NSG3850 / NSG 3850 Exam 1| Latest Update 2025 / 2026 | Pathophysiology for Nurses II | 100 out of 100 | Questions and Answers | Grade A | 100% Correct – Galen

NSG3850 / NSG 3850 Exam 1| Latest Update 2025 / 2026 | Pathophysiology for Nurses II | 100 out of 100 | Questions and Answers | Grade A | 100% Correct – Galen • Question: 2/3 of body fluid is intracellular. 1/3 is extracellular. T/F? Answer: True Question: Where is the extracellular fluid? Answer: - between cells (interstitial) - blood vessels (vascular) - dense connective tissue and bone - CSF, GI fluids, synovial (transcellular) Question: When ADH is low, urine volume is Answer: high Question: When aldosterone is high, urine volume is Answer: low Question: ADH is the "____ water" hormone. Answer: free *causes kidneys to reabsorb plain water Question: Aldosterone is the "____ water" hormone. Answer: salt *causes kidneys to reabsorb water AND sodium Question: BNP is synthesized and released from ventricular cells when ventricular diastolic pressure INCREASES abnormally, as in: Answer: heart failure. Question: Natriuretic peptides (NPs) promote fluid _______________ in _________. Answer: excretion, urine Question: Reabsorption of Na+ and H2O caused by aldosterone makes a smaller volume of urine and ___________ extracellular fluid volume. Answer: expands Question: Water moves in and out of cells via: Answer: Can electrolytes move freely across the cell membrane? osmosis No! Question: A gain of more water than salt is called: Answer: *gain water dilutional hyponatremia Question: A loss of more salt than water is called: Answer: *lose salt depletional hyponatremia Question: Aldosterone increases or decreases potassium excretion in urine? Answer: Increases Question: I have low ionized calcium levels after a massive or fast blood transfusion or FFP because of: Answer: citrate (preservative in blood products) *citrate renders calcium inactive Question: PTH increases plasma calcium, therefore, pt's with hypoparathyroidism from sx or trauma will have: Answer: low levels of calcium Question: With low levels of extracellular Ca, voltage gated Na channels are less stable. Making them more likely to open up allowing them to depolarize more easily. This makes neurons more: Answer: excitable! *which means tetany occurs Question: PTH increases plasma calcium, therefore, pt's with hyperparathyroidism will have: higher levels of calcium Answer: Question: The decreased neuromuscular excitability in hypercalcemia is caused by: Answer: elevation of threshold potential of excitable cells. Question: Chronic alcoholism is a major risk factor for which electrolyte imbalance? Answer: Hypomagnesemia Question: Acetylcholine causes muscles to: Answer: contract. Question: Mg in extracellular fluid usually depresses release of acetylcholine. Therefore if too few Mg ions are present, muscles will: Answer: contract *this is due to neuromuscular excitability Question: Too much Mg, causes acetylcholine to rarely be released causing muscular: Answer: depression Question: Phosphate is an important component of ATP. Since ATP is a major source of energy, if we have low phosphate we are more likely to be: Answer: weak Question: Pt's with hyperphosphatemia and kidney dx are likely to have to ______________ salts in soft tissues of the body. Leading to aching, stiffness in joints, itching, and conjunctivitis. Answer: phosphate Question: What electrolytes are in the ECF and ICF? Answer: ECF = K+ and Mg ICF = Na+, Cl, Bicarb Question: What are the components of blood? Answer: RBCs (carry O2) platelets (clotting) leukocytes (WBCs) (infection) Question: What does the blood transport? Answer: Oxygen (PO2) and carbon dioxide (CO2) Question: What are the compensatory mechanisms in anemia? Answer: Increase oxygen to tissues + increased resp and HR Decrease demand + fatigue, weakness, low stamina Question: Low platelet count manifestations? Answer: Bleeding (lower the amount, more bleeding) *called thrombocytopenia Question: Elevated neutrophil counts triggers an inflammatory response to: Answer: infection. Question: Basophils have an immune and inflammatory response to: Answer: allergens. Question: Low erythrocytes = high oxygen. T/F? Answer: False. You would have low oxygen. Question: I have insufficient iron for hemoglobin synthesis. I can be caused by low intake, increased demand (e.g., pregnancy), diminished absorption (e.g., chronic disease), hemorrhage, and hemodialysis. What am I? Answer: Iron-deficient anemia Question: What anemia causes increased iron absorption? Answer: Hemolytic (SCD and thalassemia) Question: In sickle cell anemia, Hgb is altered. This causes: Answer: instability and solubility of Hgb Question: What type of pulse do we have with general anemia? Answer: Tachycardic (also SOA) Question: You can develop heart failure from anemia. T/F? Answer: True Question: I have pica, koilonychias, blue sclerae, weakness and fatigue, dyspnea, palpitation, tachycardia, and erosions at the corner of the mouth. What do I have? Answer: Iron-deficient anemia Question: What is needed to make iron? Answer: Ferritin Question: Vit B12 is necessary for RBC development. T/F? Answer: True Question: Why do megaloblastic RBCs cause anemia? Answer: Bigger cells can't carry oxygen the same Question: I have a disruption in my DNA synthesis of blast cells which produces megaloblasts (macrocytic) cells. I can either have: Answer: - pernicious anemia due to lack of intrinsic factor leading to vitamin B12 deficiency - folate deficiencies from dietary deficiencies from alcoholism, liver cirrhosis, pregnancy, or infancy What type of anemia do I have? Megaloblastic Question: What are the two major categories of fluid imbalances? Answer: 1. ECF imbalances (saline imbalances) 2. Body fluid imbalances (water imbalance) Question: What are causes of fluid deficit? Answer: Anything that causes removal of Na-containing fluid from the body like GI excretion (vomit, diarrhea, etc), renal excretion (adrenal insufficiency, extensive diuretic use, etc), and hemorrhage, massive sweat, etc. (p. 535) Question: I have very yellow urine, ↓ skin turgor, dry mucus membranes, hard stools, soft sunken eyeballs, longitudinal furrows in the tongue, no tears or sweat. I also have: Answer: - sudden weight loss - oliguria - syncope - dizziness - lightheadedness - postural blood pressure ↓ with increased HR - flat neck veins when supine - prolonged cap refill and vein filling time. What do I have? Volume deficit Question: What are causes of fluid excess? Answer: Addition or retention of saline (salt water in the same concentration as normal plasma). Like excessive IV infusion and/or renal retention of Na/H2O. Question: I have sudden weight gain, edema, bounding pulse, neck vein distention, crackles, dyspnea, orthopnea, frothy sputum from pulmonary edema. What do I have? Answer: Fluid excess Question: What are causes of hyponatremia? Answer: 1. gain of more water than salt (dilutional hyponatremia) + excess ADH, excess D5W, tap water enemas, etc 2. loss of more salt than water (depletional hyponatremia) + diuretics, salt-wasting renal disease, vomit, diarrhea, sweat, burns, etc (p 537) Question: I have nonspecific CNS dysfunction. Like: Answer: - malaise - anorexia - N/V - HA - confusion - lethargy - seizures - coma Question: What do I have? Answer: Hyponatremia Question: What are causes of hypernatremia? Answer: 1. gain of more salt than water + tube feeding, overuse of salt tabs, no access to water, hypertonic IV solutions, etc 2. loss of more water than salt + diabetes insipidus, tube feeding, prolonged diarrhea and vomit (bc you are not losing Na+, you lose K+), etc Question: I have nonspecific CNS dysfunction. Like: Answer: - confusion - lethargy - seizures - coma - thirst - oliguria Question: What do I have? Answer: Hypernatremia Question: What are causes of hypokalemia? Answer: 1. decreased intake + anorexia, NPO, etc 2. shift from ECF to cells + alkalosis, excess insulin, etc 3. increased excretion + diuretics, corticosteroids, Cushing, etc 4. Diarrhea, excess sweat, vomit, GI suction, drainage Question: I have cardiac dysrhythmias with a weak & irregular pulse, depressed T-wave, abdominal distention, decreased bowel sounds, skeletal muscle weakness and paralysis, and polyuria. What do I have? Answer: Hypokalemia Question: What is the patho of hypokalemia? Answer: It alters the resting membrane potential of muscles cells - hyper polarizing them - and become less reactive to stimuli Question: What are causes of hyperkalemia? Answer: 1. increased K+ intake + rapid K+ infusion, large transfusion of stored blood, etc 2. shift of K+ from cells to ECF + acidosis, low insulin, cytotoxic drugs, etc 3. decreased K+ excretion + low urine, certain diuretics, adrenal insufficiency, etc Question: I have an elevated T wave on ECG, intestinal cramping, muscle weakness, flaccid paralysis, and possible cardiac arrest. What do I have? Answer: Hyperkalemia Question: What are causes of hypocalcemia? Answer: 1. decreased Ca intake or absorption + diet, CKD, chronic diarrhea, low absorption 2. decreased bioavailability + hypoparathyroidism, excess phosphate intake 3. Steatorrhea and pancreatitis Question: I have positive Chvostek and Trousseau sign , prolonged QT interval (*harder for muscle to relax), laryngospasm, tingling of extremities, fatigue, tetany, cramps, hypERactive reflexes. What do I have? Answer: Hypocalcemia Question: What are causes of hypercalcemia? Answer: - hyperparathyroidism - immobility - thiazide diuretics Question: What does the parathyroid control? Answer: Calcium Question: I have polyuria (*body trying to excrete excess), dehydration, anorexia, N/V, constipation, bradycardia, heart block, cardiac arrest, renal calculi, kidney stones, patho fractures, lethargy, and coma. What do I have? Answer: Hypercalcemia *increased threshold makes it harder to arouse muscle Question: What are causes of hypomagnesemia? Answer: - chronic alcoholism - malnutrition or malabsorption - chronic diarrhea - DKA - gentamicin toxicity - pancreatitis - vomit, GI suction, fistula drainage Question: I have insomnia, hyperactive reflexes, cramps, twitching, grimacing, positive Chvostek/Trousseau signs, nystagmus, ataxia, tetany, seizures, and cardiac. What do I have? Answer: Hypomagnesemia Question: What are causes of hypermagnesemia? Answer: *think Ach depression - ingestion of seawater - excess laxatives or antacids Question: I have decreased DTRs, lethargy, hypotension, bradycardia, flushing, diaphoresis, flaccid paralysis, resp depression, cardiac arrest. What do I have? Answer: Hypermagnasemia Question: What are causes of 1. hypophosphatemia? 2. hyperphosphatemia? Answer: 1. chronic alcoholism and chronic diarrhea, deficiency in ATP 2. chronic renal failure Question: I have anorexia, malaise, paresthesia, diminished reflexes, lethargy, muscle aches/weakness, resp fail., confusion, seizures, stupor. I am similar to hypercalcemia. What do I have? Answer: Hypophosphatemia *no energy Question: I have increased neuromuscular excitability, depletion of calcium, aching/stuff joints, itching, conjunctivitis. I am similar to hypocalcemia. What do I have? Answer: Hyperphosphatemia Question: What is clinical dehydration? Answer: Combo of fluid deficit and hypernatremia *S/S are a combo of both d/o's since it is both volume and concentration of fluid Question: Edema represents ___________________ interstitial fluid volume. It can also be a sign of fluid excess. Answer: increased Question: ELECTROLYTE ABSORPTION Absorption of calcium depends on what vitamin? Answer: Vitamin D *pH in the GI also has an impact Question: ELECTROLYTE DISTRIBUTION Where is ionized calcium most abundant? Answer: In ECF Question: ELECTROLYTE DISTRIBUTION The bones serve as an important reservoir for which electrolytes? Answer: - calcium - magnesium - phosphate ions Question: ELECTROLYTE DISTRIBUTION What hormones influence electrolyte pools? Answer: (electrolyte pools are in cells and bones) - epinephrine (potassium) - insulin (potassium and phosphate) - PTH (calcium) Question: ELECTROLYTE EXCRETION Diarrhea increases the excretion of which electrolytes? Answer: K+ and Mg Question: ELECTROLYTE EXCRETION Thiazide diuretics increase/decrease excretion of which electrolytes? Answer: - increases urinary excretion of K+ and Mg (general diuretics) - decreases urinary excretion of Ca Question: ELECTROLYTE EXCRETION What are examples of electrolyte loss through abnormal routes? Answer: - vomit - NG suction - paracentesis (draining ascites) - hemodialysis - wound/fistula drainage Question: Dave has ESRD (end stage renal disease) and has missed his last two dialysis appointments. He was admitted to the hospital for emergency dialysis and close monitoring after presenting to the ED with stomach cramping muscle twitches and was found to have elevated T waves when placed on cardiac monitoring. Answer: Hyperkalemia Question: Eloise is a 90-year-old female who has recently experienced a stroke and has developed dysphagia and unilateral paralysis as a result. The SLP has recommended a regular diet with nectar thick liquids. She complains that the thickened liquids are disgusting and she has been refusing most PO liquids. She is experiencing decreased level of consciousness confusion and decreased urinary output. Answer: Hypernatremia Question: Jamie drinks one bottle of wine every night. Today she went on a rigorous hike with some friends. After she began experiencing weakness and a fluttering feeling in her chest Answer: Hypokalemia Question: Emily , a 52 year old female , presented to the ED today after a syncopal episode . She states she has felt light - headed and dizzy since her doctor diagnosed her with poor heart function and started her on a new medication . Answer: Volume Deficit Question: John recently underwent a thyroidectomy for thyroid cancer treatment . He has begun experiencing muscle cramps , numbness and tingling , and fatigue Upon assessment he also has hyperactive reflexes and a prolonged QT interval on EKG monitoring . Answer: Hypocalcemia Question: Stacy was in a motor vehicle accident three years ago and experienced a thoracic spine injury . She is now paralyzed from the umbilicus down . She has recently begun complaining of increased thirst, frequent urination, constipation, and decreased appetite. Answer: Hypercalcemia *Ca is not in cells, its in ECF, not being used Question: Joy was recently diagnosed with chronic renal failure after she visited her PCP complaining of muscle cramps and fatigue , as well as itchy skin and repeated eye infections Answer: Hyperphosphatemia Question: Mike struggles to remain compliant with treatment for his chronic kidney disease . Recently he has missed two dialysis sessions . His wife called 911 for him due to worsening lethargy , decreased RR and effort and inability to move his extremities. Answer: Hypermagnesemia Question: Chris drinks a fifth of bourbon every day . His serum potassium is 2.8 . He complains of heart palpitations and muscle cramping / spasms . The nurse notes that his hand will often miss objects when he reaches out to grab them . Answer: Hypomagnesemia Question: Frank is a 75 year old male with a history of chronic heart failure . Hel attended a birthday party yesterday where he enjoyed two pieces of cake , a beer , and shared some cheese curds with a friend . During a visit with his home health nurse today he complains that he feels short of air walking from his bed to the bathroom and that his shoes feel tight . Answer: Volume Overload Question: What 3 major mechanisms regulate acid-base status of body? Answer: 1. buffers 2. respiratory system 3. renal system Question: What do buffers do? Answer: Chemicals which help control pH of body fluids *they will try to fix it before lungs kick in Question: What is included in the buffer system? Answer: 1. bicarb - in ECF, acts as chief 2. phosphate - in ICF and renal, becomes urine 3. protein - in ICF and blood 4. hemoglobin - inside RBCs Question: 20 bicarbonate : 3 carbonic acid. T/F? Answer: False. 20 bicarb : 1 carbon acid Any deviation from this alters the blood pH Question: The lungs can only excrete carbonic acid. T/F? Answer: True Question: How do the lungs attempt to correct ABG imbalances? Answer: Hyper (acidosis) or hypoventilation (alkaline) Question: The kidneys cannot excrete carbonic acid. T/F? Answer: True *they can increase excretion of metabolic acids Question: How do the kidneys attempt to correct ABG imbalances? Answer: Increase acid excretion (acidosis) or slow acid excretion (alkaline) Question: When the kidneys need to excrete more H+, what production increases? Answer: Ammonia Question: What is the patho of edema? Answer: Increase in oncotic pressure increases vascular permeability = proteins leak into the interstitial fluid Question: Lymphatic system drains from tissues and then returned to: Answer: venous system. *this process has nothing to do with electrolytes, only fluid