Advanced Pathophysiology Nursing Exam Cycle
2025/2026 | University Prep Notes | NCLEX‑Style
Comprehensive Study Pack
100 Questions
1. A patient is diagnosed with metabolic acidosis. Which arterial blood gas (ABG) value would confirm
this diagnosis?
🎯CORRECT CHOICE: pH 7.25, HCO3 18 mEq/L
💡EXPLANATION: Metabolic acidosis is characterized by a low pH (<7.35) and a low bicarbonate level
(<22 mEq/L) due to a primary loss of bicarbonate or accumulation of acids.
2. A nurse is reviewing a patient's lab results and notes an elevated C-reactive protein (CRP) level. What
does this indicate?
🎯CORRECT CHOICE: Acute inflammation
💡EXPLANATION: CRP is an acute-phase protein produced by the liver in response to inflammation.
Elevated levels indicate an ongoing inflammatory process, though it is nonspecific.
3. A patient with chronic heart failure develops dependent edema. Which pathophysiological
mechanism is primarily responsible?
🎯CORRECT CHOICE: Increased hydrostatic pressure
💡EXPLANATION: In heart failure, decreased cardiac output leads to venous congestion and increased
hydrostatic pressure in the capillaries, forcing fluid into the interstitial space, causing edema.
4. Which cellular adaptation is characterized by an increase in cell size and function?
🎯CORRECT CHOICE: Hypertrophy
💡EXPLANATION: Hypertrophy is an increase in cell size, often in response to increased workload. It can
be physiologic (e.g., muscle growth from exercise) or pathologic (e.g., cardiac hypertrophy from
hypertension).
5. A patient is diagnosed with pernicious anemia. Which deficiency is the underlying cause?
,🎯CORRECT CHOICE: Vitamin B12 deficiency due to lack of intrinsic factor
💡EXPLANATION: Pernicious anemia is an autoimmune condition where the body destroys parietal cells,
which produce intrinsic factor. Without intrinsic factor, vitamin B12 cannot be absorbed, leading to
megaloblastic anemia.
6. A nurse is assessing a patient with severe dehydration. Which electrolyte imbalance is most likely to
occur?
🎯CORRECT CHOICE: Hypernatremia
💡EXPLANATION: Dehydration leads to a loss of water relative to sodium, causing an increase in serum
sodium concentration (hypernatremia). This is due to insufficient free water in the body.
7. A patient with chronic obstructive pulmonary disease (COPD) has a compensatory respiratory
acidosis. What is the primary compensatory mechanism?
🎯CORRECT CHOICE: Renal retention of bicarbonate
💡EXPLANATION: In respiratory acidosis (elevated CO2), the kidneys compensate by retaining
bicarbonate (HCO3-) and excreting hydrogen ions (H+) to raise the pH back toward normal.
8. Which type of necrosis is commonly associated with a myocardial infarction?
🎯CORRECT CHOICE: Coagulative necrosis
💡EXPLANATION: Coagulative necrosis is the most common type of necrosis, typically occurring in solid
organs like the heart, kidney, and adrenal glands. It is characterized by the preservation of tissue
architecture for several days.
9. A patient with liver failure is at risk for bleeding. Which lab value would be most affected?
🎯CORRECT CHOICE: Prothrombin time (PT) and INR
💡EXPLANATION: The liver synthesizes most clotting factors. In liver failure, the production of these
factors decreases, leading to prolonged PT and elevated INR, increasing the risk of bleeding.
10. Which immunoglobulin is the first to be produced during a primary immune response?
🎯CORRECT CHOICE: IgM
, 💡EXPLANATION: During a primary immune response, IgM is the first antibody produced. It is a large
pentamer and is highly effective at activating complement. IgG is produced later in the response.
11. A patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which
laboratory finding is expected?
🎯CORRECT CHOICE: Hyponatremia
💡EXPLANATION: SIADH causes excessive release of ADH, leading to water retention and dilutional
hyponatremia (low serum sodium). This can cause confusion, seizures, and other neurologic symptoms.
12. The nurse is caring for a patient with an acute asthma exacerbation. Which arterial blood gas finding
is most likely in the early stages?
🎯CORRECT CHOICE: Respiratory alkalosis
💡EXPLANATION: In early asthma, the patient hyperventilates, blowing off CO2, leading to a low PaCO2
and a high pH (respiratory alkalosis). As the condition worsens, the patient may tire and develop
respiratory acidosis.
13. A patient is diagnosed with type 1 diabetes. What is the underlying pathophysiological defect?
🎯CORRECT CHOICE: Autoimmune destruction of pancreatic beta cells
💡EXPLANATION: Type 1 diabetes is an autoimmune condition where the body's immune system
destroys the insulin-producing beta cells in the pancreas, resulting in absolute insulin deficiency.
14. A patient has a wound that is healing by secondary intention. Which phase of wound healing is
characterized by the formation of granulation tissue?
🎯CORRECT CHOICE: Proliferative phase
💡EXPLANATION: The proliferative phase is the third phase of wound healing. It is characterized by the
growth of new blood vessels (angiogenesis), granulation tissue formation, and epithelialization.
15. A patient with a history of deep vein thrombosis (DVT) is prescribed warfarin. The nurse monitors
which lab value to assess the effectiveness of the therapy?
🎯CORRECT CHOICE: International Normalized Ratio (INR)
2025/2026 | University Prep Notes | NCLEX‑Style
Comprehensive Study Pack
100 Questions
1. A patient is diagnosed with metabolic acidosis. Which arterial blood gas (ABG) value would confirm
this diagnosis?
🎯CORRECT CHOICE: pH 7.25, HCO3 18 mEq/L
💡EXPLANATION: Metabolic acidosis is characterized by a low pH (<7.35) and a low bicarbonate level
(<22 mEq/L) due to a primary loss of bicarbonate or accumulation of acids.
2. A nurse is reviewing a patient's lab results and notes an elevated C-reactive protein (CRP) level. What
does this indicate?
🎯CORRECT CHOICE: Acute inflammation
💡EXPLANATION: CRP is an acute-phase protein produced by the liver in response to inflammation.
Elevated levels indicate an ongoing inflammatory process, though it is nonspecific.
3. A patient with chronic heart failure develops dependent edema. Which pathophysiological
mechanism is primarily responsible?
🎯CORRECT CHOICE: Increased hydrostatic pressure
💡EXPLANATION: In heart failure, decreased cardiac output leads to venous congestion and increased
hydrostatic pressure in the capillaries, forcing fluid into the interstitial space, causing edema.
4. Which cellular adaptation is characterized by an increase in cell size and function?
🎯CORRECT CHOICE: Hypertrophy
💡EXPLANATION: Hypertrophy is an increase in cell size, often in response to increased workload. It can
be physiologic (e.g., muscle growth from exercise) or pathologic (e.g., cardiac hypertrophy from
hypertension).
5. A patient is diagnosed with pernicious anemia. Which deficiency is the underlying cause?
,🎯CORRECT CHOICE: Vitamin B12 deficiency due to lack of intrinsic factor
💡EXPLANATION: Pernicious anemia is an autoimmune condition where the body destroys parietal cells,
which produce intrinsic factor. Without intrinsic factor, vitamin B12 cannot be absorbed, leading to
megaloblastic anemia.
6. A nurse is assessing a patient with severe dehydration. Which electrolyte imbalance is most likely to
occur?
🎯CORRECT CHOICE: Hypernatremia
💡EXPLANATION: Dehydration leads to a loss of water relative to sodium, causing an increase in serum
sodium concentration (hypernatremia). This is due to insufficient free water in the body.
7. A patient with chronic obstructive pulmonary disease (COPD) has a compensatory respiratory
acidosis. What is the primary compensatory mechanism?
🎯CORRECT CHOICE: Renal retention of bicarbonate
💡EXPLANATION: In respiratory acidosis (elevated CO2), the kidneys compensate by retaining
bicarbonate (HCO3-) and excreting hydrogen ions (H+) to raise the pH back toward normal.
8. Which type of necrosis is commonly associated with a myocardial infarction?
🎯CORRECT CHOICE: Coagulative necrosis
💡EXPLANATION: Coagulative necrosis is the most common type of necrosis, typically occurring in solid
organs like the heart, kidney, and adrenal glands. It is characterized by the preservation of tissue
architecture for several days.
9. A patient with liver failure is at risk for bleeding. Which lab value would be most affected?
🎯CORRECT CHOICE: Prothrombin time (PT) and INR
💡EXPLANATION: The liver synthesizes most clotting factors. In liver failure, the production of these
factors decreases, leading to prolonged PT and elevated INR, increasing the risk of bleeding.
10. Which immunoglobulin is the first to be produced during a primary immune response?
🎯CORRECT CHOICE: IgM
, 💡EXPLANATION: During a primary immune response, IgM is the first antibody produced. It is a large
pentamer and is highly effective at activating complement. IgG is produced later in the response.
11. A patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which
laboratory finding is expected?
🎯CORRECT CHOICE: Hyponatremia
💡EXPLANATION: SIADH causes excessive release of ADH, leading to water retention and dilutional
hyponatremia (low serum sodium). This can cause confusion, seizures, and other neurologic symptoms.
12. The nurse is caring for a patient with an acute asthma exacerbation. Which arterial blood gas finding
is most likely in the early stages?
🎯CORRECT CHOICE: Respiratory alkalosis
💡EXPLANATION: In early asthma, the patient hyperventilates, blowing off CO2, leading to a low PaCO2
and a high pH (respiratory alkalosis). As the condition worsens, the patient may tire and develop
respiratory acidosis.
13. A patient is diagnosed with type 1 diabetes. What is the underlying pathophysiological defect?
🎯CORRECT CHOICE: Autoimmune destruction of pancreatic beta cells
💡EXPLANATION: Type 1 diabetes is an autoimmune condition where the body's immune system
destroys the insulin-producing beta cells in the pancreas, resulting in absolute insulin deficiency.
14. A patient has a wound that is healing by secondary intention. Which phase of wound healing is
characterized by the formation of granulation tissue?
🎯CORRECT CHOICE: Proliferative phase
💡EXPLANATION: The proliferative phase is the third phase of wound healing. It is characterized by the
growth of new blood vessels (angiogenesis), granulation tissue formation, and epithelialization.
15. A patient with a history of deep vein thrombosis (DVT) is prescribed warfarin. The nurse monitors
which lab value to assess the effectiveness of the therapy?
🎯CORRECT CHOICE: International Normalized Ratio (INR)
