FINAL EXAM / NUR 2063 ESSENTIALS OF PATHOPHYSIOLOGY
ACTUAL FINAL EXAM 2026 /2027 APPROVED EXAM REAL
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (100% CORRECT VERIFIED SOLUTIONS) LATEST
UPDATED VERSION 2026 EDITION |GUARANTEED PASS A+ (BRAND
NEW!) FULL REVISED NUR 2063 FINAL
1. A patient has a serum pH of 7.32, PaCO2 of 48 mm Hg, and HCO3- of 24 mEq/L. This acid-base
disturbance is:
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
CORRECT ANSWER: C – Respiratory acidosis. Rationale: pH < 7.35, PaCO2 > 45 mm Hg, with normal
HCO3- indicates acute respiratory acidosis.
2. Which electrolyte imbalance is most likely to cause tetany and a positive Chvostek sign?
A. Hypocalcemia
B. Hypercalcemia
C. Hypokalemia
D. Hypernatremia
CORRECT ANSWER: A – Hypocalcemia. Rationale: Low calcium increases neuronal excitability, leading to
muscle spasms, tetany, Chvostek, and Trousseau signs.
3. A patient with a history of penicillin allergy develops hives, wheezing, and hypotension within minutes
of antibiotic administration. This is a:
A. Type II hypersensitivity
B. Type I hypersensitivity
C. Type III hypersensitivity
,D. Type IV hypersensitivity
CORRECT ANSWER: B – Type I hypersensitivity. Rationale: Immediate IgE-mediated reaction with mast
cell degranulation causes anaphylaxis.
4. In a patient with right-sided heart failure, which finding is expected?
A. Crackles in lung bases
B. Jugular venous distension
C. Paroxysmal nocturnal dyspnea
D. Pink frothy sputum
CORRECT ANSWER: B – Jugular venous distension. Rationale: Right-sided failure causes systemic venous
congestion (JVD, hepatomegaly, peripheral edema).
5. A patient has a serum sodium of 118 mEq/L and is confused. The nurse should anticipate:
A. Fluid restriction
B. Hypertonic saline
C. IV normal saline
D. Loop diuretics
CORRECT ANSWER: B – Hypertonic saline. Rationale: Severe symptomatic hyponatremia (<120 with CNS
symptoms) requires hypertonic saline (3% NaCl) cautiously.
6. A patient with chronic kidney disease has a hemoglobin of 7.8 g/dL. The most likely cause is:
A. Iron deficiency
B. Vitamin B12 deficiency
C. Erythropoietin deficiency
D. Hemolysis
,CORRECT ANSWER: C – Erythropoietin deficiency. Rationale: CKD reduces EPO production, causing
normocytic, normochromic anemia.
7. Which of the following is a characteristic of malignant tumors?
A. Well-defined capsule
B. Slow growth
C. Metastasis
D. Well-differentiated cells
CORRECT ANSWER: C – Metastasis. Rationale: Malignant tumors invade and spread to distant sites;
benign tumors are encapsulated and do not metastasize.
8. A patient with cirrhosis presents with asterixis, confusion, and elevated ammonia. This is consistent
with:
A. Hepatic encephalopathy
B. Hepatorenal syndrome
C. Spontaneous bacterial peritonitis
D. Variceal hemorrhage
CORRECT ANSWER: A – Hepatic encephalopathy. Rationale: Liver failure causes ammonia accumulation,
leading to neuropsychiatric symptoms and asterixis.
9. A patient develops diffuse ST-segment elevation on ECG, with chest pain improved by leaning
forward. This suggests:
A. Myocardial infarction
B. Acute pericarditis
C. Pulmonary embolism
D. Aortic dissection
CORRECT ANSWER: B – Acute pericarditis. Rationale: Pericarditis causes diffuse ST elevation, pain worse
supine and better leaning forward.
, 10. A patient has a deep vein thrombosis and sudden onset of dyspnea, tachycardia, and hypoxia. The
nurse suspects:
A. Pulmonary embolism
B. Pneumothorax
C. Myocardial infarction
D. Asthma attack
CORRECT ANSWER: A – Pulmonary embolism. Rationale: DVT can embolize to pulmonary arteries,
causing acute dyspnea, hypoxia, and right heart strain.
11. In diabetic ketoacidosis, which finding is expected on laboratory analysis?
A. High anion gap metabolic acidosis
B. Normal anion gap
C. Respiratory alkalosis
D. Metabolic alkalosis
CORRECT ANSWER: A – High anion gap metabolic acidosis. Rationale: Ketone bodies (acetoacetate, beta-
hydroxybutyrate) are unmeasured anions.
12. A patient with nephrotic syndrome has frothy urine, periorbital edema, and hypoalbuminemia. The
primary pathophysiology is:
A. Increased glomerular permeability to protein
B. Decreased GFR
C. Tubular necrosis
D. Urinary tract obstruction
CORRECT ANSWER: A – Increased glomerular permeability to protein. Rationale: Glomerular damage
causes massive proteinuria, hypoalbuminemia, and edema.
ACTUAL FINAL EXAM 2026 /2027 APPROVED EXAM REAL
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (100% CORRECT VERIFIED SOLUTIONS) LATEST
UPDATED VERSION 2026 EDITION |GUARANTEED PASS A+ (BRAND
NEW!) FULL REVISED NUR 2063 FINAL
1. A patient has a serum pH of 7.32, PaCO2 of 48 mm Hg, and HCO3- of 24 mEq/L. This acid-base
disturbance is:
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
CORRECT ANSWER: C – Respiratory acidosis. Rationale: pH < 7.35, PaCO2 > 45 mm Hg, with normal
HCO3- indicates acute respiratory acidosis.
2. Which electrolyte imbalance is most likely to cause tetany and a positive Chvostek sign?
A. Hypocalcemia
B. Hypercalcemia
C. Hypokalemia
D. Hypernatremia
CORRECT ANSWER: A – Hypocalcemia. Rationale: Low calcium increases neuronal excitability, leading to
muscle spasms, tetany, Chvostek, and Trousseau signs.
3. A patient with a history of penicillin allergy develops hives, wheezing, and hypotension within minutes
of antibiotic administration. This is a:
A. Type II hypersensitivity
B. Type I hypersensitivity
C. Type III hypersensitivity
,D. Type IV hypersensitivity
CORRECT ANSWER: B – Type I hypersensitivity. Rationale: Immediate IgE-mediated reaction with mast
cell degranulation causes anaphylaxis.
4. In a patient with right-sided heart failure, which finding is expected?
A. Crackles in lung bases
B. Jugular venous distension
C. Paroxysmal nocturnal dyspnea
D. Pink frothy sputum
CORRECT ANSWER: B – Jugular venous distension. Rationale: Right-sided failure causes systemic venous
congestion (JVD, hepatomegaly, peripheral edema).
5. A patient has a serum sodium of 118 mEq/L and is confused. The nurse should anticipate:
A. Fluid restriction
B. Hypertonic saline
C. IV normal saline
D. Loop diuretics
CORRECT ANSWER: B – Hypertonic saline. Rationale: Severe symptomatic hyponatremia (<120 with CNS
symptoms) requires hypertonic saline (3% NaCl) cautiously.
6. A patient with chronic kidney disease has a hemoglobin of 7.8 g/dL. The most likely cause is:
A. Iron deficiency
B. Vitamin B12 deficiency
C. Erythropoietin deficiency
D. Hemolysis
,CORRECT ANSWER: C – Erythropoietin deficiency. Rationale: CKD reduces EPO production, causing
normocytic, normochromic anemia.
7. Which of the following is a characteristic of malignant tumors?
A. Well-defined capsule
B. Slow growth
C. Metastasis
D. Well-differentiated cells
CORRECT ANSWER: C – Metastasis. Rationale: Malignant tumors invade and spread to distant sites;
benign tumors are encapsulated and do not metastasize.
8. A patient with cirrhosis presents with asterixis, confusion, and elevated ammonia. This is consistent
with:
A. Hepatic encephalopathy
B. Hepatorenal syndrome
C. Spontaneous bacterial peritonitis
D. Variceal hemorrhage
CORRECT ANSWER: A – Hepatic encephalopathy. Rationale: Liver failure causes ammonia accumulation,
leading to neuropsychiatric symptoms and asterixis.
9. A patient develops diffuse ST-segment elevation on ECG, with chest pain improved by leaning
forward. This suggests:
A. Myocardial infarction
B. Acute pericarditis
C. Pulmonary embolism
D. Aortic dissection
CORRECT ANSWER: B – Acute pericarditis. Rationale: Pericarditis causes diffuse ST elevation, pain worse
supine and better leaning forward.
, 10. A patient has a deep vein thrombosis and sudden onset of dyspnea, tachycardia, and hypoxia. The
nurse suspects:
A. Pulmonary embolism
B. Pneumothorax
C. Myocardial infarction
D. Asthma attack
CORRECT ANSWER: A – Pulmonary embolism. Rationale: DVT can embolize to pulmonary arteries,
causing acute dyspnea, hypoxia, and right heart strain.
11. In diabetic ketoacidosis, which finding is expected on laboratory analysis?
A. High anion gap metabolic acidosis
B. Normal anion gap
C. Respiratory alkalosis
D. Metabolic alkalosis
CORRECT ANSWER: A – High anion gap metabolic acidosis. Rationale: Ketone bodies (acetoacetate, beta-
hydroxybutyrate) are unmeasured anions.
12. A patient with nephrotic syndrome has frothy urine, periorbital edema, and hypoalbuminemia. The
primary pathophysiology is:
A. Increased glomerular permeability to protein
B. Decreased GFR
C. Tubular necrosis
D. Urinary tract obstruction
CORRECT ANSWER: A – Increased glomerular permeability to protein. Rationale: Glomerular damage
causes massive proteinuria, hypoalbuminemia, and edema.
