Galen NSG 3850 Exam 1 | Pathophysiology for Nurses II
(2026) Actual Q&A PDF
1. Which of the following best describes the composition of the intracellular fluid (ICF)
compartment?
A) High in sodium and chloride; low in potassium
B) High in potassium, magnesium, and phosphate; low in sodium and chloride
C) Equal concentrations of sodium and potassium
D) High in sodium and bicarbonate; low in protein
Correct Answer: High in potassium, magnesium, and phosphate; low in sodium and
chloride
Rationale: The ICF is rich in potassium, magnesium, and phosphate, and low in sodium
and chloride. The extracellular fluid (ECF) is high in sodium and chloride. This distribution
is maintained by the sodium‑potassium pump and is essential for cellular function.
2. What is the primary function of antidiuretic hormone (ADH) on urine volume?
A) ADH increases urine volume
B) ADH decreases urine volume
C) ADH has no effect on urine volume
D) ADH only affects sodium excretion
Correct Answer: ADH decreases urine volume
Rationale: ADH is the "free water" hormone that causes the kidneys to reabsorb plain
water, thereby decreasing urine volume and concentrating the urine. When ADH is low,
,urine volume is high. This mechanism helps maintain circulating volume and serum
osmolality.
3. Which hormone is primarily responsible for sodium and water retention by the kidneys?
A) Antidiuretic hormone (ADH)
B) Aldosterone
C) Atrial natriuretic peptide (ANP)
D) Brain natriuretic peptide (BNP)
Correct Answer: Aldosterone
Rationale: Aldosterone, released from the adrenal cortex, promotes sodium and water
reabsorption in the kidneys, leading to increased blood volume. ADH primarily regulates
water reabsorption, while ANP and BNP promote fluid excretion.
4. A patient has experienced several days of vomiting and diarrhea. Which finding most
strongly suggests hypovolemia?
A) Bounding pulse
B) Distended neck veins
C) Tachycardia with orthostatic hypotension
D) Peripheral edema
Correct Answer: Tachycardia with orthostatic hypotension
Rationale: Loss of intravascular fluid decreases circulating volume, producing
compensatory tachycardia and orthostatic blood‑pressure changes. Bounding pulse,
distended neck veins, and peripheral edema are signs of fluid volume excess.
,5. Which assessment finding is most consistent with fluid volume excess?
A) Flat neck veins
B) Crackles and peripheral edema
C) Dry mucous membranes
D) Poor skin turgor
Correct Answer: Crackles and peripheral edema
Rationale: Excess extracellular fluid can produce pulmonary congestion, crackles,
dependent edema, and weight gain. Flat neck veins, dry mucous membranes, and poor
skin turgor are signs of fluid volume deficit.
6. Decreased neuromuscular excitability is often the result of which electrolyte imbalance?
A) Hypercalcemia and hypermagnesemia
B) Hypomagnesemia and hyperkalemia
C) Hypocalcemia and hypokalemia
D) Hypernatremia and hypomagnesemia
Correct Answer: Hypercalcemia and hypermagnesemia
Rationale: Hypercalcemia and hypermagnesemia both reduce neuromuscular excitability,
leading to lethargy, weakness, and decreased deep tendon reflexes. Hypocalcemia and
hypokalemia increase excitability, causing tetany and muscle cramps.
7. Which event is likely to lead to hyponatremia?
A) Insufficient ADH secretion
B) Excess aldosterone secretion
, C) Administration of intravenous normal saline
D) Frequent nasogastric tube irrigation with water
Correct Answer: Frequent nasogastric tube irrigation with water
Rationale: Frequent nasogastric tube irrigation with water can lead to water absorption
and dilutional hyponatremia. Insufficient ADH secretion leads to hypernatremia, excess
aldosterone causes sodium retention, and normal saline is isotonic.
8. An increase in the resting membrane potential (hyperpolarized) is associated with which
electrolyte imbalance?
A) Hypokalemia
B) Hyperkalemia
C) Hypocalcemia
D) Hypercalcemia
Correct Answer: Hypokalemia
Rationale: Hypokalemia causes hyperpolarization of the resting membrane potential,
making cells less excitable. Hyperkalemia causes depolarization, increasing excitability.
9. Abnormalities in intracellular regulation of enzyme activity and cellular production of
ATP are associated with which electrolyte imbalance?
A) Hyponatremia
B) Hypocalcemia
C) Hypophosphatemia
D) Hypokalemia
(2026) Actual Q&A PDF
1. Which of the following best describes the composition of the intracellular fluid (ICF)
compartment?
A) High in sodium and chloride; low in potassium
B) High in potassium, magnesium, and phosphate; low in sodium and chloride
C) Equal concentrations of sodium and potassium
D) High in sodium and bicarbonate; low in protein
Correct Answer: High in potassium, magnesium, and phosphate; low in sodium and
chloride
Rationale: The ICF is rich in potassium, magnesium, and phosphate, and low in sodium
and chloride. The extracellular fluid (ECF) is high in sodium and chloride. This distribution
is maintained by the sodium‑potassium pump and is essential for cellular function.
2. What is the primary function of antidiuretic hormone (ADH) on urine volume?
A) ADH increases urine volume
B) ADH decreases urine volume
C) ADH has no effect on urine volume
D) ADH only affects sodium excretion
Correct Answer: ADH decreases urine volume
Rationale: ADH is the "free water" hormone that causes the kidneys to reabsorb plain
water, thereby decreasing urine volume and concentrating the urine. When ADH is low,
,urine volume is high. This mechanism helps maintain circulating volume and serum
osmolality.
3. Which hormone is primarily responsible for sodium and water retention by the kidneys?
A) Antidiuretic hormone (ADH)
B) Aldosterone
C) Atrial natriuretic peptide (ANP)
D) Brain natriuretic peptide (BNP)
Correct Answer: Aldosterone
Rationale: Aldosterone, released from the adrenal cortex, promotes sodium and water
reabsorption in the kidneys, leading to increased blood volume. ADH primarily regulates
water reabsorption, while ANP and BNP promote fluid excretion.
4. A patient has experienced several days of vomiting and diarrhea. Which finding most
strongly suggests hypovolemia?
A) Bounding pulse
B) Distended neck veins
C) Tachycardia with orthostatic hypotension
D) Peripheral edema
Correct Answer: Tachycardia with orthostatic hypotension
Rationale: Loss of intravascular fluid decreases circulating volume, producing
compensatory tachycardia and orthostatic blood‑pressure changes. Bounding pulse,
distended neck veins, and peripheral edema are signs of fluid volume excess.
,5. Which assessment finding is most consistent with fluid volume excess?
A) Flat neck veins
B) Crackles and peripheral edema
C) Dry mucous membranes
D) Poor skin turgor
Correct Answer: Crackles and peripheral edema
Rationale: Excess extracellular fluid can produce pulmonary congestion, crackles,
dependent edema, and weight gain. Flat neck veins, dry mucous membranes, and poor
skin turgor are signs of fluid volume deficit.
6. Decreased neuromuscular excitability is often the result of which electrolyte imbalance?
A) Hypercalcemia and hypermagnesemia
B) Hypomagnesemia and hyperkalemia
C) Hypocalcemia and hypokalemia
D) Hypernatremia and hypomagnesemia
Correct Answer: Hypercalcemia and hypermagnesemia
Rationale: Hypercalcemia and hypermagnesemia both reduce neuromuscular excitability,
leading to lethargy, weakness, and decreased deep tendon reflexes. Hypocalcemia and
hypokalemia increase excitability, causing tetany and muscle cramps.
7. Which event is likely to lead to hyponatremia?
A) Insufficient ADH secretion
B) Excess aldosterone secretion
, C) Administration of intravenous normal saline
D) Frequent nasogastric tube irrigation with water
Correct Answer: Frequent nasogastric tube irrigation with water
Rationale: Frequent nasogastric tube irrigation with water can lead to water absorption
and dilutional hyponatremia. Insufficient ADH secretion leads to hypernatremia, excess
aldosterone causes sodium retention, and normal saline is isotonic.
8. An increase in the resting membrane potential (hyperpolarized) is associated with which
electrolyte imbalance?
A) Hypokalemia
B) Hyperkalemia
C) Hypocalcemia
D) Hypercalcemia
Correct Answer: Hypokalemia
Rationale: Hypokalemia causes hyperpolarization of the resting membrane potential,
making cells less excitable. Hyperkalemia causes depolarization, increasing excitability.
9. Abnormalities in intracellular regulation of enzyme activity and cellular production of
ATP are associated with which electrolyte imbalance?
A) Hyponatremia
B) Hypocalcemia
C) Hypophosphatemia
D) Hypokalemia
