NR283 Exam 1 2 3 Final Prep Chamberlain
Pathophysiology Complete Study Guide
Questions and Well Graded Solutions with
Rationales Updated 2026-2027
Master your nursing exams with the ultimate Chamberlain University NR283 Pathophysiology
Study Package. This comprehensive bundle features verified multiple-choice questions,
accurate answers, and detailed rationales covering Exams 1, 2, 3, and the Comprehensive
Final Exam. Gain instant access to high-yield concepts including cell adaptations, fluid shifts,
ABGs, EKG interpretations, and multi-system failures. Perfect for accelerating your study and
securing an A on your next exam.
1|Page
, Exam 1 Content: Cellular, Immunity, Fluids, and Electrolytes
1. A client presents with a history of chronic smoking. A bronchial biopsy reveals that
normal ciliated columnar epithelium has been replaced by stratified squamous
epithelium. The nurse identifies this cellular adaptation as:
A) Anaplasia
B) Hyperplasia
C) Metaplasia
D) Dysplasia
• C) Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by
another mature cell type, frequently triggered by chronic irritation like cigarette
smoke. Dysplasia represents deranged, abnormal cell growth and is pre-cancerous.
Hyperplasia is an increase in the number of cells.
2. A nurse is caring for a patient with severe bilateral lower extremity edema. The
underlying pathophysiology causing this fluid movement into the interstitial space is:
A) Increased capillary oncotic pressure
B) Increased capillary hydrostatic pressure
C) Decreased interstitial hydrostatic pressure
D) Increased interstitial oncotic pressure
• B) Increased capillary hydrostatic pressure
Rationale: Increased capillary hydrostatic pressure (often caused by fluid volume
overload or venous obstruction) forces fluid out of the intravascular space and into
the interstitial space, causing edema. Increased capillary oncotic pressure would pull
fluid into the vessel, reducing edema. [1, 2]
3. Which of the following laboratory values would the nurse expect to see in a patient
presenting with clinical manifestations of syndrome of inappropriate antidiuretic
hormone (SIADH)?
A) Serum sodium 122 mEq/L
B) Serum sodium 152 mEq/L
C) Serum potassium 2.8 mEq/L
D) Serum potassium 6.2 mEq/L [1]
• A) Serum sodium 122 mEq/L
Rationale: SIADH causes excessive water retention by the renal tubules, resulting in
dilutional hyponatremia. Normal serum sodium is 135–145 mEq/L. Hypernatremia
(152 mEq/L) occurs in diabetes insipidus. [1, 2]
4. A patient has the following ABG results: pH 7.30, PaCO2 55 mmHg, HCO3 24
mEq/L. The nurse interprets this as:
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis [1, 2, 3, 4, 5]
• C) Respiratory acidosis
Rationale: The pH is low (< 7.35), indicating acidosis. The PaCO2 is high (> 45
mmHg), indicating a respiratory origin. The HCO3 is within normal limits (22–26
mEq/L), showing that renal compensation has not yet occurred. [1]
5. During the acute inflammatory process, what is the primary reason for the
development of localized heat and redness at the injury site?
2|Page
, A) Increased capillary permeability
B) Vasoconstriction of surrounding arterioles
C) Vasodilation and increased blood flow
D) Migration of neutrophils out of the vessel
• C) Vasodilation and increased blood flow
Rationale: Chemical mediators like histamine cause immediate vasodilation of local
arterioles, increasing blood flow (hyperemia) to the area. This increased vascular
volume manifests clinically as localized heat (calor) and redness (rubor). [1]
6. A nurse is reviewing an arterial blood gas result showing: pH 7.49, PaCO2 40
mmHg, HCO3 32 mEq/L. This indicates:
A) Uncompensated metabolic alkalosis
B) Fully compensated respiratory alkalosis
C) Uncompensated respiratory acidosis
D) Partially compensated metabolic acidosis [1, 2]
• A) Uncompensated metabolic alkalosis
Rationale: The pH is high (> 7.45), indicating alkalosis. The HCO3 is elevated (> 26
mEq/L), indicating a metabolic origin. Because the PaCO2 is perfectly normal (35–45
mmHg), the lungs have not initiated compensation. [1, 2, 3]
7. A patient with advanced renal failure presents with severe peaked T waves on an
electrocardiogram (ECG). The nurse anticipates which electrolyte imbalance?
A) Hypokalemia
B) Hyperkalemia
C) Hypocalcemia
D) Hypernatremia [1]
• B) Hyperkalemia
Rationale: Hyperkalemia (serum potassium > 5.0 mEq/L) alters the electrical
conduction of the myocardium. The earliest ECG change is typically narrowing and
peaking of the T wave. Hypokalemia causes flattened T waves and prominent U
waves. [1]
8. Which cell type releases histamine during an immediate Type I hypersensitivity
allergic reaction?
A) T cytotoxic cells
B) Macrophages
C) Mast cells
D) B lymphocytes
• C) Mast cells
Rationale: In Type I IgE-mediated hypersensitivity reactions, allergens bind to IgE
molecules already attached to the surface of mast cells and basophils, triggering
immediate degranulation and the release of histamine.
9. An infant receives immunity against a specific pathogen via antibodies transferred
across the placenta from the mother. The nurse documents this type of immunity as:
A) Active artificial immunity
B) Passive natural immunity
C) Active natural immunity
D) Passive artificial immunity [1]
• B) Passive natural immunity
Rationale: Passive natural immunity occurs when antibodies are transferred naturally
from mother to fetus via the placenta or to the infant via breast milk. The infant did
not produce the antibodies, making it passive, and no medical intervention occurred,
making it natural.
3|Page
, 10. A tumor biopsy report indicates that the cells are poorly differentiated, show marked
pleomorphism, and are invading surrounding tissues. This tumor is classified as:
A) Benign
B) Malignant
C) Carcinoma in situ
D) Hyperplastic
• B) Malignant
Rationale: Malignant tumors are characterized by poor cellular differentiation
(anaplasia), rapid growth, lack of a capsule, and the ability to invade surrounding
native tissues and metastasize to distant locations.
11. A patient with severe, protracted vomiting for 3 days is at high risk for developing
which acid-base imbalance?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis [1]
• B) Metabolic alkalosis
Rationale: Gastric secretions contain high concentrations of hydrogen (H+) and
chloride (Cl-) ions. Severe vomiting results in a profound loss of metabolic acids,
shifting the systemic acid-base balance toward metabolic alkalosis. [1]
12. Cell injury caused by a complete lack of oxygen delivery to tissues due to an
obstruction of blood flow is termed:
A) Hypoxemia
B) Infarction
C) Ischemia
D) Apoptosis
• C) Ischemia
Rationale: Ischemia is the reduction or total mechanical cessation of blood flow
through an arterial vessel, leading to tissue hypoxia. Infarction is the actual tissue
necrosis that results if ischemia is left prolonged and untreated.
13. A patient presents with a serum calcium level of 6.2 mg/dL. Which clinical
manifestation should the nurse assess for?
A) Hypoactive deep tendon reflexes
B) Constipation and abdominal distension
C) Positive Chvostek's sign
D) Prolonged PR interval [1]
• C) Positive Chvostek's sign
Rationale: Hypocalcemia (normal: 8.5–10.5 mg/dL) increases neuromuscular
excitability. Tapping the facial nerve induces facial muscle twitching (Chvostek's
sign). Hypercalcemia causes muscle weakness and constipation. [1, 2, 3]
14. During the cellular stage of acute inflammation, which cells are the very first to
migrate to the site of injury?
A) Monocytes
B) Lymphocytes
C) Neutrophils
D) Macrophages
• C) Neutrophils
Rationale: Neutrophils are the primary phagocytic white blood cells of early
inflammation. They arrive at the site of injury within 6 to 12 hours, long before
monocytes convert into macrophages. [1, 2]
4|Page
Pathophysiology Complete Study Guide
Questions and Well Graded Solutions with
Rationales Updated 2026-2027
Master your nursing exams with the ultimate Chamberlain University NR283 Pathophysiology
Study Package. This comprehensive bundle features verified multiple-choice questions,
accurate answers, and detailed rationales covering Exams 1, 2, 3, and the Comprehensive
Final Exam. Gain instant access to high-yield concepts including cell adaptations, fluid shifts,
ABGs, EKG interpretations, and multi-system failures. Perfect for accelerating your study and
securing an A on your next exam.
1|Page
, Exam 1 Content: Cellular, Immunity, Fluids, and Electrolytes
1. A client presents with a history of chronic smoking. A bronchial biopsy reveals that
normal ciliated columnar epithelium has been replaced by stratified squamous
epithelium. The nurse identifies this cellular adaptation as:
A) Anaplasia
B) Hyperplasia
C) Metaplasia
D) Dysplasia
• C) Metaplasia
Rationale: Metaplasia is the reversible replacement of one mature cell type by
another mature cell type, frequently triggered by chronic irritation like cigarette
smoke. Dysplasia represents deranged, abnormal cell growth and is pre-cancerous.
Hyperplasia is an increase in the number of cells.
2. A nurse is caring for a patient with severe bilateral lower extremity edema. The
underlying pathophysiology causing this fluid movement into the interstitial space is:
A) Increased capillary oncotic pressure
B) Increased capillary hydrostatic pressure
C) Decreased interstitial hydrostatic pressure
D) Increased interstitial oncotic pressure
• B) Increased capillary hydrostatic pressure
Rationale: Increased capillary hydrostatic pressure (often caused by fluid volume
overload or venous obstruction) forces fluid out of the intravascular space and into
the interstitial space, causing edema. Increased capillary oncotic pressure would pull
fluid into the vessel, reducing edema. [1, 2]
3. Which of the following laboratory values would the nurse expect to see in a patient
presenting with clinical manifestations of syndrome of inappropriate antidiuretic
hormone (SIADH)?
A) Serum sodium 122 mEq/L
B) Serum sodium 152 mEq/L
C) Serum potassium 2.8 mEq/L
D) Serum potassium 6.2 mEq/L [1]
• A) Serum sodium 122 mEq/L
Rationale: SIADH causes excessive water retention by the renal tubules, resulting in
dilutional hyponatremia. Normal serum sodium is 135–145 mEq/L. Hypernatremia
(152 mEq/L) occurs in diabetes insipidus. [1, 2]
4. A patient has the following ABG results: pH 7.30, PaCO2 55 mmHg, HCO3 24
mEq/L. The nurse interprets this as:
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis [1, 2, 3, 4, 5]
• C) Respiratory acidosis
Rationale: The pH is low (< 7.35), indicating acidosis. The PaCO2 is high (> 45
mmHg), indicating a respiratory origin. The HCO3 is within normal limits (22–26
mEq/L), showing that renal compensation has not yet occurred. [1]
5. During the acute inflammatory process, what is the primary reason for the
development of localized heat and redness at the injury site?
2|Page
, A) Increased capillary permeability
B) Vasoconstriction of surrounding arterioles
C) Vasodilation and increased blood flow
D) Migration of neutrophils out of the vessel
• C) Vasodilation and increased blood flow
Rationale: Chemical mediators like histamine cause immediate vasodilation of local
arterioles, increasing blood flow (hyperemia) to the area. This increased vascular
volume manifests clinically as localized heat (calor) and redness (rubor). [1]
6. A nurse is reviewing an arterial blood gas result showing: pH 7.49, PaCO2 40
mmHg, HCO3 32 mEq/L. This indicates:
A) Uncompensated metabolic alkalosis
B) Fully compensated respiratory alkalosis
C) Uncompensated respiratory acidosis
D) Partially compensated metabolic acidosis [1, 2]
• A) Uncompensated metabolic alkalosis
Rationale: The pH is high (> 7.45), indicating alkalosis. The HCO3 is elevated (> 26
mEq/L), indicating a metabolic origin. Because the PaCO2 is perfectly normal (35–45
mmHg), the lungs have not initiated compensation. [1, 2, 3]
7. A patient with advanced renal failure presents with severe peaked T waves on an
electrocardiogram (ECG). The nurse anticipates which electrolyte imbalance?
A) Hypokalemia
B) Hyperkalemia
C) Hypocalcemia
D) Hypernatremia [1]
• B) Hyperkalemia
Rationale: Hyperkalemia (serum potassium > 5.0 mEq/L) alters the electrical
conduction of the myocardium. The earliest ECG change is typically narrowing and
peaking of the T wave. Hypokalemia causes flattened T waves and prominent U
waves. [1]
8. Which cell type releases histamine during an immediate Type I hypersensitivity
allergic reaction?
A) T cytotoxic cells
B) Macrophages
C) Mast cells
D) B lymphocytes
• C) Mast cells
Rationale: In Type I IgE-mediated hypersensitivity reactions, allergens bind to IgE
molecules already attached to the surface of mast cells and basophils, triggering
immediate degranulation and the release of histamine.
9. An infant receives immunity against a specific pathogen via antibodies transferred
across the placenta from the mother. The nurse documents this type of immunity as:
A) Active artificial immunity
B) Passive natural immunity
C) Active natural immunity
D) Passive artificial immunity [1]
• B) Passive natural immunity
Rationale: Passive natural immunity occurs when antibodies are transferred naturally
from mother to fetus via the placenta or to the infant via breast milk. The infant did
not produce the antibodies, making it passive, and no medical intervention occurred,
making it natural.
3|Page
, 10. A tumor biopsy report indicates that the cells are poorly differentiated, show marked
pleomorphism, and are invading surrounding tissues. This tumor is classified as:
A) Benign
B) Malignant
C) Carcinoma in situ
D) Hyperplastic
• B) Malignant
Rationale: Malignant tumors are characterized by poor cellular differentiation
(anaplasia), rapid growth, lack of a capsule, and the ability to invade surrounding
native tissues and metastasize to distant locations.
11. A patient with severe, protracted vomiting for 3 days is at high risk for developing
which acid-base imbalance?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis [1]
• B) Metabolic alkalosis
Rationale: Gastric secretions contain high concentrations of hydrogen (H+) and
chloride (Cl-) ions. Severe vomiting results in a profound loss of metabolic acids,
shifting the systemic acid-base balance toward metabolic alkalosis. [1]
12. Cell injury caused by a complete lack of oxygen delivery to tissues due to an
obstruction of blood flow is termed:
A) Hypoxemia
B) Infarction
C) Ischemia
D) Apoptosis
• C) Ischemia
Rationale: Ischemia is the reduction or total mechanical cessation of blood flow
through an arterial vessel, leading to tissue hypoxia. Infarction is the actual tissue
necrosis that results if ischemia is left prolonged and untreated.
13. A patient presents with a serum calcium level of 6.2 mg/dL. Which clinical
manifestation should the nurse assess for?
A) Hypoactive deep tendon reflexes
B) Constipation and abdominal distension
C) Positive Chvostek's sign
D) Prolonged PR interval [1]
• C) Positive Chvostek's sign
Rationale: Hypocalcemia (normal: 8.5–10.5 mg/dL) increases neuromuscular
excitability. Tapping the facial nerve induces facial muscle twitching (Chvostek's
sign). Hypercalcemia causes muscle weakness and constipation. [1, 2, 3]
14. During the cellular stage of acute inflammation, which cells are the very first to
migrate to the site of injury?
A) Monocytes
B) Lymphocytes
C) Neutrophils
D) Macrophages
• C) Neutrophils
Rationale: Neutrophils are the primary phagocytic white blood cells of early
inflammation. They arrive at the site of injury within 6 to 12 hours, long before
monocytes convert into macrophages. [1, 2]
4|Page
