1
NUR 2063 / NUR2063:
Essentials of
Pathophysiology Exam
—2
Comprehensive Practice
Question Bank (Latest
2025/2026 Curriculum)
Rasmussen University
Exam 2 Focus Areas
This comprehensive question bank covers the following core topics as outlined in the
Rasmussen NUR 2063 Exam 2 curriculum: Fluid & Electrolyte Imbalances, Acid-Base
Regulation, Endocrine Disorders, Hematologic Disorders, Immunologic Disorders,
Gastrointestinal Disorders, Renal/Urinary Disorders, Cellular Regulation, Genetics,
and Inflammation/Immune Responses.
, 2
Section 1: Fluid & Electrolyte Imbalances (Questions 1–25)
1. A patient has a serum sodium level of 118 mEq/L (normal: 135–145). What
pathophysiological process is most likely causing the patient's cerebral confusion
and seizures?
A) Intracellular dehydration of neurons
B) Water movement into brain cells causing cerebral edema
C) Hyperosmolarity of the extracellular fluid
D) Sodium shift into the cerebrospinal fluid
- detailed 100% correctanswer :- B — Hyponatremia (Na <135) creates a
hypotonic extracellular environment. Water moves by osmosis from the ECF into the
more concentrated intracellular space of neurons, causing cerebral edema, increased
ICP, confusion, seizures, and coma.
2. A patient with prolonged vomiting has a serum potassium of 2.9 mEq/L. Which
electrocardiographic (ECG) change is most consistent with this electrolyte
imbalance?
A) Peaked T waves
B) Widened QRS complex
C) Flat T waves and prominent U waves
D) Shortened QT interval
- detailed 100% correctanswer :- C — Hypokalemia (K <3.5) delays ventricular
repolarization. Classic ECG findings include ST depression, flat or inverted T waves, and
the appearance of a prominent U wave. Peaked T waves are seen in hyperkalemia.
, 3
3. A patient with renal failure has a serum potassium of 6.8 mEq/L. The nurse
understands this level puts the patient at greatest risk for which lethal
complication?
A) Metabolic alkalosis
B) Cardiac arrest (ventricular fibrillation/asystole)
C) Respiratory depression
D) Hepatic encephalopathy
- detailed 100% correctanswer :- B — Hyperkalemia (K >5.0) significantly
increases the risk of lethal cardiac dysrhythmias, including ventricular fibrillation and
asystole, due to its effects on cardiac membrane excitability and conduction.
4. A patient has a serum osmolality of 320 mOsm/kg (normal: 275–295). Which
statement best describes the pathophysiology of thirst activation?
A) Osmoreceptors in the hypothalamus detect increased plasma osmolality and
stimulate thirst
B) Baroreceptors in the aorta detect hypervolemia and suppress thirst
C) Peripheral chemoreceptors detect hypercapnia and stimulate ADH
D) The renin-angiotensin system directly inhibits thirst
- detailed 100% correctanswer :- A — Osmoreceptors in the anterior
hypothalamus sense a 1–2% increase in plasma osmolality, triggering thirst and ADH
release to restore fluid balance.
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5. A patient presents with edema, weight gain, and jugular venous distention.
Which of the following pathophysiological mechanisms is most likely responsible?
A) Decreased capillary hydrostatic pressure
B) Increased plasma oncotic pressure
C) Increased capillary hydrostatic pressure
D) Decreased capillary permeability
- detailed 100% correctanswer :- C — Increased capillary hydrostatic pressure
(often from heart failure or fluid overload) forces fluid out of capillaries into the
interstitial space, causing edema. Increased plasma oncotic pressure would pull
fluid into capillaries.
6. Which of the following laboratory findings is most consistent with syndrome of
inappropriate antidiuretic hormone (SIADH)?
A) Serum sodium 155 mEq/L, serum osmolality 310 mOsm/kg
B) Serum sodium 120 mEq/L, serum osmolality 260 mOsm/kg
C) Serum sodium 140 mEq/L, serum osmolality 290 mOsm/kg
D) Serum sodium 130 mEq/L, serum osmolality 300 mOsm/kg
- detailed 100% correctanswer :- B — SIADH causes excessive water retention
due to elevated ADH, leading to dilutional hyponatremia (low serum sodium) and
decreased serum osmolality.
7. A patient with diabetic ketoacidosis has a serum potassium of 5.8 mEq/L despite
total body potassium depletion. What is the most likely explanation?
NUR 2063 / NUR2063:
Essentials of
Pathophysiology Exam
—2
Comprehensive Practice
Question Bank (Latest
2025/2026 Curriculum)
Rasmussen University
Exam 2 Focus Areas
This comprehensive question bank covers the following core topics as outlined in the
Rasmussen NUR 2063 Exam 2 curriculum: Fluid & Electrolyte Imbalances, Acid-Base
Regulation, Endocrine Disorders, Hematologic Disorders, Immunologic Disorders,
Gastrointestinal Disorders, Renal/Urinary Disorders, Cellular Regulation, Genetics,
and Inflammation/Immune Responses.
, 2
Section 1: Fluid & Electrolyte Imbalances (Questions 1–25)
1. A patient has a serum sodium level of 118 mEq/L (normal: 135–145). What
pathophysiological process is most likely causing the patient's cerebral confusion
and seizures?
A) Intracellular dehydration of neurons
B) Water movement into brain cells causing cerebral edema
C) Hyperosmolarity of the extracellular fluid
D) Sodium shift into the cerebrospinal fluid
- detailed 100% correctanswer :- B — Hyponatremia (Na <135) creates a
hypotonic extracellular environment. Water moves by osmosis from the ECF into the
more concentrated intracellular space of neurons, causing cerebral edema, increased
ICP, confusion, seizures, and coma.
2. A patient with prolonged vomiting has a serum potassium of 2.9 mEq/L. Which
electrocardiographic (ECG) change is most consistent with this electrolyte
imbalance?
A) Peaked T waves
B) Widened QRS complex
C) Flat T waves and prominent U waves
D) Shortened QT interval
- detailed 100% correctanswer :- C — Hypokalemia (K <3.5) delays ventricular
repolarization. Classic ECG findings include ST depression, flat or inverted T waves, and
the appearance of a prominent U wave. Peaked T waves are seen in hyperkalemia.
, 3
3. A patient with renal failure has a serum potassium of 6.8 mEq/L. The nurse
understands this level puts the patient at greatest risk for which lethal
complication?
A) Metabolic alkalosis
B) Cardiac arrest (ventricular fibrillation/asystole)
C) Respiratory depression
D) Hepatic encephalopathy
- detailed 100% correctanswer :- B — Hyperkalemia (K >5.0) significantly
increases the risk of lethal cardiac dysrhythmias, including ventricular fibrillation and
asystole, due to its effects on cardiac membrane excitability and conduction.
4. A patient has a serum osmolality of 320 mOsm/kg (normal: 275–295). Which
statement best describes the pathophysiology of thirst activation?
A) Osmoreceptors in the hypothalamus detect increased plasma osmolality and
stimulate thirst
B) Baroreceptors in the aorta detect hypervolemia and suppress thirst
C) Peripheral chemoreceptors detect hypercapnia and stimulate ADH
D) The renin-angiotensin system directly inhibits thirst
- detailed 100% correctanswer :- A — Osmoreceptors in the anterior
hypothalamus sense a 1–2% increase in plasma osmolality, triggering thirst and ADH
release to restore fluid balance.
, 4
5. A patient presents with edema, weight gain, and jugular venous distention.
Which of the following pathophysiological mechanisms is most likely responsible?
A) Decreased capillary hydrostatic pressure
B) Increased plasma oncotic pressure
C) Increased capillary hydrostatic pressure
D) Decreased capillary permeability
- detailed 100% correctanswer :- C — Increased capillary hydrostatic pressure
(often from heart failure or fluid overload) forces fluid out of capillaries into the
interstitial space, causing edema. Increased plasma oncotic pressure would pull
fluid into capillaries.
6. Which of the following laboratory findings is most consistent with syndrome of
inappropriate antidiuretic hormone (SIADH)?
A) Serum sodium 155 mEq/L, serum osmolality 310 mOsm/kg
B) Serum sodium 120 mEq/L, serum osmolality 260 mOsm/kg
C) Serum sodium 140 mEq/L, serum osmolality 290 mOsm/kg
D) Serum sodium 130 mEq/L, serum osmolality 300 mOsm/kg
- detailed 100% correctanswer :- B — SIADH causes excessive water retention
due to elevated ADH, leading to dilutional hyponatremia (low serum sodium) and
decreased serum osmolality.
7. A patient with diabetic ketoacidosis has a serum potassium of 5.8 mEq/L despite
total body potassium depletion. What is the most likely explanation?
