NRS 455 Exam 2 V3 | NRS 455
Pathophysiology | Actual Q&A with
Rationale (NRS455 Exam 2) | Grand
Canyon University
1. A patient is diagnosed with Chronic Bronchitis. Which of the following pathophysiological
changes is most characteristic of this condition?
A. Destruction of alveolar walls without fibrosis.
B. Hypersecretion of mucus and chronic productive cough.
C. Collapse of the small airways during expiration.
D. Reversible bronchospasm caused by environmental triggers.
Correct Answer: B
Rationale: Chronic bronchitis is primarily defined by the hypersecretion of mucus and a
chronic productive cough for at least three months. This condition results from the
irritation of airways by inhaled substances like cigarette smoke. The inflammation leads to
hypertrophy of bronchial mucosal glands and an increase in goblet cells.
2. Select all the clinical manifestations associated with Nephrotic Syndrome: (Select All That
Apply)
A. Gross hematuria
B. Hypoalbuminemia
,C. Generalized edema (Anasarca)
D. Hyperlipidemia
E. Massive proteinuria (>3.5g/day)
F. Hypolipidemia
Correct Answer: B, C, D, E
Rationale: Nephrotic syndrome is characterized by massive proteinuria and resulting
hypoalbuminemia. The loss of albumin reduces plasma oncotic pressure, leading to
generalized edema or anasarca. Additionally, the liver increases lipid synthesis to
compensate for protein loss, resulting in hyperlipidemia.
3. A patient with Acute Kidney Injury (AKI) is in the oliguric phase. Which electrolyte
imbalance is the nurse most likely to observe?
A. Hypokalemia
B. Hypercalcemia
C. Hyperkalemia
D. Hypophosphatemia
Correct Answer: C
Rationale: During the oliguric phase of AKI, the kidneys are unable to excrete potassium
effectively, leading to hyperkalemia. This phase is also associated with fluid retention and
, the accumulation of nitrogenous waste products. Monitoring for cardiac arrhythmias is a
priority because of the elevated potassium levels.
4. Which arterial blood gas (ABG) result would the nurse expect in a patient with an
exacerbation of COPD leading to hypoventilation?
A. pH 7.32, PaCO2 38, HCO3 18
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.30, PaCO2 52, HCO3 24
D. pH 7.50, PaCO2 40, HCO3 30
Correct Answer: C
Rationale: COPD patients who hypoventilate retain carbon dioxide, leading to respiratory
acidosis. A pH below 7.35 and a PaCO2 above 45 mmHg are diagnostic markers for this
imbalance. In this scenario, the bicarbonate remains normal because compensation by the
kidneys has not yet occurred.
5. What is the primary mechanism of air trapping in patients with Emphysema?
A. Loss of elastic recoil in the alveolar walls.
B. Bronchial wall thickening and fibrosis.
C. Excessive mucus production blocking the bronchioles.
D. Fluid accumulation in the pleural space.
Correct Answer: A
Pathophysiology | Actual Q&A with
Rationale (NRS455 Exam 2) | Grand
Canyon University
1. A patient is diagnosed with Chronic Bronchitis. Which of the following pathophysiological
changes is most characteristic of this condition?
A. Destruction of alveolar walls without fibrosis.
B. Hypersecretion of mucus and chronic productive cough.
C. Collapse of the small airways during expiration.
D. Reversible bronchospasm caused by environmental triggers.
Correct Answer: B
Rationale: Chronic bronchitis is primarily defined by the hypersecretion of mucus and a
chronic productive cough for at least three months. This condition results from the
irritation of airways by inhaled substances like cigarette smoke. The inflammation leads to
hypertrophy of bronchial mucosal glands and an increase in goblet cells.
2. Select all the clinical manifestations associated with Nephrotic Syndrome: (Select All That
Apply)
A. Gross hematuria
B. Hypoalbuminemia
,C. Generalized edema (Anasarca)
D. Hyperlipidemia
E. Massive proteinuria (>3.5g/day)
F. Hypolipidemia
Correct Answer: B, C, D, E
Rationale: Nephrotic syndrome is characterized by massive proteinuria and resulting
hypoalbuminemia. The loss of albumin reduces plasma oncotic pressure, leading to
generalized edema or anasarca. Additionally, the liver increases lipid synthesis to
compensate for protein loss, resulting in hyperlipidemia.
3. A patient with Acute Kidney Injury (AKI) is in the oliguric phase. Which electrolyte
imbalance is the nurse most likely to observe?
A. Hypokalemia
B. Hypercalcemia
C. Hyperkalemia
D. Hypophosphatemia
Correct Answer: C
Rationale: During the oliguric phase of AKI, the kidneys are unable to excrete potassium
effectively, leading to hyperkalemia. This phase is also associated with fluid retention and
, the accumulation of nitrogenous waste products. Monitoring for cardiac arrhythmias is a
priority because of the elevated potassium levels.
4. Which arterial blood gas (ABG) result would the nurse expect in a patient with an
exacerbation of COPD leading to hypoventilation?
A. pH 7.32, PaCO2 38, HCO3 18
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.30, PaCO2 52, HCO3 24
D. pH 7.50, PaCO2 40, HCO3 30
Correct Answer: C
Rationale: COPD patients who hypoventilate retain carbon dioxide, leading to respiratory
acidosis. A pH below 7.35 and a PaCO2 above 45 mmHg are diagnostic markers for this
imbalance. In this scenario, the bicarbonate remains normal because compensation by the
kidneys has not yet occurred.
5. What is the primary mechanism of air trapping in patients with Emphysema?
A. Loss of elastic recoil in the alveolar walls.
B. Bronchial wall thickening and fibrosis.
C. Excessive mucus production blocking the bronchioles.
D. Fluid accumulation in the pleural space.
Correct Answer: A
