NR-283 PATHOPHYSIOLOGY FINAL EXAM] QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027 CHAMBERLAIN UNIVERSITY.
Core Domains
Cellular Biology and Adaptation
Fluid, Electrolyte, and Acid-Base Balance
Inflammation and Immunity
Infection and Infectious Diseases
Genetics and Neoplasia
Alterations in Cardiovascular Function
Alterations in Respiratory Function
Alterations in Neurological Function
Alterations in Endocrine and Metabolic Function
Alterations in Renal and Gastrointestinal Function
Introduction
This comprehensive examination is designed to assess the student's mastery of core pathophysiological concepts as
they apply to clinical nursing practice. The assessment evaluates foundational knowledge of disease processes,
including cellular adaptation, immunity, and systemic imbalances, as well as the application of this knowledge to
complex patient scenarios. Students will be tested on their ability to integrate principles of pathophysiology with
clinical decision-making, emphasizing the rationale behind signs, symptoms, and therapeutic interventions. The
,exam consists of multiple-choice questions and scenario-based items designed to simulate real-world clinical
challenges and foster critical thinking.
Section One: Questions 1-100
1. A patient with chronic obstructive pulmonary disease (COPD) has a persistent cough and produces thick,
tenacious sputum. Which cellular adaptation is most likely occurring in the patient’s bronchial epithelium?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
🟢 Correct answer: B
🔴 RATIONALE: Metaplasia is the reversible replacement of one differentiated cell type with another. In the
airways of a chronic smoker or patient with COPD, the normal pseudostratified ciliated columnar epithelium is
replaced by stratified squamous epithelium. This is an adaptive response to chronic irritation, but it
compromises mucociliary clearance, leading to the retention of thick sputum. Hyperplasia is an increase in the
number of cells; hypertrophy is an increase in cell size; and dysplasia is disordered cellular growth, which is a
precancerous change.
2. A patient is diagnosed with hyperkalemia. Which of the following ECG changes would the nurse expect to
observe?
,A. A flattened T wave
B. A prominent U wave
C. Tall, peaked T waves
D. A prolonged PR interval
🟢 Correct answer: C
🔴 RATIONALE: Hyperkalemia (elevated serum potassium) affects cardiac conduction and is most classically
associated with tall, peaked, narrow T waves. As potassium levels rise further, the QRS complex widens, and the
P wave flattens, potentially leading to a sine wave pattern and cardiac arrest. A flattened T wave and prominent
U wave are characteristic of hypokalemia.
3. A patient presents with severe metabolic acidosis. Which compensatory mechanism is the body most
likely to initiate?
A. An increase in respiratory rate and depth
B. A decrease in respiratory rate and depth
C. An increase in renal reabsorption of bicarbonate
D. A decrease in renal excretion of hydrogen ions
🟢 Correct answer: A
🔴 RATIONALE: The body's primary and most immediate compensatory response to metabolic acidosis is
respiratory compensation. Chemoreceptors detect the decrease in pH and stimulate the respiratory center to
increase the rate and depth of breathing (Kussmaul respirations) to "blow off" carbon dioxide, a volatile acid.
This reduces the partial pressure of carbon dioxide (PaCO2) in the blood, helping to normalize the pH. Renal
, compensation, which involves retaining bicarbonate and excreting hydrogen ions, is a slower, longer-term
process.
4. A child is stung by a bee and immediately develops hives, facial swelling, and difficulty breathing. This
type of hypersensitivity reaction is classified as:
A. Type I
B. Type II
C. Type III
D. Type IV
🟢 Correct answer: A
🔴 RATIONALE: This is a classic presentation of anaphylaxis, a Type I hypersensitivity reaction. Type I reactions
are immunoglobulin E (IgE)-mediated and occur rapidly after exposure to an allergen. Mast cells and basophils
degranulate, releasing histamine and other vasoactive mediators that cause the systemic symptoms described.
Type II is cytotoxic (e.g., hemolytic anemia), Type III is immune-complex mediated (e.g., serum sickness), and
Type IV is delayed T-cell mediated (e.g., contact dermatitis).
5. A client has a family history of breast cancer and is found to have a mutation in the BRCA1 gene. This gene
is an example of a:
A. Proto-oncogene
B. Tumor suppressor gene
C. Oncogene
D. Mismatch repair gene
🟢 Correct answer: B
RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027 CHAMBERLAIN UNIVERSITY.
Core Domains
Cellular Biology and Adaptation
Fluid, Electrolyte, and Acid-Base Balance
Inflammation and Immunity
Infection and Infectious Diseases
Genetics and Neoplasia
Alterations in Cardiovascular Function
Alterations in Respiratory Function
Alterations in Neurological Function
Alterations in Endocrine and Metabolic Function
Alterations in Renal and Gastrointestinal Function
Introduction
This comprehensive examination is designed to assess the student's mastery of core pathophysiological concepts as
they apply to clinical nursing practice. The assessment evaluates foundational knowledge of disease processes,
including cellular adaptation, immunity, and systemic imbalances, as well as the application of this knowledge to
complex patient scenarios. Students will be tested on their ability to integrate principles of pathophysiology with
clinical decision-making, emphasizing the rationale behind signs, symptoms, and therapeutic interventions. The
,exam consists of multiple-choice questions and scenario-based items designed to simulate real-world clinical
challenges and foster critical thinking.
Section One: Questions 1-100
1. A patient with chronic obstructive pulmonary disease (COPD) has a persistent cough and produces thick,
tenacious sputum. Which cellular adaptation is most likely occurring in the patient’s bronchial epithelium?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
🟢 Correct answer: B
🔴 RATIONALE: Metaplasia is the reversible replacement of one differentiated cell type with another. In the
airways of a chronic smoker or patient with COPD, the normal pseudostratified ciliated columnar epithelium is
replaced by stratified squamous epithelium. This is an adaptive response to chronic irritation, but it
compromises mucociliary clearance, leading to the retention of thick sputum. Hyperplasia is an increase in the
number of cells; hypertrophy is an increase in cell size; and dysplasia is disordered cellular growth, which is a
precancerous change.
2. A patient is diagnosed with hyperkalemia. Which of the following ECG changes would the nurse expect to
observe?
,A. A flattened T wave
B. A prominent U wave
C. Tall, peaked T waves
D. A prolonged PR interval
🟢 Correct answer: C
🔴 RATIONALE: Hyperkalemia (elevated serum potassium) affects cardiac conduction and is most classically
associated with tall, peaked, narrow T waves. As potassium levels rise further, the QRS complex widens, and the
P wave flattens, potentially leading to a sine wave pattern and cardiac arrest. A flattened T wave and prominent
U wave are characteristic of hypokalemia.
3. A patient presents with severe metabolic acidosis. Which compensatory mechanism is the body most
likely to initiate?
A. An increase in respiratory rate and depth
B. A decrease in respiratory rate and depth
C. An increase in renal reabsorption of bicarbonate
D. A decrease in renal excretion of hydrogen ions
🟢 Correct answer: A
🔴 RATIONALE: The body's primary and most immediate compensatory response to metabolic acidosis is
respiratory compensation. Chemoreceptors detect the decrease in pH and stimulate the respiratory center to
increase the rate and depth of breathing (Kussmaul respirations) to "blow off" carbon dioxide, a volatile acid.
This reduces the partial pressure of carbon dioxide (PaCO2) in the blood, helping to normalize the pH. Renal
, compensation, which involves retaining bicarbonate and excreting hydrogen ions, is a slower, longer-term
process.
4. A child is stung by a bee and immediately develops hives, facial swelling, and difficulty breathing. This
type of hypersensitivity reaction is classified as:
A. Type I
B. Type II
C. Type III
D. Type IV
🟢 Correct answer: A
🔴 RATIONALE: This is a classic presentation of anaphylaxis, a Type I hypersensitivity reaction. Type I reactions
are immunoglobulin E (IgE)-mediated and occur rapidly after exposure to an allergen. Mast cells and basophils
degranulate, releasing histamine and other vasoactive mediators that cause the systemic symptoms described.
Type II is cytotoxic (e.g., hemolytic anemia), Type III is immune-complex mediated (e.g., serum sickness), and
Type IV is delayed T-cell mediated (e.g., contact dermatitis).
5. A client has a family history of breast cancer and is found to have a mutation in the BRCA1 gene. This gene
is an example of a:
A. Proto-oncogene
B. Tumor suppressor gene
C. Oncogene
D. Mismatch repair gene
🟢 Correct answer: B
