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NSG 3280 Pathophysiology for Nurses I
Comprehensive Review Exam Official Practice
Exam Actual Exam 2026/2027 with Detailed
Rationales | Complete Exam-Style Questions |
Pass Guaranteed – A+ Graded
Q1: A 68-year-old patient presents with chest pain, diaphoresis, and shortness of
breath. ECG shows ST-segment elevation in leads II, III, and aVF. Which coronary
artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery [CORRECT]
D. Left main coronary artery
Correct Answer: C
Rationale: Correct because leads II, III, and aVF represent the inferior wall of the
heart, which is primarily supplied by the right coronary artery in approximately
80% of individuals. This matches the classic ECG presentation of an inferior wall
myocardial infarction.
Q2: A patient with chronic kidney disease has a serum potassium level of 6.8
mEq/L. Which electrocardiogram change is the priority finding that requires
immediate intervention?
A. Flattened T waves
B. Prolonged PR interval
C. Peaked, tented T waves [CORRECT]
,2
D. Widened QRS complex
Correct Answer: C
Rationale: Correct because peaked, tented T waves are the earliest and most
characteristic ECG manifestation of hyperkalemia. This matches the progressive
cardiac effects of elevated potassium, where tall peaked T waves appear before
more dangerous conduction abnormalities develop. Priority is recognizing this
early sign before cardiac arrest risk increases.
Q3: A nurse is assessing a patient who sustained a thermal burn injury 48 hours
ago. The wound appears red, warm, and edematous with clear exudate. Which
stage of the inflammatory response is this patient demonstrating?
A. Vascular spasm phase
B. Resolution phase
C. Vascular and cellular response phase [CORRECT]
D. Maturation phase
Correct Answer: C
Rationale: Correct because the findings of erythema, warmth, edema, and exudate
indicate active vasodilation and increased vascular permeability characteristic of
the vascular and cellular response phase of acute inflammation. This matches the
classic cardinal signs of inflammation occurring 24-72 hours after tissue injury.
Q4: SCENARIO: A 54-year-old female with type 2 diabetes mellitus presents to
the emergency department complaining of burning pain in both feet that worsens at
night. She describes the sensation as "walking on hot coals." On examination, she
has decreased sensation to light touch and vibration bilaterally. Her HbA1c is
9.2%.
Which pathophysiologic mechanism best explains this patient's symptoms?
,3
A. Acute ischemia from peripheral arterial disease
B. Compression of nerve roots from lumbar disc herniation
C. Metabolic-induced peripheral neuropathy from hyperglycemia [CORRECT]
D. Vitamin B12 deficiency from malabsorption
Correct Answer: C
Rationale: Correct because chronic hyperglycemia causes accumulation of sorbitol
and fructose in peripheral nerves, leading to axonal degeneration and
demyelination. This matches the classic presentation of diabetic peripheral
neuropathy with symmetric distal sensory loss and painful dysesthesias that are
often worse at night. Priority is glycemic control to prevent progression.
Q5: A patient with emphysema is most likely to have which pattern of pulmonary
function test results?
A. Decreased FEV1, normal FVC, decreased FEV1/FVC ratio
B. Decreased FEV1, decreased FVC, normal FEV1/FVC ratio
C. Decreased FEV1, increased FVC, significantly decreased FEV1/FVC ratio
[CORRECT]
D. Normal FEV1, increased FVC, increased FEV1/FVC ratio
Correct Answer: C
Rationale: Correct because emphysema causes destruction of alveolar walls and
loss of elastic recoil, leading to air trapping and hyperinflation. This results in
decreased forced expiratory volume in 1 second (FEV1) due to airway collapse
during exhalation, while FVC may be normal or increased due to air trapping,
producing a significantly reduced FEV1/FVC ratio characteristic of obstructive
lung disease.
Q6: Which cellular adaptation is characterized by an increase in the number of
cells in response to hormonal stimulation?
, 4
A. Hypertrophy
B. Atrophy
C. Hyperplasia [CORRECT]
D. Metaplasia
Correct Answer: C
Rationale: Correct because hyperplasia is defined as an increase in the number of
cells in an organ or tissue, commonly occurring as a physiologic response to
hormonal stimulation such as breast tissue proliferation during pregnancy or
endometrial thickening during the menstrual cycle. This matches the definition
distinguishing it from hypertrophy (increase in cell size).
Q7: DATA QUESTION: Review the following arterial blood gas results:
pH: 7.32
PaCO2: 58 mmHg
HCO3: 32 mEq/L
PaO2: 78 mmHg
What is the primary acid-base disorder?
A. Uncompensated respiratory acidosis
B. Compensated metabolic alkalosis
C. Partially compensated respiratory acidosis [CORRECT]
D. Combined respiratory and metabolic acidosis
Correct Answer: C
NSG 3280 Pathophysiology for Nurses I
Comprehensive Review Exam Official Practice
Exam Actual Exam 2026/2027 with Detailed
Rationales | Complete Exam-Style Questions |
Pass Guaranteed – A+ Graded
Q1: A 68-year-old patient presents with chest pain, diaphoresis, and shortness of
breath. ECG shows ST-segment elevation in leads II, III, and aVF. Which coronary
artery is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery [CORRECT]
D. Left main coronary artery
Correct Answer: C
Rationale: Correct because leads II, III, and aVF represent the inferior wall of the
heart, which is primarily supplied by the right coronary artery in approximately
80% of individuals. This matches the classic ECG presentation of an inferior wall
myocardial infarction.
Q2: A patient with chronic kidney disease has a serum potassium level of 6.8
mEq/L. Which electrocardiogram change is the priority finding that requires
immediate intervention?
A. Flattened T waves
B. Prolonged PR interval
C. Peaked, tented T waves [CORRECT]
,2
D. Widened QRS complex
Correct Answer: C
Rationale: Correct because peaked, tented T waves are the earliest and most
characteristic ECG manifestation of hyperkalemia. This matches the progressive
cardiac effects of elevated potassium, where tall peaked T waves appear before
more dangerous conduction abnormalities develop. Priority is recognizing this
early sign before cardiac arrest risk increases.
Q3: A nurse is assessing a patient who sustained a thermal burn injury 48 hours
ago. The wound appears red, warm, and edematous with clear exudate. Which
stage of the inflammatory response is this patient demonstrating?
A. Vascular spasm phase
B. Resolution phase
C. Vascular and cellular response phase [CORRECT]
D. Maturation phase
Correct Answer: C
Rationale: Correct because the findings of erythema, warmth, edema, and exudate
indicate active vasodilation and increased vascular permeability characteristic of
the vascular and cellular response phase of acute inflammation. This matches the
classic cardinal signs of inflammation occurring 24-72 hours after tissue injury.
Q4: SCENARIO: A 54-year-old female with type 2 diabetes mellitus presents to
the emergency department complaining of burning pain in both feet that worsens at
night. She describes the sensation as "walking on hot coals." On examination, she
has decreased sensation to light touch and vibration bilaterally. Her HbA1c is
9.2%.
Which pathophysiologic mechanism best explains this patient's symptoms?
,3
A. Acute ischemia from peripheral arterial disease
B. Compression of nerve roots from lumbar disc herniation
C. Metabolic-induced peripheral neuropathy from hyperglycemia [CORRECT]
D. Vitamin B12 deficiency from malabsorption
Correct Answer: C
Rationale: Correct because chronic hyperglycemia causes accumulation of sorbitol
and fructose in peripheral nerves, leading to axonal degeneration and
demyelination. This matches the classic presentation of diabetic peripheral
neuropathy with symmetric distal sensory loss and painful dysesthesias that are
often worse at night. Priority is glycemic control to prevent progression.
Q5: A patient with emphysema is most likely to have which pattern of pulmonary
function test results?
A. Decreased FEV1, normal FVC, decreased FEV1/FVC ratio
B. Decreased FEV1, decreased FVC, normal FEV1/FVC ratio
C. Decreased FEV1, increased FVC, significantly decreased FEV1/FVC ratio
[CORRECT]
D. Normal FEV1, increased FVC, increased FEV1/FVC ratio
Correct Answer: C
Rationale: Correct because emphysema causes destruction of alveolar walls and
loss of elastic recoil, leading to air trapping and hyperinflation. This results in
decreased forced expiratory volume in 1 second (FEV1) due to airway collapse
during exhalation, while FVC may be normal or increased due to air trapping,
producing a significantly reduced FEV1/FVC ratio characteristic of obstructive
lung disease.
Q6: Which cellular adaptation is characterized by an increase in the number of
cells in response to hormonal stimulation?
, 4
A. Hypertrophy
B. Atrophy
C. Hyperplasia [CORRECT]
D. Metaplasia
Correct Answer: C
Rationale: Correct because hyperplasia is defined as an increase in the number of
cells in an organ or tissue, commonly occurring as a physiologic response to
hormonal stimulation such as breast tissue proliferation during pregnancy or
endometrial thickening during the menstrual cycle. This matches the definition
distinguishing it from hypertrophy (increase in cell size).
Q7: DATA QUESTION: Review the following arterial blood gas results:
pH: 7.32
PaCO2: 58 mmHg
HCO3: 32 mEq/L
PaO2: 78 mmHg
What is the primary acid-base disorder?
A. Uncompensated respiratory acidosis
B. Compensated metabolic alkalosis
C. Partially compensated respiratory acidosis [CORRECT]
D. Combined respiratory and metabolic acidosis
Correct Answer: C
