WGU D236 PATHOPHYSIOLOGY
COMPREHENSIVE OA PREP (2026)
QUESTIONS AND ANSWERS
1. A patient presents with metabolic acidosis. Which compensatory mechanism would the
nurse expect to observe?
A. Increased respiratory rate and depth (Kussmaul respirations)
B. Decreased respiratory rate to retain CO2
C. Increased renal excretion of bicarbonate ions
D. Decreased renal excretion of hydrogen ions
Answer: A
Conceptual Explanation: In metabolic acidosis, the lungs compensate by increasing the
rate and depth of breathing (Kussmaul respirations) to ‘blow off’ excess CO2 and reduce
the acid load.
2. Which cellular adaptation is characterized by the deranged growth of a specific tissue that
results in cells that vary in size, shape, and organization?
A. Metaplasia
,B. Hypertrophy
C. Atrophy
D. Dysplasia
Answer: D
Conceptual Explanation: Dysplasia refers to abnormal changes in the size, shape, and
organization of mature cells; it is often a precursor to cancer but is potentially reversible.
3. A patient is diagnosed with Goodpasture syndrome, where antibodies attack the
glomerular basement membrane. This is an example of which type of hypersensitivity?
A. Type I (IgE-mediated)
B. Type II (Antibody-mediated/Cytotoxic)
C. Type III (Immune complex-mediated)
D. Type IV (Cell-mediated/Delayed)
Answer: B
Conceptual Explanation: Type II hypersensitivity involves antibodies (IgG or IgM) binding
to antigens on specific cell surfaces or tissues, leading to complement activation and cell
lysis.
4. Which clinical manifestation is a hallmark of left-sided heart failure?
A. Jugular venous distension
B. Peripheral dependent edema
, C. Pulmonary crackles and orthopnea
D. Hepatomegaly and ascites
Answer: C
Conceptual Explanation: Left-sided heart failure leads to blood backing up into the
pulmonary circulation, causing pulmonary edema, which manifests as crackles, shortness
of breath, and orthopnea.
5. What is the primary trigger for the activation of the Renin-Angiotensin-Aldosterone System
(RAAS)?
A. Increased blood pressure in the afferent arteriole
B. Inhibition of the sympathetic nervous system
C. Hypernatremia (high sodium levels)
D. Decreased perfusion pressure to the kidneys
Answer: D
Conceptual Explanation: RAAS is activated by decreased renal blood flow (perfusion),
decreased blood pressure, or decreased sodium delivery to the distal tubule.
6. What is the underlying pathophysiology of Multiple Sclerosis (MS)?
A. Degeneration of the dopamine-producing neurons in the substantia nigra
B. Demyelination of nerve fibers in the central nervous system (CNS)
C. Accumulation of amyloid-beta plaques in the cerebral cortex
COMPREHENSIVE OA PREP (2026)
QUESTIONS AND ANSWERS
1. A patient presents with metabolic acidosis. Which compensatory mechanism would the
nurse expect to observe?
A. Increased respiratory rate and depth (Kussmaul respirations)
B. Decreased respiratory rate to retain CO2
C. Increased renal excretion of bicarbonate ions
D. Decreased renal excretion of hydrogen ions
Answer: A
Conceptual Explanation: In metabolic acidosis, the lungs compensate by increasing the
rate and depth of breathing (Kussmaul respirations) to ‘blow off’ excess CO2 and reduce
the acid load.
2. Which cellular adaptation is characterized by the deranged growth of a specific tissue that
results in cells that vary in size, shape, and organization?
A. Metaplasia
,B. Hypertrophy
C. Atrophy
D. Dysplasia
Answer: D
Conceptual Explanation: Dysplasia refers to abnormal changes in the size, shape, and
organization of mature cells; it is often a precursor to cancer but is potentially reversible.
3. A patient is diagnosed with Goodpasture syndrome, where antibodies attack the
glomerular basement membrane. This is an example of which type of hypersensitivity?
A. Type I (IgE-mediated)
B. Type II (Antibody-mediated/Cytotoxic)
C. Type III (Immune complex-mediated)
D. Type IV (Cell-mediated/Delayed)
Answer: B
Conceptual Explanation: Type II hypersensitivity involves antibodies (IgG or IgM) binding
to antigens on specific cell surfaces or tissues, leading to complement activation and cell
lysis.
4. Which clinical manifestation is a hallmark of left-sided heart failure?
A. Jugular venous distension
B. Peripheral dependent edema
, C. Pulmonary crackles and orthopnea
D. Hepatomegaly and ascites
Answer: C
Conceptual Explanation: Left-sided heart failure leads to blood backing up into the
pulmonary circulation, causing pulmonary edema, which manifests as crackles, shortness
of breath, and orthopnea.
5. What is the primary trigger for the activation of the Renin-Angiotensin-Aldosterone System
(RAAS)?
A. Increased blood pressure in the afferent arteriole
B. Inhibition of the sympathetic nervous system
C. Hypernatremia (high sodium levels)
D. Decreased perfusion pressure to the kidneys
Answer: D
Conceptual Explanation: RAAS is activated by decreased renal blood flow (perfusion),
decreased blood pressure, or decreased sodium delivery to the distal tubule.
6. What is the underlying pathophysiology of Multiple Sclerosis (MS)?
A. Degeneration of the dopamine-producing neurons in the substantia nigra
B. Demyelination of nerve fibers in the central nervous system (CNS)
C. Accumulation of amyloid-beta plaques in the cerebral cortex
