1
NSG 3850 Exam 1 Patho 2 Exam Questions and
Answers Practice Questions with Solutions
Newest | Already Graded A+
Section 3: Full-Length NSG 3850 Practice Exam
This section contains a complete practice exam with questions and rationales to test your knowledge.
Section 3.1: Fluid & Electrolytes
1. A patient is admitted with confusion, muscle weakness, and a serum sodium level of 125 mEq/L.
The nurse recognizes these symptoms are most likely due to which imbalance?
A. Hypernatremia
B. Hyponatremia
C. Hyperkalemia
D. Hypocalcemia
Answer: B. Hyponatremia
*Rationale: The normal range for serum sodium is 135-145 mEq/L. A level of 125 mEq/L is diagnostic
of hyponatremia. The neurologic symptoms (confusion, lethargy, seizures) are the hallmark due to
cellular swelling and cerebral edema as water shifts into brain cells.*
2. Which of the following is the most sensitive indicator of a gain or loss of body fluid?
A. Intake and output records
B. Daily weight measurements
C. Skin turgor assessment
D. Blood pressure monitoring
Answer: B. Daily weight measurements
Rationale: Daily weight measurement is the most reliable indicator of fluid status. A change of 1
kilogram (2.2 lbs) is equivalent to 1 liter of fluid gained or lost. Intake and output records are helpful
but can be inaccurate.
3. A patient with a prolonged history of vomiting develops metabolic alkalosis. Which electrolyte
imbalance is most likely to accompany this condition?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypercalcemia
Answer: B. Hypokalemia
Rationale: Loss of gastric acid (HCl) leads to metabolic alkalosis. To compensate, the kidneys excrete
,2
potassium to conserve hydrogen ions, leading to hypokalemia. Vomiting also causes volume
depletion, stimulating aldosterone, which further increases potassium excretion.
4. What is likely to lead to hyponatremia?
A. insufficient ADH secretion
B. excess aldosterone secretion
C. administration of IV normal saline
D. frequent NG tube irrigation with water
Answer: D. frequent NG tube irrigation with water
Rationale: Frequent NG tube irrigation with plain water can lead to a loss of sodium-rich
gastrointestinal fluids, while replacing it only with water, causing dilutional hyponatremia. Options A
and B would lead to hypernatremia. IV normal saline is isotonic and would not cause hyponatremia.
5. Decreased neuromuscular excitability is often the result of:
A. hypercalcemia and hypermagnesemia
B. hypomagnesemia and hyperkalemia
C. hypocalcemia and hypokalemia
D. hypernatremia and hypomagnesemia
Answer: A. hypercalcemia and hypermagnesemia
Rationale: Both hypercalcemia and hypermagnesemia block sodium channels and decrease the
excitability of nerve and muscle cell membranes. In contrast, hypocalcemia and hypomagnesemia
increase neuromuscular excitability.
6. The electrolyte that has a higher concentration in the extracellular fluid than in the intracellular
fluid is _____ ions.
A. sodium
B. phosphate
C. magnesium
D. potassium
Answer: A. sodium
*Rationale: Sodium is the primary cation in the extracellular fluid (ECF), with a concentration of about
135-145 mEq/L, compared to only 10-14 mEq/L inside the cell. Potassium, magnesium, and phosphate
are the primary intracellular ions.*
7. Which electrolyte imbalance causes increase neuromuscular excitability?
A. hypokalemia and hyperphosphatemia
B. hyperkalemia and hypophosphatemia
C. hypocalcemia and hypomagnesemia
D. hypercalcemia and hypermagnesemia
Answer: C. hypocalcemia and hypomagnesemia
Rationale: Hypocalcemia and hypomagnesemia both increase the permeability of neuronal
membranes to sodium, causing them to fire more easily. This results in increased neuromuscular
excitability, which can manifest as muscle cramps, tetany, hyperreflexia, and even seizures.
,3
8. Abnormalities in intracellular regulation of enzyme activity and cellular production of ATP are
associated with:
A. hyponatremia
B. hypocalcemia
C. hypophosphatemia
D. hypokalemia
Answer: C. hypophosphatemia
Rationale: Phosphorus is a critical component of adenosine triphosphate (ATP), the body's primary
energy currency. Severe hypophosphatemia leads to ATP depletion, which impairs cellular energy
metabolism and enzyme function, causing muscle weakness, respiratory failure, and other systemic
effects.
9. The fraction of total body water (TBW) volume contained in the intracellular space in adults is:
A. three fourths
B. two thirds
C. one half
D. one third
Answer: B. two thirds
*Rationale: In adults, approximately two-thirds (about 40% of total body weight) of the total body
water is located within the cells (intracellular fluid). The remaining one-third (about 20% of total body
weight) is extracellular fluid.*
10. Clinical manifestations of severe symptomatic hypophosphatemia are caused by:
A. excess proteins
B. renal damage
C. deficiency of ATP
D. hypocalcemia
Answer: C. deficiency of ATP
Rationale: As described earlier, phosphorus is essential for ATP synthesis. A deficiency in phosphorus
directly leads to decreased ATP production, causing widespread cellular dysfunction, especially in
tissues with high energy demands like muscles and nerves.
Section 3.2: Acid-Base Balance
11. The nurse notes that a patient's arterial blood gas (ABG) results show: pH 7.32, PaCO2 50 mm Hg,
and HCO3- 26 mEq/L. These findings are consistent with:
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: C. Respiratory acidosis
*Rationale: The pH is low (acidosis). The PaCO2 is high (normal 35-45 mmHg), and the HCO3- is normal
(22-26 mEq/L). Using the ROME mnemonic (Respiratory Opposite), a low pH and high PaCO2 indicate
an uncompensated respiratory acidosis, likely from hypoventilation.*
, 4
12. The body compensates for metabolic alkalosis by:
A. hypoventilation
B. decreasing arterial carbon dioxide
C. increasing bicarbonate ion excretion
D. hyperventilation
Answer: A. hypoventilation
*Rationale: Metabolic alkalosis means there's too much base (high HCO3-). The lungs compensate by
trying to retain CO2 (an acid) to bring the pH back down. This is achieved through hypoventilation
(slower, shallower breathing).*
13. The ABG pH = 7.52, PaCO2 = 30mmHg, HCO3- = 24mmHg demonstrates:
A. metabolic acidosis
B. respiratory acidosis
C. respiratory alkalosis
D. carbonic acid excess
Answer: C. respiratory alkalosis
*Rationale: The pH is high (alkalosis). The PaCO2 is low, and the HCO3- is normal. Using ROME
(Respiratory Opposite), a high pH and low PaCO2 indicate an uncompensated respiratory alkalosis,
likely from hyperventilation.*
14. Which acid are the kidneys unable to excrete?
A. metabolic
B. carbonic
C. bicarbonate
D. ammonia
Answer: B. carbonic
Rationale: The kidneys can excrete metabolic acids (like lactic acid) and ammonia, and they can
regulate bicarbonate. However, carbonic acid (H2CO3) is volatile and must be converted to CO2 and
water to be excreted by the lungs.
Section 3.3: Cellular Injury, Inflammation, and Genetics
15. The process responsible for distribution of fluid between the interstitial and intracellular
compartments is:
A. filtration
B. osmosis
C. active transport
D. diffusion
Answer: B. osmosis
Rationale: Water moves between the interstitial and intracellular compartments across cell
membranes based on the concentration of solutes (mainly sodium and potassium). This passive
movement of water from an area of low solute concentration to an area of high solute concentration
is called osmosis.
NSG 3850 Exam 1 Patho 2 Exam Questions and
Answers Practice Questions with Solutions
Newest | Already Graded A+
Section 3: Full-Length NSG 3850 Practice Exam
This section contains a complete practice exam with questions and rationales to test your knowledge.
Section 3.1: Fluid & Electrolytes
1. A patient is admitted with confusion, muscle weakness, and a serum sodium level of 125 mEq/L.
The nurse recognizes these symptoms are most likely due to which imbalance?
A. Hypernatremia
B. Hyponatremia
C. Hyperkalemia
D. Hypocalcemia
Answer: B. Hyponatremia
*Rationale: The normal range for serum sodium is 135-145 mEq/L. A level of 125 mEq/L is diagnostic
of hyponatremia. The neurologic symptoms (confusion, lethargy, seizures) are the hallmark due to
cellular swelling and cerebral edema as water shifts into brain cells.*
2. Which of the following is the most sensitive indicator of a gain or loss of body fluid?
A. Intake and output records
B. Daily weight measurements
C. Skin turgor assessment
D. Blood pressure monitoring
Answer: B. Daily weight measurements
Rationale: Daily weight measurement is the most reliable indicator of fluid status. A change of 1
kilogram (2.2 lbs) is equivalent to 1 liter of fluid gained or lost. Intake and output records are helpful
but can be inaccurate.
3. A patient with a prolonged history of vomiting develops metabolic alkalosis. Which electrolyte
imbalance is most likely to accompany this condition?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypercalcemia
Answer: B. Hypokalemia
Rationale: Loss of gastric acid (HCl) leads to metabolic alkalosis. To compensate, the kidneys excrete
,2
potassium to conserve hydrogen ions, leading to hypokalemia. Vomiting also causes volume
depletion, stimulating aldosterone, which further increases potassium excretion.
4. What is likely to lead to hyponatremia?
A. insufficient ADH secretion
B. excess aldosterone secretion
C. administration of IV normal saline
D. frequent NG tube irrigation with water
Answer: D. frequent NG tube irrigation with water
Rationale: Frequent NG tube irrigation with plain water can lead to a loss of sodium-rich
gastrointestinal fluids, while replacing it only with water, causing dilutional hyponatremia. Options A
and B would lead to hypernatremia. IV normal saline is isotonic and would not cause hyponatremia.
5. Decreased neuromuscular excitability is often the result of:
A. hypercalcemia and hypermagnesemia
B. hypomagnesemia and hyperkalemia
C. hypocalcemia and hypokalemia
D. hypernatremia and hypomagnesemia
Answer: A. hypercalcemia and hypermagnesemia
Rationale: Both hypercalcemia and hypermagnesemia block sodium channels and decrease the
excitability of nerve and muscle cell membranes. In contrast, hypocalcemia and hypomagnesemia
increase neuromuscular excitability.
6. The electrolyte that has a higher concentration in the extracellular fluid than in the intracellular
fluid is _____ ions.
A. sodium
B. phosphate
C. magnesium
D. potassium
Answer: A. sodium
*Rationale: Sodium is the primary cation in the extracellular fluid (ECF), with a concentration of about
135-145 mEq/L, compared to only 10-14 mEq/L inside the cell. Potassium, magnesium, and phosphate
are the primary intracellular ions.*
7. Which electrolyte imbalance causes increase neuromuscular excitability?
A. hypokalemia and hyperphosphatemia
B. hyperkalemia and hypophosphatemia
C. hypocalcemia and hypomagnesemia
D. hypercalcemia and hypermagnesemia
Answer: C. hypocalcemia and hypomagnesemia
Rationale: Hypocalcemia and hypomagnesemia both increase the permeability of neuronal
membranes to sodium, causing them to fire more easily. This results in increased neuromuscular
excitability, which can manifest as muscle cramps, tetany, hyperreflexia, and even seizures.
,3
8. Abnormalities in intracellular regulation of enzyme activity and cellular production of ATP are
associated with:
A. hyponatremia
B. hypocalcemia
C. hypophosphatemia
D. hypokalemia
Answer: C. hypophosphatemia
Rationale: Phosphorus is a critical component of adenosine triphosphate (ATP), the body's primary
energy currency. Severe hypophosphatemia leads to ATP depletion, which impairs cellular energy
metabolism and enzyme function, causing muscle weakness, respiratory failure, and other systemic
effects.
9. The fraction of total body water (TBW) volume contained in the intracellular space in adults is:
A. three fourths
B. two thirds
C. one half
D. one third
Answer: B. two thirds
*Rationale: In adults, approximately two-thirds (about 40% of total body weight) of the total body
water is located within the cells (intracellular fluid). The remaining one-third (about 20% of total body
weight) is extracellular fluid.*
10. Clinical manifestations of severe symptomatic hypophosphatemia are caused by:
A. excess proteins
B. renal damage
C. deficiency of ATP
D. hypocalcemia
Answer: C. deficiency of ATP
Rationale: As described earlier, phosphorus is essential for ATP synthesis. A deficiency in phosphorus
directly leads to decreased ATP production, causing widespread cellular dysfunction, especially in
tissues with high energy demands like muscles and nerves.
Section 3.2: Acid-Base Balance
11. The nurse notes that a patient's arterial blood gas (ABG) results show: pH 7.32, PaCO2 50 mm Hg,
and HCO3- 26 mEq/L. These findings are consistent with:
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: C. Respiratory acidosis
*Rationale: The pH is low (acidosis). The PaCO2 is high (normal 35-45 mmHg), and the HCO3- is normal
(22-26 mEq/L). Using the ROME mnemonic (Respiratory Opposite), a low pH and high PaCO2 indicate
an uncompensated respiratory acidosis, likely from hypoventilation.*
, 4
12. The body compensates for metabolic alkalosis by:
A. hypoventilation
B. decreasing arterial carbon dioxide
C. increasing bicarbonate ion excretion
D. hyperventilation
Answer: A. hypoventilation
*Rationale: Metabolic alkalosis means there's too much base (high HCO3-). The lungs compensate by
trying to retain CO2 (an acid) to bring the pH back down. This is achieved through hypoventilation
(slower, shallower breathing).*
13. The ABG pH = 7.52, PaCO2 = 30mmHg, HCO3- = 24mmHg demonstrates:
A. metabolic acidosis
B. respiratory acidosis
C. respiratory alkalosis
D. carbonic acid excess
Answer: C. respiratory alkalosis
*Rationale: The pH is high (alkalosis). The PaCO2 is low, and the HCO3- is normal. Using ROME
(Respiratory Opposite), a high pH and low PaCO2 indicate an uncompensated respiratory alkalosis,
likely from hyperventilation.*
14. Which acid are the kidneys unable to excrete?
A. metabolic
B. carbonic
C. bicarbonate
D. ammonia
Answer: B. carbonic
Rationale: The kidneys can excrete metabolic acids (like lactic acid) and ammonia, and they can
regulate bicarbonate. However, carbonic acid (H2CO3) is volatile and must be converted to CO2 and
water to be excreted by the lungs.
Section 3.3: Cellular Injury, Inflammation, and Genetics
15. The process responsible for distribution of fluid between the interstitial and intracellular
compartments is:
A. filtration
B. osmosis
C. active transport
D. diffusion
Answer: B. osmosis
Rationale: Water moves between the interstitial and intracellular compartments across cell
membranes based on the concentration of solutes (mainly sodium and potassium). This passive
movement of water from an area of low solute concentration to an area of high solute concentration
is called osmosis.
