COMPREHENSIVE TEST BANK
LATEST EDITION
Multiple-Choice Questions with Correct Answers & Detailed Rationales
Based on Official Study Materials, Past Exams, and Quizzes
WGU D236
PATHOPHYSIOLOGY
Objective Assessment Practice Question Bank
Exam-Style Multiple Choice · Correct Answers · Rationales
TOPIC COVERAGE
Fluid & Electrolytes · Acid-Base Balance · RAAS
Respiratory Pathophysiology · Upper & Lower Tract
Cardiovascular · Hematology · Thrombosis
Musculoskeletal · Fractures · Osteoporosis & OA
Neurologic · ALS · Prenatal & Genetic Disorders
Immune & Infectious Disease · Skin Disorders
Endocrine & Metabolic · Homeostasis Disruptions
WESTERN GOVERNORS UNIVERSITY
Pathophysiology · Objective Assessment Preparation
HIGH-QUALITY · EXAM-FOCUSED · UNIQUE QUESTIONS
,WGU D236 Pathophysiology | Practice Bank Western Governors University
Section 1: Fluid, Electrolytes & Acid-Base Balance
1. A patient with severe COPD becomes somnolent. ABG: pH 7.29, PCO2 62. Which primary disorder is
present?
A. Metabolic alkalosis from diuretic use
B. Respiratory acidosis from CO2 retention
C. Respiratory alkalosis from hyperventilation
D. Normal status with lab error
Correct Answer: B
Rationale:
Elevated PCO2 with low pH defines respiratory acidosis from inadequate ventilation.
COPD is a classic substrate for CO2 retention.
2. After three days of vomiting, pH is 7.51 and bicarbonate is high. Which disorder fits?
A. High-gap metabolic acidosis
B. Metabolic alkalosis from gastric acid loss
C. Acute respiratory acidosis
D. Chronic respiratory alkalosis
Correct Answer: B
Rationale:
Loss of stomach acid raises pH and HCO3.
Volume contraction often accompanies prolonged vomiting.
3. DKA presents with ketones, high glucose, low HCO3, and a wide anion gap. Which acid-base diagnosis
is correct?
A. Normal-gap acidosis from diarrhea
B. High anion gap metabolic acidosis from ketoacids
C. Primary metabolic alkalosis
D. Mixed respiratory-metabolic alkalosis
Correct Answer: B
Rationale:
Ketone anions are unmeasured and widen the gap while consuming bicarbonate.
Insulin deficiency drives hepatic ketogenesis.
Page 2
,WGU D236 Pathophysiology | Practice Bank Western Governors University
4. How do the kidneys compensate for alkalosis. Which option is correct?
A. Excrete H+ and retain all HCO3
B. Retain H+ and excrete HCO3
C. Stop all distal ion transport
D. Convert all HCO3 to CO2 without excretion
Correct Answer: B
Rationale:
Retaining hydrogen and eliminating bicarbonate lowers pH toward normal.
Renal compensation is slower than respiratory change.
5. Untreated acidosis commonly elevates which serum electrolyte via transcellular shift. Which option is
correct?
A. Ionized calcium only falls
B. Potassium rises as H+ enters cells
C. Sodium doubles from osmotic shift alone
D. Chloride becomes unmeasurable
Correct Answer: B
Rationale:
Hydrogen entry into cells is balanced by potassium exit into serum.
Hyperkalemia can then disturb cardiac conduction.
6. A malnourished child has low albumin and edema. Which Starling change explains the edema?
A. Increased oncotic pressure pulls fluid inward
B. Reduced oncotic pressure lets fluid leave capillaries
C. Lymphatics generate higher pressure than arteries
D. Only heart-failure hydrostatic pressure causes pediatric edema
Correct Answer: B
Rationale:
Albumin is the main determinant of plasma oncotic pressure.
Low oncotic pressure increases net filtration into tissues.
7. RAAS is fully activated after a fall in renal perfusion. What is the net effect on volume and pressure?
A. Lower volume and lower pressure
Page 3
, WGU D236 Pathophysiology | Practice Bank Western Governors University
B. Higher volume and higher pressure
C. Higher volume with paradoxical hypotension
D. No change in either
Correct Answer: B
Rationale:
Angiotensin II constricts vessels; aldosterone retains sodium and water.
Urinary potassium excretion also increases.
8. What does the R.O.M.E. mnemonic summarize for ABG reading?
A. Renal output matches erythrocyte count
B. Respiratory: pH and PCO2 opposite; Metabolic: pH and HCO3 same direction
C. Random enzyme order determines pH
D. O2 metabolism always equals CO2 production
Correct Answer: B
Rationale:
Respiratory Opposite and Metabolic Equal speed classification of the primary process.
Full interpretation still requires clinical context.
9. Potassium is 6.5 mEq/L with peaked T waves. How can hyperkalemia cause arrest?
A. Only skeletal muscle is affected
B. Excess K+ disrupts myocardial membrane potential and triggers lethal arrhythmias
C. Contractility rises without electrical risk
D. All electrolytes fall uniformly with no cardiac risk
Correct Answer: B
Rationale:
Potassium sets resting membrane potential in cardiac myocytes.
Membrane stabilization and K+ reduction are urgent when ECG changes appear.
10. Cuff inflation produces carpal spasm. Which imbalance does Trousseau sign indicate?
A. Isolated hypernatremia
B. Hypocalcemia with neuromuscular irritability
C. Hypermagnesemia without calcium change
D. Mild hyperkalemia alone
Page 4
LATEST EDITION
Multiple-Choice Questions with Correct Answers & Detailed Rationales
Based on Official Study Materials, Past Exams, and Quizzes
WGU D236
PATHOPHYSIOLOGY
Objective Assessment Practice Question Bank
Exam-Style Multiple Choice · Correct Answers · Rationales
TOPIC COVERAGE
Fluid & Electrolytes · Acid-Base Balance · RAAS
Respiratory Pathophysiology · Upper & Lower Tract
Cardiovascular · Hematology · Thrombosis
Musculoskeletal · Fractures · Osteoporosis & OA
Neurologic · ALS · Prenatal & Genetic Disorders
Immune & Infectious Disease · Skin Disorders
Endocrine & Metabolic · Homeostasis Disruptions
WESTERN GOVERNORS UNIVERSITY
Pathophysiology · Objective Assessment Preparation
HIGH-QUALITY · EXAM-FOCUSED · UNIQUE QUESTIONS
,WGU D236 Pathophysiology | Practice Bank Western Governors University
Section 1: Fluid, Electrolytes & Acid-Base Balance
1. A patient with severe COPD becomes somnolent. ABG: pH 7.29, PCO2 62. Which primary disorder is
present?
A. Metabolic alkalosis from diuretic use
B. Respiratory acidosis from CO2 retention
C. Respiratory alkalosis from hyperventilation
D. Normal status with lab error
Correct Answer: B
Rationale:
Elevated PCO2 with low pH defines respiratory acidosis from inadequate ventilation.
COPD is a classic substrate for CO2 retention.
2. After three days of vomiting, pH is 7.51 and bicarbonate is high. Which disorder fits?
A. High-gap metabolic acidosis
B. Metabolic alkalosis from gastric acid loss
C. Acute respiratory acidosis
D. Chronic respiratory alkalosis
Correct Answer: B
Rationale:
Loss of stomach acid raises pH and HCO3.
Volume contraction often accompanies prolonged vomiting.
3. DKA presents with ketones, high glucose, low HCO3, and a wide anion gap. Which acid-base diagnosis
is correct?
A. Normal-gap acidosis from diarrhea
B. High anion gap metabolic acidosis from ketoacids
C. Primary metabolic alkalosis
D. Mixed respiratory-metabolic alkalosis
Correct Answer: B
Rationale:
Ketone anions are unmeasured and widen the gap while consuming bicarbonate.
Insulin deficiency drives hepatic ketogenesis.
Page 2
,WGU D236 Pathophysiology | Practice Bank Western Governors University
4. How do the kidneys compensate for alkalosis. Which option is correct?
A. Excrete H+ and retain all HCO3
B. Retain H+ and excrete HCO3
C. Stop all distal ion transport
D. Convert all HCO3 to CO2 without excretion
Correct Answer: B
Rationale:
Retaining hydrogen and eliminating bicarbonate lowers pH toward normal.
Renal compensation is slower than respiratory change.
5. Untreated acidosis commonly elevates which serum electrolyte via transcellular shift. Which option is
correct?
A. Ionized calcium only falls
B. Potassium rises as H+ enters cells
C. Sodium doubles from osmotic shift alone
D. Chloride becomes unmeasurable
Correct Answer: B
Rationale:
Hydrogen entry into cells is balanced by potassium exit into serum.
Hyperkalemia can then disturb cardiac conduction.
6. A malnourished child has low albumin and edema. Which Starling change explains the edema?
A. Increased oncotic pressure pulls fluid inward
B. Reduced oncotic pressure lets fluid leave capillaries
C. Lymphatics generate higher pressure than arteries
D. Only heart-failure hydrostatic pressure causes pediatric edema
Correct Answer: B
Rationale:
Albumin is the main determinant of plasma oncotic pressure.
Low oncotic pressure increases net filtration into tissues.
7. RAAS is fully activated after a fall in renal perfusion. What is the net effect on volume and pressure?
A. Lower volume and lower pressure
Page 3
, WGU D236 Pathophysiology | Practice Bank Western Governors University
B. Higher volume and higher pressure
C. Higher volume with paradoxical hypotension
D. No change in either
Correct Answer: B
Rationale:
Angiotensin II constricts vessels; aldosterone retains sodium and water.
Urinary potassium excretion also increases.
8. What does the R.O.M.E. mnemonic summarize for ABG reading?
A. Renal output matches erythrocyte count
B. Respiratory: pH and PCO2 opposite; Metabolic: pH and HCO3 same direction
C. Random enzyme order determines pH
D. O2 metabolism always equals CO2 production
Correct Answer: B
Rationale:
Respiratory Opposite and Metabolic Equal speed classification of the primary process.
Full interpretation still requires clinical context.
9. Potassium is 6.5 mEq/L with peaked T waves. How can hyperkalemia cause arrest?
A. Only skeletal muscle is affected
B. Excess K+ disrupts myocardial membrane potential and triggers lethal arrhythmias
C. Contractility rises without electrical risk
D. All electrolytes fall uniformly with no cardiac risk
Correct Answer: B
Rationale:
Potassium sets resting membrane potential in cardiac myocytes.
Membrane stabilization and K+ reduction are urgent when ECG changes appear.
10. Cuff inflation produces carpal spasm. Which imbalance does Trousseau sign indicate?
A. Isolated hypernatremia
B. Hypocalcemia with neuromuscular irritability
C. Hypermagnesemia without calcium change
D. Mild hyperkalemia alone
Page 4
