Pathophysiology
Midterm Exam 2026–2027 | Nightingale College
Study Guide, Practice Questions & Detailed
Rationales
THIS EXAM REVIEW INCLUDES
➢Pathophysiology Midterm Exam review material
➢Practice questions, where included
➢Answers and detailed rationales, where provided
,Test Bank: Pathophysiology & Nursing Care
1. For a patient with respiratory acidosis, chronic compensation by
the body will include:
A. The kidneys to excrete H+
B. The lungs to increase the respiratory rate
C. The kidneys to retain HCO3-
D. The lungs to decrease the respiratory rate
Correct Answer: A. The kidneys to excrete H+
Rationale: In chronic respiratory acidosis, the primary problem is an
excess of carbon dioxide (and thus H+) due to inadequate ventilation.
The lungs are the cause of the problem and cannot compensate. The
kidneys compensate by excreting more hydrogen ions (H+) and
reabsorbing more bicarbonate (HCO3-), which helps to raise the blood
pH back toward normal.
2. Which of the following conditions would cause the nurse to
monitor for hyperkalemia?
A. Acute acidosis
B. Acute alkalosis
C. Respiratory alkalosis
D. Metabolic alkalosis
,Correct Answer: A. Acute acidosis
Rationale: In a state of acidosis, there is an excess of hydrogen ions
(H+) in the extracellular fluid. To buffer the H+, the H+ ions move into
the cells in exchange for potassium (K+) ions, which move out of the
cells into the extracellular fluid. This shift can lead to hyperkalemia
(elevated serum potassium).
3. While planning care for elderly individuals, the nurse remembers
the elderly are at a higher risk for developing dehydration because
they have:
A. decreased muscle mass.
B. increased body water.
C. increased thirst mechanism.
D. decreased adipose tissue.
Correct Answer: A. decreased muscle mass.
Rationale: Muscle tissue holds a significant amount of water. As people
age, they tend to lose muscle mass and have a higher proportion of
adipose (fat) tissue, which holds less water. This decrease in total body
water makes the elderly more susceptible to dehydration. Additionally,
the thirst mechanism often diminishes with age.
4. A nurse is reviewing lab reports. The nurse recalls blood plasma is
located in which of the following fluid compartments?
, A. Intracellular fluid (ICF)
B. Interstitial fluid
C. Intravascular fluid
D. Transcellular fluid
Correct Answer: C. Intravascular fluid
Rationale: Blood plasma is the liquid component of blood and is found
within the blood vessels. Therefore, it is part of the intravascular fluid
compartment. Interstitial fluid surrounds the cells, and intracellular
fluid is inside the cells.
5. Which of the following patients is the most at risk for developing
hypernatremia?
A. A patient with heart failure.
B. A patient with syndrome of inappropriate antidiuretic hormone
(SIADH).
C. A patient with dehydration.
D. A patient with excessive water intake.
Correct Answer: C. A patient with dehydration.
Rationale: Hypernatremia is a serum sodium level greater than 145
mEq/L. It often occurs with a deficit of free water. Dehydration,
whether from fever, diarrhea, or inadequate intake, leads to a loss of
water that is proportionally greater than the loss of sodium, causing
Midterm Exam 2026–2027 | Nightingale College
Study Guide, Practice Questions & Detailed
Rationales
THIS EXAM REVIEW INCLUDES
➢Pathophysiology Midterm Exam review material
➢Practice questions, where included
➢Answers and detailed rationales, where provided
,Test Bank: Pathophysiology & Nursing Care
1. For a patient with respiratory acidosis, chronic compensation by
the body will include:
A. The kidneys to excrete H+
B. The lungs to increase the respiratory rate
C. The kidneys to retain HCO3-
D. The lungs to decrease the respiratory rate
Correct Answer: A. The kidneys to excrete H+
Rationale: In chronic respiratory acidosis, the primary problem is an
excess of carbon dioxide (and thus H+) due to inadequate ventilation.
The lungs are the cause of the problem and cannot compensate. The
kidneys compensate by excreting more hydrogen ions (H+) and
reabsorbing more bicarbonate (HCO3-), which helps to raise the blood
pH back toward normal.
2. Which of the following conditions would cause the nurse to
monitor for hyperkalemia?
A. Acute acidosis
B. Acute alkalosis
C. Respiratory alkalosis
D. Metabolic alkalosis
,Correct Answer: A. Acute acidosis
Rationale: In a state of acidosis, there is an excess of hydrogen ions
(H+) in the extracellular fluid. To buffer the H+, the H+ ions move into
the cells in exchange for potassium (K+) ions, which move out of the
cells into the extracellular fluid. This shift can lead to hyperkalemia
(elevated serum potassium).
3. While planning care for elderly individuals, the nurse remembers
the elderly are at a higher risk for developing dehydration because
they have:
A. decreased muscle mass.
B. increased body water.
C. increased thirst mechanism.
D. decreased adipose tissue.
Correct Answer: A. decreased muscle mass.
Rationale: Muscle tissue holds a significant amount of water. As people
age, they tend to lose muscle mass and have a higher proportion of
adipose (fat) tissue, which holds less water. This decrease in total body
water makes the elderly more susceptible to dehydration. Additionally,
the thirst mechanism often diminishes with age.
4. A nurse is reviewing lab reports. The nurse recalls blood plasma is
located in which of the following fluid compartments?
, A. Intracellular fluid (ICF)
B. Interstitial fluid
C. Intravascular fluid
D. Transcellular fluid
Correct Answer: C. Intravascular fluid
Rationale: Blood plasma is the liquid component of blood and is found
within the blood vessels. Therefore, it is part of the intravascular fluid
compartment. Interstitial fluid surrounds the cells, and intracellular
fluid is inside the cells.
5. Which of the following patients is the most at risk for developing
hypernatremia?
A. A patient with heart failure.
B. A patient with syndrome of inappropriate antidiuretic hormone
(SIADH).
C. A patient with dehydration.
D. A patient with excessive water intake.
Correct Answer: C. A patient with dehydration.
Rationale: Hypernatremia is a serum sodium level greater than 145
mEq/L. It often occurs with a deficit of free water. Dehydration,
whether from fever, diarrhea, or inadequate intake, leads to a loss of
water that is proportionally greater than the loss of sodium, causing
