NSG 3280 PATHOPHYSIOLOGY EXAM
2 COMPREHENSIVE RESOURCE
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CORRECT ANSWERS WITH
RATIONALES | 100% PASS
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NSG 3280 Pathophysiology Exam 2 Comprehensive
Practice Bank
Advanced Nursing Concept Review: Detailed Correct
Answers with Rationales (100% Pass Guarantee /
Grade A+ Verified / Instant Download)
1. A patient is admitted to the emergency department
with an acute localized tissue injury following a
mechanical trauma to the lower extremity. The nurse
assesses the area and notes severe localized swelling
(tumor) and severe throbbing pain (dolor). Which of
the following pathophysiological mechanisms explains
the development of these specific cardinal signs of
acute inflammation?
A. The swelling is caused by localized arteriolar constriction,
and the pain is caused by the depletion of local prostaglandins.
B. The swelling is caused by increased capillary hydrostatic
pressure and endothelial cell contraction allowing protein-rich
fluid to leak into the interstitium, while the pain is caused by
chemical mediators like bradykinin and prostaglandins
stimulating nociceptors.
C. The swelling is caused by a massive influx of red blood cells
into the extracellular matrix, and the pain is caused by the
sudden destruction of peripheral motor nerve pathways.
,D. The swelling is caused by decreased capillary permeability,
and the pain is caused by systemic leukocytosis irritating
central nervous pathways.
Correct Answer: B. The swelling is caused by
increased capillary hydrostatic pressure and
endothelial cell contraction allowing protein-rich fluid
to leak into the interstitium, while the pain is caused
by chemical mediators like bradykinin and
prostaglandins stimulating nociceptors.
Rationale: Acute tissue injury triggers the immediate release
of chemical mediators such as histamine and bradykinin.
These mediators cause endothelial cells to contract, widening
the intercellular junctions and dramatically increasing
capillary permeability. This allows an exudate of protein-rich
fluid and plasma to escape into the interstitial spaces,
increasing interstitial oncotic pressure and causing localized
edema (swelling). Simultaneously, the chemical mediators
bradykinin and prostaglandins directly sensitize and
stimulate local nociceptors (pain receptors). Localized fluid
accumulation also increases mechanical pressure on these
nerve endings, aggravating the sensation of pain.
2. A nurse is caring for a patient who has developed a
profound systemic inflammatory response syndrome
(SIRS). The nurse understands that during the
vascular phase of inflammation, chemical mediators
cause widespread changes. What are the primary
vascular changes associated with the acute
inflammatory response, and what is their ultimate
clinical purpose?
A. Widespread vasoconstriction and decreased capillary
permeability to isolate the infectious agent within the
intravascular compartment.
B. Arteriolar vasodilation to increase blood flow to the injured
area and increased capillary permeability to allow defense cells
,and plasma proteins to move into the tissue.
C. Decreased capillary hydrostatic pressure and a decrease in
the absolute number of circulating leukocytes to prevent auto-
immune destruction.
D. Endothelial cell elongation and thickening to prevent plasma
proteins from leaking out into the extracellular matrix.
Correct Answer: B. Arteriolar vasodilation to
increase blood flow to the injured area and increased
capillary permeability to allow defense cells and
plasma proteins to move into the tissue.
Rationale: The vascular stage of acute inflammation is
characterized by transient vasoconstriction followed
immediately by profound vasodilation of arterioles. This
vasodilation increases blood flow to the affected area
(hyperemia), which causes the classic signs of redness (rubor)
and heat (calor). Concurrently, increased capillary
permeability allows leukocytes, fluid, and essential plasma
proteins—such as clotting factors and complement
components—to exit the bloodstream and enter the inflamed
tissue to neutralize the injury, dilute toxins, and begin repair.
3. During a cellular-level review of acute
inflammation, a nursing student asks how leukocytes
move from the central bloodstream toward the
vascular wall to fight an infection in the tissues. Which
term accurately describes the process where
leukocytes accumulate and line up along the
endothelial surface of blood vessels?
A. Chemotaxis
B. Opsonization
C. Margination
D. Phagocytosis
Correct Answer: C. Margination.
Rationale: As blood flow slows during the vascular phase of
inflammation due to increased fluid loss through permeable
, capillaries, leukocytes naturally move out of the central axial
column of blood flow and accumulate along the periphery of
the vessel lumen. This initial step of lining up along the
endothelial surface is known as margination. Following
margination, leukocytes roll along the endothelium, adhere
firmly via adhesion molecules (integrins and selectins), and
then squeeze through the endothelial junctions (diapedesis) to
travel toward the site of injury.
4. A patient with a severe bacterial infection exhibits a
high fever and an elevated white blood cell count of
18,000/mm³. The nurse notes that the differential
count shows a significant "shift to the left." How
should the nurse pathophysiologically interpret a
"shift to the left" in a patient experiencing acute
inflammation?
A. There is an increased percentage of mature lymphocytes that
are migrating to the left lymph nodes of the body.
B. There is an increased release of immature, band neutrophils
from the bone marrow due to a high demand for phagocytic
cells.
C. The bone marrow has ceased production of leukocytes, and
existing white blood cells are dying off rapidly.
D. The immune system has shifted from an innate immune
response to a chronic, cell-mediated adaptive immune
response.
Correct Answer: B. There is an increased release of
immature, band neutrophils from the bone marrow
due to a high demand for phagocytic cells.
Rationale: Neutrophils are the primary cellular responders
during acute bacterial infections. When an intense, acute
inflammatory process depletes the pool of mature circulating
neutrophils, the bone marrow is stimulated by colony-
stimulating factors to rapidly release stored leukocytes. This
results in an increased proportion of immature, unsegmented
2 COMPREHENSIVE RESOURCE
GRADE A+ VERIFIED DETAILED
CORRECT ANSWERS WITH
RATIONALES | 100% PASS
GUARANTEE | INSTANT DOWNLOAD
NSG 3280 Pathophysiology Exam 2 Comprehensive
Practice Bank
Advanced Nursing Concept Review: Detailed Correct
Answers with Rationales (100% Pass Guarantee /
Grade A+ Verified / Instant Download)
1. A patient is admitted to the emergency department
with an acute localized tissue injury following a
mechanical trauma to the lower extremity. The nurse
assesses the area and notes severe localized swelling
(tumor) and severe throbbing pain (dolor). Which of
the following pathophysiological mechanisms explains
the development of these specific cardinal signs of
acute inflammation?
A. The swelling is caused by localized arteriolar constriction,
and the pain is caused by the depletion of local prostaglandins.
B. The swelling is caused by increased capillary hydrostatic
pressure and endothelial cell contraction allowing protein-rich
fluid to leak into the interstitium, while the pain is caused by
chemical mediators like bradykinin and prostaglandins
stimulating nociceptors.
C. The swelling is caused by a massive influx of red blood cells
into the extracellular matrix, and the pain is caused by the
sudden destruction of peripheral motor nerve pathways.
,D. The swelling is caused by decreased capillary permeability,
and the pain is caused by systemic leukocytosis irritating
central nervous pathways.
Correct Answer: B. The swelling is caused by
increased capillary hydrostatic pressure and
endothelial cell contraction allowing protein-rich fluid
to leak into the interstitium, while the pain is caused
by chemical mediators like bradykinin and
prostaglandins stimulating nociceptors.
Rationale: Acute tissue injury triggers the immediate release
of chemical mediators such as histamine and bradykinin.
These mediators cause endothelial cells to contract, widening
the intercellular junctions and dramatically increasing
capillary permeability. This allows an exudate of protein-rich
fluid and plasma to escape into the interstitial spaces,
increasing interstitial oncotic pressure and causing localized
edema (swelling). Simultaneously, the chemical mediators
bradykinin and prostaglandins directly sensitize and
stimulate local nociceptors (pain receptors). Localized fluid
accumulation also increases mechanical pressure on these
nerve endings, aggravating the sensation of pain.
2. A nurse is caring for a patient who has developed a
profound systemic inflammatory response syndrome
(SIRS). The nurse understands that during the
vascular phase of inflammation, chemical mediators
cause widespread changes. What are the primary
vascular changes associated with the acute
inflammatory response, and what is their ultimate
clinical purpose?
A. Widespread vasoconstriction and decreased capillary
permeability to isolate the infectious agent within the
intravascular compartment.
B. Arteriolar vasodilation to increase blood flow to the injured
area and increased capillary permeability to allow defense cells
,and plasma proteins to move into the tissue.
C. Decreased capillary hydrostatic pressure and a decrease in
the absolute number of circulating leukocytes to prevent auto-
immune destruction.
D. Endothelial cell elongation and thickening to prevent plasma
proteins from leaking out into the extracellular matrix.
Correct Answer: B. Arteriolar vasodilation to
increase blood flow to the injured area and increased
capillary permeability to allow defense cells and
plasma proteins to move into the tissue.
Rationale: The vascular stage of acute inflammation is
characterized by transient vasoconstriction followed
immediately by profound vasodilation of arterioles. This
vasodilation increases blood flow to the affected area
(hyperemia), which causes the classic signs of redness (rubor)
and heat (calor). Concurrently, increased capillary
permeability allows leukocytes, fluid, and essential plasma
proteins—such as clotting factors and complement
components—to exit the bloodstream and enter the inflamed
tissue to neutralize the injury, dilute toxins, and begin repair.
3. During a cellular-level review of acute
inflammation, a nursing student asks how leukocytes
move from the central bloodstream toward the
vascular wall to fight an infection in the tissues. Which
term accurately describes the process where
leukocytes accumulate and line up along the
endothelial surface of blood vessels?
A. Chemotaxis
B. Opsonization
C. Margination
D. Phagocytosis
Correct Answer: C. Margination.
Rationale: As blood flow slows during the vascular phase of
inflammation due to increased fluid loss through permeable
, capillaries, leukocytes naturally move out of the central axial
column of blood flow and accumulate along the periphery of
the vessel lumen. This initial step of lining up along the
endothelial surface is known as margination. Following
margination, leukocytes roll along the endothelium, adhere
firmly via adhesion molecules (integrins and selectins), and
then squeeze through the endothelial junctions (diapedesis) to
travel toward the site of injury.
4. A patient with a severe bacterial infection exhibits a
high fever and an elevated white blood cell count of
18,000/mm³. The nurse notes that the differential
count shows a significant "shift to the left." How
should the nurse pathophysiologically interpret a
"shift to the left" in a patient experiencing acute
inflammation?
A. There is an increased percentage of mature lymphocytes that
are migrating to the left lymph nodes of the body.
B. There is an increased release of immature, band neutrophils
from the bone marrow due to a high demand for phagocytic
cells.
C. The bone marrow has ceased production of leukocytes, and
existing white blood cells are dying off rapidly.
D. The immune system has shifted from an innate immune
response to a chronic, cell-mediated adaptive immune
response.
Correct Answer: B. There is an increased release of
immature, band neutrophils from the bone marrow
due to a high demand for phagocytic cells.
Rationale: Neutrophils are the primary cellular responders
during acute bacterial infections. When an intense, acute
inflammatory process depletes the pool of mature circulating
neutrophils, the bone marrow is stimulated by colony-
stimulating factors to rapidly release stored leukocytes. This
results in an increased proportion of immature, unsegmented
