NR283 PATHOPHYSIOLOGY EXAM 2
STUDY GUIDE | WEEKS 3–5 | 520
PRACTICE QUESTIONS WITH CORRECT
ANSWERS & CLINICAL RATIONALES |
LATEST UPDATE FOR CHAMBERLAIN
BSN STUDENTS | 2026–2027 NURSING
EXAM PREP | GRADE A
1. A patient presents with severe polyuria (12 L/day) and intense polydipsia
following a traumatic brain injury. The urine specific gravity is 1.002. Which
mechanism explains this condition?
A. Excessive secretion of antidiuretic hormone causing water retention
B. Insufficient insulin production leading to osmotic diuresis from hyperglycemia
C. Destruction of the posterior pituitary leading to a deficiency in antidiuretic
hormone
D. Structural damage to the renal glomerulus causing massive protein loss
Correct Answer: C
Rationale: Traumatic brain injury can damage the hypothalamus or posterior pituitary
gland, arresting the synthesis or release of antidiuretic hormone (ADH), resulting in
Central Diabetes Insipidus. Without ADH, the aquaporin channels in the collecting
ducts of the kidneys remain closed, preventing water reabsorption, leaving the urine
highly dilute (low specific gravity) and triggering profound systemic dehydration and
compensatory thirst.
2. A patient is admitted with a serum sodium level of 118 mEq/L. Which cellular
shift occurs in the brain tissue as a direct result of this electrolyte imbalance?
A. Water moves out of the intracellular space into the extracellular space, shrinking
brain cells
B. Solutes pump rapidly out of the blood vessels, causing microvascular collapse
C. Water moves from the hypotonic extracellular fluid into the hypertonic intracellular
space, swelling brain cells
D. Sodium ions rush into the intracellular matrix, causing depolarization and cellular
lysis
,Correct Answer: C
Rationale: Severe hyponatremia renders the extracellular fluid highly hypotonic relative
to the intracellular environment of brain cells. Following the osmotic gradient, water
moves across the semi-permeable cell membranes into the cells to equalize
concentration. This intracellular fluid shift leads to cerebral edema, manifesting
clinically as confusion, seizures, and potential coma.
3. A patient has a potassium level of 6.8 mEq/L. Which ECG change should the
nurse expect to see?
A. Flattened T waves
B. Prominent U waves
C. Peaked (tented) T waves
D. Prolonged QT interval
Correct Answer: C
Rationale: Hyperkalemia (serum potassium >5.0 mEq/L) causes tall, peaked (tented) T
waves on ECG. Flattened T waves and prominent U waves are seen in hypokalemia.
4. A patient has a calcium level of 7.2 mg/dL. Which assessment finding would
the nurse expect?
A. Positive Chvostek's sign
B. Constipation
C. Polyuria
D. Bone pain
Correct Answer: A
Rationale: Hypocalcemia (serum calcium <8.5 mg/dL) causes increased neuromuscular
excitability, leading to positive Chvostek's sign (facial twitching when tapping the facial
nerve) and Trousseau's sign (carpal spasm with blood pressure cuff inflation).
5. A patient has the following arterial blood gas results: pH 7.30, PaCO₂ 50 mm
Hg, HCO₃⁻ 24 mEq/L. Which acid-base imbalance is present?
A. Uncompensated metabolic acidosis
B. Uncompensated respiratory acidosis
C. Partially compensated metabolic acidosis
D. Partially compensated respiratory acidosis
Correct Answer: B
Rationale: The pH is below normal (7.35), indicating acidosis. The PaCO₂ is elevated
(>45 mm Hg), indicating a respiratory cause. The HCO₃⁻ is normal (22–26 mEq/L),
indicating no metabolic compensation. This is uncompensated respiratory acidosis,
often caused by hypoventilation.
6. Which electrolyte is the most abundant intracellular cation?
A. Sodium
,B. Chloride
C. Potassium
D. Magnesium
Correct Answer: C
Rationale: Potassium is the most abundant intracellular cation, with approximately
98% of the body's potassium found inside cells. This intracellular-extracellular gradient
is essential for nerve impulse transmission, muscle contraction, and cardiac function.
7. A 5-year-old patient is diagnosed with acute leukemia. The patient will most
likely be treated with:
A. Radiation therapy
B. Chemotherapy
C. Bone marrow transplant
D. Corticosteroids
Correct Answer: B
Rationale: Chemotherapy is the primary treatment for acute leukemia in pediatric
patients, often followed by other modalities depending on the subtype and risk
stratification.
8. A 30-year-old presenting with hematuria, menorrhagia, and bleeding gums is
diagnosed with immune thrombocytopenic purpura (ITP). The nurse realizes
the most likely cause is:
A. Antibody destruction of platelets
B. Decreased platelet production
C. Splenic sequestration
D. Bone marrow suppression
Correct Answer: A
Rationale: ITP is an autoimmune disorder characterized by antibody-mediated
destruction of platelets, leading to thrombocytopenia and bleeding manifestations.
9. A 40-year-old develops disseminated intravascular coagulation (DIC). Upon
obtaining the history, which finding is most likely the cause for this condition?
A. Sepsis
B. Hypertension
C. Diabetes mellitus
D. Obesity
Correct Answer: A
Rationale: Sepsis is a common trigger for DIC, as systemic infection leads to widespread
activation of coagulation cascades and consumption of clotting factors.
, 10. A patient who experiences chronic GI bleeding is diagnosed with anemia.
What is the primary cause of the patient's anemia?
A. Iron deficiency
B. Vitamin B12 deficiency
C. Folate deficiency
D. Aplastic anemia
Correct Answer: A
Rationale: Chronic GI bleeding leads to iron loss over time, resulting in iron-deficiency
anemia, the most common cause of anemia in this context.
11. A patient recently diagnosed with pernicious anemia asks the nurse, "How
long will it take for the disease to be cured?" Which of the following is the best
response from the nurse?
A. "This disease requires lifelong Vitamin B12 injections and is not cured."
B. "You will need to take oral iron supplements for six months."
C. "A bone marrow transplant will cure the disease."
D. "Dietary changes alone will resolve the anemia."
Correct Answer: A
Rationale: Pernicious anemia is caused by a lack of intrinsic factor, leading to Vitamin
B12 malabsorption. It requires lifelong Vitamin B12 replacement, typically via
injections, and is not cured.
12. Multiple opportunistic infections develop with acute leukemia primarily
because:
A. Many circulating leukocytes are immature
B. Platelet count is decreased
C. Red blood cell production is increased
D. Lymph nodes are enlarged
Correct Answer: A
Rationale: In acute leukemia, the bone marrow produces large numbers of immature,
non-functional leukocytes, which cannot mount an effective immune response, leading
to increased susceptibility to opportunistic infections.
13. A nurse is planning care for a client following a cardiac catheterization
accessed through the femoral artery. Which of the following actions should the
nurse plan to take?
A. Perform neuromuscular checks with vital signs
B. Ambulate the client immediately
C. Apply a warm compress to the site
D. Encourage the client to sit upright
STUDY GUIDE | WEEKS 3–5 | 520
PRACTICE QUESTIONS WITH CORRECT
ANSWERS & CLINICAL RATIONALES |
LATEST UPDATE FOR CHAMBERLAIN
BSN STUDENTS | 2026–2027 NURSING
EXAM PREP | GRADE A
1. A patient presents with severe polyuria (12 L/day) and intense polydipsia
following a traumatic brain injury. The urine specific gravity is 1.002. Which
mechanism explains this condition?
A. Excessive secretion of antidiuretic hormone causing water retention
B. Insufficient insulin production leading to osmotic diuresis from hyperglycemia
C. Destruction of the posterior pituitary leading to a deficiency in antidiuretic
hormone
D. Structural damage to the renal glomerulus causing massive protein loss
Correct Answer: C
Rationale: Traumatic brain injury can damage the hypothalamus or posterior pituitary
gland, arresting the synthesis or release of antidiuretic hormone (ADH), resulting in
Central Diabetes Insipidus. Without ADH, the aquaporin channels in the collecting
ducts of the kidneys remain closed, preventing water reabsorption, leaving the urine
highly dilute (low specific gravity) and triggering profound systemic dehydration and
compensatory thirst.
2. A patient is admitted with a serum sodium level of 118 mEq/L. Which cellular
shift occurs in the brain tissue as a direct result of this electrolyte imbalance?
A. Water moves out of the intracellular space into the extracellular space, shrinking
brain cells
B. Solutes pump rapidly out of the blood vessels, causing microvascular collapse
C. Water moves from the hypotonic extracellular fluid into the hypertonic intracellular
space, swelling brain cells
D. Sodium ions rush into the intracellular matrix, causing depolarization and cellular
lysis
,Correct Answer: C
Rationale: Severe hyponatremia renders the extracellular fluid highly hypotonic relative
to the intracellular environment of brain cells. Following the osmotic gradient, water
moves across the semi-permeable cell membranes into the cells to equalize
concentration. This intracellular fluid shift leads to cerebral edema, manifesting
clinically as confusion, seizures, and potential coma.
3. A patient has a potassium level of 6.8 mEq/L. Which ECG change should the
nurse expect to see?
A. Flattened T waves
B. Prominent U waves
C. Peaked (tented) T waves
D. Prolonged QT interval
Correct Answer: C
Rationale: Hyperkalemia (serum potassium >5.0 mEq/L) causes tall, peaked (tented) T
waves on ECG. Flattened T waves and prominent U waves are seen in hypokalemia.
4. A patient has a calcium level of 7.2 mg/dL. Which assessment finding would
the nurse expect?
A. Positive Chvostek's sign
B. Constipation
C. Polyuria
D. Bone pain
Correct Answer: A
Rationale: Hypocalcemia (serum calcium <8.5 mg/dL) causes increased neuromuscular
excitability, leading to positive Chvostek's sign (facial twitching when tapping the facial
nerve) and Trousseau's sign (carpal spasm with blood pressure cuff inflation).
5. A patient has the following arterial blood gas results: pH 7.30, PaCO₂ 50 mm
Hg, HCO₃⁻ 24 mEq/L. Which acid-base imbalance is present?
A. Uncompensated metabolic acidosis
B. Uncompensated respiratory acidosis
C. Partially compensated metabolic acidosis
D. Partially compensated respiratory acidosis
Correct Answer: B
Rationale: The pH is below normal (7.35), indicating acidosis. The PaCO₂ is elevated
(>45 mm Hg), indicating a respiratory cause. The HCO₃⁻ is normal (22–26 mEq/L),
indicating no metabolic compensation. This is uncompensated respiratory acidosis,
often caused by hypoventilation.
6. Which electrolyte is the most abundant intracellular cation?
A. Sodium
,B. Chloride
C. Potassium
D. Magnesium
Correct Answer: C
Rationale: Potassium is the most abundant intracellular cation, with approximately
98% of the body's potassium found inside cells. This intracellular-extracellular gradient
is essential for nerve impulse transmission, muscle contraction, and cardiac function.
7. A 5-year-old patient is diagnosed with acute leukemia. The patient will most
likely be treated with:
A. Radiation therapy
B. Chemotherapy
C. Bone marrow transplant
D. Corticosteroids
Correct Answer: B
Rationale: Chemotherapy is the primary treatment for acute leukemia in pediatric
patients, often followed by other modalities depending on the subtype and risk
stratification.
8. A 30-year-old presenting with hematuria, menorrhagia, and bleeding gums is
diagnosed with immune thrombocytopenic purpura (ITP). The nurse realizes
the most likely cause is:
A. Antibody destruction of platelets
B. Decreased platelet production
C. Splenic sequestration
D. Bone marrow suppression
Correct Answer: A
Rationale: ITP is an autoimmune disorder characterized by antibody-mediated
destruction of platelets, leading to thrombocytopenia and bleeding manifestations.
9. A 40-year-old develops disseminated intravascular coagulation (DIC). Upon
obtaining the history, which finding is most likely the cause for this condition?
A. Sepsis
B. Hypertension
C. Diabetes mellitus
D. Obesity
Correct Answer: A
Rationale: Sepsis is a common trigger for DIC, as systemic infection leads to widespread
activation of coagulation cascades and consumption of clotting factors.
, 10. A patient who experiences chronic GI bleeding is diagnosed with anemia.
What is the primary cause of the patient's anemia?
A. Iron deficiency
B. Vitamin B12 deficiency
C. Folate deficiency
D. Aplastic anemia
Correct Answer: A
Rationale: Chronic GI bleeding leads to iron loss over time, resulting in iron-deficiency
anemia, the most common cause of anemia in this context.
11. A patient recently diagnosed with pernicious anemia asks the nurse, "How
long will it take for the disease to be cured?" Which of the following is the best
response from the nurse?
A. "This disease requires lifelong Vitamin B12 injections and is not cured."
B. "You will need to take oral iron supplements for six months."
C. "A bone marrow transplant will cure the disease."
D. "Dietary changes alone will resolve the anemia."
Correct Answer: A
Rationale: Pernicious anemia is caused by a lack of intrinsic factor, leading to Vitamin
B12 malabsorption. It requires lifelong Vitamin B12 replacement, typically via
injections, and is not cured.
12. Multiple opportunistic infections develop with acute leukemia primarily
because:
A. Many circulating leukocytes are immature
B. Platelet count is decreased
C. Red blood cell production is increased
D. Lymph nodes are enlarged
Correct Answer: A
Rationale: In acute leukemia, the bone marrow produces large numbers of immature,
non-functional leukocytes, which cannot mount an effective immune response, leading
to increased susceptibility to opportunistic infections.
13. A nurse is planning care for a client following a cardiac catheterization
accessed through the femoral artery. Which of the following actions should the
nurse plan to take?
A. Perform neuromuscular checks with vital signs
B. Ambulate the client immediately
C. Apply a warm compress to the site
D. Encourage the client to sit upright
