1
NSG 3280 Pathophysiology for Nurses I
Comprehensive Review Exam Official Practice
Exam Actual Exam 2026/2027 with Detailed
Rationales | Complete Exam-Style Questions |
Pass Guaranteed – A+ Graded
Q1: A 68-year-old patient presents with chronic shortness of breath, peripheral
edema, and jugular vein distension. The nurse recognizes these findings are most
consistent with which type of heart failure?
A. Left-sided heart failure with forward failure
B. Right-sided heart failure with backward failure
C. Right-sided heart failure with backward failure [CORRECT]
D. Biventricular failure with low output state
Correct Answer: C
Rationale: Correct because jugular vein distension and peripheral edema are classic
manifestations of right-sided (right ventricular) heart failure resulting from
backward pressure transmission into the systemic venous circulation. This matches
the pathophysiology of systemic venous congestion. Priority is recognizing right-
sided versus left-sided failure patterns.
Q2: Which cellular adaptation is characterized by an increase in the number of
cells in response to hormonal stimulation?
A. Hypertrophy
B. Atrophy
C. Hyperplasia [CORRECT]
,2
D. Metaplasia
Correct Answer: C
Rationale: Correct because hyperplasia is defined as an increase in the number of
cells resulting from increased cell division, commonly seen in hormonally
responsive tissues such as the endometrium during menstrual cycles or breast
tissue during pregnancy. This matches the definition of cellular proliferation rather
than increase in cell size.
Q3: A patient with severe vomiting has a serum sodium of 152 mEq/L. The nurse
identifies this finding as indicative of:
A. Hyponatremia
B. Isotonic fluid volume deficit
C. Hypertonic dehydration (hypernatremia) [CORRECT]
D. Hypotonic fluid volume excess
Correct Answer: C
Rationale: Correct because a serum sodium level above 145 mEq/L indicates
hypernatremia, which occurs when water loss exceeds sodium loss, as seen with
persistent vomiting leading to hypotonic fluid loss. Priority is recognizing
hypertonic fluid imbalances and their clinical implications.
Q4: Which inflammatory mediator is primarily responsible for causing
vasodilation and increased vascular permeability during the acute inflammatory
response?
A. Bradykinin
B. Serotonin
C. Histamine [CORRECT]
D. Prostaglandins
,3
Correct Answer: C
Rationale: Correct because histamine is stored in mast cells and basophils and is
rapidly released upon tissue injury, causing immediate vasodilation and increased
capillary permeability—the hallmark early events of acute inflammation. This
matches the primary role of histamine in initiating the vascular phase of
inflammation.
Q5: A patient with type 2 diabetes mellitus has a hemoglobin A1c of 9.2%. The
nurse understands this value reflects average blood glucose control over
approximately:
A. The past 24 hours
B. The past 1 week
C. The past 8–12 weeks [CORRECT]
D. The past 6 months
Correct Answer: C
Rationale: Correct because hemoglobin A1c reflects glycosylation of hemoglobin
over the lifespan of red blood cells, which averages 120 days or approximately 8–
12 weeks. This matches the standard clinical interpretation of HbA1c values for
long-term glycemic monitoring.
Q6: Which genetic inheritance pattern is characterized by affected individuals
appearing in every generation and both males and females being equally affected?
A. X-linked recessive
B. Autosomal recessive
C. Autosomal dominant [CORRECT]
D. Mitochondrial inheritance
Correct Answer: C
, 4
Rationale: Correct because autosomal dominant inheritance demonstrates vertical
transmission through generations with equal distribution among males and
females, and affected individuals have a 50% chance of passing the trait to
offspring. This matches the classic pedigree pattern of dominant disorders like
Huntington disease or Marfan syndrome.
Q7: A patient presents with a blood pH of 7.32, PaCO₂ of 48 mmHg, and HCO₃⁻ of
22 mEq/L. The nurse interprets this arterial blood gas result as:
A. Uncompensated respiratory alkalosis
B. Compensated metabolic acidosis
C. Uncompensated respiratory acidosis [CORRECT]
D. Partially compensated metabolic alkalosis
Correct Answer: C
Rationale: Correct because the pH is below normal (7.35–7.45), the PaCO₂ is
elevated indicating respiratory acidosis, and the HCO₃⁻ remains within normal
range indicating no renal compensation has occurred yet. This matches the pattern
of acute or uncompensated respiratory acidosis. Priority is applying systematic
ABG interpretation.
Q8: The nurse is caring for a patient receiving chemotherapy who develops
pancytopenia. This finding most directly results from bone marrow suppression
affecting:
A. Only erythropoiesis
B. Only leukopoiesis
C. All hematopoietic cell lines [CORRECT]
D. Megakaryocyte production only
Correct Answer: C
NSG 3280 Pathophysiology for Nurses I
Comprehensive Review Exam Official Practice
Exam Actual Exam 2026/2027 with Detailed
Rationales | Complete Exam-Style Questions |
Pass Guaranteed – A+ Graded
Q1: A 68-year-old patient presents with chronic shortness of breath, peripheral
edema, and jugular vein distension. The nurse recognizes these findings are most
consistent with which type of heart failure?
A. Left-sided heart failure with forward failure
B. Right-sided heart failure with backward failure
C. Right-sided heart failure with backward failure [CORRECT]
D. Biventricular failure with low output state
Correct Answer: C
Rationale: Correct because jugular vein distension and peripheral edema are classic
manifestations of right-sided (right ventricular) heart failure resulting from
backward pressure transmission into the systemic venous circulation. This matches
the pathophysiology of systemic venous congestion. Priority is recognizing right-
sided versus left-sided failure patterns.
Q2: Which cellular adaptation is characterized by an increase in the number of
cells in response to hormonal stimulation?
A. Hypertrophy
B. Atrophy
C. Hyperplasia [CORRECT]
,2
D. Metaplasia
Correct Answer: C
Rationale: Correct because hyperplasia is defined as an increase in the number of
cells resulting from increased cell division, commonly seen in hormonally
responsive tissues such as the endometrium during menstrual cycles or breast
tissue during pregnancy. This matches the definition of cellular proliferation rather
than increase in cell size.
Q3: A patient with severe vomiting has a serum sodium of 152 mEq/L. The nurse
identifies this finding as indicative of:
A. Hyponatremia
B. Isotonic fluid volume deficit
C. Hypertonic dehydration (hypernatremia) [CORRECT]
D. Hypotonic fluid volume excess
Correct Answer: C
Rationale: Correct because a serum sodium level above 145 mEq/L indicates
hypernatremia, which occurs when water loss exceeds sodium loss, as seen with
persistent vomiting leading to hypotonic fluid loss. Priority is recognizing
hypertonic fluid imbalances and their clinical implications.
Q4: Which inflammatory mediator is primarily responsible for causing
vasodilation and increased vascular permeability during the acute inflammatory
response?
A. Bradykinin
B. Serotonin
C. Histamine [CORRECT]
D. Prostaglandins
,3
Correct Answer: C
Rationale: Correct because histamine is stored in mast cells and basophils and is
rapidly released upon tissue injury, causing immediate vasodilation and increased
capillary permeability—the hallmark early events of acute inflammation. This
matches the primary role of histamine in initiating the vascular phase of
inflammation.
Q5: A patient with type 2 diabetes mellitus has a hemoglobin A1c of 9.2%. The
nurse understands this value reflects average blood glucose control over
approximately:
A. The past 24 hours
B. The past 1 week
C. The past 8–12 weeks [CORRECT]
D. The past 6 months
Correct Answer: C
Rationale: Correct because hemoglobin A1c reflects glycosylation of hemoglobin
over the lifespan of red blood cells, which averages 120 days or approximately 8–
12 weeks. This matches the standard clinical interpretation of HbA1c values for
long-term glycemic monitoring.
Q6: Which genetic inheritance pattern is characterized by affected individuals
appearing in every generation and both males and females being equally affected?
A. X-linked recessive
B. Autosomal recessive
C. Autosomal dominant [CORRECT]
D. Mitochondrial inheritance
Correct Answer: C
, 4
Rationale: Correct because autosomal dominant inheritance demonstrates vertical
transmission through generations with equal distribution among males and
females, and affected individuals have a 50% chance of passing the trait to
offspring. This matches the classic pedigree pattern of dominant disorders like
Huntington disease or Marfan syndrome.
Q7: A patient presents with a blood pH of 7.32, PaCO₂ of 48 mmHg, and HCO₃⁻ of
22 mEq/L. The nurse interprets this arterial blood gas result as:
A. Uncompensated respiratory alkalosis
B. Compensated metabolic acidosis
C. Uncompensated respiratory acidosis [CORRECT]
D. Partially compensated metabolic alkalosis
Correct Answer: C
Rationale: Correct because the pH is below normal (7.35–7.45), the PaCO₂ is
elevated indicating respiratory acidosis, and the HCO₃⁻ remains within normal
range indicating no renal compensation has occurred yet. This matches the pattern
of acute or uncompensated respiratory acidosis. Priority is applying systematic
ABG interpretation.
Q8: The nurse is caring for a patient receiving chemotherapy who develops
pancytopenia. This finding most directly results from bone marrow suppression
affecting:
A. Only erythropoiesis
B. Only leukopoiesis
C. All hematopoietic cell lines [CORRECT]
D. Megakaryocyte production only
Correct Answer: C
