NURS 3366 PATHOPHYSIOLOGY – COMPREHENSIVE
FINAL ACTUAL EXAM 2026–2027| HIGH-YIELD
QUESTIONS WITH CORRECT VERIFIED ANSWERS AND
DETAILED RATIONALES FOR NURSING STUDENT
SUCCESS| INSTANT DOWNLOAND PDF
Correct answers are in bold with rationales.
1. A 65-year-old patient presents with chest pain radiating to the left arm.
ECG shows ST-segment elevation in leads II, III, and aVF. Which area of the
heart is affected?
A. Anterior
B. Lateral
C. Inferior
D. Septal
Rationale: ST elevation in II, III, aVF indicates an inferior myocardial infarction.
2. A patient presents with shortness of breath and pink frothy sputum.
Pulmonary auscultation reveals crackles bilaterally. Most likely
pathophysiology?
A. Obstructive lung disease
B. Left-sided heart failure leading to pulmonary edema
C. Pulmonary embolism
D. Asthma
Rationale: Left ventricular failure increases hydrostatic pressure in pulmonary
capillaries, causing edema.
3. A patient has a sodium level of 128 mEq/L. Symptoms include confusion,
headache, and nausea. Most likely condition?
A. Hypernatremia
B. Hyponatremia
, C. Hypokalemia
D. Hyperkalemia
Rationale: Sodium <135 mEq/L defines hyponatremia; neurological symptoms are
common.
4. A patient presents with polyuria, polydipsia, and polyphagia. Labs show
fasting glucose 220 mg/dL and positive ketones. Most likely diagnosis?
A. Type 1 diabetes mellitus
B. Type 2 diabetes mellitus
C. Diabetes insipidus
D. Hyperthyroidism
Rationale: Hyperglycemia with ketones and classic symptoms suggests type 1
diabetes.
5. A 45-year-old patient presents with sudden-onset dyspnea, pleuritic chest
pain, and tachycardia. Most likely cause?
A. Pneumonia
B. Asthma exacerbation
C. Pulmonary embolism
D. Myocardial infarction
Rationale: Sudden dyspnea, pleuritic pain, and tachycardia are classic PE signs.
6. A patient presents with fatigue, pallor, and spoon-shaped nails. Lab: low
hemoglobin and microcytosis. Most likely cause?
A. Iron-deficiency anemia
B. Vitamin B12 deficiency
C. Aplastic anemia
D. Hemolytic anemia
Rationale: Microcytic anemia with fatigue and pallor suggests iron deficiency.
7. A patient presents with hypotension, tachycardia, warm flushed skin, and
fever due to gram-negative sepsis. What type of shock is this?
A. Cardiogenic
B. Hypovolemic
, C. Septic (distributive) shock
D. Obstructive
Rationale: Vasodilation, warm skin, and infection indicate septic shock.
8. A 55-year-old patient presents with chronic cough, dyspnea, and barrel
chest. Pulmonary function tests show decreased FEV1/FVC ratio. Most
likely pathophysiology?
A. Chronic obstructive pulmonary disease (COPD)
B. Pulmonary fibrosis
C. Asthma
D. Pneumonia
Rationale: COPD is obstructive; decreased FEV1/FVC ratio confirms airflow
limitation.
9. A patient presents with bruising, petechiae, and prolonged bleeding time.
Platelet count is low, coagulation studies normal. Most likely cause?
A. Thrombocytopenia (ITP)
B. Hemophilia A
C. Vitamin K deficiency
D. Liver disease
Rationale: Isolated low platelets with normal coagulation suggests ITP.
10.A patient presents with severe diarrhea and hypokalemia. Which ECG
change is expected?
A. Peaked T waves
B. Prolonged PR interval
C. Flattened T waves and U waves
D. Shortened QT interval
Rationale: Hypokalemia causes flattened T waves and prominent U waves on
ECG.
11.A patient has hypothyroidism. Which finding is expected?
A. Weight loss and tachycardia
B. Fatigue, cold intolerance, and bradycardia
FINAL ACTUAL EXAM 2026–2027| HIGH-YIELD
QUESTIONS WITH CORRECT VERIFIED ANSWERS AND
DETAILED RATIONALES FOR NURSING STUDENT
SUCCESS| INSTANT DOWNLOAND PDF
Correct answers are in bold with rationales.
1. A 65-year-old patient presents with chest pain radiating to the left arm.
ECG shows ST-segment elevation in leads II, III, and aVF. Which area of the
heart is affected?
A. Anterior
B. Lateral
C. Inferior
D. Septal
Rationale: ST elevation in II, III, aVF indicates an inferior myocardial infarction.
2. A patient presents with shortness of breath and pink frothy sputum.
Pulmonary auscultation reveals crackles bilaterally. Most likely
pathophysiology?
A. Obstructive lung disease
B. Left-sided heart failure leading to pulmonary edema
C. Pulmonary embolism
D. Asthma
Rationale: Left ventricular failure increases hydrostatic pressure in pulmonary
capillaries, causing edema.
3. A patient has a sodium level of 128 mEq/L. Symptoms include confusion,
headache, and nausea. Most likely condition?
A. Hypernatremia
B. Hyponatremia
, C. Hypokalemia
D. Hyperkalemia
Rationale: Sodium <135 mEq/L defines hyponatremia; neurological symptoms are
common.
4. A patient presents with polyuria, polydipsia, and polyphagia. Labs show
fasting glucose 220 mg/dL and positive ketones. Most likely diagnosis?
A. Type 1 diabetes mellitus
B. Type 2 diabetes mellitus
C. Diabetes insipidus
D. Hyperthyroidism
Rationale: Hyperglycemia with ketones and classic symptoms suggests type 1
diabetes.
5. A 45-year-old patient presents with sudden-onset dyspnea, pleuritic chest
pain, and tachycardia. Most likely cause?
A. Pneumonia
B. Asthma exacerbation
C. Pulmonary embolism
D. Myocardial infarction
Rationale: Sudden dyspnea, pleuritic pain, and tachycardia are classic PE signs.
6. A patient presents with fatigue, pallor, and spoon-shaped nails. Lab: low
hemoglobin and microcytosis. Most likely cause?
A. Iron-deficiency anemia
B. Vitamin B12 deficiency
C. Aplastic anemia
D. Hemolytic anemia
Rationale: Microcytic anemia with fatigue and pallor suggests iron deficiency.
7. A patient presents with hypotension, tachycardia, warm flushed skin, and
fever due to gram-negative sepsis. What type of shock is this?
A. Cardiogenic
B. Hypovolemic
, C. Septic (distributive) shock
D. Obstructive
Rationale: Vasodilation, warm skin, and infection indicate septic shock.
8. A 55-year-old patient presents with chronic cough, dyspnea, and barrel
chest. Pulmonary function tests show decreased FEV1/FVC ratio. Most
likely pathophysiology?
A. Chronic obstructive pulmonary disease (COPD)
B. Pulmonary fibrosis
C. Asthma
D. Pneumonia
Rationale: COPD is obstructive; decreased FEV1/FVC ratio confirms airflow
limitation.
9. A patient presents with bruising, petechiae, and prolonged bleeding time.
Platelet count is low, coagulation studies normal. Most likely cause?
A. Thrombocytopenia (ITP)
B. Hemophilia A
C. Vitamin K deficiency
D. Liver disease
Rationale: Isolated low platelets with normal coagulation suggests ITP.
10.A patient presents with severe diarrhea and hypokalemia. Which ECG
change is expected?
A. Peaked T waves
B. Prolonged PR interval
C. Flattened T waves and U waves
D. Shortened QT interval
Rationale: Hypokalemia causes flattened T waves and prominent U waves on
ECG.
11.A patient has hypothyroidism. Which finding is expected?
A. Weight loss and tachycardia
B. Fatigue, cold intolerance, and bradycardia
