Nightingale SCI 225: Pathophysiology Midterm Examination –
2026
1. A 54-year-old patient with pulmonary tuberculosis is evaluated for syndrome
of inappropriate ADH secretion (SIADH). Which electrolyte imbalance would
be expected in this patient?
o Answer: Hyponatremia
o Rationale: SIADH causes increased water reabsorption by the kidneys, leading to
dilutional hyponatremia. Potassium levels are not directly affected; sodium is
lowered, not elevated, and hypokalemia is not a feature of SIADH.
2. A 52-year-old male enters a sleep study to gather information about his sleep
disturbances. He reports that his wife will not let him sleep in the bed with her
until he stops snoring so loudly. He also reports feeling tired a lot through the
day. When the nurse checks the chart, what is the most likely diagnosis?
o Answer: Obstructive sleep apnea syndrome (OSAS)
o Rationale: OSAS is characterized by upper airway obstruction during sleep,
leading to excessive snoring, multiple apneic episodes (≥10 seconds), and daytime
fatigue. Insomnia involves difficulty falling/staying asleep without snoring;
somnambulism is sleepwalking; jet-lag syndrome relates to circadian disruption.
3. During the sleep cycle, when does loss of temperature control occur?
o Answer: During REM sleep
o Rationale: Thermoregulation is lost during REM sleep, which is not associated
with non-REM sleep, light sleep, or delta wave sleep.
4. A 50-year-old diabetic patient experiences visual disturbances and decides to
visit his primary care provider. After examination, the primary care provider
tells the patient that the cells that allow him to see are degenerated. Which of
the following structures is most likely damaged?
o Answer: Retina
o Rationale: The retina converts light into nerve impulses; damage here causes
visual disturbances. The pupil controls light entry, the cornea is the transparent
, front part of the eye, and the lens focuses light—none primarily contain the
photoreceptor cells responsible for vision.
5. Hikers are attempting to cross the Arizona desert with a small supply of
water. The temperatures cause them to sweat profusely and become
dehydrated. The hikers are experiencing:
o Answer: Heat exhaustion
o Rationale: Heat exhaustion results from prolonged high temperatures, causing
profuse sweating, dehydration, decreased plasma volume, hypotension, and
symptoms like weakness and dizziness. Heat cramping involves sodium loss and
muscle cramps; heat stroke is a life-threatening failure of thermoregulation
(>40°C); malignant hyperthermia is a rare inherited muscle disorder triggered by
anesthetics.
6. An infant is diagnosed with noncommunicating hydrocephalus. What is an
immediate priority concern for this patient?
o Answer: Interstitial edema
o Rationale: Noncommunicating hydrocephalus blocks CSF flow, causing increased
pressure and interstitial edema. Metabolic, vasogenic, or ischemic edema are not
the primary immediate concerns in this condition.
7. A 65-year-old patient who recently suffered a cerebral vascular accident is
now unable to recognize and identify objects by touch because of injury to the
sensory cortex. How should the nurse document this finding?
o Answer: Agnosia
o Rationale: Agnosia is the failure to recognize objects by touch (or other senses)
despite intact sensory function. Hypomimesis is reduced facial expression;
dysphasia is language comprehension impairment; echolalia is repeating words.
8. A patient experiences a severe head injury hitting a tree while riding a
motorcycle. Breathing becomes deep and rapid but with normal pattern.
What term should the nurse use for this condition?
o Answer: Central neurogenic hyperventilation
2026
1. A 54-year-old patient with pulmonary tuberculosis is evaluated for syndrome
of inappropriate ADH secretion (SIADH). Which electrolyte imbalance would
be expected in this patient?
o Answer: Hyponatremia
o Rationale: SIADH causes increased water reabsorption by the kidneys, leading to
dilutional hyponatremia. Potassium levels are not directly affected; sodium is
lowered, not elevated, and hypokalemia is not a feature of SIADH.
2. A 52-year-old male enters a sleep study to gather information about his sleep
disturbances. He reports that his wife will not let him sleep in the bed with her
until he stops snoring so loudly. He also reports feeling tired a lot through the
day. When the nurse checks the chart, what is the most likely diagnosis?
o Answer: Obstructive sleep apnea syndrome (OSAS)
o Rationale: OSAS is characterized by upper airway obstruction during sleep,
leading to excessive snoring, multiple apneic episodes (≥10 seconds), and daytime
fatigue. Insomnia involves difficulty falling/staying asleep without snoring;
somnambulism is sleepwalking; jet-lag syndrome relates to circadian disruption.
3. During the sleep cycle, when does loss of temperature control occur?
o Answer: During REM sleep
o Rationale: Thermoregulation is lost during REM sleep, which is not associated
with non-REM sleep, light sleep, or delta wave sleep.
4. A 50-year-old diabetic patient experiences visual disturbances and decides to
visit his primary care provider. After examination, the primary care provider
tells the patient that the cells that allow him to see are degenerated. Which of
the following structures is most likely damaged?
o Answer: Retina
o Rationale: The retina converts light into nerve impulses; damage here causes
visual disturbances. The pupil controls light entry, the cornea is the transparent
, front part of the eye, and the lens focuses light—none primarily contain the
photoreceptor cells responsible for vision.
5. Hikers are attempting to cross the Arizona desert with a small supply of
water. The temperatures cause them to sweat profusely and become
dehydrated. The hikers are experiencing:
o Answer: Heat exhaustion
o Rationale: Heat exhaustion results from prolonged high temperatures, causing
profuse sweating, dehydration, decreased plasma volume, hypotension, and
symptoms like weakness and dizziness. Heat cramping involves sodium loss and
muscle cramps; heat stroke is a life-threatening failure of thermoregulation
(>40°C); malignant hyperthermia is a rare inherited muscle disorder triggered by
anesthetics.
6. An infant is diagnosed with noncommunicating hydrocephalus. What is an
immediate priority concern for this patient?
o Answer: Interstitial edema
o Rationale: Noncommunicating hydrocephalus blocks CSF flow, causing increased
pressure and interstitial edema. Metabolic, vasogenic, or ischemic edema are not
the primary immediate concerns in this condition.
7. A 65-year-old patient who recently suffered a cerebral vascular accident is
now unable to recognize and identify objects by touch because of injury to the
sensory cortex. How should the nurse document this finding?
o Answer: Agnosia
o Rationale: Agnosia is the failure to recognize objects by touch (or other senses)
despite intact sensory function. Hypomimesis is reduced facial expression;
dysphasia is language comprehension impairment; echolalia is repeating words.
8. A patient experiences a severe head injury hitting a tree while riding a
motorcycle. Breathing becomes deep and rapid but with normal pattern.
What term should the nurse use for this condition?
o Answer: Central neurogenic hyperventilation
