NR-283 Pathophysiology Final
Examination Review 2026–2027 | 100
Original NCLEX-Style Practice
Questions, Comprehensive Final
Exam Prep, Detailed Rationales &
High-Yield Success Guide
Question 1
A patient with septic shock develops hypotension primarily because of:
A. Increased blood viscosity
B. Systemic vasodilation
C. Increased cardiac output
D. Hypercalcemia
Correct Answer: B
Rationale: Septic shock causes widespread release of inflammatory mediators that lead to
systemic vasodilation, capillary leakage, and reduced tissue perfusion. This is a hallmark
feature tested frequently on nursing examinations.
Question 2
Which electrolyte imbalance is most likely to cause life-threatening cardiac dysrhythmias?
A. Hyperkalemia
B. Hypernatremia
C. Hyperchloremia
D. Hyperphosphatemia
Correct Answer: A
,Rationale: Potassium is critical for cardiac electrical activity. Severe hyperkalemia can
produce peaked T waves, conduction abnormalities, ventricular arrhythmias, and cardiac
arrest.
Question 3
The most common cause of chronic kidney disease is:
A. Hypertension and diabetes mellitus
B. Appendicitis
C. Asthma
D. Osteoporosis
Correct Answer: A
Rationale: Diabetes mellitus and hypertension account for the majority of chronic kidney
disease cases due to progressive damage to renal blood vessels and nephrons.
Question 4
Which condition is characterized by decreased bone mass and increased fracture risk?
A. Osteomyelitis
B. Osteoporosis
C. Osteoarthritis
D. Gout
Correct Answer: B
Rationale: Osteoporosis causes decreased bone density and structural deterioration,
increasing the risk of fractures, especially in older adults.
Question 5
A patient with left-sided heart failure commonly presents with:
A. Ascites only
B. Peripheral edema only
C. Pulmonary congestion and dyspnea
D. Splenomegaly
Correct Answer: C
,Rationale: Left ventricular dysfunction causes blood to back up into the pulmonary
circulation, resulting in pulmonary edema, crackles, and shortness of breath.
Question 6
Which hormone is responsible for increasing blood glucose levels during stress?
A. Insulin
B. Cortisol
C. Calcitonin
D. Oxytocin
Correct Answer: B
Rationale: Cortisol increases glucose production and decreases glucose utilization, helping
the body respond to physiologic stress.
Question 7
The primary pathophysiologic process in atherosclerosis involves:
A. Bone destruction
B. Plaque formation within arterial walls
C. Increased bile production
D. Excess insulin secretion
Correct Answer: B
Rationale: Atherosclerosis develops when lipids, inflammatory cells, and fibrous tissue
accumulate within arterial walls, narrowing blood vessels and reducing blood flow.
Question 8
A pulmonary embolism most commonly originates from:
A. Coronary arteries
B. Cerebral arteries
C. Deep veins of the legs
D. Pulmonary veins
Correct Answer: C
, Rationale: Most pulmonary emboli originate from deep vein thrombosis in the lower
extremities and travel to the pulmonary circulation.
Question 9
Which acid-base disorder is commonly associated with COPD?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Metabolic acidosis
Correct Answer: A
Rationale: COPD often causes carbon dioxide retention, leading to chronic respiratory
acidosis and renal compensation.
Question 10
Hyperthyroidism typically results in:
A. Bradycardia
B. Weight gain
C. Heat intolerance
D. Reduced metabolism
Correct Answer: C
Rationale: Excess thyroid hormone increases metabolic activity, causing heat intolerance,
weight loss, tachycardia, and nervousness.
Question 11
Which condition results from inadequate oxygen delivery to tissues?
A. Hyperplasia
B. Hypoxia
C. Metaplasia
D. Dysplasia
Correct Answer: B
Examination Review 2026–2027 | 100
Original NCLEX-Style Practice
Questions, Comprehensive Final
Exam Prep, Detailed Rationales &
High-Yield Success Guide
Question 1
A patient with septic shock develops hypotension primarily because of:
A. Increased blood viscosity
B. Systemic vasodilation
C. Increased cardiac output
D. Hypercalcemia
Correct Answer: B
Rationale: Septic shock causes widespread release of inflammatory mediators that lead to
systemic vasodilation, capillary leakage, and reduced tissue perfusion. This is a hallmark
feature tested frequently on nursing examinations.
Question 2
Which electrolyte imbalance is most likely to cause life-threatening cardiac dysrhythmias?
A. Hyperkalemia
B. Hypernatremia
C. Hyperchloremia
D. Hyperphosphatemia
Correct Answer: A
,Rationale: Potassium is critical for cardiac electrical activity. Severe hyperkalemia can
produce peaked T waves, conduction abnormalities, ventricular arrhythmias, and cardiac
arrest.
Question 3
The most common cause of chronic kidney disease is:
A. Hypertension and diabetes mellitus
B. Appendicitis
C. Asthma
D. Osteoporosis
Correct Answer: A
Rationale: Diabetes mellitus and hypertension account for the majority of chronic kidney
disease cases due to progressive damage to renal blood vessels and nephrons.
Question 4
Which condition is characterized by decreased bone mass and increased fracture risk?
A. Osteomyelitis
B. Osteoporosis
C. Osteoarthritis
D. Gout
Correct Answer: B
Rationale: Osteoporosis causes decreased bone density and structural deterioration,
increasing the risk of fractures, especially in older adults.
Question 5
A patient with left-sided heart failure commonly presents with:
A. Ascites only
B. Peripheral edema only
C. Pulmonary congestion and dyspnea
D. Splenomegaly
Correct Answer: C
,Rationale: Left ventricular dysfunction causes blood to back up into the pulmonary
circulation, resulting in pulmonary edema, crackles, and shortness of breath.
Question 6
Which hormone is responsible for increasing blood glucose levels during stress?
A. Insulin
B. Cortisol
C. Calcitonin
D. Oxytocin
Correct Answer: B
Rationale: Cortisol increases glucose production and decreases glucose utilization, helping
the body respond to physiologic stress.
Question 7
The primary pathophysiologic process in atherosclerosis involves:
A. Bone destruction
B. Plaque formation within arterial walls
C. Increased bile production
D. Excess insulin secretion
Correct Answer: B
Rationale: Atherosclerosis develops when lipids, inflammatory cells, and fibrous tissue
accumulate within arterial walls, narrowing blood vessels and reducing blood flow.
Question 8
A pulmonary embolism most commonly originates from:
A. Coronary arteries
B. Cerebral arteries
C. Deep veins of the legs
D. Pulmonary veins
Correct Answer: C
, Rationale: Most pulmonary emboli originate from deep vein thrombosis in the lower
extremities and travel to the pulmonary circulation.
Question 9
Which acid-base disorder is commonly associated with COPD?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Metabolic acidosis
Correct Answer: A
Rationale: COPD often causes carbon dioxide retention, leading to chronic respiratory
acidosis and renal compensation.
Question 10
Hyperthyroidism typically results in:
A. Bradycardia
B. Weight gain
C. Heat intolerance
D. Reduced metabolism
Correct Answer: C
Rationale: Excess thyroid hormone increases metabolic activity, causing heat intolerance,
weight loss, tachycardia, and nervousness.
Question 11
Which condition results from inadequate oxygen delivery to tissues?
A. Hyperplasia
B. Hypoxia
C. Metaplasia
D. Dysplasia
Correct Answer: B
