NSG 120 HESI Pathophysiology Success
Guide 2026/2027 | Verified Questions &
Answers | Graded A+ HERZING UNIVERSITY
1. A client with chronic heart failure has peripheral edema and ascites. This is
most likely due to which pathophysiologic mechanism?
A) Decreased plasma oncotic pressure
B) Increased hydrostatic pressure
C) Lymphatic obstruction
D) Sodium retention
Answer B: Increased hydrostatic pressure
Rationale: Heart failure increases venous hydrostatic pressure, driving fluid into
interstitial spaces (edema).
2. A client with pneumonia has a fever and elevated white blood cell count.
Which inflammatory mediator is primarily responsible for fever?
A) Histamine
B) Prostaglandins
C) Leukotrienes
D) Bradykinin
Answer B: Prostaglandins
,Rationale: Prostaglandins (especially PGE2) act on the hypothalamus to raise body
temperature set point.
3. A client with type 1 diabetes is in diabetic ketoacidosis (DKA). Which acid-
base imbalance is expected?
A) Metabolic alkalosis
B) Metabolic acidosis (high anion gap)
C) Respiratory acidosis
D) Respiratory alkalosis
Answer B: Metabolic acidosis (high anion gap)
Rationale: Ketone bodies (acetoacetic acid, β-hydroxybutyric acid) cause anion
gap metabolic acidosis.
4. A client with chronic kidney disease has a serum potassium of 6.8 mEq/L.
Which ECG change is most characteristic?
A) Prominent U waves
B) Peaked T waves
C) Prolonged PR interval
D) ST depression
Answer B: Peaked T waves
Rationale: Hyperkalemia causes peaked T waves; as it worsens, QRS widens.
,5. A client with a myocardial infarction develops crackles in bilateral lung
bases and an S3 gallop. This indicates:
A) Pericarditis
B) Left ventricular failure (pulmonary edema)
C) Right ventricular failure
D) Cardiogenic shock
Answer B: Left ventricular failure (pulmonary edema)
Rationale: Left heart failure causes pulmonary congestion, crackles, and S3.
6. A client with COPD has an FEV1/FVC ratio of 0.65. Which pathophysiologic
change is most consistent?
A) Decreased total lung capacity
B) Airflow obstruction due to airway narrowing and loss of elastic recoil
C) Restrictive pattern
D) Normal lung compliance
Answer B: Airflow obstruction due to airway narrowing and loss of elastic
recoil
Rationale: COPD causes irreversible airflow obstruction; FEV1/FVC <0.70 indicates
obstruction.
7. A client with liver cirrhosis has ascites. Which factor contributes most to
ascites formation?
A) Decreased aldosterone
, B) Portal hypertension and decreased plasma albumin
C) Increased lymphatic drainage
D) Renal failure
Answer B: Portal hypertension and decreased plasma albumin
Rationale: Portal hypertension increases hydrostatic pressure; low albumin
decreases oncotic pressure, leading to ascites.
8. A client with a brain tumor develops syndrome of inappropriate
antidiuretic hormone (SIADH). Which finding is expected?
A) Hypernatremia and polyuria
B) Hyponatremia and concentrated urine
C) Hyperkalemia and oliguria
D) Hypokalemia and dilute urine
Answer B: Hyponatremia and concentrated urine
Rationale: SIADH causes water retention, dilutional hyponatremia, and
concentrated urine (high osmolality).
9. A client with a severe allergic reaction develops laryngeal edema and
hypotension. Which type of hypersensitivity reaction is occurring? E) Type IV
(delayed)
A) Type I (IgE-mediated)
B) Type I (IgE-mediated)
C) Type II (cytotoxic)
Guide 2026/2027 | Verified Questions &
Answers | Graded A+ HERZING UNIVERSITY
1. A client with chronic heart failure has peripheral edema and ascites. This is
most likely due to which pathophysiologic mechanism?
A) Decreased plasma oncotic pressure
B) Increased hydrostatic pressure
C) Lymphatic obstruction
D) Sodium retention
Answer B: Increased hydrostatic pressure
Rationale: Heart failure increases venous hydrostatic pressure, driving fluid into
interstitial spaces (edema).
2. A client with pneumonia has a fever and elevated white blood cell count.
Which inflammatory mediator is primarily responsible for fever?
A) Histamine
B) Prostaglandins
C) Leukotrienes
D) Bradykinin
Answer B: Prostaglandins
,Rationale: Prostaglandins (especially PGE2) act on the hypothalamus to raise body
temperature set point.
3. A client with type 1 diabetes is in diabetic ketoacidosis (DKA). Which acid-
base imbalance is expected?
A) Metabolic alkalosis
B) Metabolic acidosis (high anion gap)
C) Respiratory acidosis
D) Respiratory alkalosis
Answer B: Metabolic acidosis (high anion gap)
Rationale: Ketone bodies (acetoacetic acid, β-hydroxybutyric acid) cause anion
gap metabolic acidosis.
4. A client with chronic kidney disease has a serum potassium of 6.8 mEq/L.
Which ECG change is most characteristic?
A) Prominent U waves
B) Peaked T waves
C) Prolonged PR interval
D) ST depression
Answer B: Peaked T waves
Rationale: Hyperkalemia causes peaked T waves; as it worsens, QRS widens.
,5. A client with a myocardial infarction develops crackles in bilateral lung
bases and an S3 gallop. This indicates:
A) Pericarditis
B) Left ventricular failure (pulmonary edema)
C) Right ventricular failure
D) Cardiogenic shock
Answer B: Left ventricular failure (pulmonary edema)
Rationale: Left heart failure causes pulmonary congestion, crackles, and S3.
6. A client with COPD has an FEV1/FVC ratio of 0.65. Which pathophysiologic
change is most consistent?
A) Decreased total lung capacity
B) Airflow obstruction due to airway narrowing and loss of elastic recoil
C) Restrictive pattern
D) Normal lung compliance
Answer B: Airflow obstruction due to airway narrowing and loss of elastic
recoil
Rationale: COPD causes irreversible airflow obstruction; FEV1/FVC <0.70 indicates
obstruction.
7. A client with liver cirrhosis has ascites. Which factor contributes most to
ascites formation?
A) Decreased aldosterone
, B) Portal hypertension and decreased plasma albumin
C) Increased lymphatic drainage
D) Renal failure
Answer B: Portal hypertension and decreased plasma albumin
Rationale: Portal hypertension increases hydrostatic pressure; low albumin
decreases oncotic pressure, leading to ascites.
8. A client with a brain tumor develops syndrome of inappropriate
antidiuretic hormone (SIADH). Which finding is expected?
A) Hypernatremia and polyuria
B) Hyponatremia and concentrated urine
C) Hyperkalemia and oliguria
D) Hypokalemia and dilute urine
Answer B: Hyponatremia and concentrated urine
Rationale: SIADH causes water retention, dilutional hyponatremia, and
concentrated urine (high osmolality).
9. A client with a severe allergic reaction develops laryngeal edema and
hypotension. Which type of hypersensitivity reaction is occurring? E) Type IV
(delayed)
A) Type I (IgE-mediated)
B) Type I (IgE-mediated)
C) Type II (cytotoxic)
