NR 283 PATHOPHYSIOLOGY
COMPREHENSIVE EXAM REVIEW
QUESTIONS AND ANSWERS. JUST
RELEASED
1. Which cellular adaptation is most likely to occur in the esophageal lining of a patient with
chronic gastroesophageal reflux disease (GERD)?
A. Hypertrophy of squamous cells
B. Hyperplasia of the smooth muscle
C. Atrophy of the mucosal lining
D. Metaplasia of squamous cells to columnar cells
Answer: D
Conceptual Explanation: Metaplasia is a reversible change in which one adult cell type is
replaced by another to better withstand chronic irritation, such as gastric acid in Barrett’s
esophagus.
2. A patient presents with a serum sodium level of 160 mEq/L. Which pathophysiological
mechanism is the primary concern for the central nervous system?
A. Intracellular swelling of neurons
B. Neuronal shrinkage due to water shifting out of cells
,C. Increased intracranial pressure due to vasodilation
D. Decreased excitability of the sodium-potassium pump
Answer: B
Conceptual Explanation: Hypernatremia creates a hypertonic extracellular environment,
causing water to move out of the cells via osmosis, leading to cellular dehydration and
brain cell shrinkage.
3. Which arterial blood gas (ABG) result is most indicative of partially compensated
respiratory acidosis?
A. pH 7.32, PaCO2 50, HCO3 28
B. pH 7.45, PaCO2 30, HCO3 20
C. pH 7.35, PaCO2 48, HCO3 26
D. pH 7.28, PaCO2 35, HCO3 18
Answer: A
Conceptual Explanation: In partially compensated respiratory acidosis, the pH is still
acidic (<7.35), the PaCO2 is high (primary cause), and the HCO3 is high (kidneys
attempting to compensate).
4. During the inflammatory process, what is the primary role of leukotrienes compared to
histamine?
A. Leukotrienes act faster than histamine to cause vasodilation
, B. Leukotrienes sustain the inflammatory response and are more potent in inducing
bronchoconstriction
C. Leukotrienes are responsible for the immediate redness seen in injury
D. Leukotrienes inhibit the production of prostaglandins
Answer: B
Conceptual Explanation: Leukotrienes are ‘late-phase’ mediators compared to histamine;
they are synthesized after mast cell activation and are significantly more potent in
mediating inflammation and airway constriction.
5. A patient with Grave’s disease exhibits hyperthyroidism due to which hypersensitivity
mechanism?
A. Type II: Antibody-mediated stimulation of cell receptors
B. Type I: IgE-mediated mast cell degranulation
C. Type III: Immune complex deposition in the thyroid
D. Type IV: T-cell mediated destruction of follicles
Answer: A
Conceptual Explanation: Grave’s disease is a Type II hypersensitivity where
autoantibodies (TSI) bind to and stimulate the TSH receptor, leading to excessive thyroid
hormone production.
COMPREHENSIVE EXAM REVIEW
QUESTIONS AND ANSWERS. JUST
RELEASED
1. Which cellular adaptation is most likely to occur in the esophageal lining of a patient with
chronic gastroesophageal reflux disease (GERD)?
A. Hypertrophy of squamous cells
B. Hyperplasia of the smooth muscle
C. Atrophy of the mucosal lining
D. Metaplasia of squamous cells to columnar cells
Answer: D
Conceptual Explanation: Metaplasia is a reversible change in which one adult cell type is
replaced by another to better withstand chronic irritation, such as gastric acid in Barrett’s
esophagus.
2. A patient presents with a serum sodium level of 160 mEq/L. Which pathophysiological
mechanism is the primary concern for the central nervous system?
A. Intracellular swelling of neurons
B. Neuronal shrinkage due to water shifting out of cells
,C. Increased intracranial pressure due to vasodilation
D. Decreased excitability of the sodium-potassium pump
Answer: B
Conceptual Explanation: Hypernatremia creates a hypertonic extracellular environment,
causing water to move out of the cells via osmosis, leading to cellular dehydration and
brain cell shrinkage.
3. Which arterial blood gas (ABG) result is most indicative of partially compensated
respiratory acidosis?
A. pH 7.32, PaCO2 50, HCO3 28
B. pH 7.45, PaCO2 30, HCO3 20
C. pH 7.35, PaCO2 48, HCO3 26
D. pH 7.28, PaCO2 35, HCO3 18
Answer: A
Conceptual Explanation: In partially compensated respiratory acidosis, the pH is still
acidic (<7.35), the PaCO2 is high (primary cause), and the HCO3 is high (kidneys
attempting to compensate).
4. During the inflammatory process, what is the primary role of leukotrienes compared to
histamine?
A. Leukotrienes act faster than histamine to cause vasodilation
, B. Leukotrienes sustain the inflammatory response and are more potent in inducing
bronchoconstriction
C. Leukotrienes are responsible for the immediate redness seen in injury
D. Leukotrienes inhibit the production of prostaglandins
Answer: B
Conceptual Explanation: Leukotrienes are ‘late-phase’ mediators compared to histamine;
they are synthesized after mast cell activation and are significantly more potent in
mediating inflammation and airway constriction.
5. A patient with Grave’s disease exhibits hyperthyroidism due to which hypersensitivity
mechanism?
A. Type II: Antibody-mediated stimulation of cell receptors
B. Type I: IgE-mediated mast cell degranulation
C. Type III: Immune complex deposition in the thyroid
D. Type IV: T-cell mediated destruction of follicles
Answer: A
Conceptual Explanation: Grave’s disease is a Type II hypersensitivity where
autoantibodies (TSI) bind to and stimulate the TSH receptor, leading to excessive thyroid
hormone production.
