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NSG 3280 Pathophysiology for Nurses Exam 1,2,3 |
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NSG 3280 Pathophysiology for Nurses Exam 1,2,3 FINAL
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questions, complete answers, and focused rationales for
INTRODUCTION
This document is an important and very helpful preparation
resource for NSG 3280 Pathophysiology for Nurses Exam 1,2,3
FINAL Exam. Every item uses a focused exam stem, four
response options, a keyed response, and a clear rationale,
making it easier to understand the subject, spot distractors, and
build real exam confidence.
Page 1
, Question 1
A cell exposed to a prolonged hypoxic insult switches from aerobic to
anaerobic metabolism. Which consequence most directly explains the shift
from reversible to irreversible injury?
A. Increased intracellular pH from lactate accumulation
B. Failure of the sodium-potassium ATPase pump with calcium influx
C. Activation of caspases via the extrinsic apoptotic pathway
D. Enhanced mitochondrial ATP production via oxidative
phosphorylation
Correct Answer: B - Failure of the sodium-potassium ATPase
pump with calcium influx
RATIONALE
Hypoxia depletes ATP, causing Na+/K+ ATPase failure, cell swelling,
and calcium influx that activates proteases and phospholipases,
leading to irreversible damage. Lactate lowers pH, not raises it.
Caspase activation is characteristic of apoptosis, not the primary
necrosis pathway in hypoxic injury. Oxidative phosphorylation is
impaired, not enhanced, in hypoxia.
Question 2
A patient with a known autosomal dominant disorder has a child with an
unaffected partner. Which statement about the risk of transmission is most
accurate?
A. All offspring will be carriers but unaffected
B. Each offspring has a 50% chance of inheriting the mutation
C. The disorder will skip a generation due to incomplete penetrance
D. Only male offspring can inherit the mutation
Correct Answer: B - Each offspring has a 50% chance of
inheriting the mutation
Page 2
, RATIONALE
In autosomal dominant inheritance, a heterozygous affected parent
transmits the mutant allele to 50% of offspring, regardless of sex.
Carriers are not a concept in dominant disorders; affected individuals
are heterozygous. Skipping generations is not typical unless de novo
mutation or reduced penetrance is specified. Sex-linked inheritance
does not apply here.
Question 3
Which laboratory pattern best distinguishes disseminated intravascular
coagulation (DIC) from immune thrombocytopenic purpura (ITP)?
A. Elevated D-dimer and prolonged PT/PTT in DIC
B. Isolated thrombocytopenia with normal coagulation studies in DIC
C. Increased fibrinogen and shortened bleeding time in DIC
D. Presence of antiplatelet antibodies in DIC
Correct Answer: A - Elevated D-dimer and prolonged PT/PTT in
DIC
RATIONALE
DIC is characterized by widespread activation of coagulation,
consumption of clotting factors, and fibrinolysis, leading to elevated
D-dimer and prolonged PT/PTT. ITP typically shows isolated
thrombocytopenia with normal coagulation studies and no D-dimer
elevation. Fibrinogen is usually decreased in DIC, not increased.
Antiplatelet antibodies are seen in ITP, not DIC.
Question 4
A patient with type 1 diabetes presents with Kussmaul respirations, fruity
breath, and a blood glucose of 480 mg/dL. Which pathophysiologic mechanism
best explains the respiratory pattern?
A. Primary respiratory alkalosis due to anxiety
B. Compensatory hyperventilation for metabolic acidosis from ketone
Page 3
, bodies
C. Direct stimulation of the medulla by hyperglycemia
D. Respiratory compensation for metabolic alkalosis
Correct Answer: B - Compensatory hyperventilation for
metabolic acidosis from ketone bodies
RATIONALE
Diabetic ketoacidosis produces metabolic acidosis from ketone bodies;
hyperventilation (Kussmaul) lowers PaCO2 to compensate. Anxiety
would cause a different pattern and is not the primary driver here.
Hyperglycemia does not directly stimulate the medulla. Metabolic
alkalosis would cause hypoventilation, not hyperventilation.
Question 5
Which statement best explains why a patient with chronic kidney disease
develops anemia?
A. Decreased erythropoietin production by damaged peritubular
interstitial cells
B. Increased destruction of red blood cells by the spleen
C. Iron overload from repeated transfusions
D. Vitamin B12 deficiency due to malabsorption
Correct Answer: A - Decreased erythropoietin production by
damaged peritubular interstitial cells
RATIONALE
The kidneys produce erythropoietin in response to hypoxia; damaged
kidneys fail to produce adequate erythropoietin, leading to normocytic
normochromic anemia. Splenic destruction is not the primary
mechanism in CKD. Iron overload can occur with transfusions but
does not cause anemia. B12 deficiency is not specific to CKD.
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