of mature neutrophils has been depleted by a severe infection.
Guide, Practice Questions & Exam Review
Comprehensive study resource for NR 283 Pathophysiology Exam 1 at Chamberlain
University. Covers foundational concepts including cellular adaptation, cellular injury,
inflammation, immunity, genetics, stress responses, fluid and electrolyte balance, acid-base
regulation, and mechanisms of disease. Includes practice questions, answer explanations, concept
reviews, and exam-focused study material designed to help nursing students strengthen critical-
thinking skills and prepare for success on Exam 1.
Question 1:
A patient with long-standing, untreated hypertension shows significant concentric
thickening of the left ventricular wall on an echocardiogram. The nurse recognizes this
adaptive structural change as:
A) Hyperplasia
B) Metaplasia
C) Hypertrophy
D) Atrophy
Answer: C) Hypertrophy
Rationale: Hypertrophy is an increase in the size of individual cells, leading to an
increase in the overall size of the tissue or organ. Because permanent myocardial cells
cannot divide to replicate, they adapt to the increased workload of pumping against
systemic resistance by increasing their cell size.
Question 2:
A tissue biopsy report from a patient with chronic gastroesophageal reflux disease
(GERD) indicates that the normal ciliated columnar epithelium of the lower esophagus
has been replaced by stratified squamous epithelium. The nurse identifies this
reversible cellular change as:
A) Dysplasia
B) Metaplasia
C) Anaplasia
D) Hyperplasia
Answer: B) Metaplasia
,Rationale: Metaplasia is a reversible cellular adaptation where one mature, adult cell
type is replaced by another mature cell type that is better suited to withstand chronic
irritation, stress, or inflammation, such as exposure to gastric acid.
Question 3:
A pathology report shows that a patient's tissue sample contains cellular injury
characterized by the activation of digestive lipases, which break down intracellular
triglycerides into free fatty acids that combine with calcium to form chalky white
deposits. The nurse knows this describes:
A) Coagulative necrosis
B) Caseous necrosis
C) Liquefactive necrosis
D) Fat necrosis [1]
Answer: D) Fat necrosis [1]
Rationale: Fat necrosis occurs specifically in adipose tissue when damaged cells
release active lipases (frequently seen in acute pancreatitis or breast tissue trauma).
The released fatty acids undergo saponification by binding with calcium ions, appearing
as chalky, soap-like deposits.
Question 4:
A patient is admitted to the medical unit with a serum potassium level of 6.5 mEq/L.
Which of the following alterations should the nurse expect to observe first on the
patient's continuous ECG monitor?
A) Prominent, distinct U waves
B) Prolonged QT intervals
C) Tall, peaked, tented T waves
D) Flattened ST segments
Answer: C) Tall, peaked, tented T waves
Rationale: Hyperkalemia (potassium level > 5.0 mEq/L) changes cell membrane
potentials and speeds up repolarization. The earliest diagnostic cardiotoxic sign of an
elevated serum potassium level on an ECG is the development of narrow, tall, peaked T
waves.
,Question 5:
Widespread edema and ascites develop in a patient with end-stage liver cirrhosis. Lab
values reveal a serum albumin level of 1.9 g/dL. The nurse understands that this fluid
accumulation is driven by which primary pathophysiological mechanism?
A) Increased capillary hydrostatic pressure
B) Decreased capillary oncotic pressure
C) Increased interstitial hydrostatic pressure
D) Lymphatic obstruction
Answer: B) Decreased capillary oncotic pressure
Rationale: Albumin is the primary plasma protein responsible for maintaining capillary
oncotic (colloid) pressure, which pulls interstitial fluid back into the blood vessels. When
the liver cannot synthesize albumin, oncotic pressure drops, causing fluid to leak into
tissue spaces.
Question 6:
An arterial blood gas (ABG) sample drawn from a patient in acute respiratory distress
reveals the following values: pH 7.28, PaCO2 54 mmHg, and HCO3 24 mEq/L. How
should the nurse interpret this imbalance?
A) Uncompensated metabolic acidosis
B) Fully compensated respiratory alkalosis
C) Uncompensated respiratory acidosis
D) Partially compensated metabolic alkalosis
Answer: C) Uncompensated respiratory acidosis
Rationale: The pH is low (< 7.35), indicating acidosis. The PaCO2 is high (> 45 mmHg),
matching the acidotic state (respiratory origin). Because the HCO3 is normal (22–26
mEq/L), the kidneys have not yet compensated for the respiratory retention of carbon
dioxide.
Question 7:
During an acute inflammatory response, which chemical mediator is stored in mast cells
and released immediately to cause localized vasodilation and increased capillary
permeability?
A) Leukotrienes
B) Histamine
, C) Interleukins
D) Prostaglandins
Answer: B) Histamine
Rationale: Histamine is a preformed vasoactive amine stored within mast cell granules.
Upon tissue injury or IgE cross-linking, it degranulates instantly to cause endothelial cell
contraction, leading to local vasodilation and fluid leakage.
Question 8:
A patient presents to the emergency department experiencing a severe type I
hypersensitivity anaphylactic reaction to a bee sting. The nurse knows that this
immediate immune response is mediated by which antibody?
A) IgG
B) IgM
C) IgA
D) IgE
Answer: D) IgE
Rationale: Type I hypersensitivity reactions are immediate allergic responses mediated
by IgE antibodies. Upon re-exposure, allergens bind to IgE molecules already attached
to mast cells, triggering mass chemical mediator release.
Question 9:
A nurse is reviewing the lab results for a patient with a severe wound infection and
notes a "shift to the left" on the white blood cell differential report. The nurse
understands that a shift to the left indicates:
A) An increase in mature lymphocytes
B) An elevated number of circulating eosinophils
C) An increased percentage of immature neutrophils (band cells) in response to acute
infection
D) A reduction in the overall absolute leukocyte count
Answer: C) An increased percentage of immature neutrophils (band cells) in
response to acute infection
Rationale: A "shift to the left" means the bone marrow is rapidly producing and releasing
immature neutrophils (known as bands) into systemic circulation because the body's
store of mature neutrophils has been depleted by a severe infection.
