NURS 6202 FINAL EXAM / APPROVED NURS 6202 ACTUAL FINAL EXAM
2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE COMPLETE
ACCURATE EXAM
1. A 68-year-old patient with a long history of poorly controlled hypertension
presents with progressive exertional dyspnea, orthopnea, and bilateral
lower-extremity edema. Echocardiography demonstrates a reduced left
ventricular ejection fraction. Which pathophysiologic mechanism best
explains the development of pulmonary congestion in this patient?
A. Increased pulmonary vascular resistance caused by systemic
vasoconstriction
B. Decreased plasma oncotic pressure caused by hepatic dysfunction
C. Increased left ventricular filling pressure transmitted backward into the
pulmonary circulation
D. Increased lymphatic drainage caused by chronic ventricular remodeling
Answer: C
2. A patient with severe chronic obstructive pulmonary disease develops
worsening dyspnea and fatigue. Arterial blood gas analysis shows pH 7.31,
PaCO₂ 58 mmHg, and HCO₃⁻ 28 mEq/L. Which interpretation best describes
these findings?
A. Partially compensated respiratory acidosis
B. Uncompensated metabolic acidosis
C. Fully compensated respiratory alkalosis
D. Metabolic alkalosis with respiratory compensation
Answer: A
3. A 59-year-old patient with type 2 diabetes has persistent hyperglycemia
despite insulin therapy. The patient develops polyuria, polydipsia, and
increasing serum osmolality. Which mechanism most directly contributes to
these manifestations?
A. Increased glucose uptake by skeletal muscle
B. Glucose-induced osmotic diuresis in the renal tubules
C. Increased aldosterone secretion caused by hyperglycemia
pg. 1
, D. Reduced hepatic glycogenolysis
Answer: B
4. A patient with chronic kidney disease develops fatigue, pallor, and reduced
exercise tolerance. Laboratory testing demonstrates a normocytic,
normochromic anemia. Which mechanism most directly accounts for this
finding?
A. Increased erythrocyte destruction in the spleen
B. Excessive gastrointestinal blood loss
C. Reduced intestinal absorption of folate
D. Decreased renal production of erythropoietin
Answer: D
5. A patient develops septic shock following a severe bacterial infection.
Despite adequate fluid administration, the patient remains hypotensive
with warm extremities and tachycardia. Which mechanism is primarily
responsible for the early distributive hemodynamic pattern?
A. Widespread inflammatory vasodilation with reduced systemic vascular
resistance
B. Increased myocardial contractility caused by catecholamine release
C. Increased circulating blood volume caused by sodium retention
D. Severe left ventricular outflow obstruction
Answer: A
6. A patient with cirrhosis develops increasing abdominal girth and shifting
dullness. Which combination of mechanisms most directly contributes to
ascites formation?
A. Increased plasma oncotic pressure and reduced portal pressure
B. Reduced hepatic lymph production and increased renal sodium excretion
C. Portal hypertension, sodium and water retention, and reduced plasma
oncotic pressure
D. Increased albumin synthesis and decreased splanchnic blood flow
Answer: C
pg. 2
, 7. A patient with nephrotic syndrome has generalized edema and significant
proteinuria. Which alteration is primarily responsible for the movement of
fluid from the intravascular compartment into the interstitial space?
A. Increased hydrostatic pressure caused by pulmonary hypertension
B. Decreased plasma oncotic pressure caused by urinary albumin loss
C. Increased intracellular oncotic pressure caused by hypernatremia
D. Decreased capillary permeability caused by inflammation
Answer: B
8. A patient presents with crushing substernal chest pain and an elevated
cardiac troponin level. Which cellular event most directly explains the
release of cardiac troponin into the circulation?
A. Increased myocardial glycogen storage
B. Enhanced coronary vasodilation
C. Increased mitochondrial ATP production
D. Disruption of myocardial cell membranes following ischemic injury
Answer: D
9. A patient with an acute myocardial infarction develops ventricular
remodeling several weeks later. Which process contributes most directly to
the structural changes associated with chronic remodeling?
A. Myocardial necrosis followed by inflammatory activation, fibrosis, and
ventricular dilation
B. Complete regeneration of necrotic cardiomyocytes
C. Permanent reduction in ventricular wall stress through cardiomyocyte
loss
D. Increased coronary arterial diameter caused by scar formation
Answer: A
10. A patient with hyperthyroidism reports heat intolerance, weight loss
despite increased appetite, tremulousness, and tachycardia. Which
physiologic process best explains the increased metabolic manifestations?
A. Reduced mitochondrial activity
B. Increased tissue sensitivity to catecholamines and increased metabolic
pg. 3
, activity
C. Reduced oxygen consumption by skeletal muscle
D. Suppression of cellular protein turnover
Answer: B
11. A patient with primary hypothyroidism has fatigue, cold intolerance,
constipation, and weight gain. Which laboratory pattern would most
strongly support the diagnosis?
A. Increased TSH and decreased free T4
B. Decreased TSH and increased free T4
C. Decreased TSH and decreased free T4
D. Increased TSH and increased free T4
Answer: A
12. A patient with primary adrenal insufficiency presents with weakness, weight
loss, hypotension, hyponatremia, and hyperkalemia. Which endocrine
abnormality best explains the electrolyte findings?
A. Excess cortisol and aldosterone secretion
B. Excess antidiuretic hormone suppression
C. Increased thyroid hormone secretion
D. Deficient aldosterone production with impaired sodium retention and
potassium excretion
Answer: D
13. A patient with syndrome of inappropriate antidiuretic hormone secretion
develops confusion and headache. Laboratory results reveal low serum
sodium and inappropriately concentrated urine. Which mechanism best
explains the hyponatremia?
A. Excessive renal sodium loss caused by aldosterone excess
B. Increased free-water retention caused by inappropriate ADH activity
C. Increased gastrointestinal sodium loss
D. Decreased glomerular filtration caused by dehydration
Answer: B
pg. 4
2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE COMPLETE
ACCURATE EXAM
1. A 68-year-old patient with a long history of poorly controlled hypertension
presents with progressive exertional dyspnea, orthopnea, and bilateral
lower-extremity edema. Echocardiography demonstrates a reduced left
ventricular ejection fraction. Which pathophysiologic mechanism best
explains the development of pulmonary congestion in this patient?
A. Increased pulmonary vascular resistance caused by systemic
vasoconstriction
B. Decreased plasma oncotic pressure caused by hepatic dysfunction
C. Increased left ventricular filling pressure transmitted backward into the
pulmonary circulation
D. Increased lymphatic drainage caused by chronic ventricular remodeling
Answer: C
2. A patient with severe chronic obstructive pulmonary disease develops
worsening dyspnea and fatigue. Arterial blood gas analysis shows pH 7.31,
PaCO₂ 58 mmHg, and HCO₃⁻ 28 mEq/L. Which interpretation best describes
these findings?
A. Partially compensated respiratory acidosis
B. Uncompensated metabolic acidosis
C. Fully compensated respiratory alkalosis
D. Metabolic alkalosis with respiratory compensation
Answer: A
3. A 59-year-old patient with type 2 diabetes has persistent hyperglycemia
despite insulin therapy. The patient develops polyuria, polydipsia, and
increasing serum osmolality. Which mechanism most directly contributes to
these manifestations?
A. Increased glucose uptake by skeletal muscle
B. Glucose-induced osmotic diuresis in the renal tubules
C. Increased aldosterone secretion caused by hyperglycemia
pg. 1
, D. Reduced hepatic glycogenolysis
Answer: B
4. A patient with chronic kidney disease develops fatigue, pallor, and reduced
exercise tolerance. Laboratory testing demonstrates a normocytic,
normochromic anemia. Which mechanism most directly accounts for this
finding?
A. Increased erythrocyte destruction in the spleen
B. Excessive gastrointestinal blood loss
C. Reduced intestinal absorption of folate
D. Decreased renal production of erythropoietin
Answer: D
5. A patient develops septic shock following a severe bacterial infection.
Despite adequate fluid administration, the patient remains hypotensive
with warm extremities and tachycardia. Which mechanism is primarily
responsible for the early distributive hemodynamic pattern?
A. Widespread inflammatory vasodilation with reduced systemic vascular
resistance
B. Increased myocardial contractility caused by catecholamine release
C. Increased circulating blood volume caused by sodium retention
D. Severe left ventricular outflow obstruction
Answer: A
6. A patient with cirrhosis develops increasing abdominal girth and shifting
dullness. Which combination of mechanisms most directly contributes to
ascites formation?
A. Increased plasma oncotic pressure and reduced portal pressure
B. Reduced hepatic lymph production and increased renal sodium excretion
C. Portal hypertension, sodium and water retention, and reduced plasma
oncotic pressure
D. Increased albumin synthesis and decreased splanchnic blood flow
Answer: C
pg. 2
, 7. A patient with nephrotic syndrome has generalized edema and significant
proteinuria. Which alteration is primarily responsible for the movement of
fluid from the intravascular compartment into the interstitial space?
A. Increased hydrostatic pressure caused by pulmonary hypertension
B. Decreased plasma oncotic pressure caused by urinary albumin loss
C. Increased intracellular oncotic pressure caused by hypernatremia
D. Decreased capillary permeability caused by inflammation
Answer: B
8. A patient presents with crushing substernal chest pain and an elevated
cardiac troponin level. Which cellular event most directly explains the
release of cardiac troponin into the circulation?
A. Increased myocardial glycogen storage
B. Enhanced coronary vasodilation
C. Increased mitochondrial ATP production
D. Disruption of myocardial cell membranes following ischemic injury
Answer: D
9. A patient with an acute myocardial infarction develops ventricular
remodeling several weeks later. Which process contributes most directly to
the structural changes associated with chronic remodeling?
A. Myocardial necrosis followed by inflammatory activation, fibrosis, and
ventricular dilation
B. Complete regeneration of necrotic cardiomyocytes
C. Permanent reduction in ventricular wall stress through cardiomyocyte
loss
D. Increased coronary arterial diameter caused by scar formation
Answer: A
10. A patient with hyperthyroidism reports heat intolerance, weight loss
despite increased appetite, tremulousness, and tachycardia. Which
physiologic process best explains the increased metabolic manifestations?
A. Reduced mitochondrial activity
B. Increased tissue sensitivity to catecholamines and increased metabolic
pg. 3
, activity
C. Reduced oxygen consumption by skeletal muscle
D. Suppression of cellular protein turnover
Answer: B
11. A patient with primary hypothyroidism has fatigue, cold intolerance,
constipation, and weight gain. Which laboratory pattern would most
strongly support the diagnosis?
A. Increased TSH and decreased free T4
B. Decreased TSH and increased free T4
C. Decreased TSH and decreased free T4
D. Increased TSH and increased free T4
Answer: A
12. A patient with primary adrenal insufficiency presents with weakness, weight
loss, hypotension, hyponatremia, and hyperkalemia. Which endocrine
abnormality best explains the electrolyte findings?
A. Excess cortisol and aldosterone secretion
B. Excess antidiuretic hormone suppression
C. Increased thyroid hormone secretion
D. Deficient aldosterone production with impaired sodium retention and
potassium excretion
Answer: D
13. A patient with syndrome of inappropriate antidiuretic hormone secretion
develops confusion and headache. Laboratory results reveal low serum
sodium and inappropriately concentrated urine. Which mechanism best
explains the hyponatremia?
A. Excessive renal sodium loss caused by aldosterone excess
B. Increased free-water retention caused by inappropriate ADH activity
C. Increased gastrointestinal sodium loss
D. Decreased glomerular filtration caused by dehydration
Answer: B
pg. 4
