NURS 307 ADVANCED NURSING
ASSESSMENT AND
PATHOPHYSIOLOGY EXAM
QUESTIONS AND VERIFIED ANSWERS |
100% CORRECT | GRADE A+
1. A patient presents with a pH of 7.25, PaCO2 of 55 mmHg, and HCO3 of 28 mEq/L. Which
acid-base imbalance is occurring?
A. Fully compensated metabolic acidosis
B. Uncompensated metabolic alkalosis
C. Partially compensated respiratory acidosis
D. Partially compensated respiratory alkalosis
Answer: C
Conceptual Explanation: The pH is low (acidosis), PaCO2 is high (respiratory cause), and
HCO3 is elevated as the kidneys attempt to compensate, but since pH is still outside the
normal range, it is partially compensated.
2. In a patient with Acute Respiratory Distress Syndrome (ARDS), which pathophysiological
change is most responsible for refractory hypoxemia?
A. Increased pulmonary compliance
,B. Decreased capillary permeability
C. Intrapulmonary shunting due to alveolar collapse
D. Excessive surfactant production
Answer: C
Conceptual Explanation: ARDS involves damaged alveolar-capillary membranes and
surfactant loss, leading to alveolar collapse (atelectasis) and significant shunting where
blood passes through the lungs without being oxygenated.
3. Which of the following clinical manifestations is recognized as part of Cushing’s Triad,
indicating increased intracranial pressure (ICP)?
A. Bradycardia, widened pulse pressure, and irregular respirations
B. Tachycardia, hypotension, and tachypnea
C. Narrowed pulse pressure, tachycardia, and hypertension
D. Hypotension, bradycardia, and Cheyne-Stokes breathing
Answer: A
Conceptual Explanation: Cushing’s Triad consists of systolic hypertension with a widened
pulse pressure, bradycardia, and irregular/altered respiratory patterns.
4. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which EKG change is the most critical to monitor for?
A. Prominent U waves
, B. Prolonged QT interval
C. Tall, peaked T waves
D. Shortened PR interval
Answer: C
Conceptual Explanation: Hyperkalemia classically causes tall, peaked T waves. As it
worsens, it can lead to QRS widening and cardiac arrest.
5. A nurse is caring for a patient in Hypovolemic Shock. Which compensatory mechanism is
triggered by the baroreceptors in the aortic arch and carotid sinus?
A. Parasympathetic nervous system activation
B. Inhibition of the Renin-Angiotensin-Aldosterone System
C. Decrease in heart rate to preserve myocardial oxygen
D. Stimulation of the sympathetic nervous system
Answer: D
Conceptual Explanation: Decreased blood pressure triggers baroreceptors to activate the
SNS, increasing heart rate and systemic vascular resistance to maintain cardiac output.
6. Which hormone deficiency is responsible for the symptoms of Diabetes Insipidus?
A. Insulin
B. Antidiuretic Hormone (ADH)
ASSESSMENT AND
PATHOPHYSIOLOGY EXAM
QUESTIONS AND VERIFIED ANSWERS |
100% CORRECT | GRADE A+
1. A patient presents with a pH of 7.25, PaCO2 of 55 mmHg, and HCO3 of 28 mEq/L. Which
acid-base imbalance is occurring?
A. Fully compensated metabolic acidosis
B. Uncompensated metabolic alkalosis
C. Partially compensated respiratory acidosis
D. Partially compensated respiratory alkalosis
Answer: C
Conceptual Explanation: The pH is low (acidosis), PaCO2 is high (respiratory cause), and
HCO3 is elevated as the kidneys attempt to compensate, but since pH is still outside the
normal range, it is partially compensated.
2. In a patient with Acute Respiratory Distress Syndrome (ARDS), which pathophysiological
change is most responsible for refractory hypoxemia?
A. Increased pulmonary compliance
,B. Decreased capillary permeability
C. Intrapulmonary shunting due to alveolar collapse
D. Excessive surfactant production
Answer: C
Conceptual Explanation: ARDS involves damaged alveolar-capillary membranes and
surfactant loss, leading to alveolar collapse (atelectasis) and significant shunting where
blood passes through the lungs without being oxygenated.
3. Which of the following clinical manifestations is recognized as part of Cushing’s Triad,
indicating increased intracranial pressure (ICP)?
A. Bradycardia, widened pulse pressure, and irregular respirations
B. Tachycardia, hypotension, and tachypnea
C. Narrowed pulse pressure, tachycardia, and hypertension
D. Hypotension, bradycardia, and Cheyne-Stokes breathing
Answer: A
Conceptual Explanation: Cushing’s Triad consists of systolic hypertension with a widened
pulse pressure, bradycardia, and irregular/altered respiratory patterns.
4. A patient with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which EKG change is the most critical to monitor for?
A. Prominent U waves
, B. Prolonged QT interval
C. Tall, peaked T waves
D. Shortened PR interval
Answer: C
Conceptual Explanation: Hyperkalemia classically causes tall, peaked T waves. As it
worsens, it can lead to QRS widening and cardiac arrest.
5. A nurse is caring for a patient in Hypovolemic Shock. Which compensatory mechanism is
triggered by the baroreceptors in the aortic arch and carotid sinus?
A. Parasympathetic nervous system activation
B. Inhibition of the Renin-Angiotensin-Aldosterone System
C. Decrease in heart rate to preserve myocardial oxygen
D. Stimulation of the sympathetic nervous system
Answer: D
Conceptual Explanation: Decreased blood pressure triggers baroreceptors to activate the
SNS, increasing heart rate and systemic vascular resistance to maintain cardiac output.
6. Which hormone deficiency is responsible for the symptoms of Diabetes Insipidus?
A. Insulin
B. Antidiuretic Hormone (ADH)
