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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 obstructive pulmonary disease
(COPD) and is experiencing respiratory acidosis. Which of the following arterial
blood gas (ABG) values would the nurse expect to find?
A. pH 7.50, PaCO2 30 mmHg, HCO3- 24 mEq/L
B. pH 7.35, PaCO2 45 mmHg, HCO3- 26 mEq/L
C. pH 7.30, PaCO2 55 mmHg, HCO3- 28 mEq/L [CORRECT]
D. pH 7.48, PaCO2 35 mmHg, HCO3- 22 mEq/L
Correct Answer: C
Rationale: Respiratory acidosis occurs when CO2 retention causes decreased pH
(below 7.35) and elevated PaCO2 (above 45 mmHg). In chronic COPD,
compensatory mechanisms increase HCO3-, making option C the classic
presentation of compensated or partially compensated respiratory acidosis. This
matches the expected ABG pattern in patients with chronic CO2 retention.
Q2: A patient with heart failure is prescribed furosemide (Lasix). After several
days of therapy, the nurse notes the patient reports muscle weakness and has
diminished deep tendon reflexes. Which electrolyte imbalance is most likely
responsible?
A. Hypernatremia
,2
B. Hypercalcemia
C. Hypokalemia [CORRECT]
D. Hypermagnesemia
Correct Answer: C
Rationale: Loop diuretics like furosemide cause potassium wasting in the urine,
leading to hypokalemia. Muscle weakness and diminished deep tendon reflexes are
classic manifestations of low potassium levels because potassium is essential for
normal neuromuscular function. Priority is monitoring serum potassium levels in
patients receiving loop diuretics.
Q3: A 45-year-old female presents with a painless lump in her left breast. Biopsy
reveals malignant cells showing uncontrolled proliferation with loss of normal
tissue architecture. Which cellular adaptation process has progressed to neoplasia
in this case?
A. Atrophy
B. Hyperplasia
C. Dysplasia progressing to neoplasia [CORRECT]
D. Metaplasia
Correct Answer: C
Rationale: Dysplasia represents disordered cellular development and is often a
precursor to cancer (neoplasia). Malignant transformation involves progression
from dysplastic changes to invasive cancer characterized by uncontrolled
proliferation, loss of differentiation, and invasion of surrounding tissues. This
matches the pathological sequence seen in breast carcinoma development.
,3
Q4: During the inflammatory response, which cell type arrives at the site of injury
first and initiates the acute inflammatory process?
A. Lymphocytes
B. Monocytes/Macrophages
C. Neutrophils [CORRECT]
D. Eosinophils
Correct Answer: C
Rationale: Neutrophils are the first responders in acute inflammation, typically
arriving within minutes to hours after tissue injury. They phagocytose bacteria and
debris and release inflammatory mediators. This matches the chronological
sequence of cellular infiltration during the acute inflammatory response where
neutrophils predominate in the first 24-72 hours.
Q5: A patient with type 1 diabetes mellitus presents with Kussmaul respirations,
fruity breath odor, and confusion. Laboratory results show glucose 450 mg/dL, pH
7.25, HCO3- 12 mEq/L. What type of acid-base disorder is present?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Metabolic acidosis [CORRECT]
D. Mixed respiratory and metabolic alkalosis
Correct Answer: C
Rationale: Diabetic ketoacidosis (DKA) produces metabolic acidosis due to
accumulation of ketoacids (acetoacetate and β-hydroxybutyrate). The low pH
(7.25) and low HCO3- (12 mEq/L) confirm metabolic acidosis. Kussmaul
, 4
respirations represent compensatory hyperventilation to blow off CO2. This
matches the classic DKA presentation.
Q6: A child is diagnosed with cystic fibrosis, an autosomal recessive disorder.
Both parents are carriers. What is the probability that their next child will also have
cystic fibrosis?
A. 0%
B. 25%
C. 25% (1 in 4 chance) [CORRECT]
D. 50%
Correct Answer: C
Rationale: In autosomal recessive inheritance, when both parents are carriers
(heterozygous), each pregnancy carries a 25% chance of the child being affected
(homozygous recessive), 50% chance of being a carrier, and 25% chance of being
unaffected non-carrier. This matches Mendelian inheritance patterns for autosomal
recessive disorders like cystic fibrosis.
Q7: A patient receiving chemotherapy develops neutropenia with an absolute
neutrophil count (ANC) of 800 cells/mm³. What is the priority nursing
intervention?
A. Encourage increased oral fluid intake
B. Administer PRN acetaminophen for fever
C. Implement neutropenic precautions immediately [CORRECT]
D. Encourage visitors to maintain social distancing
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 obstructive pulmonary disease
(COPD) and is experiencing respiratory acidosis. Which of the following arterial
blood gas (ABG) values would the nurse expect to find?
A. pH 7.50, PaCO2 30 mmHg, HCO3- 24 mEq/L
B. pH 7.35, PaCO2 45 mmHg, HCO3- 26 mEq/L
C. pH 7.30, PaCO2 55 mmHg, HCO3- 28 mEq/L [CORRECT]
D. pH 7.48, PaCO2 35 mmHg, HCO3- 22 mEq/L
Correct Answer: C
Rationale: Respiratory acidosis occurs when CO2 retention causes decreased pH
(below 7.35) and elevated PaCO2 (above 45 mmHg). In chronic COPD,
compensatory mechanisms increase HCO3-, making option C the classic
presentation of compensated or partially compensated respiratory acidosis. This
matches the expected ABG pattern in patients with chronic CO2 retention.
Q2: A patient with heart failure is prescribed furosemide (Lasix). After several
days of therapy, the nurse notes the patient reports muscle weakness and has
diminished deep tendon reflexes. Which electrolyte imbalance is most likely
responsible?
A. Hypernatremia
,2
B. Hypercalcemia
C. Hypokalemia [CORRECT]
D. Hypermagnesemia
Correct Answer: C
Rationale: Loop diuretics like furosemide cause potassium wasting in the urine,
leading to hypokalemia. Muscle weakness and diminished deep tendon reflexes are
classic manifestations of low potassium levels because potassium is essential for
normal neuromuscular function. Priority is monitoring serum potassium levels in
patients receiving loop diuretics.
Q3: A 45-year-old female presents with a painless lump in her left breast. Biopsy
reveals malignant cells showing uncontrolled proliferation with loss of normal
tissue architecture. Which cellular adaptation process has progressed to neoplasia
in this case?
A. Atrophy
B. Hyperplasia
C. Dysplasia progressing to neoplasia [CORRECT]
D. Metaplasia
Correct Answer: C
Rationale: Dysplasia represents disordered cellular development and is often a
precursor to cancer (neoplasia). Malignant transformation involves progression
from dysplastic changes to invasive cancer characterized by uncontrolled
proliferation, loss of differentiation, and invasion of surrounding tissues. This
matches the pathological sequence seen in breast carcinoma development.
,3
Q4: During the inflammatory response, which cell type arrives at the site of injury
first and initiates the acute inflammatory process?
A. Lymphocytes
B. Monocytes/Macrophages
C. Neutrophils [CORRECT]
D. Eosinophils
Correct Answer: C
Rationale: Neutrophils are the first responders in acute inflammation, typically
arriving within minutes to hours after tissue injury. They phagocytose bacteria and
debris and release inflammatory mediators. This matches the chronological
sequence of cellular infiltration during the acute inflammatory response where
neutrophils predominate in the first 24-72 hours.
Q5: A patient with type 1 diabetes mellitus presents with Kussmaul respirations,
fruity breath odor, and confusion. Laboratory results show glucose 450 mg/dL, pH
7.25, HCO3- 12 mEq/L. What type of acid-base disorder is present?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Metabolic acidosis [CORRECT]
D. Mixed respiratory and metabolic alkalosis
Correct Answer: C
Rationale: Diabetic ketoacidosis (DKA) produces metabolic acidosis due to
accumulation of ketoacids (acetoacetate and β-hydroxybutyrate). The low pH
(7.25) and low HCO3- (12 mEq/L) confirm metabolic acidosis. Kussmaul
, 4
respirations represent compensatory hyperventilation to blow off CO2. This
matches the classic DKA presentation.
Q6: A child is diagnosed with cystic fibrosis, an autosomal recessive disorder.
Both parents are carriers. What is the probability that their next child will also have
cystic fibrosis?
A. 0%
B. 25%
C. 25% (1 in 4 chance) [CORRECT]
D. 50%
Correct Answer: C
Rationale: In autosomal recessive inheritance, when both parents are carriers
(heterozygous), each pregnancy carries a 25% chance of the child being affected
(homozygous recessive), 50% chance of being a carrier, and 25% chance of being
unaffected non-carrier. This matches Mendelian inheritance patterns for autosomal
recessive disorders like cystic fibrosis.
Q7: A patient receiving chemotherapy develops neutropenia with an absolute
neutrophil count (ANC) of 800 cells/mm³. What is the priority nursing
intervention?
A. Encourage increased oral fluid intake
B. Administer PRN acetaminophen for fever
C. Implement neutropenic precautions immediately [CORRECT]
D. Encourage visitors to maintain social distancing
