NR 283 PATHOPHYSIOLOGY FINAL EXAM
CHAMBERLAIN UNIVERSITY ACTUAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS WITH
RATIONALES 100% GUARANTEED PASS!!
<LATEST VERSION>
1.
A client has had poorly controlled hypertension for several years. An
echocardiogram demonstrates thickening of the left ventricular wall. Which
cellular adaptation best explains this finding?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Answer: B. Hypertrophy
Rationale: Hypertrophy is an increase in the size of existing cells caused by
increased workload. Cardiac muscle cells enlarge in response to chronic pressure
overload, such as longstanding hypertension. Hyperplasia involves an increase in
cell number, metaplasia is replacement of one mature cell type with another, and
dysplasia involves abnormal cellular growth and organization.
,2.
A long-term smoker develops chronic irritation of the bronchial epithelium. Which
cellular change is most likely to occur as an adaptive response?
A. Replacement of ciliated columnar cells with stratified squamous cells
B. Enlargement of individual alveolar cells
C. Uncontrolled proliferation of malignant cells
D. Increased production of pancreatic beta cells
Answer: A. Replacement of ciliated columnar cells with stratified squamous
cells
Rationale: Chronic irritation can cause metaplasia, in which one differentiated
mature cell type is reversibly replaced by another better able to tolerate the stress.
In the respiratory tract, chronic smoking can promote replacement of ciliated
columnar epithelium with stratified squamous epithelium. Although protective
against irritation, this adaptation reduces normal mucociliary clearance and can
increase susceptibility to further injury.
3.
A client presents after 2 days of severe vomiting and diarrhea. The nurse notes dry
mucous membranes, tachycardia, orthostatic hypotension, and decreased urine
output. Which pathophysiologic process best accounts for these findings?
A. Increased intravascular hydrostatic pressure
B. Loss of extracellular fluid volume
C. Movement of fluid from the intravascular space into the interstitial space
D. Increased total body water caused by impaired renal excretion
Answer: B. Loss of extracellular fluid volume
Rationale: Vomiting and diarrhea can produce fluid volume deficit by reducing
extracellular fluid, including intravascular volume. Decreased circulating volume
results in tachycardia, hypotension, thirst, reduced urine output, and poor tissue
perfusion. Fluid volume excess would instead be associated with findings such as
edema, hypertension, and pulmonary congestion.
,4.
A client with chronic kidney disease has generalized edema, elevated blood
pressure, and bilateral crackles. Which mechanism most directly contributes to the
edema?
A. Decreased capillary hydrostatic pressure
B. Increased plasma oncotic pressure
C. Sodium and water retention
D. Increased intracellular potassium concentration
Answer: C. Sodium and water retention
Rationale: Impaired renal function reduces the kidneys' ability to excrete sodium
and water. Expansion of extracellular fluid increases hydrostatic pressure within
the vascular system, promoting movement of fluid into the interstitial tissues and
producing edema. Excess fluid can also accumulate in the lungs, causing crackles.
5.
A client's arterial blood gas results are:
pH: 7.28
PaCO₂: 52 mmHg
HCO₃⁻: 24 mEq/L
How should these results be interpreted?
A. Uncompensated respiratory acidosis
B. Uncompensated metabolic acidosis
C. Compensated respiratory alkalosis
D. Compensated metabolic acidosis
Answer: A. Uncompensated respiratory acidosis
Rationale: The pH is below 7.35, indicating acidemia. The PaCO₂ is elevated,
identifying a respiratory cause. The HCO₃⁻ remains within the normal range,
indicating that significant metabolic compensation has not occurred. This pattern is
consistent with uncompensated respiratory acidosis.
, 6.
A client with persistent diarrhea has the following ABG results:
pH: 7.30
PaCO₂: 32 mmHg
HCO₃⁻: 16 mEq/L
Which interpretation is most accurate?
A. Respiratory acidosis with renal compensation
B. Metabolic acidosis with respiratory compensation
C. Respiratory alkalosis with metabolic compensation
D. Metabolic alkalosis with respiratory compensation
Answer: B. Metabolic acidosis with respiratory compensation
Rationale: The low pH indicates acidemia, while the decreased HCO₃⁻ identifies a
metabolic cause. The reduced PaCO₂ indicates that the client is compensating
through increased ventilation, eliminating carbon dioxide. Diarrhea can cause
substantial bicarbonate loss and therefore metabolic acidosis.
7.
A client with severe chronic obstructive pulmonary disease has an ABG showing a
PaCO₂ of 58 mmHg. Which physiologic change would most directly result from
this abnormality?
A. Increased blood pH caused by loss of hydrogen ions
B. Decreased carbonic acid formation
C. Increased hydrogen ion concentration
D. Increased bicarbonate excretion by the kidneys
Answer: C. Increased hydrogen ion concentration
Rationale: Carbon dioxide combines with water to form carbonic acid, which
dissociates into hydrogen ions and bicarbonate. Retention of CO₂ therefore
increases hydrogen ion concentration and lowers blood pH. With chronic
CHAMBERLAIN UNIVERSITY ACTUAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS WITH
RATIONALES 100% GUARANTEED PASS!!
<LATEST VERSION>
1.
A client has had poorly controlled hypertension for several years. An
echocardiogram demonstrates thickening of the left ventricular wall. Which
cellular adaptation best explains this finding?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Answer: B. Hypertrophy
Rationale: Hypertrophy is an increase in the size of existing cells caused by
increased workload. Cardiac muscle cells enlarge in response to chronic pressure
overload, such as longstanding hypertension. Hyperplasia involves an increase in
cell number, metaplasia is replacement of one mature cell type with another, and
dysplasia involves abnormal cellular growth and organization.
,2.
A long-term smoker develops chronic irritation of the bronchial epithelium. Which
cellular change is most likely to occur as an adaptive response?
A. Replacement of ciliated columnar cells with stratified squamous cells
B. Enlargement of individual alveolar cells
C. Uncontrolled proliferation of malignant cells
D. Increased production of pancreatic beta cells
Answer: A. Replacement of ciliated columnar cells with stratified squamous
cells
Rationale: Chronic irritation can cause metaplasia, in which one differentiated
mature cell type is reversibly replaced by another better able to tolerate the stress.
In the respiratory tract, chronic smoking can promote replacement of ciliated
columnar epithelium with stratified squamous epithelium. Although protective
against irritation, this adaptation reduces normal mucociliary clearance and can
increase susceptibility to further injury.
3.
A client presents after 2 days of severe vomiting and diarrhea. The nurse notes dry
mucous membranes, tachycardia, orthostatic hypotension, and decreased urine
output. Which pathophysiologic process best accounts for these findings?
A. Increased intravascular hydrostatic pressure
B. Loss of extracellular fluid volume
C. Movement of fluid from the intravascular space into the interstitial space
D. Increased total body water caused by impaired renal excretion
Answer: B. Loss of extracellular fluid volume
Rationale: Vomiting and diarrhea can produce fluid volume deficit by reducing
extracellular fluid, including intravascular volume. Decreased circulating volume
results in tachycardia, hypotension, thirst, reduced urine output, and poor tissue
perfusion. Fluid volume excess would instead be associated with findings such as
edema, hypertension, and pulmonary congestion.
,4.
A client with chronic kidney disease has generalized edema, elevated blood
pressure, and bilateral crackles. Which mechanism most directly contributes to the
edema?
A. Decreased capillary hydrostatic pressure
B. Increased plasma oncotic pressure
C. Sodium and water retention
D. Increased intracellular potassium concentration
Answer: C. Sodium and water retention
Rationale: Impaired renal function reduces the kidneys' ability to excrete sodium
and water. Expansion of extracellular fluid increases hydrostatic pressure within
the vascular system, promoting movement of fluid into the interstitial tissues and
producing edema. Excess fluid can also accumulate in the lungs, causing crackles.
5.
A client's arterial blood gas results are:
pH: 7.28
PaCO₂: 52 mmHg
HCO₃⁻: 24 mEq/L
How should these results be interpreted?
A. Uncompensated respiratory acidosis
B. Uncompensated metabolic acidosis
C. Compensated respiratory alkalosis
D. Compensated metabolic acidosis
Answer: A. Uncompensated respiratory acidosis
Rationale: The pH is below 7.35, indicating acidemia. The PaCO₂ is elevated,
identifying a respiratory cause. The HCO₃⁻ remains within the normal range,
indicating that significant metabolic compensation has not occurred. This pattern is
consistent with uncompensated respiratory acidosis.
, 6.
A client with persistent diarrhea has the following ABG results:
pH: 7.30
PaCO₂: 32 mmHg
HCO₃⁻: 16 mEq/L
Which interpretation is most accurate?
A. Respiratory acidosis with renal compensation
B. Metabolic acidosis with respiratory compensation
C. Respiratory alkalosis with metabolic compensation
D. Metabolic alkalosis with respiratory compensation
Answer: B. Metabolic acidosis with respiratory compensation
Rationale: The low pH indicates acidemia, while the decreased HCO₃⁻ identifies a
metabolic cause. The reduced PaCO₂ indicates that the client is compensating
through increased ventilation, eliminating carbon dioxide. Diarrhea can cause
substantial bicarbonate loss and therefore metabolic acidosis.
7.
A client with severe chronic obstructive pulmonary disease has an ABG showing a
PaCO₂ of 58 mmHg. Which physiologic change would most directly result from
this abnormality?
A. Increased blood pH caused by loss of hydrogen ions
B. Decreased carbonic acid formation
C. Increased hydrogen ion concentration
D. Increased bicarbonate excretion by the kidneys
Answer: C. Increased hydrogen ion concentration
Rationale: Carbon dioxide combines with water to form carbonic acid, which
dissociates into hydrogen ions and bicarbonate. Retention of CO₂ therefore
increases hydrogen ion concentration and lowers blood pH. With chronic
