Galen NSG 3280 Exam 2 | Pathophysiology for Nurses I
(2026) Actual Q&A PDF
1. A patient with chronic kidney disease develops anemia. What is the primary
pathophysiologic cause of this anemia?
A) Iron deficiency from poor dietary intake
B) Vitamin B12 malabsorption due to uremic toxins
C) Decreased production of erythropoietin by damaged kidneys
D) Hemolysis of red blood cells from uremic environment
Correct Answer: Decreased production of erythropoietin by damaged kidneys
Rationale: The kidneys produce erythropoietin, which stimulates red blood cell
production in the bone marrow. In chronic kidney disease, damaged renal tissue
produces less erythropoietin, leading to a normocytic, normochromic anemia. Iron
deficiency and B12 malabsorption are not the primary causes in CKD, and hemolysis
is less common.
2. The renin-angiotensin-aldosterone system plays a central role in blood pressure
regulation. Which enzyme is responsible for converting angiotensin I to angiotensin
II?
A) Renin
B) Aldosterone synthase
C) Angiotensin-converting enzyme
D) Angiotensinogenase
Correct Answer: Angiotensin-converting enzyme
,Rationale: ACE, found primarily in the vascular endothelium of the lungs, cleaves the
inactive decapeptide angiotensin I into the potent vasoconstrictor angiotensin II.
Renin converts angiotensinogen to angiotensin I, and aldosterone is a hormone that
acts on the kidneys, not an enzyme.
3. Which type of necrosis is most commonly associated with a myocardial infarction?
A) Liquefactive necrosis
B) Caseous necrosis
C) Coagulative necrosis
D) Fat necrosis
Correct Answer: Coagulative necrosis
Rationale: Coagulative necrosis results from ischemia in solid organs like the heart.
The cell architecture is preserved initially while proteins denature, which is
characteristic of myocardial infarction. Liquefactive necrosis is common in the brain,
caseous necrosis in tuberculosis, and fat necrosis in adipose tissue.
4. A patient presents with the classic triad of polyuria, polydipsia, and polyphagia.
Blood glucose is 320 mg/dL. Which condition is most likely?
A) Hypoglycemia
B) Diabetes insipidus
C) Diabetes mellitus
D) Addison's disease
Correct Answer: Diabetes mellitus
Rationale: The classic triad of polyuria, polydipsia, and polyphagia, along with a
markedly elevated blood glucose level (>200 mg/dL), confirms the diagnosis of
,diabetes mellitus. Diabetes insipidus causes polyuria and polydipsia but without
hyperglycemia.
5. Which of the following best describes the primary pathophysiologic mechanism in
heart failure with reduced ejection fraction?
A) Increased ventricular compliance
B) Impaired ventricular filling
C) Reduced myocardial contractility
D) Excessive preload reduction
Correct Answer: Reduced myocardial contractility
Rationale: HFrEF is characterized by systolic dysfunction where the left ventricle
cannot contract forcefully enough to eject adequate blood volumes, resulting in a
reduced ejection fraction below 40%. Impaired ventricular filling is characteristic of
heart failure with preserved ejection fraction.
6. A patient has been immobilized in a cast for 6 weeks following a leg fracture.
When the cast is removed, the nurse notices the affected leg is significantly smaller in
muscle mass compared to the uninjured leg. Which cellular adaptation is responsible
for this change?
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Correct Answer: Atrophy
, Rationale: Atrophy is defined as a decrease in cell size, which in this case is caused
by the disuse of the muscle during the period of immobilization. Hypertrophy is an
increase in cell size, hyperplasia is an increase in cell number, and metaplasia is a
change in cell type.
7. A patient with a history of chronic smoking presents with chronic bronchitis. A
biopsy of the bronchial lining reveals that the normal ciliated columnar epithelium
has been replaced by stratified squamous epithelium. Which type of cellular
adaptation has occurred?
A) Dysplasia
B) Metaplasia
C) Hyperplasia
D) Anaplasia
Correct Answer: Metaplasia
Rationale: Metaplasia is a reversible change where one adult cell type is replaced by
another, often in response to chronic irritation like cigarette smoke. Dysplasia refers
to disordered growth, hyperplasia is an increase in cell number, and anaplasia is a
lack of differentiation.
8. During a physiology lecture, the instructor explains that hypoxia is the most
common cause of cellular injury. Why is hypoxia so detrimental to the cell?
A) It causes the cell to produce excessive free radicals.
B) It deprives the cell of oxygen needed for aerobic metabolism, leading to a failure
of ATP production.
C) It directly destroys the nucleus of the cell.
D) It causes the cell to swell with water.
(2026) Actual Q&A PDF
1. A patient with chronic kidney disease develops anemia. What is the primary
pathophysiologic cause of this anemia?
A) Iron deficiency from poor dietary intake
B) Vitamin B12 malabsorption due to uremic toxins
C) Decreased production of erythropoietin by damaged kidneys
D) Hemolysis of red blood cells from uremic environment
Correct Answer: Decreased production of erythropoietin by damaged kidneys
Rationale: The kidneys produce erythropoietin, which stimulates red blood cell
production in the bone marrow. In chronic kidney disease, damaged renal tissue
produces less erythropoietin, leading to a normocytic, normochromic anemia. Iron
deficiency and B12 malabsorption are not the primary causes in CKD, and hemolysis
is less common.
2. The renin-angiotensin-aldosterone system plays a central role in blood pressure
regulation. Which enzyme is responsible for converting angiotensin I to angiotensin
II?
A) Renin
B) Aldosterone synthase
C) Angiotensin-converting enzyme
D) Angiotensinogenase
Correct Answer: Angiotensin-converting enzyme
,Rationale: ACE, found primarily in the vascular endothelium of the lungs, cleaves the
inactive decapeptide angiotensin I into the potent vasoconstrictor angiotensin II.
Renin converts angiotensinogen to angiotensin I, and aldosterone is a hormone that
acts on the kidneys, not an enzyme.
3. Which type of necrosis is most commonly associated with a myocardial infarction?
A) Liquefactive necrosis
B) Caseous necrosis
C) Coagulative necrosis
D) Fat necrosis
Correct Answer: Coagulative necrosis
Rationale: Coagulative necrosis results from ischemia in solid organs like the heart.
The cell architecture is preserved initially while proteins denature, which is
characteristic of myocardial infarction. Liquefactive necrosis is common in the brain,
caseous necrosis in tuberculosis, and fat necrosis in adipose tissue.
4. A patient presents with the classic triad of polyuria, polydipsia, and polyphagia.
Blood glucose is 320 mg/dL. Which condition is most likely?
A) Hypoglycemia
B) Diabetes insipidus
C) Diabetes mellitus
D) Addison's disease
Correct Answer: Diabetes mellitus
Rationale: The classic triad of polyuria, polydipsia, and polyphagia, along with a
markedly elevated blood glucose level (>200 mg/dL), confirms the diagnosis of
,diabetes mellitus. Diabetes insipidus causes polyuria and polydipsia but without
hyperglycemia.
5. Which of the following best describes the primary pathophysiologic mechanism in
heart failure with reduced ejection fraction?
A) Increased ventricular compliance
B) Impaired ventricular filling
C) Reduced myocardial contractility
D) Excessive preload reduction
Correct Answer: Reduced myocardial contractility
Rationale: HFrEF is characterized by systolic dysfunction where the left ventricle
cannot contract forcefully enough to eject adequate blood volumes, resulting in a
reduced ejection fraction below 40%. Impaired ventricular filling is characteristic of
heart failure with preserved ejection fraction.
6. A patient has been immobilized in a cast for 6 weeks following a leg fracture.
When the cast is removed, the nurse notices the affected leg is significantly smaller in
muscle mass compared to the uninjured leg. Which cellular adaptation is responsible
for this change?
A) Hypertrophy
B) Hyperplasia
C) Atrophy
D) Metaplasia
Correct Answer: Atrophy
, Rationale: Atrophy is defined as a decrease in cell size, which in this case is caused
by the disuse of the muscle during the period of immobilization. Hypertrophy is an
increase in cell size, hyperplasia is an increase in cell number, and metaplasia is a
change in cell type.
7. A patient with a history of chronic smoking presents with chronic bronchitis. A
biopsy of the bronchial lining reveals that the normal ciliated columnar epithelium
has been replaced by stratified squamous epithelium. Which type of cellular
adaptation has occurred?
A) Dysplasia
B) Metaplasia
C) Hyperplasia
D) Anaplasia
Correct Answer: Metaplasia
Rationale: Metaplasia is a reversible change where one adult cell type is replaced by
another, often in response to chronic irritation like cigarette smoke. Dysplasia refers
to disordered growth, hyperplasia is an increase in cell number, and anaplasia is a
lack of differentiation.
8. During a physiology lecture, the instructor explains that hypoxia is the most
common cause of cellular injury. Why is hypoxia so detrimental to the cell?
A) It causes the cell to produce excessive free radicals.
B) It deprives the cell of oxygen needed for aerobic metabolism, leading to a failure
of ATP production.
C) It directly destroys the nucleus of the cell.
D) It causes the cell to swell with water.
