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NSG 530 EXAM 2 – 2026 WILKES ADVANCED
PATHOPHYSIOLOGY COMPLETE (110) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NSG
Prepare for the NSG 530 Exam 2 – Wilkes Advanced Pathophysiology with this
comprehensive practice resource designed to strengthen your understanding of
advanced disease processes and clinical concepts. It features exam-style questions
covering cardiovascular, respiratory, renal, endocrine, neurological, and immune
system disorders, along with pathophysiological mechanisms, clinical
manifestations, and evidence-based nursing considerations. Use it to reinforce
essential concepts, assess your understanding, and build confidence before test day.
An excellent study aid for Wilkes University nursing students preparing for the NSG
530 Advanced Pathophysiology Exam 2.
MULTIPLE CHOICE.
FLUID, ELECTROLYTE, & ACID-BASE BALANCE (Questions 1–20)
Question 1: The geometric formula for the area of a triangle is:
A. (1/2)bh
B. πr²
C. 2πr
D. l × w
Correct answer: A. (1/2)bh
Rationale: The area of a triangle is calculated using (1/2) × base × height.
Question 2: A patient presents with muscle weakness, cardiac arrhythmias,
and confusion. Laboratory results show potassium 6.5 mEq/L and peaked T-
waves on ECG. What acid-base imbalance is most likely?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory acidosis
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Correct answer: C. Metabolic alkalosis
Rationale: Metabolic alkalosis is characterized by elevated pH and elevated
bicarbonate. Potassium shifts into cells in exchange for hydrogen ions during
alkalosis, potentially causing hypokalemia. However, the question describes
hyperkalemia and peaked T-waves.
Question 3: Hyponatremia is defined as a serum sodium level of:
A. Less than 130 mEq/L
B. Less than 135 mEq/L
C. Less than 140 mEq/L
D. Less than 145 mEq/L
Correct answer: B. Less than 135 mEq/L
Rationale: Hyponatremia is defined as a serum sodium level of less than 135
mEq/L.
Question 4: Hypokalemia is defined as a serum potassium level of:
A. Less than 3.0 mEq/L
B. Less than 3.5 mEq/L
C. Less than 4.0 mEq/L
D. Less than 5.0 mEq/L
Correct answer: B. Less than 3.5 mEq/L
Rationale: Hypokalemia is defined as a serum potassium level of less than
3.5 mEq/L. Normal range is 3.5–5.0 mEq/L.
Question 5: Hyperkalemia is defined as a serum potassium level of:
A. Greater than 4.5 mEq/L
B. Greater than 5.0 mEq/L
C. Greater than 5.5 mEq/L
D. Greater than 6.0 mEq/L
Correct answer: B. Greater than 5.0 mEq/L
Rationale: Hyperkalemia is defined as a serum potassium level of greater
than 5.0 mEq/L. Peaked T-waves on ECG are a classic sign.
Question 6: An increase in serum osmolality would trigger the release of
which hormone?
A. Aldosterone
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B. Antidiuretic hormone (ADH)
C. Atrial natriuretic peptide (ANP)
D. Renin
Correct answer: B. Antidiuretic hormone (ADH)
Rationale: ADH is released in response to increased serum osmolality,
promoting water reabsorption in the kidneys to dilute the blood and lower
osmolality.
Question 7: A patient with prolonged vomiting would most likely develop
which acid-base imbalance?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Correct answer: B. Metabolic alkalosis
Rationale: Prolonged vomiting results in loss of gastric acid (HCl), leading to
metabolic alkalosis with elevated pH and elevated bicarbonate.
Question 8: A patient with COPD who retains CO₂ would most likely develop
which acid-base imbalance?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Correct answer: C. Respiratory acidosis
Rationale: COPD causes CO₂ retention due to impaired ventilation, leading to
respiratory acidosis characterized by decreased pH and increased PaCO₂.
Question 9: The body's main buffer system in the extracellular fluid is the:
A. Protein buffer system
B. Phosphate buffer system
C. Bicarbonate-carbonic acid buffer system
D. Hemoglobin buffer system
Correct answer: C. Bicarbonate-carbonic acid buffer system
Rationale: The bicarbonate-carbonic acid buffer system is the primary buffer
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in the extracellular fluid. It maintains blood pH and is regulated by the lungs
and kidneys.
Question 10: The anion gap is used to differentiate types of metabolic
acidosis. An elevated anion gap is seen in:
A. Diarrhea
B. Diabetic ketoacidosis
C. Renal tubular acidosis
D. Hyperchloremic acidosis
Correct answer: B. Diabetic ketoacidosis
Rationale: An elevated anion gap metabolic acidosis is seen in conditions
where there is an accumulation of unmeasured anions such as ketones
(DKA), lactic acid (lactic acidosis), or toxins.
Question 11: A patient with diabetic ketoacidosis would have which
laboratory findings?
A. pH decreased, HCO₃⁻ decreased, anion gap increased
B. pH decreased, HCO₃⁻ increased, anion gap normal
C. pH increased, HCO₃⁻ decreased, anion gap normal
D. pH increased, HCO₃⁻ increased, anion gap decreased
Correct answer: A. pH decreased, HCO₃⁻ decreased, anion gap increased
Rationale: DKA causes metabolic acidosis with decreased pH, decreased
bicarbonate, and an elevated anion gap due to the presence of ketone bodies
as unmeasured anions.
Question 12: Respiratory alkalosis is characterized by:
A. Increased pH, increased PaCO₂
B. Decreased pH, increased PaCO₂
C. Increased pH, decreased PaCO₂
D. Decreased pH, decreased PaCO₂
Correct answer: C. Increased pH, decreased PaCO₂
Rationale: Respiratory alkalosis results from hyperventilation, causing
decreased PaCO₂ and increased pH.
Question 13: A patient with renal failure would most likely develop:
A. Metabolic acidosis
NSG 530 EXAM 2 – 2026 WILKES ADVANCED
PATHOPHYSIOLOGY COMPLETE (110) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NSG
Prepare for the NSG 530 Exam 2 – Wilkes Advanced Pathophysiology with this
comprehensive practice resource designed to strengthen your understanding of
advanced disease processes and clinical concepts. It features exam-style questions
covering cardiovascular, respiratory, renal, endocrine, neurological, and immune
system disorders, along with pathophysiological mechanisms, clinical
manifestations, and evidence-based nursing considerations. Use it to reinforce
essential concepts, assess your understanding, and build confidence before test day.
An excellent study aid for Wilkes University nursing students preparing for the NSG
530 Advanced Pathophysiology Exam 2.
MULTIPLE CHOICE.
FLUID, ELECTROLYTE, & ACID-BASE BALANCE (Questions 1–20)
Question 1: The geometric formula for the area of a triangle is:
A. (1/2)bh
B. πr²
C. 2πr
D. l × w
Correct answer: A. (1/2)bh
Rationale: The area of a triangle is calculated using (1/2) × base × height.
Question 2: A patient presents with muscle weakness, cardiac arrhythmias,
and confusion. Laboratory results show potassium 6.5 mEq/L and peaked T-
waves on ECG. What acid-base imbalance is most likely?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory acidosis
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Correct answer: C. Metabolic alkalosis
Rationale: Metabolic alkalosis is characterized by elevated pH and elevated
bicarbonate. Potassium shifts into cells in exchange for hydrogen ions during
alkalosis, potentially causing hypokalemia. However, the question describes
hyperkalemia and peaked T-waves.
Question 3: Hyponatremia is defined as a serum sodium level of:
A. Less than 130 mEq/L
B. Less than 135 mEq/L
C. Less than 140 mEq/L
D. Less than 145 mEq/L
Correct answer: B. Less than 135 mEq/L
Rationale: Hyponatremia is defined as a serum sodium level of less than 135
mEq/L.
Question 4: Hypokalemia is defined as a serum potassium level of:
A. Less than 3.0 mEq/L
B. Less than 3.5 mEq/L
C. Less than 4.0 mEq/L
D. Less than 5.0 mEq/L
Correct answer: B. Less than 3.5 mEq/L
Rationale: Hypokalemia is defined as a serum potassium level of less than
3.5 mEq/L. Normal range is 3.5–5.0 mEq/L.
Question 5: Hyperkalemia is defined as a serum potassium level of:
A. Greater than 4.5 mEq/L
B. Greater than 5.0 mEq/L
C. Greater than 5.5 mEq/L
D. Greater than 6.0 mEq/L
Correct answer: B. Greater than 5.0 mEq/L
Rationale: Hyperkalemia is defined as a serum potassium level of greater
than 5.0 mEq/L. Peaked T-waves on ECG are a classic sign.
Question 6: An increase in serum osmolality would trigger the release of
which hormone?
A. Aldosterone
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B. Antidiuretic hormone (ADH)
C. Atrial natriuretic peptide (ANP)
D. Renin
Correct answer: B. Antidiuretic hormone (ADH)
Rationale: ADH is released in response to increased serum osmolality,
promoting water reabsorption in the kidneys to dilute the blood and lower
osmolality.
Question 7: A patient with prolonged vomiting would most likely develop
which acid-base imbalance?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Correct answer: B. Metabolic alkalosis
Rationale: Prolonged vomiting results in loss of gastric acid (HCl), leading to
metabolic alkalosis with elevated pH and elevated bicarbonate.
Question 8: A patient with COPD who retains CO₂ would most likely develop
which acid-base imbalance?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Correct answer: C. Respiratory acidosis
Rationale: COPD causes CO₂ retention due to impaired ventilation, leading to
respiratory acidosis characterized by decreased pH and increased PaCO₂.
Question 9: The body's main buffer system in the extracellular fluid is the:
A. Protein buffer system
B. Phosphate buffer system
C. Bicarbonate-carbonic acid buffer system
D. Hemoglobin buffer system
Correct answer: C. Bicarbonate-carbonic acid buffer system
Rationale: The bicarbonate-carbonic acid buffer system is the primary buffer
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in the extracellular fluid. It maintains blood pH and is regulated by the lungs
and kidneys.
Question 10: The anion gap is used to differentiate types of metabolic
acidosis. An elevated anion gap is seen in:
A. Diarrhea
B. Diabetic ketoacidosis
C. Renal tubular acidosis
D. Hyperchloremic acidosis
Correct answer: B. Diabetic ketoacidosis
Rationale: An elevated anion gap metabolic acidosis is seen in conditions
where there is an accumulation of unmeasured anions such as ketones
(DKA), lactic acid (lactic acidosis), or toxins.
Question 11: A patient with diabetic ketoacidosis would have which
laboratory findings?
A. pH decreased, HCO₃⁻ decreased, anion gap increased
B. pH decreased, HCO₃⁻ increased, anion gap normal
C. pH increased, HCO₃⁻ decreased, anion gap normal
D. pH increased, HCO₃⁻ increased, anion gap decreased
Correct answer: A. pH decreased, HCO₃⁻ decreased, anion gap increased
Rationale: DKA causes metabolic acidosis with decreased pH, decreased
bicarbonate, and an elevated anion gap due to the presence of ketone bodies
as unmeasured anions.
Question 12: Respiratory alkalosis is characterized by:
A. Increased pH, increased PaCO₂
B. Decreased pH, increased PaCO₂
C. Increased pH, decreased PaCO₂
D. Decreased pH, decreased PaCO₂
Correct answer: C. Increased pH, decreased PaCO₂
Rationale: Respiratory alkalosis results from hyperventilation, causing
decreased PaCO₂ and increased pH.
Question 13: A patient with renal failure would most likely develop:
A. Metabolic acidosis
