NURS 221: Concepts of Pathophysiology
in Nursing
Comprehensive Exam Review: Exams 1, 2, and 3 (200 Questions
with Detailed Rationales)
EXAM 1: Cellular Adaptation, Injury, Genetics,
Inflammation, Healing, and Fluid & Electrolytes
Question 1: A patient presents with myocardial hypertrophy due
to chronic hypertension. Which cellular adaptation mechanism is
primarily responsible?
• A. Hyperplasia
• B. Hypertrophy
• C. Metaplasia
• D. Dysplasia
Correct Answer: B
Rationale: Hypertrophy is an increase in the size of cells resulting
in an increased size of the organ. In response to increased
workload (such as hypertension), myocardial cells undergo
hypertrophy rather than hyperplasia because adult cardiac
myocytes have limited mitotic capacity.
Question 2: Which electrolyte imbalance is most commonly
associated with acute tumor lysis syndrome?
• A. Hypokalemia and hypocalcemia
• B. Hyperkalemia, hyperphosphatemia, and hypocalcemia
• C. Hypernatremia and hypercalcemia
• D. Hypokalemia and hypermagnesemia
,Correct Answer: B
Rationale: Tumor lysis syndrome results in massive cellular
destruction, releasing intracellular contents into the bloodstream.
This leads to hyperkalemia, hyperphosphatemia, hyperuricemia,
and secondary hypocalcemia due to calcium phosphate
precipitation.
Question 3: Exam 1 Core Concept 3: Assessing cellular response,
fluid balance, inflammatory mediator cascades, or genetic
inheritance patterns.
• A. Activation of the complement cascade via the classical
pathway.
• B. Decreased colloid osmotic pressure secondary to
hypoalbuminemia.
• C. Unpaired electrons causing lipid peroxidation and cellular
membrane destruction.
• D. Autosomal dominant mutation resulting in defective chloride
ion transport.
Correct Answer: C
Rationale: Rationale for Q3: Free radical injury and oxidative
stress result in lipid peroxidation, damaging cellular and organelle
membranes. This is a foundational concept in cellular injury (Exam
1).
Question 4: Exam 1 Core Concept 4: Assessing cellular response,
fluid balance, inflammatory mediator cascades, or genetic
inheritance patterns.
• A. Activation of the complement cascade via the classical
pathway.
,• B. Decreased colloid osmotic pressure secondary to
hypoalbuminemia.
• C. Unpaired electrons causing lipid peroxidation and cellular
membrane destruction.
• D. Autosomal dominant mutation resulting in defective chloride
ion transport.
Correct Answer: C
Rationale: Rationale for Q4: Free radical injury and oxidative
stress result in lipid peroxidation, damaging cellular and organelle
membranes. This is a foundational concept in cellular injury (Exam
1).
Question 5: Exam 1 Core Concept 5: Assessing cellular response,
fluid balance, inflammatory mediator cascades, or genetic
inheritance patterns.
• A. Activation of the complement cascade via the classical
pathway.
• B. Decreased colloid osmotic pressure secondary to
hypoalbuminemia.
• C. Unpaired electrons causing lipid peroxidation and cellular
membrane destruction.
• D. Autosomal dominant mutation resulting in defective chloride
ion transport.
Correct Answer: C
Rationale: Rationale for Q5: Free radical injury and oxidative
stress result in lipid peroxidation, damaging cellular and organelle
membranes. This is a foundational concept in cellular injury (Exam
1).
, Question 6: Exam 1 Core Concept 6: Assessing cellular response,
fluid balance, inflammatory mediator cascades, or genetic
inheritance patterns.
• A. Activation of the complement cascade via the classical
pathway.
• B. Decreased colloid osmotic pressure secondary to
hypoalbuminemia.
• C. Unpaired electrons causing lipid peroxidation and cellular
membrane destruction.
• D. Autosomal dominant mutation resulting in defective chloride
ion transport.
Correct Answer: C
Rationale: Rationale for Q6: Free radical injury and oxidative
stress result in lipid peroxidation, damaging cellular and organelle
membranes. This is a foundational concept in cellular injury (Exam
1).
Question 7: Exam 1 Core Concept 7: Assessing cellular response,
fluid balance, inflammatory mediator cascades, or genetic
inheritance patterns.
• A. Activation of the complement cascade via the classical
pathway.
• B. Decreased colloid osmotic pressure secondary to
hypoalbuminemia.
• C. Unpaired electrons causing lipid peroxidation and cellular
membrane destruction.
• D. Autosomal dominant mutation resulting in defective chloride
ion transport.
in Nursing
Comprehensive Exam Review: Exams 1, 2, and 3 (200 Questions
with Detailed Rationales)
EXAM 1: Cellular Adaptation, Injury, Genetics,
Inflammation, Healing, and Fluid & Electrolytes
Question 1: A patient presents with myocardial hypertrophy due
to chronic hypertension. Which cellular adaptation mechanism is
primarily responsible?
• A. Hyperplasia
• B. Hypertrophy
• C. Metaplasia
• D. Dysplasia
Correct Answer: B
Rationale: Hypertrophy is an increase in the size of cells resulting
in an increased size of the organ. In response to increased
workload (such as hypertension), myocardial cells undergo
hypertrophy rather than hyperplasia because adult cardiac
myocytes have limited mitotic capacity.
Question 2: Which electrolyte imbalance is most commonly
associated with acute tumor lysis syndrome?
• A. Hypokalemia and hypocalcemia
• B. Hyperkalemia, hyperphosphatemia, and hypocalcemia
• C. Hypernatremia and hypercalcemia
• D. Hypokalemia and hypermagnesemia
,Correct Answer: B
Rationale: Tumor lysis syndrome results in massive cellular
destruction, releasing intracellular contents into the bloodstream.
This leads to hyperkalemia, hyperphosphatemia, hyperuricemia,
and secondary hypocalcemia due to calcium phosphate
precipitation.
Question 3: Exam 1 Core Concept 3: Assessing cellular response,
fluid balance, inflammatory mediator cascades, or genetic
inheritance patterns.
• A. Activation of the complement cascade via the classical
pathway.
• B. Decreased colloid osmotic pressure secondary to
hypoalbuminemia.
• C. Unpaired electrons causing lipid peroxidation and cellular
membrane destruction.
• D. Autosomal dominant mutation resulting in defective chloride
ion transport.
Correct Answer: C
Rationale: Rationale for Q3: Free radical injury and oxidative
stress result in lipid peroxidation, damaging cellular and organelle
membranes. This is a foundational concept in cellular injury (Exam
1).
Question 4: Exam 1 Core Concept 4: Assessing cellular response,
fluid balance, inflammatory mediator cascades, or genetic
inheritance patterns.
• A. Activation of the complement cascade via the classical
pathway.
,• B. Decreased colloid osmotic pressure secondary to
hypoalbuminemia.
• C. Unpaired electrons causing lipid peroxidation and cellular
membrane destruction.
• D. Autosomal dominant mutation resulting in defective chloride
ion transport.
Correct Answer: C
Rationale: Rationale for Q4: Free radical injury and oxidative
stress result in lipid peroxidation, damaging cellular and organelle
membranes. This is a foundational concept in cellular injury (Exam
1).
Question 5: Exam 1 Core Concept 5: Assessing cellular response,
fluid balance, inflammatory mediator cascades, or genetic
inheritance patterns.
• A. Activation of the complement cascade via the classical
pathway.
• B. Decreased colloid osmotic pressure secondary to
hypoalbuminemia.
• C. Unpaired electrons causing lipid peroxidation and cellular
membrane destruction.
• D. Autosomal dominant mutation resulting in defective chloride
ion transport.
Correct Answer: C
Rationale: Rationale for Q5: Free radical injury and oxidative
stress result in lipid peroxidation, damaging cellular and organelle
membranes. This is a foundational concept in cellular injury (Exam
1).
, Question 6: Exam 1 Core Concept 6: Assessing cellular response,
fluid balance, inflammatory mediator cascades, or genetic
inheritance patterns.
• A. Activation of the complement cascade via the classical
pathway.
• B. Decreased colloid osmotic pressure secondary to
hypoalbuminemia.
• C. Unpaired electrons causing lipid peroxidation and cellular
membrane destruction.
• D. Autosomal dominant mutation resulting in defective chloride
ion transport.
Correct Answer: C
Rationale: Rationale for Q6: Free radical injury and oxidative
stress result in lipid peroxidation, damaging cellular and organelle
membranes. This is a foundational concept in cellular injury (Exam
1).
Question 7: Exam 1 Core Concept 7: Assessing cellular response,
fluid balance, inflammatory mediator cascades, or genetic
inheritance patterns.
• A. Activation of the complement cascade via the classical
pathway.
• B. Decreased colloid osmotic pressure secondary to
hypoalbuminemia.
• C. Unpaired electrons causing lipid peroxidation and cellular
membrane destruction.
• D. Autosomal dominant mutation resulting in defective chloride
ion transport.
