NSG 5140 – Week 10 Exam with verified answers with rationales
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Question 1
A 67-year-old patient with long-standing hypertension develops left ventricular hypertrophy.
Which cellular adaptation is responsible?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Correct Answer: B. Hypertrophy
Rationale: Cardiac muscle cells cannot divide effectively. In response to chronic pressure
overload, existing myocytes enlarge, producing hypertrophy. Hyperplasia involves an increase in
cell number, which does not occur in mature cardiac muscle.
Question 2
A patient with septic shock develops metabolic acidosis. Which laboratory value best confirms
metabolic acidosis?
A. pH 7.30, HCO₃⁻ 18 mEq/L
B. pH 7.48, HCO₃⁻ 30 mEq/L
C. pH 7.52, PaCO₂ 28 mmHg
D. pH 7.40, HCO₃⁻ 24 mEq/L
Correct Answer: A
Rationale: Metabolic acidosis is characterized by a low pH (<7.35) and low bicarbonate (<22
mEq/L). Septic shock often causes lactic acidosis from tissue hypoperfusion.
Question 3
The primary cause of edema in congestive heart failure is:
A. Increased plasma oncotic pressure
B. Increased hydrostatic pressure
,C. Decreased capillary permeability
D. Increased lymphatic drainage
Correct Answer: B
Rationale: Heart failure increases venous pressure, elevating capillary hydrostatic pressure and
forcing fluid into the interstitial space.
Question 4
Which electrolyte abnormality places a patient at greatest risk for fatal cardiac dysrhythmias?
A. Sodium 132 mEq/L
B. Potassium 2.8 mEq/L
C. Chloride 102 mEq/L
D. Magnesium 2.0 mg/dL
Correct Answer: B
Rationale: Severe hypokalemia predisposes patients to ventricular dysrhythmias by altering
myocardial electrical activity.
Question 5
Which inflammatory mediator is primarily responsible for vasodilation during acute
inflammation?
A. Histamine
B. Albumin
C. Insulin
D. Fibrinogen
Correct Answer: A
Rationale: Histamine released from mast cells causes rapid vasodilation and increased vascular
permeability.
Question 6
The earliest manifestation of septic shock is usually:
,A. Warm, flushed skin
B. Bradycardia
C. Cyanosis
D. Pulmonary edema
Correct Answer: A
Rationale: Early septic shock is characterized by peripheral vasodilation, producing warm,
flushed skin and bounding pulses.
Question 7
A patient with diabetic ketoacidosis is expected to have:
A. Hyperglycemia and metabolic acidosis
B. Hypoglycemia and respiratory alkalosis
C. Hypercalcemia
D. Respiratory acidosis only
Correct Answer: A
Rationale: Insulin deficiency leads to hyperglycemia, ketone production, and metabolic acidosis.
Question 8
Which hormone directly lowers serum calcium?
A. Parathyroid hormone
B. Calcitonin
C. Aldosterone
D. Cortisol
Correct Answer: B
Rationale: Calcitonin inhibits osteoclast activity, lowering blood calcium levels.
Question 9
The most common cause of chronic kidney disease is:
, A. Diabetes mellitus
B. Hyperthyroidism
C. Asthma
D. Peptic ulcer disease
Correct Answer: A
Rationale: Diabetes mellitus is the leading cause of chronic kidney disease worldwide.
Question 10
A patient with COPD develops chronic CO₂ retention. The kidneys compensate by:
A. Excreting bicarbonate
B. Retaining bicarbonate
C. Excreting sodium
D. Decreasing hydrogen ion secretion
Correct Answer: B
Rationale: Renal compensation for chronic respiratory acidosis involves increasing bicarbonate
reabsorption.
Question 11
Which patient is at highest risk for pulmonary embolism?
A. Recent hip replacement surgery
B. Seasonal allergies
C. Controlled hypertension
D. Hypothyroidism
Correct Answer: A
Rationale: Orthopedic surgery significantly increases the risk of deep vein thrombosis and
pulmonary embolism.
Question 12
The primary pathophysiologic feature of asthma is:
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Question 1
A 67-year-old patient with long-standing hypertension develops left ventricular hypertrophy.
Which cellular adaptation is responsible?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
Correct Answer: B. Hypertrophy
Rationale: Cardiac muscle cells cannot divide effectively. In response to chronic pressure
overload, existing myocytes enlarge, producing hypertrophy. Hyperplasia involves an increase in
cell number, which does not occur in mature cardiac muscle.
Question 2
A patient with septic shock develops metabolic acidosis. Which laboratory value best confirms
metabolic acidosis?
A. pH 7.30, HCO₃⁻ 18 mEq/L
B. pH 7.48, HCO₃⁻ 30 mEq/L
C. pH 7.52, PaCO₂ 28 mmHg
D. pH 7.40, HCO₃⁻ 24 mEq/L
Correct Answer: A
Rationale: Metabolic acidosis is characterized by a low pH (<7.35) and low bicarbonate (<22
mEq/L). Septic shock often causes lactic acidosis from tissue hypoperfusion.
Question 3
The primary cause of edema in congestive heart failure is:
A. Increased plasma oncotic pressure
B. Increased hydrostatic pressure
,C. Decreased capillary permeability
D. Increased lymphatic drainage
Correct Answer: B
Rationale: Heart failure increases venous pressure, elevating capillary hydrostatic pressure and
forcing fluid into the interstitial space.
Question 4
Which electrolyte abnormality places a patient at greatest risk for fatal cardiac dysrhythmias?
A. Sodium 132 mEq/L
B. Potassium 2.8 mEq/L
C. Chloride 102 mEq/L
D. Magnesium 2.0 mg/dL
Correct Answer: B
Rationale: Severe hypokalemia predisposes patients to ventricular dysrhythmias by altering
myocardial electrical activity.
Question 5
Which inflammatory mediator is primarily responsible for vasodilation during acute
inflammation?
A. Histamine
B. Albumin
C. Insulin
D. Fibrinogen
Correct Answer: A
Rationale: Histamine released from mast cells causes rapid vasodilation and increased vascular
permeability.
Question 6
The earliest manifestation of septic shock is usually:
,A. Warm, flushed skin
B. Bradycardia
C. Cyanosis
D. Pulmonary edema
Correct Answer: A
Rationale: Early septic shock is characterized by peripheral vasodilation, producing warm,
flushed skin and bounding pulses.
Question 7
A patient with diabetic ketoacidosis is expected to have:
A. Hyperglycemia and metabolic acidosis
B. Hypoglycemia and respiratory alkalosis
C. Hypercalcemia
D. Respiratory acidosis only
Correct Answer: A
Rationale: Insulin deficiency leads to hyperglycemia, ketone production, and metabolic acidosis.
Question 8
Which hormone directly lowers serum calcium?
A. Parathyroid hormone
B. Calcitonin
C. Aldosterone
D. Cortisol
Correct Answer: B
Rationale: Calcitonin inhibits osteoclast activity, lowering blood calcium levels.
Question 9
The most common cause of chronic kidney disease is:
, A. Diabetes mellitus
B. Hyperthyroidism
C. Asthma
D. Peptic ulcer disease
Correct Answer: A
Rationale: Diabetes mellitus is the leading cause of chronic kidney disease worldwide.
Question 10
A patient with COPD develops chronic CO₂ retention. The kidneys compensate by:
A. Excreting bicarbonate
B. Retaining bicarbonate
C. Excreting sodium
D. Decreasing hydrogen ion secretion
Correct Answer: B
Rationale: Renal compensation for chronic respiratory acidosis involves increasing bicarbonate
reabsorption.
Question 11
Which patient is at highest risk for pulmonary embolism?
A. Recent hip replacement surgery
B. Seasonal allergies
C. Controlled hypertension
D. Hypothyroidism
Correct Answer: A
Rationale: Orthopedic surgery significantly increases the risk of deep vein thrombosis and
pulmonary embolism.
Question 12
The primary pathophysiologic feature of asthma is:
