NURSING PATHOPHYSIOLOGY EXAM 1|
LATEST UPDATE 2026|2027|A
COMPREHENSIVE REVIEW OF 300
PRACTICE QUESTIONS WITH ANSWERS
RATIONALES| PASS GUARANTEED
SECTION 1: CELLULAR & GENETIC PATHOPHYSIOLOGY (Questions
1–25)
1. A patient with heart failure has an ejection fraction of 30%. This indicates:
A. Diastolic dysfunction
B. Systolic dysfunction
C. Normal cardiac function
D. Increased contractility
Answer: B
Rationale: An ejection fraction below 40% indicates systolic dysfunction,
meaning the heart cannot contract effectively to pump blood out.
2. Which electrolyte imbalance is most commonly associated with prolonged
vomiting?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypercalcemia
Answer: C
Rationale: Prolonged vomiting causes loss of gastric potassium and hydrochloric
acid, leading to hypokalemia and metabolic alkalosis.
,3. The primary pathophysiologic problem in asthma is:
A. Alveolar collapse
B. Reversible airway obstruction and inflammation
C. Permanent airway destruction
D. Pulmonary embolism
Answer: B
Rationale: Asthma is characterized by reversible bronchoconstriction and airway
inflammation, distinguishing it from COPD.
4. A patient with cirrhosis develops ascites. The primary mechanism is:
A. Increased albumin production
B. Portal hypertension and decreased oncotic pressure
C. Increased renal perfusion
D. Decreased aldosterone secretion
Answer: B
Rationale: Cirrhosis causes portal hypertension and decreased albumin
production, reducing oncotic pressure and causing fluid to shift into the peritoneal
cavity.
5. Which type of hypersensitivity reaction is responsible for anaphylaxis?
A. Type I (IgE-mediated)
B. Type II (Cytotoxic)
C. Type III (Immune complex)
D. Type IV (Delayed)
Answer: A
Rationale: Anaphylaxis is a Type I hypersensitivity reaction mediated by IgE
antibodies triggering mast cell degranulation.
,6. In diabetic ketoacidosis (DKA), the primary acid-base disturbance is:
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Metabolic acidosis with anion gap
D. Respiratory acidosis
Answer: C
Rationale: DKA produces ketone bodies (acids), causing metabolic acidosis with
an elevated anion gap.
7. The hallmark pathophysiologic change in osteoarthritis is:
A. Systemic inflammation of joints
B. Autoimmune destruction of synovium
C. Degeneration of articular cartilage
D. Uric acid crystal deposition
Answer: C
Rationale: Osteoarthritis is a degenerative joint disease characterized by
progressive loss of articular cartilage.
8. A patient with chronic kidney disease most likely has anemia due to:
A. Iron overload
B. Decreased erythropoietin production
C. Increased red blood cell destruction
D. Vitamin K deficiency
Answer: B
Rationale: The kidneys produce erythropoietin; damaged kidneys produce less,
leading to anemia.
9. Which condition results from a deficiency of antidiuretic hormone (ADH)?
A. SIADH
B. Diabetes insipidus
, C. Diabetes mellitus
D. Cushing's syndrome
Answer: B
Rationale: Diabetes insipidus results from inadequate ADH, causing excessive
dilute urine output and polyuria.
10. The underlying cause of type 1 diabetes mellitus is:
A. Insulin resistance
B. Autoimmune destruction of pancreatic beta cells
C. Excess glucagon production
D. Obesity
Answer: B
Rationale: Type 1 DM results from autoimmune destruction of beta cells, leading
to absolute insulin deficiency.
11. A patient with a pulmonary embolism will most likely demonstrate:
A. Increased PaO2
B. V/Q mismatch and hypoxemia
C. Metabolic alkalosis
D. Bradycardia
Answer: B
Rationale: PE obstructs pulmonary blood flow, causing ventilation-perfusion
mismatch and hypoxemia.
12. In acute myocardial infarction, troponin levels:
A. Decrease immediately
B. Rise within 3–6 hours and remain elevated
C. Are not useful diagnostically
D. Only rise after 48 hours
LATEST UPDATE 2026|2027|A
COMPREHENSIVE REVIEW OF 300
PRACTICE QUESTIONS WITH ANSWERS
RATIONALES| PASS GUARANTEED
SECTION 1: CELLULAR & GENETIC PATHOPHYSIOLOGY (Questions
1–25)
1. A patient with heart failure has an ejection fraction of 30%. This indicates:
A. Diastolic dysfunction
B. Systolic dysfunction
C. Normal cardiac function
D. Increased contractility
Answer: B
Rationale: An ejection fraction below 40% indicates systolic dysfunction,
meaning the heart cannot contract effectively to pump blood out.
2. Which electrolyte imbalance is most commonly associated with prolonged
vomiting?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypercalcemia
Answer: C
Rationale: Prolonged vomiting causes loss of gastric potassium and hydrochloric
acid, leading to hypokalemia and metabolic alkalosis.
,3. The primary pathophysiologic problem in asthma is:
A. Alveolar collapse
B. Reversible airway obstruction and inflammation
C. Permanent airway destruction
D. Pulmonary embolism
Answer: B
Rationale: Asthma is characterized by reversible bronchoconstriction and airway
inflammation, distinguishing it from COPD.
4. A patient with cirrhosis develops ascites. The primary mechanism is:
A. Increased albumin production
B. Portal hypertension and decreased oncotic pressure
C. Increased renal perfusion
D. Decreased aldosterone secretion
Answer: B
Rationale: Cirrhosis causes portal hypertension and decreased albumin
production, reducing oncotic pressure and causing fluid to shift into the peritoneal
cavity.
5. Which type of hypersensitivity reaction is responsible for anaphylaxis?
A. Type I (IgE-mediated)
B. Type II (Cytotoxic)
C. Type III (Immune complex)
D. Type IV (Delayed)
Answer: A
Rationale: Anaphylaxis is a Type I hypersensitivity reaction mediated by IgE
antibodies triggering mast cell degranulation.
,6. In diabetic ketoacidosis (DKA), the primary acid-base disturbance is:
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Metabolic acidosis with anion gap
D. Respiratory acidosis
Answer: C
Rationale: DKA produces ketone bodies (acids), causing metabolic acidosis with
an elevated anion gap.
7. The hallmark pathophysiologic change in osteoarthritis is:
A. Systemic inflammation of joints
B. Autoimmune destruction of synovium
C. Degeneration of articular cartilage
D. Uric acid crystal deposition
Answer: C
Rationale: Osteoarthritis is a degenerative joint disease characterized by
progressive loss of articular cartilage.
8. A patient with chronic kidney disease most likely has anemia due to:
A. Iron overload
B. Decreased erythropoietin production
C. Increased red blood cell destruction
D. Vitamin K deficiency
Answer: B
Rationale: The kidneys produce erythropoietin; damaged kidneys produce less,
leading to anemia.
9. Which condition results from a deficiency of antidiuretic hormone (ADH)?
A. SIADH
B. Diabetes insipidus
, C. Diabetes mellitus
D. Cushing's syndrome
Answer: B
Rationale: Diabetes insipidus results from inadequate ADH, causing excessive
dilute urine output and polyuria.
10. The underlying cause of type 1 diabetes mellitus is:
A. Insulin resistance
B. Autoimmune destruction of pancreatic beta cells
C. Excess glucagon production
D. Obesity
Answer: B
Rationale: Type 1 DM results from autoimmune destruction of beta cells, leading
to absolute insulin deficiency.
11. A patient with a pulmonary embolism will most likely demonstrate:
A. Increased PaO2
B. V/Q mismatch and hypoxemia
C. Metabolic alkalosis
D. Bradycardia
Answer: B
Rationale: PE obstructs pulmonary blood flow, causing ventilation-perfusion
mismatch and hypoxemia.
12. In acute myocardial infarction, troponin levels:
A. Decrease immediately
B. Rise within 3–6 hours and remain elevated
C. Are not useful diagnostically
D. Only rise after 48 hours
