N212 PATHOPHYSIOLOGY EXAM
1 2026 Eastwick College | Study Guide
with Verified Answers
Question 1
A patient with a major burn injury presents with black-colored sputum. What does
this most likely indicate?
A. Carbon monoxide poisoning
B. Inhalation injury with particulate matter
C. Pulmonary edema
D. Pneumonia
Correct Answer: B
Rationale: Inhalation injury with particulate matter is indicated by black-
colored sputum in burn patients. This suggests the patient was exposed to
smoke/combtustion products with soot/particulates deposited in the
airway. Carbon monoxide poisoning causes cherry-red skin, not black
sputum. Pulmonary edema causes pink frothy sputum. Pneumonia may cause
purulent sputum but not black. Nursing must assess for inhalation injury in burn
patients.
Question 2
Which pathophysiological mechanism is MOST responsible for the development
of type 1 diabetes mellitus?
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells
C. Excessive glucagon production
D. Hepatic overproduction of glucose
Correct Answer: B
Rationale: Autoimmune destruction of pancreatic beta cells is the primary
,mechanism for type 1 diabetes mellitus. T-cell mediated autoimmune process
destroys insulin-producing beta cells, causing absolute insulin deficiency. Insulin
resistance is type 2 diabetes. Excessive glucagon and hepatic glucose
overproduction occur in diabetes but are secondary. Nursing must understand the
autoimmune etiology of type 1 DM.
Question 3
A patient presents with metabolic acidosis (pH 7.25, HCO3 15 mEq/L). Which
compensation mechanism is expected?
A. Increased respiratory rate (Kussmaul respirations)
B. Decreased respiratory rate
C. Increased bicarbonate retention
D. Decreased renal acid excretion
Correct Answer: A
Rationale: Increased respiratory rate (Kussmaul respirations) is the expected
compensation for metabolic acidosis. The respiratory system compensates by
hyperventilating to blow off CO2, raising pH. Decreased respiratory
rate worsens acidosis. Bicarbonate retention is renal compensation
(slower). Decreased acid excretion worsens acidosis. Nursing must recognize
compensatory mechanisms.
Question 4
Which condition is the MOST common cause of viral sinus infections?
A. Streptococcus pneumoniae
B. Common cold virus (rhinovirus) or influenza virus
C. Haemophilus influenzae
D. Staphylococcus aureus
Correct Answer: B
Rationale: Common cold virus (rhinovirus) or influenza virus causes the
MOST viral sinus infections (~90% of cases). Streptococcus, Haemophilus,
Staphylococcus are bacterial pathogens (~10% of sinus infections). Viral
,infections resolve spontaneously without antibiotics. Nursing must differentiate
viral vs bacterial sinusitis for appropriate treatment.
Question 5
A patient with chronic kidney disease has serum potassium of 6.5 mEq/L. What is
the primary pathophysiological concern?
A. Risk of cardiac arrhythmias
B. Metabolic alkalosis
C. Hypocalcemia
D. Hyponatremia
Correct Answer: A
Rationale: Risk of cardiac arrhythmias is the primary concern
with hyperkalemia (K+ 6.5 mEq/L). High potassium depolarizes cardiac cells,
causing dangerous arrhythmias (peaked T waves, widened QRS, ventricular
fibrillation). Metabolic alkalosis is incorrect (hyperkalemia causes
acidosis). Hypocalcemia and hyponatremia may occur but arrhythmias are
primary concern. Nursing must monitor ECG with hyperkalemia.
Question 6
Which pathophysiological change occurs in emphysema?
A. Increased airway resistance from bronchoconstriction
B. Destruction of alveolar walls and loss of elastic recoil
C. Mucosal inflammation and edema
D. Excessive mucus production
Correct Answer: B
Rationale: Destruction of alveolar walls and loss of elastic recoil occurs
in emphysema (COPD subtype). Enzymes (from inflammation) destroy alveolar
septa, reducing surface area for gas exchange and causing air trapping. Increased
airway resistance is chronic bronchitis. Mucosal inflammation and excessive
mucus are also chronic bronchitis. Nursing must distinguish emphysema from
chronic bronchitis.
, Question 7
A patient presents with hyponatremia (Na+ 120 mEq/L). Which clinical
manifestation is MOST concerning?
A. Muscle cramps
B. Cerebral edema and seizures
C. Dry mucous membranes
D. Tachycardia
Correct Answer: B
Rationale: Cerebral edema and seizures are MOST concerning
with hyponatremia (Na+ 120 mEq/L). Low sodium causes water to shift into
cells, causing cerebral edema, headache, confusion, seizures, coma. Muscle
cramps occur but less severe. Dry mucous membranes and tachycardia are
hypovolemia signs. Nursing must monitor neuro status with hyponatremia.
Question 8
Which mechanism explains the development of edema in heart failure?
A. Decreased aldosterone secretion
B. Increased venous pressure and sodium/water retention
C. Decreased capillary permeability
D. Increased plasma albumin
Correct Answer: B
Rationale: Increased venous pressure and sodium/water
retention explains edema in heart failure. Reduced cardiac output activates
RAAS → sodium/water retention. Increased venous pressure causes fluid to leak
into tissues. Decreased aldosterone would reduce edema. Decreased capillary
permeability and increased albumin reduce edema. Nursing must understand
heart failure pathophysiology.
Question 9
A patient with aplastic anemia has which laboratory finding?
1 2026 Eastwick College | Study Guide
with Verified Answers
Question 1
A patient with a major burn injury presents with black-colored sputum. What does
this most likely indicate?
A. Carbon monoxide poisoning
B. Inhalation injury with particulate matter
C. Pulmonary edema
D. Pneumonia
Correct Answer: B
Rationale: Inhalation injury with particulate matter is indicated by black-
colored sputum in burn patients. This suggests the patient was exposed to
smoke/combtustion products with soot/particulates deposited in the
airway. Carbon monoxide poisoning causes cherry-red skin, not black
sputum. Pulmonary edema causes pink frothy sputum. Pneumonia may cause
purulent sputum but not black. Nursing must assess for inhalation injury in burn
patients.
Question 2
Which pathophysiological mechanism is MOST responsible for the development
of type 1 diabetes mellitus?
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells
C. Excessive glucagon production
D. Hepatic overproduction of glucose
Correct Answer: B
Rationale: Autoimmune destruction of pancreatic beta cells is the primary
,mechanism for type 1 diabetes mellitus. T-cell mediated autoimmune process
destroys insulin-producing beta cells, causing absolute insulin deficiency. Insulin
resistance is type 2 diabetes. Excessive glucagon and hepatic glucose
overproduction occur in diabetes but are secondary. Nursing must understand the
autoimmune etiology of type 1 DM.
Question 3
A patient presents with metabolic acidosis (pH 7.25, HCO3 15 mEq/L). Which
compensation mechanism is expected?
A. Increased respiratory rate (Kussmaul respirations)
B. Decreased respiratory rate
C. Increased bicarbonate retention
D. Decreased renal acid excretion
Correct Answer: A
Rationale: Increased respiratory rate (Kussmaul respirations) is the expected
compensation for metabolic acidosis. The respiratory system compensates by
hyperventilating to blow off CO2, raising pH. Decreased respiratory
rate worsens acidosis. Bicarbonate retention is renal compensation
(slower). Decreased acid excretion worsens acidosis. Nursing must recognize
compensatory mechanisms.
Question 4
Which condition is the MOST common cause of viral sinus infections?
A. Streptococcus pneumoniae
B. Common cold virus (rhinovirus) or influenza virus
C. Haemophilus influenzae
D. Staphylococcus aureus
Correct Answer: B
Rationale: Common cold virus (rhinovirus) or influenza virus causes the
MOST viral sinus infections (~90% of cases). Streptococcus, Haemophilus,
Staphylococcus are bacterial pathogens (~10% of sinus infections). Viral
,infections resolve spontaneously without antibiotics. Nursing must differentiate
viral vs bacterial sinusitis for appropriate treatment.
Question 5
A patient with chronic kidney disease has serum potassium of 6.5 mEq/L. What is
the primary pathophysiological concern?
A. Risk of cardiac arrhythmias
B. Metabolic alkalosis
C. Hypocalcemia
D. Hyponatremia
Correct Answer: A
Rationale: Risk of cardiac arrhythmias is the primary concern
with hyperkalemia (K+ 6.5 mEq/L). High potassium depolarizes cardiac cells,
causing dangerous arrhythmias (peaked T waves, widened QRS, ventricular
fibrillation). Metabolic alkalosis is incorrect (hyperkalemia causes
acidosis). Hypocalcemia and hyponatremia may occur but arrhythmias are
primary concern. Nursing must monitor ECG with hyperkalemia.
Question 6
Which pathophysiological change occurs in emphysema?
A. Increased airway resistance from bronchoconstriction
B. Destruction of alveolar walls and loss of elastic recoil
C. Mucosal inflammation and edema
D. Excessive mucus production
Correct Answer: B
Rationale: Destruction of alveolar walls and loss of elastic recoil occurs
in emphysema (COPD subtype). Enzymes (from inflammation) destroy alveolar
septa, reducing surface area for gas exchange and causing air trapping. Increased
airway resistance is chronic bronchitis. Mucosal inflammation and excessive
mucus are also chronic bronchitis. Nursing must distinguish emphysema from
chronic bronchitis.
, Question 7
A patient presents with hyponatremia (Na+ 120 mEq/L). Which clinical
manifestation is MOST concerning?
A. Muscle cramps
B. Cerebral edema and seizures
C. Dry mucous membranes
D. Tachycardia
Correct Answer: B
Rationale: Cerebral edema and seizures are MOST concerning
with hyponatremia (Na+ 120 mEq/L). Low sodium causes water to shift into
cells, causing cerebral edema, headache, confusion, seizures, coma. Muscle
cramps occur but less severe. Dry mucous membranes and tachycardia are
hypovolemia signs. Nursing must monitor neuro status with hyponatremia.
Question 8
Which mechanism explains the development of edema in heart failure?
A. Decreased aldosterone secretion
B. Increased venous pressure and sodium/water retention
C. Decreased capillary permeability
D. Increased plasma albumin
Correct Answer: B
Rationale: Increased venous pressure and sodium/water
retention explains edema in heart failure. Reduced cardiac output activates
RAAS → sodium/water retention. Increased venous pressure causes fluid to leak
into tissues. Decreased aldosterone would reduce edema. Decreased capillary
permeability and increased albumin reduce edema. Nursing must understand
heart failure pathophysiology.
Question 9
A patient with aplastic anemia has which laboratory finding?
