N212 PATHOPHYSIOLOGY EXAM 3
(EASTWICK COLLEGE) QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT
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Core Domains
• Cellular Adaptation, Injury, and Death
• Inflammation and Immune Response
• Fluid, Electrolyte, and Acid-Base Balance
• Cardiovascular Pathophysiology
• Respiratory Pathophysiology
• Renal and Urinary System Pathophysiology
• Endocrine Pathophysiology
• Gastrointestinal and Hepatic Pathophysiology
• Neurological Pathophysiology
• Hematological Pathophysiology
Introduction
This comprehensive examination is designed to assess advanced
understanding of pathophysiological mechanisms across major body
systems, emphasizing the integration of molecular, cellular, and systemic
processes. The assessment evaluates foundational theory, applied clinical
knowledge, regulatory compliance, ethical considerations, and critical
decision-making skills through multiple-choice questions and real-world
scenarios. Each question challenges the learner to apply
pathophysiological principles to clinical practice, demonstrating the ability
,to analyze complex patient presentations, interpret diagnostic data, and
formulate evidence-based interventions. Mastery of these concepts is
essential for safe, competent nursing practice and optimal patient
outcomes.
SECTION ONE: QUESTIONS 1–100
Question 1
A 65-year-old patient with a history of chronic hypertension presents
with progressive shortness of breath, orthopnea, and peripheral edema.
Echocardiography reveals an ejection fraction of 35%. Which
pathophysiological mechanism BEST explains this patient's
presentation?
A. Increased cardiac output due to sympathetic activation
B. Impaired diastolic filling with preserved systolic function
C. Decreased myocardial contractility leading to reduced stroke volume
D. Right ventricular hypertrophy secondary to pulmonary hypertension
C
RATIONALE: An ejection fraction of 35% indicates systolic heart
failure with reduced ejection fraction (HFrEF). This results from
decreased myocardial contractility, which reduces stroke volume and
cardiac output, leading to fluid retention and the clinical manifestations
of shortness of breath, orthopnea, and peripheral edema.
Question 2
A patient with chronic obstructive pulmonary disease (COPD) has
arterial blood gas results showing pH 7.32, PaCO2 58 mmHg, and
HCO3- 30 mEq/L. Which acid-base disturbance is present?
A. Acute respiratory acidosis
B. Chronic respiratory acidosis with metabolic compensation
,C. Metabolic acidosis with respiratory compensation
D. Mixed respiratory and metabolic acidosis
B
RATIONALE: The elevated PaCO2 indicates respiratory acidosis. The
pH is low but not severely so, and the HCO3- is elevated, indicating
renal compensation. In chronic respiratory acidosis, the kidneys retain
bicarbonate to buffer the acidosis, resulting in a compensatory
metabolic alkalosis.
Question 3
Which cellular adaptation is characterized by an increase in the size of
cells in response to increased workload?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
C
RATIONALE: Hypertrophy is an increase in cell size, not number, in
response to increased demand or trophic stimulation. This is commonly
seen in cardiac muscle cells of patients with hypertension or aortic
stenosis.
Question 4
A patient with type 1 diabetes mellitus develops diabetic ketoacidosis
(DKA). Which pathophysiological process is the PRIMARY cause of
ketoacid production?
A. Increased gluconeogenesis in the liver
B. Decreased glucose uptake by peripheral tissues
C. Increased lipolysis and fatty acid oxidation
D. Impaired insulin secretion from pancreatic beta cells
, C
RATIONALE: In DKA, the absence of insulin leads to increased
lipolysis, releasing free fatty acids that are oxidized in the liver to ketone
bodies (acetoacetate, beta-hydroxybutyrate). This results in metabolic
acidosis.
Question 5
A 72-year-old patient is diagnosed with community-acquired
pneumonia. The patient develops sepsis with hypotension, tachycardia,
and tachypnea. Which stage of sepsis is characterized by organ
dysfunction and hypotension refractory to fluid resuscitation?
A. Systemic inflammatory response syndrome (SIRS)
B. Sepsis
C. Severe sepsis
D. Septic shock
D
RATIONALE: Septic shock is defined as sepsis with persistent
hypotension requiring vasopressors to maintain mean arterial pressure
≥65 mmHg despite adequate fluid resuscitation, accompanied by lactic
acidosis and organ dysfunction.
Question 6
A patient with chronic kidney disease has a serum creatinine of 4.5
mg/dL and a blood urea nitrogen (BUN) of 60 mg/dL. Which
pathophysiological mechanism BEST explains the elevated BUN-to-
creatinine ratio?
A. Increased protein catabolism
B. Decreased glomerular filtration rate (GFR)
C. Increased urea reabsorption in the collecting ducts
D. Decreased tubular secretion of creatinine
B
(EASTWICK COLLEGE) QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
Core Domains
• Cellular Adaptation, Injury, and Death
• Inflammation and Immune Response
• Fluid, Electrolyte, and Acid-Base Balance
• Cardiovascular Pathophysiology
• Respiratory Pathophysiology
• Renal and Urinary System Pathophysiology
• Endocrine Pathophysiology
• Gastrointestinal and Hepatic Pathophysiology
• Neurological Pathophysiology
• Hematological Pathophysiology
Introduction
This comprehensive examination is designed to assess advanced
understanding of pathophysiological mechanisms across major body
systems, emphasizing the integration of molecular, cellular, and systemic
processes. The assessment evaluates foundational theory, applied clinical
knowledge, regulatory compliance, ethical considerations, and critical
decision-making skills through multiple-choice questions and real-world
scenarios. Each question challenges the learner to apply
pathophysiological principles to clinical practice, demonstrating the ability
,to analyze complex patient presentations, interpret diagnostic data, and
formulate evidence-based interventions. Mastery of these concepts is
essential for safe, competent nursing practice and optimal patient
outcomes.
SECTION ONE: QUESTIONS 1–100
Question 1
A 65-year-old patient with a history of chronic hypertension presents
with progressive shortness of breath, orthopnea, and peripheral edema.
Echocardiography reveals an ejection fraction of 35%. Which
pathophysiological mechanism BEST explains this patient's
presentation?
A. Increased cardiac output due to sympathetic activation
B. Impaired diastolic filling with preserved systolic function
C. Decreased myocardial contractility leading to reduced stroke volume
D. Right ventricular hypertrophy secondary to pulmonary hypertension
C
RATIONALE: An ejection fraction of 35% indicates systolic heart
failure with reduced ejection fraction (HFrEF). This results from
decreased myocardial contractility, which reduces stroke volume and
cardiac output, leading to fluid retention and the clinical manifestations
of shortness of breath, orthopnea, and peripheral edema.
Question 2
A patient with chronic obstructive pulmonary disease (COPD) has
arterial blood gas results showing pH 7.32, PaCO2 58 mmHg, and
HCO3- 30 mEq/L. Which acid-base disturbance is present?
A. Acute respiratory acidosis
B. Chronic respiratory acidosis with metabolic compensation
,C. Metabolic acidosis with respiratory compensation
D. Mixed respiratory and metabolic acidosis
B
RATIONALE: The elevated PaCO2 indicates respiratory acidosis. The
pH is low but not severely so, and the HCO3- is elevated, indicating
renal compensation. In chronic respiratory acidosis, the kidneys retain
bicarbonate to buffer the acidosis, resulting in a compensatory
metabolic alkalosis.
Question 3
Which cellular adaptation is characterized by an increase in the size of
cells in response to increased workload?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
C
RATIONALE: Hypertrophy is an increase in cell size, not number, in
response to increased demand or trophic stimulation. This is commonly
seen in cardiac muscle cells of patients with hypertension or aortic
stenosis.
Question 4
A patient with type 1 diabetes mellitus develops diabetic ketoacidosis
(DKA). Which pathophysiological process is the PRIMARY cause of
ketoacid production?
A. Increased gluconeogenesis in the liver
B. Decreased glucose uptake by peripheral tissues
C. Increased lipolysis and fatty acid oxidation
D. Impaired insulin secretion from pancreatic beta cells
, C
RATIONALE: In DKA, the absence of insulin leads to increased
lipolysis, releasing free fatty acids that are oxidized in the liver to ketone
bodies (acetoacetate, beta-hydroxybutyrate). This results in metabolic
acidosis.
Question 5
A 72-year-old patient is diagnosed with community-acquired
pneumonia. The patient develops sepsis with hypotension, tachycardia,
and tachypnea. Which stage of sepsis is characterized by organ
dysfunction and hypotension refractory to fluid resuscitation?
A. Systemic inflammatory response syndrome (SIRS)
B. Sepsis
C. Severe sepsis
D. Septic shock
D
RATIONALE: Septic shock is defined as sepsis with persistent
hypotension requiring vasopressors to maintain mean arterial pressure
≥65 mmHg despite adequate fluid resuscitation, accompanied by lactic
acidosis and organ dysfunction.
Question 6
A patient with chronic kidney disease has a serum creatinine of 4.5
mg/dL and a blood urea nitrogen (BUN) of 60 mg/dL. Which
pathophysiological mechanism BEST explains the elevated BUN-to-
creatinine ratio?
A. Increased protein catabolism
B. Decreased glomerular filtration rate (GFR)
C. Increased urea reabsorption in the collecting ducts
D. Decreased tubular secretion of creatinine
B
