Advanced Pathophysiology Nursing Exam
Cycle 2025/2026 | University Prep Notes |
NCLEX‑Style Comprehensive Study Pack
100 Questions
1. A patient is diagnosed with metabolic acidosis. Which arterial blood gas (ABG) value would confirm
this diagnosis?
A) pH 7.48, HCO3 30 mEq/L
B) pH 7.25, HCO3 18 mEq/L
C) pH 7.35, HCO3 22 mEq/L
D) pH 7.50, HCO3 20 mEq/L
🎯CORRECT CHOICE: B) pH 7.25, HCO3 18 mEq/L
💡EXPLANATION: Metabolic acidosis is characterized by a low pH (<7.35) and a low bicarbonate level
(<22 mEq/L) due to a primary loss of bicarbonate or accumulation of acids.
2. A nurse is reviewing a patient's lab results and notes an elevated C-reactive protein (CRP) level. What
does this indicate?
A) Chronic liver disease
B) Acute inflammation
C) Renal failure
D) Cardiac ischemia
🎯CORRECT CHOICE: B) Acute inflammation
💡EXPLANATION: CRP is an acute-phase protein produced by the liver in response to inflammation.
Elevated levels indicate an ongoing inflammatory process, though it is nonspecific.
,3. A patient with chronic heart failure develops dependent edema. Which pathophysiological
mechanism is primarily responsible?
A) Decreased capillary permeability
B) Increased hydrostatic pressure
C) Decreased plasma oncotic pressure
D) Lymphatic obstruction
🎯CORRECT CHOICE: B) Increased hydrostatic pressure
💡EXPLANATION: In heart failure, decreased cardiac output leads to venous congestion and increased
hydrostatic pressure in the capillaries, forcing fluid into the interstitial space, causing edema.
4. Which cellular adaptation is characterized by an increase in cell size and function?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
🎯CORRECT CHOICE: B) Hypertrophy
💡EXPLANATION: Hypertrophy is an increase in cell size, often in response to increased workload. It can
be physiologic (e.g., muscle growth from exercise) or pathologic (e.g., cardiac hypertrophy from
hypertension).
5. A patient is diagnosed with pernicious anemia. Which deficiency is the underlying cause?
A) Iron deficiency
B) Vitamin B12 deficiency due to lack of intrinsic factor
C) Folic acid deficiency
D) Vitamin K deficiency
🎯CORRECT CHOICE: B) Vitamin B12 deficiency due to lack of intrinsic factor
,💡EXPLANATION: Pernicious anemia is an autoimmune condition where the body destroys parietal cells,
which produce intrinsic factor. Without intrinsic factor, vitamin B12 cannot be absorbed, leading to
megaloblastic anemia.
6. A nurse is assessing a patient with severe dehydration. Which electrolyte imbalance is most likely to
occur?
A) Hyponatremia
B) Hypernatremia
C) Hypokalemia
D) Hypercalcemia
🎯CORRECT CHOICE: B) Hypernatremia
💡EXPLANATION: Dehydration leads to a loss of water relative to sodium, causing an increase in serum
sodium concentration (hypernatremia). This is due to insufficient free water in the body.
7. A patient with chronic obstructive pulmonary disease (COPD) has a compensatory respiratory
acidosis. What is the primary compensatory mechanism?
A) Hyperventilation to blow off CO2
B) Renal retention of bicarbonate
C) Respiratory alkalosis
D) Increased bicarbonate excretion
🎯CORRECT CHOICE: B) Renal retention of bicarbonate
💡EXPLANATION: In respiratory acidosis (elevated CO2), the kidneys compensate by retaining
bicarbonate (HCO3-) and excreting hydrogen ions (H+) to raise the pH back toward normal.
8. Which type of necrosis is commonly associated with a myocardial infarction?
A) Liquefactive necrosis
B) Caseous necrosis
C) Coagulative necrosis
D) Fat necrosis
, 🎯CORRECT CHOICE: C) Coagulative necrosis
💡EXPLANATION: Coagulative necrosis is the most common type of necrosis, typically occurring in solid
organs like the heart, kidney, and adrenal glands. It is characterized by the preservation of tissue
architecture for several days.
9. A patient with liver failure is at risk for bleeding. Which lab value would be most affected?
A) Complete blood count
B) Serum albumin
C) Prothrombin time (PT) and INR
D) Serum creatinine
🎯CORRECT CHOICE: C) Prothrombin time (PT) and INR
💡EXPLANATION: The liver synthesizes most clotting factors. In liver failure, the production of these
factors decreases, leading to prolonged PT and elevated INR, increasing the risk of bleeding.
10. Which immunoglobulin is the first to be produced during a primary immune response?
A) IgG
B) IgM
C) IgA
D) IgE
🎯CORRECT CHOICE: B) IgM
💡EXPLANATION: During a primary immune response, IgM is the first antibody produced. It is a large
pentamer and is highly effective at activating complement. IgG is produced later in the response.
11. A patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which
laboratory finding is expected?
A) Hypernatremia
B) Hyponatremia
Cycle 2025/2026 | University Prep Notes |
NCLEX‑Style Comprehensive Study Pack
100 Questions
1. A patient is diagnosed with metabolic acidosis. Which arterial blood gas (ABG) value would confirm
this diagnosis?
A) pH 7.48, HCO3 30 mEq/L
B) pH 7.25, HCO3 18 mEq/L
C) pH 7.35, HCO3 22 mEq/L
D) pH 7.50, HCO3 20 mEq/L
🎯CORRECT CHOICE: B) pH 7.25, HCO3 18 mEq/L
💡EXPLANATION: Metabolic acidosis is characterized by a low pH (<7.35) and a low bicarbonate level
(<22 mEq/L) due to a primary loss of bicarbonate or accumulation of acids.
2. A nurse is reviewing a patient's lab results and notes an elevated C-reactive protein (CRP) level. What
does this indicate?
A) Chronic liver disease
B) Acute inflammation
C) Renal failure
D) Cardiac ischemia
🎯CORRECT CHOICE: B) Acute inflammation
💡EXPLANATION: CRP is an acute-phase protein produced by the liver in response to inflammation.
Elevated levels indicate an ongoing inflammatory process, though it is nonspecific.
,3. A patient with chronic heart failure develops dependent edema. Which pathophysiological
mechanism is primarily responsible?
A) Decreased capillary permeability
B) Increased hydrostatic pressure
C) Decreased plasma oncotic pressure
D) Lymphatic obstruction
🎯CORRECT CHOICE: B) Increased hydrostatic pressure
💡EXPLANATION: In heart failure, decreased cardiac output leads to venous congestion and increased
hydrostatic pressure in the capillaries, forcing fluid into the interstitial space, causing edema.
4. Which cellular adaptation is characterized by an increase in cell size and function?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
🎯CORRECT CHOICE: B) Hypertrophy
💡EXPLANATION: Hypertrophy is an increase in cell size, often in response to increased workload. It can
be physiologic (e.g., muscle growth from exercise) or pathologic (e.g., cardiac hypertrophy from
hypertension).
5. A patient is diagnosed with pernicious anemia. Which deficiency is the underlying cause?
A) Iron deficiency
B) Vitamin B12 deficiency due to lack of intrinsic factor
C) Folic acid deficiency
D) Vitamin K deficiency
🎯CORRECT CHOICE: B) Vitamin B12 deficiency due to lack of intrinsic factor
,💡EXPLANATION: Pernicious anemia is an autoimmune condition where the body destroys parietal cells,
which produce intrinsic factor. Without intrinsic factor, vitamin B12 cannot be absorbed, leading to
megaloblastic anemia.
6. A nurse is assessing a patient with severe dehydration. Which electrolyte imbalance is most likely to
occur?
A) Hyponatremia
B) Hypernatremia
C) Hypokalemia
D) Hypercalcemia
🎯CORRECT CHOICE: B) Hypernatremia
💡EXPLANATION: Dehydration leads to a loss of water relative to sodium, causing an increase in serum
sodium concentration (hypernatremia). This is due to insufficient free water in the body.
7. A patient with chronic obstructive pulmonary disease (COPD) has a compensatory respiratory
acidosis. What is the primary compensatory mechanism?
A) Hyperventilation to blow off CO2
B) Renal retention of bicarbonate
C) Respiratory alkalosis
D) Increased bicarbonate excretion
🎯CORRECT CHOICE: B) Renal retention of bicarbonate
💡EXPLANATION: In respiratory acidosis (elevated CO2), the kidneys compensate by retaining
bicarbonate (HCO3-) and excreting hydrogen ions (H+) to raise the pH back toward normal.
8. Which type of necrosis is commonly associated with a myocardial infarction?
A) Liquefactive necrosis
B) Caseous necrosis
C) Coagulative necrosis
D) Fat necrosis
, 🎯CORRECT CHOICE: C) Coagulative necrosis
💡EXPLANATION: Coagulative necrosis is the most common type of necrosis, typically occurring in solid
organs like the heart, kidney, and adrenal glands. It is characterized by the preservation of tissue
architecture for several days.
9. A patient with liver failure is at risk for bleeding. Which lab value would be most affected?
A) Complete blood count
B) Serum albumin
C) Prothrombin time (PT) and INR
D) Serum creatinine
🎯CORRECT CHOICE: C) Prothrombin time (PT) and INR
💡EXPLANATION: The liver synthesizes most clotting factors. In liver failure, the production of these
factors decreases, leading to prolonged PT and elevated INR, increasing the risk of bleeding.
10. Which immunoglobulin is the first to be produced during a primary immune response?
A) IgG
B) IgM
C) IgA
D) IgE
🎯CORRECT CHOICE: B) IgM
💡EXPLANATION: During a primary immune response, IgM is the first antibody produced. It is a large
pentamer and is highly effective at activating complement. IgG is produced later in the response.
11. A patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which
laboratory finding is expected?
A) Hypernatremia
B) Hyponatremia
