NR283 Exam 3 Actual Exam Style V3 | NR
283 Pathophysiology | Chamberlain
1. A patient is diagnosed with gastroesophageal reflux disease (GERD). What is the primary
underlying cause of this condition?
A. Excessive production of hydrochloric acid in the stomach
B. Inappropriate relaxation of the lower esophageal sphincter
C. An infection by the bacterium Helicobacter pylori
D. Delayed gastric emptying due to autonomic neuropathy
Answer: B
Rationale: GERD occurs when the lower esophageal sphincter (LES) does not close
properly, allowing stomach acid to back up into the esophagus. This relaxation is often
inappropriate and independent of swallowing. Chronic exposure to acid leads to irritation
and potential damage to the esophageal lining.
2. Which clinical manifestation is a hallmark sign of acute pancreatitis?
A. Left lower quadrant pain relieved by defecation
B. Painless jaundice and clay-colored stools
C. Severe epigastric pain radiating to the back
D. Frequent bloody diarrhea and tenesmus
,Answer: C
Rationale: Acute pancreatitis typically presents with severe, steady epigastric or left upper
quadrant pain that frequently radiates to the back. The pain is caused by the autodigestion
of the pancreas by its own enzymes. It often worsens after eating or when lying flat, leading
patients to seek a fetal position for relief.
3. What is the primary mechanism behind the development of ascites in patients with
cirrhosis?
A. Portal hypertension and decreased serum albumin levels
B. Increased oncotic pressure and hyperalbuminemia
C. Excessive secretion of bile into the peritoneal cavity
D. Obstruction of the common bile duct by gallstones
Answer: A
Rationale: Ascites in cirrhosis is driven by portal hypertension, which increases
hydrostatic pressure in the mesenteric vessels. Simultaneously, the liver’s inability to
synthesize albumin leads to hypoalbuminemia, which lowers capillary oncotic pressure.
This combination results in the shifting of fluid from the vascular space into the peritoneal
cavity.
4. A patient with chronic kidney disease (CKD) develops anemia. What is the most likely
cause?
A. Loss of red blood cells through the urine
, B. Premature destruction of red blood cells in the spleen
C. Iron deficiency due to poor intestinal absorption
D. Inadequate production of erythropoietin by the kidneys
Answer: D
Rationale: The kidneys are responsible for producing erythropoietin, a hormone that
stimulates red blood cell production in the bone marrow. As renal function declines in CKD,
the production of this hormone decreases significantly. Consequently, the bone marrow
produces fewer red blood cells, leading to chronic anemia.
5. Which electrolyte imbalance is a common and life-threatening complication of acute
kidney injury (AKI)?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B
Rationale: In AKI, the kidneys are unable to effectively excrete potassium, leading to its
accumulation in the blood. Hyperkalemia is particularly dangerous because it alters the
electrical activity of the heart. Severe cases can result in fatal cardiac dysrhythmias and
cardiac arrest.
283 Pathophysiology | Chamberlain
1. A patient is diagnosed with gastroesophageal reflux disease (GERD). What is the primary
underlying cause of this condition?
A. Excessive production of hydrochloric acid in the stomach
B. Inappropriate relaxation of the lower esophageal sphincter
C. An infection by the bacterium Helicobacter pylori
D. Delayed gastric emptying due to autonomic neuropathy
Answer: B
Rationale: GERD occurs when the lower esophageal sphincter (LES) does not close
properly, allowing stomach acid to back up into the esophagus. This relaxation is often
inappropriate and independent of swallowing. Chronic exposure to acid leads to irritation
and potential damage to the esophageal lining.
2. Which clinical manifestation is a hallmark sign of acute pancreatitis?
A. Left lower quadrant pain relieved by defecation
B. Painless jaundice and clay-colored stools
C. Severe epigastric pain radiating to the back
D. Frequent bloody diarrhea and tenesmus
,Answer: C
Rationale: Acute pancreatitis typically presents with severe, steady epigastric or left upper
quadrant pain that frequently radiates to the back. The pain is caused by the autodigestion
of the pancreas by its own enzymes. It often worsens after eating or when lying flat, leading
patients to seek a fetal position for relief.
3. What is the primary mechanism behind the development of ascites in patients with
cirrhosis?
A. Portal hypertension and decreased serum albumin levels
B. Increased oncotic pressure and hyperalbuminemia
C. Excessive secretion of bile into the peritoneal cavity
D. Obstruction of the common bile duct by gallstones
Answer: A
Rationale: Ascites in cirrhosis is driven by portal hypertension, which increases
hydrostatic pressure in the mesenteric vessels. Simultaneously, the liver’s inability to
synthesize albumin leads to hypoalbuminemia, which lowers capillary oncotic pressure.
This combination results in the shifting of fluid from the vascular space into the peritoneal
cavity.
4. A patient with chronic kidney disease (CKD) develops anemia. What is the most likely
cause?
A. Loss of red blood cells through the urine
, B. Premature destruction of red blood cells in the spleen
C. Iron deficiency due to poor intestinal absorption
D. Inadequate production of erythropoietin by the kidneys
Answer: D
Rationale: The kidneys are responsible for producing erythropoietin, a hormone that
stimulates red blood cell production in the bone marrow. As renal function declines in CKD,
the production of this hormone decreases significantly. Consequently, the bone marrow
produces fewer red blood cells, leading to chronic anemia.
5. Which electrolyte imbalance is a common and life-threatening complication of acute
kidney injury (AKI)?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B
Rationale: In AKI, the kidneys are unable to effectively excrete potassium, leading to its
accumulation in the blood. Hyperkalemia is particularly dangerous because it alters the
electrical activity of the heart. Severe cases can result in fatal cardiac dysrhythmias and
cardiac arrest.
