NSG 5140 Advanced Pathophysiology Final
Exam 2026/2027 – 150 Questions with Verified
Answers & Detailed Rationales | PDF Study
Guide
Q1: A patient presents with hyperkalemia. Which of the following is the priority
intervention?
A: Administer IV calcium gluconate
Rationale: Hyperkalemia can cause life-threatening arrhythmias; calcium
gluconate stabilizes the myocardium while other treatments shift potassium
intracellularly.
Q2: Which cellular adaptation occurs in response to chronic hypoxia?
A: Hypertrophy
Rationale: Cells increase in size to maintain function under stress; atrophy
occurs with decreased workload or ischemia.
Q3: A patient with metabolic acidosis exhibits rapid, deep respirations. This is an
example of:
A: Compensatory respiratory alkalosis
Rationale: Kussmaul respirations help excrete CO₂ to raise pH and partially
compensate for metabolic acidosis.
Q4: Which electrolyte imbalance is most associated with tetany and muscle
spasms?
A: Hypocalcemia
Rationale: Low calcium increases neuromuscular excitability, causing tetany,
Chvostek, and Trousseau signs.
Q5: Which type of shock is caused by severe infection?
A: Septic shock
Rationale: Septic shock results from systemic infection causing vasodilation,
hypotension, and organ hypoperfusion.
,Q6: What is the primary pathophysiologic change in chronic obstructive
pulmonary disease (COPD)?
A: Airflow limitation due to airway inflammation and alveolar destruction
Rationale: Chronic inflammation causes airway narrowing and destruction of
alveolar walls, reducing gas exchange.
Q7: A patient’s arterial blood gas shows pH 7.50, PaCO₂ 30 mmHg. This
represents:
A: Respiratory alkalosis
Rationale: High pH with low CO₂ indicates a primary respiratory alkalosis,
usually due to hyperventilation.
Q8: Which hormone deficiency causes diabetes insipidus?
A: Antidiuretic hormone (ADH)
Rationale: Lack of ADH prevents water reabsorption in the kidneys, resulting in
polyuria and dehydration.
Q9: Which condition results from prolonged hypoxia at the cellular level?
A: Cellular necrosis
Rationale: Severe oxygen deprivation causes irreversible cell death, unlike
reversible injury which can recover.
Q10: Which type of fluid shift occurs when a patient develops severe burns?
A: Third-spacing
Rationale: Plasma leaks into interstitial tissues due to increased capillary
permeability, leading to edema and hypovolemia.
Q11: Which type of anemia is caused by vitamin B12 deficiency?
A: Megaloblastic anemia
Rationale: B12 deficiency leads to impaired DNA synthesis, causing large,
immature red blood cells.
Q12: A patient presents with edema, hypoalbuminemia, and ascites. The
primary pathophysiologic mechanism is:
A: Decreased plasma oncotic pressure
, Rationale: Low albumin reduces oncotic pressure, allowing fluid to shift into
interstitial spaces and body cavities.
Q13: What is the main pathophysiologic mechanism in Type 1 diabetes
mellitus?
A: Autoimmune destruction of pancreatic beta cells
Rationale: Loss of insulin production leads to hyperglycemia and ketoacidosis if
untreated.
Q14: Which electrolyte imbalance is commonly seen with chronic kidney
disease?
A: Hyperphosphatemia
Rationale: Impaired phosphate excretion by the kidneys increases serum
phosphate levels, often causing secondary hypocalcemia.
Q15: A patient with left-sided heart failure is likely to present with:
A: Pulmonary edema
Rationale: Left ventricular dysfunction causes blood backup into pulmonary
circulation, leading to fluid accumulation in the lungs.
Q16: The pathophysiology of emphysema primarily involves:
A: Destruction of alveolar walls and loss of elastic recoil
Rationale: This reduces gas exchange surface area and causes air trapping.
Q17: Which type of shock is characterized by widespread vasodilation and low
systemic vascular resistance?
A: Distributive shock
Rationale: Includes septic, neurogenic, and anaphylactic shock, all caused by
systemic vasodilation.
Q18: Which lab finding is indicative of diabetic ketoacidosis (DKA)?
A: Elevated serum ketones and metabolic acidosis
Rationale: Insulin deficiency leads to fat breakdown, producing ketones and
decreasing blood pH.
Exam 2026/2027 – 150 Questions with Verified
Answers & Detailed Rationales | PDF Study
Guide
Q1: A patient presents with hyperkalemia. Which of the following is the priority
intervention?
A: Administer IV calcium gluconate
Rationale: Hyperkalemia can cause life-threatening arrhythmias; calcium
gluconate stabilizes the myocardium while other treatments shift potassium
intracellularly.
Q2: Which cellular adaptation occurs in response to chronic hypoxia?
A: Hypertrophy
Rationale: Cells increase in size to maintain function under stress; atrophy
occurs with decreased workload or ischemia.
Q3: A patient with metabolic acidosis exhibits rapid, deep respirations. This is an
example of:
A: Compensatory respiratory alkalosis
Rationale: Kussmaul respirations help excrete CO₂ to raise pH and partially
compensate for metabolic acidosis.
Q4: Which electrolyte imbalance is most associated with tetany and muscle
spasms?
A: Hypocalcemia
Rationale: Low calcium increases neuromuscular excitability, causing tetany,
Chvostek, and Trousseau signs.
Q5: Which type of shock is caused by severe infection?
A: Septic shock
Rationale: Septic shock results from systemic infection causing vasodilation,
hypotension, and organ hypoperfusion.
,Q6: What is the primary pathophysiologic change in chronic obstructive
pulmonary disease (COPD)?
A: Airflow limitation due to airway inflammation and alveolar destruction
Rationale: Chronic inflammation causes airway narrowing and destruction of
alveolar walls, reducing gas exchange.
Q7: A patient’s arterial blood gas shows pH 7.50, PaCO₂ 30 mmHg. This
represents:
A: Respiratory alkalosis
Rationale: High pH with low CO₂ indicates a primary respiratory alkalosis,
usually due to hyperventilation.
Q8: Which hormone deficiency causes diabetes insipidus?
A: Antidiuretic hormone (ADH)
Rationale: Lack of ADH prevents water reabsorption in the kidneys, resulting in
polyuria and dehydration.
Q9: Which condition results from prolonged hypoxia at the cellular level?
A: Cellular necrosis
Rationale: Severe oxygen deprivation causes irreversible cell death, unlike
reversible injury which can recover.
Q10: Which type of fluid shift occurs when a patient develops severe burns?
A: Third-spacing
Rationale: Plasma leaks into interstitial tissues due to increased capillary
permeability, leading to edema and hypovolemia.
Q11: Which type of anemia is caused by vitamin B12 deficiency?
A: Megaloblastic anemia
Rationale: B12 deficiency leads to impaired DNA synthesis, causing large,
immature red blood cells.
Q12: A patient presents with edema, hypoalbuminemia, and ascites. The
primary pathophysiologic mechanism is:
A: Decreased plasma oncotic pressure
, Rationale: Low albumin reduces oncotic pressure, allowing fluid to shift into
interstitial spaces and body cavities.
Q13: What is the main pathophysiologic mechanism in Type 1 diabetes
mellitus?
A: Autoimmune destruction of pancreatic beta cells
Rationale: Loss of insulin production leads to hyperglycemia and ketoacidosis if
untreated.
Q14: Which electrolyte imbalance is commonly seen with chronic kidney
disease?
A: Hyperphosphatemia
Rationale: Impaired phosphate excretion by the kidneys increases serum
phosphate levels, often causing secondary hypocalcemia.
Q15: A patient with left-sided heart failure is likely to present with:
A: Pulmonary edema
Rationale: Left ventricular dysfunction causes blood backup into pulmonary
circulation, leading to fluid accumulation in the lungs.
Q16: The pathophysiology of emphysema primarily involves:
A: Destruction of alveolar walls and loss of elastic recoil
Rationale: This reduces gas exchange surface area and causes air trapping.
Q17: Which type of shock is characterized by widespread vasodilation and low
systemic vascular resistance?
A: Distributive shock
Rationale: Includes septic, neurogenic, and anaphylactic shock, all caused by
systemic vasodilation.
Q18: Which lab finding is indicative of diabetic ketoacidosis (DKA)?
A: Elevated serum ketones and metabolic acidosis
Rationale: Insulin deficiency leads to fat breakdown, producing ketones and
decreasing blood pH.
