NSG120 Pathophysiology MIDTERM EXAM COMPLETE
GUIDE - Herzing University 2026/2027 Update |
Concepts + Application + Questions | Grade A
Each unit = three-part study system:
A. Mechanism Review (bullet concepts)
B. Nursing Connection (“Why It Matters”)
C. 4–5 verified MCQs (including SATA) with pathophysiology-based rationales that cite
Part A.
UNIT 1 FOUNDATIONS OF PATHOPHYSIOLOGY (Cell Injury,
Inflammation, Healing, Fluids)
A. Mechanism Review
● Cellular injury triggers: hypoxia, toxins, infection, immune attack.
● Adaptations: atrophy (↓ size), hypertrophy (↑ size), hyperplasia (↑ number),
metaplasia (cell type switch), dysplasia (deranged growth).
● Acute inflammation: vasodilation → redness/heat; capillary permeability →
swelling; pain mediators (prostaglandins).
, ● Fluid Volume Deficit (FVD): loss of ECF → ↓ capillary hydrostatic pressure →
compensatory ↑ HR, ↓ BP, ↑ serum Na (hemoconcentration).
● Fluid Volume Excess (FVE): ↑ hydrostatic or ↓ oncotic (HF, cirrhosis) → edema,
weight gain, ↓ serum Na (hemodilution).
● Metabolic acidosis: ↑ H⁺ → buffers release K⁺ → hyperkalemia (ECF shift).
● Metabolic alkalosis: ↓ H⁺ → H⁺ leaves ICF, K⁺ enters → hypokalemia.
B. Nursing Connection
● Monitor vital signs and skin turgor for FVD; expect saline or LR replacement.
● Auscultate lungs for crackles, check daily weights, restrict fluids, give diuretics for
FVE.
● With metabolic acidosis, watch cardiac monitor (hyperkalemia → peaked
T-waves, wide QRS).
● With metabolic alkalosis, watch for hypokalemia signs (weakness, U-waves,
ileus).
C. Practice Questions
1. A patient with severe diarrhea is at greatest risk for developing which imbalance?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Metabolic Acidosis
D. Respiratory Alkalosis
Answer: C
Rationale: Loss of bicarbonate-rich intestinal fluid → ↓ HCO₃⁻ → metabolic
acidosis (Part A).
2. (SATA) Which are compensatory responses to metabolic acidosis?
A. Hyperventilation
B. Hypoventilation
C. Increased renal HCO₃⁻ reabsorption
D. K⁺ shift out of cells
E. Decreased urinary ammonium
Answers: A, C, D
Rationale: Lungs blow off CO₂ (A), kidneys regenerate HCO₃⁻ (C), acidosis drives
K⁺ out (D) (Part A).
3. A patient with heart failure receiving IV furosemide develops muscle cramps and
weak pulse. Serum Na 128 mEq/L. Which imbalance is present?
GUIDE - Herzing University 2026/2027 Update |
Concepts + Application + Questions | Grade A
Each unit = three-part study system:
A. Mechanism Review (bullet concepts)
B. Nursing Connection (“Why It Matters”)
C. 4–5 verified MCQs (including SATA) with pathophysiology-based rationales that cite
Part A.
UNIT 1 FOUNDATIONS OF PATHOPHYSIOLOGY (Cell Injury,
Inflammation, Healing, Fluids)
A. Mechanism Review
● Cellular injury triggers: hypoxia, toxins, infection, immune attack.
● Adaptations: atrophy (↓ size), hypertrophy (↑ size), hyperplasia (↑ number),
metaplasia (cell type switch), dysplasia (deranged growth).
● Acute inflammation: vasodilation → redness/heat; capillary permeability →
swelling; pain mediators (prostaglandins).
, ● Fluid Volume Deficit (FVD): loss of ECF → ↓ capillary hydrostatic pressure →
compensatory ↑ HR, ↓ BP, ↑ serum Na (hemoconcentration).
● Fluid Volume Excess (FVE): ↑ hydrostatic or ↓ oncotic (HF, cirrhosis) → edema,
weight gain, ↓ serum Na (hemodilution).
● Metabolic acidosis: ↑ H⁺ → buffers release K⁺ → hyperkalemia (ECF shift).
● Metabolic alkalosis: ↓ H⁺ → H⁺ leaves ICF, K⁺ enters → hypokalemia.
B. Nursing Connection
● Monitor vital signs and skin turgor for FVD; expect saline or LR replacement.
● Auscultate lungs for crackles, check daily weights, restrict fluids, give diuretics for
FVE.
● With metabolic acidosis, watch cardiac monitor (hyperkalemia → peaked
T-waves, wide QRS).
● With metabolic alkalosis, watch for hypokalemia signs (weakness, U-waves,
ileus).
C. Practice Questions
1. A patient with severe diarrhea is at greatest risk for developing which imbalance?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Metabolic Acidosis
D. Respiratory Alkalosis
Answer: C
Rationale: Loss of bicarbonate-rich intestinal fluid → ↓ HCO₃⁻ → metabolic
acidosis (Part A).
2. (SATA) Which are compensatory responses to metabolic acidosis?
A. Hyperventilation
B. Hypoventilation
C. Increased renal HCO₃⁻ reabsorption
D. K⁺ shift out of cells
E. Decreased urinary ammonium
Answers: A, C, D
Rationale: Lungs blow off CO₂ (A), kidneys regenerate HCO₃⁻ (C), acidosis drives
K⁺ out (D) (Part A).
3. A patient with heart failure receiving IV furosemide develops muscle cramps and
weak pulse. Serum Na 128 mEq/L. Which imbalance is present?
