Page 1 of 158
NUR 2063 Essentials of Pathophysiology Exam 2 –
Rasmussen University QUESTIONS AND VERIFIED
ANSWERS WITH RATIONALES
NUR 2063 Essentials of Pathophysiology Exam 2 – Rasmussen University
10 Most Tested Coverage Areas
1. Acid-Base Imbalances - pH normal range 7.35-7.45; carbonic acid/bicarbonate ratio 1:20;
respiratory acidosis (pneumonia, COPD, hypoventilation); metabolic acidosis (renal failure, DKA);
compensation mechanisms (hyperventilation for metabolic acidosis; renal H+ excretion for
respiratory acidosis)
2. Fluid and Electrolyte Disorders - Hyperkalemia and metabolic acidosis in renal failure;
hypokalemia in primary aldosteronism; ADH regulation of water reabsorption in collecting ducts;
clinical manifestations of electrolyte disturbances
3. Endocrine Disorders - Hypothyroidism (myxedema, fatigue, cold intolerance, constipation,
weight gain); Hyperthyroidism/Graves' disease (goiter, exophthalmos, heat intolerance, weight
loss); Type 1 vs Type 2 diabetes (Type 1: adipose/fat breakdown for energy; Type 2: peripheral
insulin resistance); Three P's of diabetes (polydipsia, polyuria, polyphagia)
4. Renal Disorders - Kidney functions (blood pressure regulation, blood osmolarity, toxin removal,
blood filtration, activate vitamin D); Acute kidney injury phases (oliguric, diuretic, recovery);
Chronic kidney disease stages and GFR; Nephrolithiasis manifestations (flank pain radiating to
groin, hematuria, N/V)
5. Gastrointestinal Disorders - Gastritis (acute vs chronic; H. pylori and autoimmune causes);
Peptic Ulcer Disease (epigastric pain patterns; H. pylori role; complications: hemorrhage,
obstruction, perforation, peritonitis); GERD and Barrett's esophagus
6. Hematologic Disorders - Anemia types; Pernicious anemia (intrinsic factor deficiency, Schilling
test); Iron deficiency anemia (chronic GI bleeding); Vitamin B12 deficiency (macrocytic anemia,
gastrectomy risk factor); Erythrocyte properties (biconcavity, reversible deformability,
hemoglobin carries 4 oxygen molecules)
7. GI Surgical Emergencies - Appendicitis (periumbilical pain migrating to RLQ/McBurney's point;
rebound tenderness; nausea, vomiting, fever); Intussusception (telescoping of intestine); Bowel
obstruction (functional vs mechanical); Diverticulitis (sigmoid colon most common)
8. Infectious GI Disorders - Pseudomembranous colitis/C. diff (antibiotic exposure, foul-
smelling/bloody stool, treatment: metronidazole or vancomycin, handwashing with soap/water
only); H. pylori in peptic ulcer disease
9. Renal and Urinary Manifestations - Benign Prostatic Hypertrophy (dribbling, hesitancy,
decreased stream, urinary retention); UTIs (female risk, dysuria, frequency, hematuria);
Pyelonephritis; Cystitis; Polycystic kidney disease management (increase fluids, monitor BP)
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10. Hematological Assessment - Normal leukocyte count (5,000-10,000/mm³); Anisocytosis
(erythrocytes assume various shapes); Hypochromic erythrocytes (low hemoglobin
concentration); Hemoglobin carries 4 oxygen molecules; Normocytic-normochromic anemia
(hemolytic anemia)
1. A patient with a long history of smoking presents with excessive tiredness, shortness of breath, and
general malaise. Lab results reveal decreased pH, increased PaCO₂, and normal bicarbonate. What is
the correct interpretation of these findings?
A) Metabolic acidosis, uncompensated
B) Respiratory acidosis, uncompensated
C) Metabolic alkalosis, fully compensated
D) Respiratory acidosis, partially compensated
Answer: B
Rationale: Decreased pH indicates acidosis. Increased PaCO₂ indicates a respiratory cause (retained CO₂).
Normal bicarbonate means no renal compensation has occurred. This is uncompensated respiratory
acidosis, common in chronic lung disease with hypoventilation .
2. A patient with renal failure is being assessed. Which acid-base imbalance should the nurse expect
to find in this patient?
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A) Respiratory acidosis
B) Metabolic acidosis
C) Respiratory alkalosis
D) Metabolic alkalosis
Answer: B
Rationale: The kidneys are responsible for excreting hydrogen ions and regenerating bicarbonate. In
renal failure, the kidneys cannot excrete metabolic acids, leading to metabolic acidosis. The nurse
should also assess for hyperkalemia, as both conditions occur together in renal failure .
3. The nurse is reviewing a patient's lab results and notes the patient is in metabolic acidosis. How will
the body compensate for this imbalance?
A) The kidneys will retain bicarbonate
B) The respiratory system will hyperventilate to blow off CO₂
C) The respiratory system will hypoventilate to retain CO₂
D) The kidneys will excrete more hydrogen ions
Answer: B
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Rationale: In metabolic acidosis, the respiratory system compensates by hyperventilating (Kussmaul
respirations) to blow off CO₂ and increase pH. This is a rapid compensatory mechanism compared to
renal compensation, which takes days .
4. A patient is diagnosed with primary aldosteronism. Which electrolyte imbalance is most
characteristic of this condition?
A) Hyperkalemia
B) Hypokalemia
C) Hyponatremia
D) Hypercalcemia
Answer: B
Rationale: Primary aldosteronism is characterized by excessive aldosterone production, which causes
the kidneys to retain sodium and excrete potassium, leading to hypokalemia. Hypertension and
hypokalemia are hallmark findings .
5. A patient presents with a swollen, non-pitting edema of the face and extremities, fatigue, and cold
intolerance. What is this condition called?
NUR 2063 Essentials of Pathophysiology Exam 2 –
Rasmussen University QUESTIONS AND VERIFIED
ANSWERS WITH RATIONALES
NUR 2063 Essentials of Pathophysiology Exam 2 – Rasmussen University
10 Most Tested Coverage Areas
1. Acid-Base Imbalances - pH normal range 7.35-7.45; carbonic acid/bicarbonate ratio 1:20;
respiratory acidosis (pneumonia, COPD, hypoventilation); metabolic acidosis (renal failure, DKA);
compensation mechanisms (hyperventilation for metabolic acidosis; renal H+ excretion for
respiratory acidosis)
2. Fluid and Electrolyte Disorders - Hyperkalemia and metabolic acidosis in renal failure;
hypokalemia in primary aldosteronism; ADH regulation of water reabsorption in collecting ducts;
clinical manifestations of electrolyte disturbances
3. Endocrine Disorders - Hypothyroidism (myxedema, fatigue, cold intolerance, constipation,
weight gain); Hyperthyroidism/Graves' disease (goiter, exophthalmos, heat intolerance, weight
loss); Type 1 vs Type 2 diabetes (Type 1: adipose/fat breakdown for energy; Type 2: peripheral
insulin resistance); Three P's of diabetes (polydipsia, polyuria, polyphagia)
4. Renal Disorders - Kidney functions (blood pressure regulation, blood osmolarity, toxin removal,
blood filtration, activate vitamin D); Acute kidney injury phases (oliguric, diuretic, recovery);
Chronic kidney disease stages and GFR; Nephrolithiasis manifestations (flank pain radiating to
groin, hematuria, N/V)
5. Gastrointestinal Disorders - Gastritis (acute vs chronic; H. pylori and autoimmune causes);
Peptic Ulcer Disease (epigastric pain patterns; H. pylori role; complications: hemorrhage,
obstruction, perforation, peritonitis); GERD and Barrett's esophagus
6. Hematologic Disorders - Anemia types; Pernicious anemia (intrinsic factor deficiency, Schilling
test); Iron deficiency anemia (chronic GI bleeding); Vitamin B12 deficiency (macrocytic anemia,
gastrectomy risk factor); Erythrocyte properties (biconcavity, reversible deformability,
hemoglobin carries 4 oxygen molecules)
7. GI Surgical Emergencies - Appendicitis (periumbilical pain migrating to RLQ/McBurney's point;
rebound tenderness; nausea, vomiting, fever); Intussusception (telescoping of intestine); Bowel
obstruction (functional vs mechanical); Diverticulitis (sigmoid colon most common)
8. Infectious GI Disorders - Pseudomembranous colitis/C. diff (antibiotic exposure, foul-
smelling/bloody stool, treatment: metronidazole or vancomycin, handwashing with soap/water
only); H. pylori in peptic ulcer disease
9. Renal and Urinary Manifestations - Benign Prostatic Hypertrophy (dribbling, hesitancy,
decreased stream, urinary retention); UTIs (female risk, dysuria, frequency, hematuria);
Pyelonephritis; Cystitis; Polycystic kidney disease management (increase fluids, monitor BP)
, Page 2 of 158
10. Hematological Assessment - Normal leukocyte count (5,000-10,000/mm³); Anisocytosis
(erythrocytes assume various shapes); Hypochromic erythrocytes (low hemoglobin
concentration); Hemoglobin carries 4 oxygen molecules; Normocytic-normochromic anemia
(hemolytic anemia)
1. A patient with a long history of smoking presents with excessive tiredness, shortness of breath, and
general malaise. Lab results reveal decreased pH, increased PaCO₂, and normal bicarbonate. What is
the correct interpretation of these findings?
A) Metabolic acidosis, uncompensated
B) Respiratory acidosis, uncompensated
C) Metabolic alkalosis, fully compensated
D) Respiratory acidosis, partially compensated
Answer: B
Rationale: Decreased pH indicates acidosis. Increased PaCO₂ indicates a respiratory cause (retained CO₂).
Normal bicarbonate means no renal compensation has occurred. This is uncompensated respiratory
acidosis, common in chronic lung disease with hypoventilation .
2. A patient with renal failure is being assessed. Which acid-base imbalance should the nurse expect
to find in this patient?
, Page 3 of 158
A) Respiratory acidosis
B) Metabolic acidosis
C) Respiratory alkalosis
D) Metabolic alkalosis
Answer: B
Rationale: The kidneys are responsible for excreting hydrogen ions and regenerating bicarbonate. In
renal failure, the kidneys cannot excrete metabolic acids, leading to metabolic acidosis. The nurse
should also assess for hyperkalemia, as both conditions occur together in renal failure .
3. The nurse is reviewing a patient's lab results and notes the patient is in metabolic acidosis. How will
the body compensate for this imbalance?
A) The kidneys will retain bicarbonate
B) The respiratory system will hyperventilate to blow off CO₂
C) The respiratory system will hypoventilate to retain CO₂
D) The kidneys will excrete more hydrogen ions
Answer: B
, Page 4 of 158
Rationale: In metabolic acidosis, the respiratory system compensates by hyperventilating (Kussmaul
respirations) to blow off CO₂ and increase pH. This is a rapid compensatory mechanism compared to
renal compensation, which takes days .
4. A patient is diagnosed with primary aldosteronism. Which electrolyte imbalance is most
characteristic of this condition?
A) Hyperkalemia
B) Hypokalemia
C) Hyponatremia
D) Hypercalcemia
Answer: B
Rationale: Primary aldosteronism is characterized by excessive aldosterone production, which causes
the kidneys to retain sodium and excrete potassium, leading to hypokalemia. Hypertension and
hypokalemia are hallmark findings .
5. A patient presents with a swollen, non-pitting edema of the face and extremities, fatigue, and cold
intolerance. What is this condition called?
