NR 283 EXAM 3/ ACTUAL PATHOPHYSIOLOGY NR283 EXAM 3 LATEST
2026/2027 COMPLETE ACCURATE EXAM
1. A client with chronic anemia reports progressive fatigue, exertional
dyspnea, dizziness, and reduced ability to perform usual activities.
Laboratory testing demonstrates a decreased hemoglobin concentration.
Which pathophysiologic change best explains the client's symptoms?
A. Increased destruction of platelets causing impaired clot formation
B. Increased plasma volume causing dilution of white blood cells
C. Increased production of antibodies causing systemic inflammation
D. Reduced oxygen-carrying capacity of the blood resulting in inadequate
tissue oxygen delivery
Answer: D
2. A client develops anemia several weeks after sustaining significant blood
loss during surgery. The bone marrow responds by increasing erythrocyte
production. Which hormone is primarily responsible for stimulating this
compensatory response?
A. Erythropoietin
B. Thrombopoietin
C. Calcitonin
D. Aldosterone
Answer: A
3. A client has chronic kidney disease and develops normocytic anemia
despite having adequate dietary iron and vitamin B12. Which
pathophysiologic mechanism best explains the anemia?
A. Excessive destruction of erythrocytes by the spleen
B. Reduced renal production of erythropoietin
C. Increased intestinal absorption of iron
D. Excessive production of intrinsic factor
Answer: B
1
, 4. A client has a laboratory profile showing microcytic, hypochromic
erythrocytes, decreased serum ferritin, and reduced hemoglobin. Which
disorder is most consistent with these findings?
A. Pernicious anemia
B. Aplastic anemia
C. Iron-deficiency anemia
D. Hemolytic anemia
Answer: C
5. A client follows a strict diet lacking animal products and develops fatigue,
paresthesias, and a macrocytic anemia. Which deficiency is most likely
responsible for the neurologic manifestations and abnormal erythrocyte
development?
A. Vitamin B12
B. Iron
C. Vitamin K
D. Calcium
Answer: A
6. A client develops severe anemia after receiving a medication that damages
hematopoietic stem cells. Laboratory testing reveals pancytopenia involving
erythrocytes, leukocytes, and platelets. Which pathophysiologic process
best explains this presentation?
A. Excessive production of mature blood cells
B. Bone marrow failure resulting in decreased production of multiple blood
cell lines
C. Increased erythropoietin production
D. Isolated destruction of circulating erythrocytes
Answer: B
7. A client with sickle cell disease experiences severe pain after becoming
dehydrated. Which mechanism is primarily responsible for the painful vaso-
occlusive episode?
2
, A. Excessive platelet production causes widespread thrombosis
B. Increased plasma volume causes hemodilution
C. Abnormal hemoglobin promotes erythrocyte sickling and obstruction of
small vessels
D. Increased erythropoietin directly causes vascular spasm
Answer: C
8. A client with sickle cell disease develops chronic anemia and intermittent
episodes of tissue ischemia. Which underlying abnormality produces these
complications?
A. Complete absence of hemoglobin
B. Production of structurally abnormal hemoglobin that polymerizes under
low-oxygen conditions
C. Excessive production of normal erythrocytes
D. Failure of platelets to aggregate
Answer: B
9. A client with hereditary spherocytosis develops jaundice and anemia.
Which mechanism most directly contributes to the premature destruction
of erythrocytes?
A. Increased erythrocyte production in the bone marrow
B. Decreased bilirubin formation
C. Abnormal erythrocyte membranes that make cells susceptible to splenic
destruction
D. Excessive production of intrinsic factor
Answer: C
10. A client develops jaundice, elevated bilirubin, and anemia after exposure to
a medication that triggers rapid erythrocyte destruction. Which process is
most consistent with these findings?
A. Hemolysis
B. Thrombocytopenia
3
, C. Leukopoiesis
D. Hemoconcentration
Answer: A
11. A client with a platelet count that is significantly below normal develops
petechiae and prolonged bleeding after minor trauma. Which
pathophysiologic problem is most directly responsible?
A. Increased red blood cell production
B. Impaired primary hemostasis caused by inadequate platelet numbers
C. Excessive fibrin breakdown caused by increased erythropoietin
D. Increased oxygen-carrying capacity
Answer: B
12. A client develops widespread bleeding, prolonged clotting studies, and
consumption of platelets and clotting factors during severe systemic illness.
Which disorder best describes this process?
A. Iron-deficiency anemia
B. Thalassemia
C. Disseminated intravascular coagulation
D. Hemophilia A
Answer: C
13. A child with hemophilia experiences prolonged bleeding after a minor
injury. Which pathophysiologic explanation best accounts for the bleeding
tendency?
A. Deficiency of a coagulation factor impairs formation of stable fibrin clots
B. Excessive platelet production prevents clot formation
C. Increased erythrocyte destruction causes hemorrhage
D. Increased vitamin K production causes bleeding
Answer: A
14. A client with leukemia develops recurrent infections, fatigue, anemia, and
easy bruising. Which explanation best accounts for the combination of
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2026/2027 COMPLETE ACCURATE EXAM
1. A client with chronic anemia reports progressive fatigue, exertional
dyspnea, dizziness, and reduced ability to perform usual activities.
Laboratory testing demonstrates a decreased hemoglobin concentration.
Which pathophysiologic change best explains the client's symptoms?
A. Increased destruction of platelets causing impaired clot formation
B. Increased plasma volume causing dilution of white blood cells
C. Increased production of antibodies causing systemic inflammation
D. Reduced oxygen-carrying capacity of the blood resulting in inadequate
tissue oxygen delivery
Answer: D
2. A client develops anemia several weeks after sustaining significant blood
loss during surgery. The bone marrow responds by increasing erythrocyte
production. Which hormone is primarily responsible for stimulating this
compensatory response?
A. Erythropoietin
B. Thrombopoietin
C. Calcitonin
D. Aldosterone
Answer: A
3. A client has chronic kidney disease and develops normocytic anemia
despite having adequate dietary iron and vitamin B12. Which
pathophysiologic mechanism best explains the anemia?
A. Excessive destruction of erythrocytes by the spleen
B. Reduced renal production of erythropoietin
C. Increased intestinal absorption of iron
D. Excessive production of intrinsic factor
Answer: B
1
, 4. A client has a laboratory profile showing microcytic, hypochromic
erythrocytes, decreased serum ferritin, and reduced hemoglobin. Which
disorder is most consistent with these findings?
A. Pernicious anemia
B. Aplastic anemia
C. Iron-deficiency anemia
D. Hemolytic anemia
Answer: C
5. A client follows a strict diet lacking animal products and develops fatigue,
paresthesias, and a macrocytic anemia. Which deficiency is most likely
responsible for the neurologic manifestations and abnormal erythrocyte
development?
A. Vitamin B12
B. Iron
C. Vitamin K
D. Calcium
Answer: A
6. A client develops severe anemia after receiving a medication that damages
hematopoietic stem cells. Laboratory testing reveals pancytopenia involving
erythrocytes, leukocytes, and platelets. Which pathophysiologic process
best explains this presentation?
A. Excessive production of mature blood cells
B. Bone marrow failure resulting in decreased production of multiple blood
cell lines
C. Increased erythropoietin production
D. Isolated destruction of circulating erythrocytes
Answer: B
7. A client with sickle cell disease experiences severe pain after becoming
dehydrated. Which mechanism is primarily responsible for the painful vaso-
occlusive episode?
2
, A. Excessive platelet production causes widespread thrombosis
B. Increased plasma volume causes hemodilution
C. Abnormal hemoglobin promotes erythrocyte sickling and obstruction of
small vessels
D. Increased erythropoietin directly causes vascular spasm
Answer: C
8. A client with sickle cell disease develops chronic anemia and intermittent
episodes of tissue ischemia. Which underlying abnormality produces these
complications?
A. Complete absence of hemoglobin
B. Production of structurally abnormal hemoglobin that polymerizes under
low-oxygen conditions
C. Excessive production of normal erythrocytes
D. Failure of platelets to aggregate
Answer: B
9. A client with hereditary spherocytosis develops jaundice and anemia.
Which mechanism most directly contributes to the premature destruction
of erythrocytes?
A. Increased erythrocyte production in the bone marrow
B. Decreased bilirubin formation
C. Abnormal erythrocyte membranes that make cells susceptible to splenic
destruction
D. Excessive production of intrinsic factor
Answer: C
10. A client develops jaundice, elevated bilirubin, and anemia after exposure to
a medication that triggers rapid erythrocyte destruction. Which process is
most consistent with these findings?
A. Hemolysis
B. Thrombocytopenia
3
, C. Leukopoiesis
D. Hemoconcentration
Answer: A
11. A client with a platelet count that is significantly below normal develops
petechiae and prolonged bleeding after minor trauma. Which
pathophysiologic problem is most directly responsible?
A. Increased red blood cell production
B. Impaired primary hemostasis caused by inadequate platelet numbers
C. Excessive fibrin breakdown caused by increased erythropoietin
D. Increased oxygen-carrying capacity
Answer: B
12. A client develops widespread bleeding, prolonged clotting studies, and
consumption of platelets and clotting factors during severe systemic illness.
Which disorder best describes this process?
A. Iron-deficiency anemia
B. Thalassemia
C. Disseminated intravascular coagulation
D. Hemophilia A
Answer: C
13. A child with hemophilia experiences prolonged bleeding after a minor
injury. Which pathophysiologic explanation best accounts for the bleeding
tendency?
A. Deficiency of a coagulation factor impairs formation of stable fibrin clots
B. Excessive platelet production prevents clot formation
C. Increased erythrocyte destruction causes hemorrhage
D. Increased vitamin K production causes bleeding
Answer: A
14. A client with leukemia develops recurrent infections, fatigue, anemia, and
easy bruising. Which explanation best accounts for the combination of
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