NURS 230 Pathophysiology Exam Prep Workbook
#8 Q's & A's (2026/2027)
Question 2 | Domain: Respiratory Pathophysiology
Chronic bronchitis is clinically defined as a productive cough lasting at least how long?
A. 1 month per year for 1 year
B. 3 months per year for 2 consecutive years
C. 6 months per year for 1 year
D. 1 year continuously
Rationale: The classic clinical definition of chronic bronchitis is a productive cough occurring
on most days for at least 3 months per year, for 2 consecutive years, after other causes have
been excluded. This time-based criterion distinguishes it from an acute or transient cough
illness.
Distractor Analysis: Incorrect options represent alternative respiratory conditions,
mechanisms, or concepts commonly confused with the correct answer.
Question 3 | Domain: Respiratory Pathophysiology
The majority of pulmonary emboli originate from which source?
A. Right atrial thrombi
B. Deep veins of the lower extremities
C. Pulmonary artery thrombi
D. Left ventricular mural thrombi
Rationale: Most pulmonary emboli arise from deep vein thrombosis (DVT) in the lower
extremities, particularly the femoral and iliac veins, which then dislodge and travel through the
venous system to the pulmonary circulation. Left-sided cardiac thrombi (D) would embolize
systemically, not to the lungs.
Distractor Analysis: Incorrect options represent alternative respiratory conditions,
mechanisms, or concepts commonly confused with the correct answer.
,Question 4 | Domain: Respiratory Pathophysiology
A V/Q ratio of zero indicates which condition?
A. Dead space ventilation
B. Normal gas exchange
C. Shunt
D. Hyperventilation
Rationale: A V/Q ratio of zero means there is perfusion to an alveolar unit but no ventilation
at all, which is the definition of a shunt. Blood passes through the lung without being
oxygenated. Dead space (A) is the opposite — ventilation without perfusion, giving a V/Q
ratio approaching infinity.
Distractor Analysis: Incorrect options represent alternative respiratory conditions,
mechanisms, or concepts commonly confused with the correct answer.
Question 5 | Domain: Respiratory Pathophysiology
What percentage of oxygen is transported bound to hemoglobin under normal
conditions?
A. 50%
B. 75%
C. 98%
D. 25%
Rationale: Approximately 97–98% of oxygen in the blood is carried bound to hemoglobin,
while only a small fraction (about 1–2%) is dissolved directly in plasma. This is why
hemoglobin concentration and function are critical determinants of oxygen-carrying capacity.
Distractor Analysis: Incorrect options represent alternative respiratory conditions,
mechanisms, or concepts commonly confused with the correct answer.
,Question 6 | Domain: Respiratory Pathophysiology
Lung compliance refers to:
A. The rate of airflow during expiration
B. The ease with which the lungs expand for a given change in pressure
C. The resistance of the airways to airflow
D. The amount of dead space ventilation
Rationale: Compliance describes the distensibility of the lungs — how much volume change
occurs per unit of pressure change. High compliance means the lungs expand easily (as in
emphysema), while low compliance means they are stiff and resist expansion (as in fibrosis).
Airway resistance (C) is a separate mechanical property related to airflow, not lung
distensibility.
Distractor Analysis: Incorrect options represent alternative respiratory conditions,
mechanisms, or concepts commonly confused with the correct answer.
Question 7 | Domain: Respiratory Pathophysiology
A patient with asthma reports wheezing and chest tightness after exposure to cold air.
This trigger is classified as:
A. Allergic
B. Non-allergic/irritant
C. Infectious
D. Exercise-induced
Rationale: Cold air is a classic non-allergic (irritant) trigger that causes airway hyperreactivity
and bronchoconstriction without involving an IgE-mediated allergic response. Allergic triggers
(A) typically involve allergens like pollen, dust mites, or pet dander.
Distractor Analysis: Incorrect options represent alternative respiratory conditions,
mechanisms, or concepts commonly confused with the correct answer.
, Question 8 | Domain: Respiratory Pathophysiology
A patient with emphysema has chronic hypoxemia. Which mechanism best explains this
finding?
A. Bronchospasm
B. Loss of alveolar surface area and elastic recoil
C. Excess mucus production
D. Pulmonary vasoconstriction from hypocapnia
Rationale: Emphysema involves destruction of alveolar walls and capillary beds, reducing
the surface area available for gas exchange, along with loss of elastic recoil that impairs
expiratory airflow. This structural damage directly impairs oxygen diffusion, producing chronic
hypoxemia. Excess mucus (C) is more characteristic of chronic bronchitis.
Distractor Analysis: Incorrect options represent alternative respiratory conditions,
mechanisms, or concepts commonly confused with the correct answer.
Question 9 | Domain: Respiratory Pathophysiology
A postoperative patient suddenly develops dyspnea, pleuritic chest pain, and tachycardia.
Which complication should the nurse suspect first?
A. Pneumonia
B. Pulmonary embolism
C. Pneumothorax
D. Myocardial infarction
Rationale: Sudden-onset dyspnea, pleuritic chest pain, and tachycardia in a postoperative
patient (a high-risk state for venous stasis and clot formation) is the classic presentation of
pulmonary embolism. Immobility and surgery are major risk factors per Virchow's triad.
Distractor Analysis: Incorrect options represent alternative respiratory conditions,
mechanisms, or concepts commonly confused with the correct answer.
#8 Q's & A's (2026/2027)
Question 2 | Domain: Respiratory Pathophysiology
Chronic bronchitis is clinically defined as a productive cough lasting at least how long?
A. 1 month per year for 1 year
B. 3 months per year for 2 consecutive years
C. 6 months per year for 1 year
D. 1 year continuously
Rationale: The classic clinical definition of chronic bronchitis is a productive cough occurring
on most days for at least 3 months per year, for 2 consecutive years, after other causes have
been excluded. This time-based criterion distinguishes it from an acute or transient cough
illness.
Distractor Analysis: Incorrect options represent alternative respiratory conditions,
mechanisms, or concepts commonly confused with the correct answer.
Question 3 | Domain: Respiratory Pathophysiology
The majority of pulmonary emboli originate from which source?
A. Right atrial thrombi
B. Deep veins of the lower extremities
C. Pulmonary artery thrombi
D. Left ventricular mural thrombi
Rationale: Most pulmonary emboli arise from deep vein thrombosis (DVT) in the lower
extremities, particularly the femoral and iliac veins, which then dislodge and travel through the
venous system to the pulmonary circulation. Left-sided cardiac thrombi (D) would embolize
systemically, not to the lungs.
Distractor Analysis: Incorrect options represent alternative respiratory conditions,
mechanisms, or concepts commonly confused with the correct answer.
,Question 4 | Domain: Respiratory Pathophysiology
A V/Q ratio of zero indicates which condition?
A. Dead space ventilation
B. Normal gas exchange
C. Shunt
D. Hyperventilation
Rationale: A V/Q ratio of zero means there is perfusion to an alveolar unit but no ventilation
at all, which is the definition of a shunt. Blood passes through the lung without being
oxygenated. Dead space (A) is the opposite — ventilation without perfusion, giving a V/Q
ratio approaching infinity.
Distractor Analysis: Incorrect options represent alternative respiratory conditions,
mechanisms, or concepts commonly confused with the correct answer.
Question 5 | Domain: Respiratory Pathophysiology
What percentage of oxygen is transported bound to hemoglobin under normal
conditions?
A. 50%
B. 75%
C. 98%
D. 25%
Rationale: Approximately 97–98% of oxygen in the blood is carried bound to hemoglobin,
while only a small fraction (about 1–2%) is dissolved directly in plasma. This is why
hemoglobin concentration and function are critical determinants of oxygen-carrying capacity.
Distractor Analysis: Incorrect options represent alternative respiratory conditions,
mechanisms, or concepts commonly confused with the correct answer.
,Question 6 | Domain: Respiratory Pathophysiology
Lung compliance refers to:
A. The rate of airflow during expiration
B. The ease with which the lungs expand for a given change in pressure
C. The resistance of the airways to airflow
D. The amount of dead space ventilation
Rationale: Compliance describes the distensibility of the lungs — how much volume change
occurs per unit of pressure change. High compliance means the lungs expand easily (as in
emphysema), while low compliance means they are stiff and resist expansion (as in fibrosis).
Airway resistance (C) is a separate mechanical property related to airflow, not lung
distensibility.
Distractor Analysis: Incorrect options represent alternative respiratory conditions,
mechanisms, or concepts commonly confused with the correct answer.
Question 7 | Domain: Respiratory Pathophysiology
A patient with asthma reports wheezing and chest tightness after exposure to cold air.
This trigger is classified as:
A. Allergic
B. Non-allergic/irritant
C. Infectious
D. Exercise-induced
Rationale: Cold air is a classic non-allergic (irritant) trigger that causes airway hyperreactivity
and bronchoconstriction without involving an IgE-mediated allergic response. Allergic triggers
(A) typically involve allergens like pollen, dust mites, or pet dander.
Distractor Analysis: Incorrect options represent alternative respiratory conditions,
mechanisms, or concepts commonly confused with the correct answer.
, Question 8 | Domain: Respiratory Pathophysiology
A patient with emphysema has chronic hypoxemia. Which mechanism best explains this
finding?
A. Bronchospasm
B. Loss of alveolar surface area and elastic recoil
C. Excess mucus production
D. Pulmonary vasoconstriction from hypocapnia
Rationale: Emphysema involves destruction of alveolar walls and capillary beds, reducing
the surface area available for gas exchange, along with loss of elastic recoil that impairs
expiratory airflow. This structural damage directly impairs oxygen diffusion, producing chronic
hypoxemia. Excess mucus (C) is more characteristic of chronic bronchitis.
Distractor Analysis: Incorrect options represent alternative respiratory conditions,
mechanisms, or concepts commonly confused with the correct answer.
Question 9 | Domain: Respiratory Pathophysiology
A postoperative patient suddenly develops dyspnea, pleuritic chest pain, and tachycardia.
Which complication should the nurse suspect first?
A. Pneumonia
B. Pulmonary embolism
C. Pneumothorax
D. Myocardial infarction
Rationale: Sudden-onset dyspnea, pleuritic chest pain, and tachycardia in a postoperative
patient (a high-risk state for venous stasis and clot formation) is the classic presentation of
pulmonary embolism. Immobility and surgery are major risk factors per Virchow's triad.
Distractor Analysis: Incorrect options represent alternative respiratory conditions,
mechanisms, or concepts commonly confused with the correct answer.
