NRS 455 Exam 1 V1 | NRS 455
Pathophysiology | Actual Q&A with
Rationale (NRS455 Exam 1) | Grand
Canyon University
1. A patient is diagnosed with hypokalemia. Which of the following clinical manifestations
should the nurse expect to find? (Select All That Apply)
A. Muscle weakness
B. Prominent U waves on EKG
C. Peaked T waves on EKG
D. Constipation
E. Hyperactive bowel sounds
F. Paralytic ileus
Correct Answer: A, B, D, F
Rationale: Hypokalemia involves a decrease in serum potassium levels which leads to
hyperpolarization of the cell membrane. This state decreases the excitability of muscle
tissues, resulting in weakness and potentially paralytic ileus. The EKG typically shows a
flattened T wave and the presence of a prominent U wave rather than peaked T waves.
,2. A 55-year-old male smoker presents with a persistent cough. A biopsy of his bronchial
lining reveals that normal columnar ciliated epithelial cells have been replaced by stratified
squamous epithelial cells. This process is known as:
A. Atrophy
B. Metaplasia
C. Hyperplasia
D. Dysplasia
Correct Answer: B
Rationale: Metaplasia is a reversible conversion from one adult cell type to another adult
cell type in response to chronic irritation. In smokers, the fragile columnar cells are
replaced by tougher squamous cells to survive the smoke exposure. While these new cells
are more resilient, they lose the protective ciliary function of the original tissue.
3. Which mechanism is primarily responsible for the development of generalized edema in a
patient with liver failure and low albumin levels?
A. Increased capillary hydrostatic pressure
B. Decreased capillary oncotic pressure
C. Increased capillary permeability
D. Lymphatic obstruction
Correct Answer: B
, Rationale: Albumin is the primary protein responsible for maintaining the osmotic
pressure that pulls fluid into the vascular space. In liver failure, albumin production
decreases, leading to a drop in capillary oncotic pressure. Consequently, fluid moves out of
the vessels and into the interstitial space, causing edema.
4. A patient has an arterial blood gas (ABG) result showing pH 7.30, PaCO2 55 mmHg, and
HCO3 24 mEq/L. Which acid-base imbalance does this represent?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Respiratory acidosis
Correct Answer: D
Rationale: The pH of 7.30 indicates acidosis as it is below the normal range of 7.35-7.45.
The PaCO2 of 55 is elevated, which suggests a respiratory cause for the acidity. Since the
HCO3 is within the normal range, the body has not yet compensated for this imbalance.
5. During the vascular phase of acute inflammation, what is the primary purpose of
vasodilation?
A. To decrease blood flow to the area of injury
B. To increase the velocity of blood flow to remove toxins
C. To increase blood flow and deliver leukocytes to the site
Pathophysiology | Actual Q&A with
Rationale (NRS455 Exam 1) | Grand
Canyon University
1. A patient is diagnosed with hypokalemia. Which of the following clinical manifestations
should the nurse expect to find? (Select All That Apply)
A. Muscle weakness
B. Prominent U waves on EKG
C. Peaked T waves on EKG
D. Constipation
E. Hyperactive bowel sounds
F. Paralytic ileus
Correct Answer: A, B, D, F
Rationale: Hypokalemia involves a decrease in serum potassium levels which leads to
hyperpolarization of the cell membrane. This state decreases the excitability of muscle
tissues, resulting in weakness and potentially paralytic ileus. The EKG typically shows a
flattened T wave and the presence of a prominent U wave rather than peaked T waves.
,2. A 55-year-old male smoker presents with a persistent cough. A biopsy of his bronchial
lining reveals that normal columnar ciliated epithelial cells have been replaced by stratified
squamous epithelial cells. This process is known as:
A. Atrophy
B. Metaplasia
C. Hyperplasia
D. Dysplasia
Correct Answer: B
Rationale: Metaplasia is a reversible conversion from one adult cell type to another adult
cell type in response to chronic irritation. In smokers, the fragile columnar cells are
replaced by tougher squamous cells to survive the smoke exposure. While these new cells
are more resilient, they lose the protective ciliary function of the original tissue.
3. Which mechanism is primarily responsible for the development of generalized edema in a
patient with liver failure and low albumin levels?
A. Increased capillary hydrostatic pressure
B. Decreased capillary oncotic pressure
C. Increased capillary permeability
D. Lymphatic obstruction
Correct Answer: B
, Rationale: Albumin is the primary protein responsible for maintaining the osmotic
pressure that pulls fluid into the vascular space. In liver failure, albumin production
decreases, leading to a drop in capillary oncotic pressure. Consequently, fluid moves out of
the vessels and into the interstitial space, causing edema.
4. A patient has an arterial blood gas (ABG) result showing pH 7.30, PaCO2 55 mmHg, and
HCO3 24 mEq/L. Which acid-base imbalance does this represent?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Respiratory acidosis
Correct Answer: D
Rationale: The pH of 7.30 indicates acidosis as it is below the normal range of 7.35-7.45.
The PaCO2 of 55 is elevated, which suggests a respiratory cause for the acidity. Since the
HCO3 is within the normal range, the body has not yet compensated for this imbalance.
5. During the vascular phase of acute inflammation, what is the primary purpose of
vasodilation?
A. To decrease blood flow to the area of injury
B. To increase the velocity of blood flow to remove toxins
C. To increase blood flow and deliver leukocytes to the site
