,NSG3850/NSG 3850 Exam 1 | Advanced Pathophysiology |
Galen College | Q & A | 2026/2027 Edition (PDF)
1. Approximately what proportion of total body fluid is located in the intracellular compartment?
A) One-quarter
B) One-third
C) Two-thirds
D) Three-quarters
Correct Answer: Two-thirds
Expert Rationale: Approximately two-thirds (about 40% of total body weight) of total body fluid is
intracellular, while the remaining one-third is extracellular. This intracellular fluid is essential for cellular
metabolism and function.
2. Where is extracellular fluid primarily located in the body?
A) Only within blood vessels
B) Only between cells
C) Between cells, in blood vessels, and in transcellular spaces
D) Only in the cerebrospinal fluid
Correct Answer: Between cells, in blood vessels, and in transcellular spaces
Expert Rationale: Extracellular fluid is located in several compartments: between cells (interstitial),
within blood vessels (intravascular), and in transcellular spaces such as cerebrospinal fluid,
gastrointestinal fluids, and synovial fluid.
3. What is the primary effect of antidiuretic hormone (ADH) on urine volume?
A) ADH increases urine volume
B) ADH decreases urine volume
C) ADH has no effect on urine volume
,D) ADH only affects sodium excretion
Correct Answer: ADH decreases urine volume
Expert Rationale: ADH is the "free water" hormone that causes the kidneys to reabsorb plain water,
thereby decreasing urine volume and concentrating the urine. When ADH is low, urine volume is high.
4. What is the primary effect of aldosterone on urine volume?
A) Aldosterone increases urine volume
B) Aldosterone decreases urine volume
C) Aldosterone has no effect on urine volume
D) Aldosterone only affects potassium excretion
Correct Answer: Aldosterone decreases urine volume
Expert Rationale: Aldosterone is the "salt water" hormone that causes the kidneys to reabsorb both
water and sodium, decreasing urine volume and expanding extracellular fluid volume. When
aldosterone is high, urine volume is low.
5. A patient presents with confusion, ataxia, and ophthalmoplegia. Which vitamin deficiency is the
underlying cause of this presentation?
A) Vitamin B1 (thiamine)
B) Vitamin B3 (niacin)
C) Vitamin B6 (pyridoxine)
D) Vitamin B12 (cobalamin)
Correct Answer: Vitamin B1 (thiamine)
Expert Rationale: The classic triad of confusion, ataxia, and ophthalmoplegia is Wernicke's
encephalopathy, caused by thiamine (Vitamin B1) deficiency. This is commonly seen in patients with
chronic alcoholism due to poor nutrition and impaired absorption.
, 6. A patient with fatigue, weight gain, cold intolerance, and constipation has laboratory findings of
elevated TSH and low free T4. Which pathophysiologic mechanism best explains this presentation?
A) Autoimmune destruction of pancreatic beta cells
B) Lymphocytic infiltration of the thyroid gland leading to hypothyroidism
C) Excessive secretion of growth hormone from the pituitary
D) Adrenal cortex insufficiency
Correct Answer: Lymphocytic infiltration of the thyroid gland leading to hypothyroidism
Expert Rationale: These symptoms and laboratory findings are characteristic of hypothyroidism, most
commonly caused by Hashimoto's thyroiditis, an autoimmune condition involving lymphocytic
infiltration of the thyroid gland.
7. Which of the following is a characteristic sign of hypercalcemia?
A) Tetany
B) Muscle weakness
C) Positive Chvostek's sign
D) Positive Trousseau's sign
Correct Answer: Muscle weakness
Expert Rationale: Hypercalcemia causes decreased neuromuscular excitability by elevating the threshold
potential of excitable cells, leading to muscle weakness. Tetany and positive Chvostek's and Trousseau's
signs are associated with hypocalcemia.
8. A patient is admitted with confusion and lethargy. Serum sodium is 158 mEq/L. The nurse should
recognize this as which condition?
A) Hyponatremia
B) Hypernatremia
C) Hypokalemia
Galen College | Q & A | 2026/2027 Edition (PDF)
1. Approximately what proportion of total body fluid is located in the intracellular compartment?
A) One-quarter
B) One-third
C) Two-thirds
D) Three-quarters
Correct Answer: Two-thirds
Expert Rationale: Approximately two-thirds (about 40% of total body weight) of total body fluid is
intracellular, while the remaining one-third is extracellular. This intracellular fluid is essential for cellular
metabolism and function.
2. Where is extracellular fluid primarily located in the body?
A) Only within blood vessels
B) Only between cells
C) Between cells, in blood vessels, and in transcellular spaces
D) Only in the cerebrospinal fluid
Correct Answer: Between cells, in blood vessels, and in transcellular spaces
Expert Rationale: Extracellular fluid is located in several compartments: between cells (interstitial),
within blood vessels (intravascular), and in transcellular spaces such as cerebrospinal fluid,
gastrointestinal fluids, and synovial fluid.
3. What is the primary effect of antidiuretic hormone (ADH) on urine volume?
A) ADH increases urine volume
B) ADH decreases urine volume
C) ADH has no effect on urine volume
,D) ADH only affects sodium excretion
Correct Answer: ADH decreases urine volume
Expert Rationale: ADH is the "free water" hormone that causes the kidneys to reabsorb plain water,
thereby decreasing urine volume and concentrating the urine. When ADH is low, urine volume is high.
4. What is the primary effect of aldosterone on urine volume?
A) Aldosterone increases urine volume
B) Aldosterone decreases urine volume
C) Aldosterone has no effect on urine volume
D) Aldosterone only affects potassium excretion
Correct Answer: Aldosterone decreases urine volume
Expert Rationale: Aldosterone is the "salt water" hormone that causes the kidneys to reabsorb both
water and sodium, decreasing urine volume and expanding extracellular fluid volume. When
aldosterone is high, urine volume is low.
5. A patient presents with confusion, ataxia, and ophthalmoplegia. Which vitamin deficiency is the
underlying cause of this presentation?
A) Vitamin B1 (thiamine)
B) Vitamin B3 (niacin)
C) Vitamin B6 (pyridoxine)
D) Vitamin B12 (cobalamin)
Correct Answer: Vitamin B1 (thiamine)
Expert Rationale: The classic triad of confusion, ataxia, and ophthalmoplegia is Wernicke's
encephalopathy, caused by thiamine (Vitamin B1) deficiency. This is commonly seen in patients with
chronic alcoholism due to poor nutrition and impaired absorption.
, 6. A patient with fatigue, weight gain, cold intolerance, and constipation has laboratory findings of
elevated TSH and low free T4. Which pathophysiologic mechanism best explains this presentation?
A) Autoimmune destruction of pancreatic beta cells
B) Lymphocytic infiltration of the thyroid gland leading to hypothyroidism
C) Excessive secretion of growth hormone from the pituitary
D) Adrenal cortex insufficiency
Correct Answer: Lymphocytic infiltration of the thyroid gland leading to hypothyroidism
Expert Rationale: These symptoms and laboratory findings are characteristic of hypothyroidism, most
commonly caused by Hashimoto's thyroiditis, an autoimmune condition involving lymphocytic
infiltration of the thyroid gland.
7. Which of the following is a characteristic sign of hypercalcemia?
A) Tetany
B) Muscle weakness
C) Positive Chvostek's sign
D) Positive Trousseau's sign
Correct Answer: Muscle weakness
Expert Rationale: Hypercalcemia causes decreased neuromuscular excitability by elevating the threshold
potential of excitable cells, leading to muscle weakness. Tetany and positive Chvostek's and Trousseau's
signs are associated with hypocalcemia.
8. A patient is admitted with confusion and lethargy. Serum sodium is 158 mEq/L. The nurse should
recognize this as which condition?
A) Hyponatremia
B) Hypernatremia
C) Hypokalemia
