NR283 Exam 2 Actual Exam Style V3 | NR
283 Pathophysiology | Chamberlain
1. A patient presents with a serum potassium level of 6.2 mEq/L. Which electrocardiogram
(ECG) change is the nurse most likely to observe?
A. Tall, peaked T-waves
B. Prominent U-waves
C. ST-segment depression
D. Inverted T-waves
Correct Answer: A
Expert Explanation: Hyperkalemia leads to a faster repolarization of the myocardial cells.
This physiological shift manifests as tall, peaked T-waves on a standard 12-lead ECG. If the
potassium level continues to rise, it can lead to a widened QRS complex and eventual
cardiac arrest.
2. A client is diagnosed with Nephrotic Syndrome. Which clinical finding is considered a
hallmark of this condition?
A. Severe proteinuria exceeding 3.5 grams per day
B. Hematuria with red blood cell casts
C. Increased serum albumin levels
D. Hypotension due to fluid retention
,Correct Answer: A
Expert Explanation: Nephrotic syndrome is characterized by massive glomerular
permeability to proteins. This results in severe proteinuria, which subsequently causes
hypoalbuminemia in the blood. The loss of oncotic pressure leads to generalized edema
throughout the body.
3. Which ABG result indicates partially compensated respiratory acidosis?
A. pH 7.32, PaCO2 50, HCO3 24
B. pH 7.36, PaCO2 55, HCO3 30
C. pH 7.48, PaCO2 30, HCO3 22
D. pH 7.33, PaCO2 52, HCO3 29
Correct Answer: D
Expert Explanation: In respiratory acidosis, the pH is low and the PaCO2 is high. Partial
compensation occurs when the kidneys retain bicarbonate (HCO3) to raise the pH, but the
pH remains below the normal range of 7.35. Therefore, a pH of 7.33 with high CO2 and high
HCO3 represents partial compensation.
4. A patient with chronic obstructive pulmonary disease (COPD) has a barrel chest. What is
the primary cause of this anatomical change?
A. Hypertrophy of the diaphragm
B. Air trapping and alveolar hyperinflation
, C. Chronic inflammation of the bronchioles
D. Pulmonary edema causing chest wall expansion
Correct Answer: B
Expert Explanation: The barrel chest seen in emphysema is caused by the permanent
enlargement of the gas-exchange airways. Loss of elastic recoil prevents the lungs from
fully exhaling, leading to air trapping. Over time, the increased residual volume forces the
rib cage to expand outward to accommodate the trapped air.
5. What is the primary mechanism behind the development of cardiogenic shock?
A. Failure of the heart to pump effectively
B. Severe systemic vasodilation
C. Significant loss of blood volume
D. Obstruction of blood flow through the lungs
Correct Answer: A
Expert Explanation: Cardiogenic shock occurs when the heart is unable to maintain
sufficient cardiac output to meet the metabolic demands of the tissues. This is usually the
result of extensive myocardial damage, such as a large myocardial infarction. The decrease
in stroke volume leads to systemic hypoperfusion despite adequate intravascular volume.
283 Pathophysiology | Chamberlain
1. A patient presents with a serum potassium level of 6.2 mEq/L. Which electrocardiogram
(ECG) change is the nurse most likely to observe?
A. Tall, peaked T-waves
B. Prominent U-waves
C. ST-segment depression
D. Inverted T-waves
Correct Answer: A
Expert Explanation: Hyperkalemia leads to a faster repolarization of the myocardial cells.
This physiological shift manifests as tall, peaked T-waves on a standard 12-lead ECG. If the
potassium level continues to rise, it can lead to a widened QRS complex and eventual
cardiac arrest.
2. A client is diagnosed with Nephrotic Syndrome. Which clinical finding is considered a
hallmark of this condition?
A. Severe proteinuria exceeding 3.5 grams per day
B. Hematuria with red blood cell casts
C. Increased serum albumin levels
D. Hypotension due to fluid retention
,Correct Answer: A
Expert Explanation: Nephrotic syndrome is characterized by massive glomerular
permeability to proteins. This results in severe proteinuria, which subsequently causes
hypoalbuminemia in the blood. The loss of oncotic pressure leads to generalized edema
throughout the body.
3. Which ABG result indicates partially compensated respiratory acidosis?
A. pH 7.32, PaCO2 50, HCO3 24
B. pH 7.36, PaCO2 55, HCO3 30
C. pH 7.48, PaCO2 30, HCO3 22
D. pH 7.33, PaCO2 52, HCO3 29
Correct Answer: D
Expert Explanation: In respiratory acidosis, the pH is low and the PaCO2 is high. Partial
compensation occurs when the kidneys retain bicarbonate (HCO3) to raise the pH, but the
pH remains below the normal range of 7.35. Therefore, a pH of 7.33 with high CO2 and high
HCO3 represents partial compensation.
4. A patient with chronic obstructive pulmonary disease (COPD) has a barrel chest. What is
the primary cause of this anatomical change?
A. Hypertrophy of the diaphragm
B. Air trapping and alveolar hyperinflation
, C. Chronic inflammation of the bronchioles
D. Pulmonary edema causing chest wall expansion
Correct Answer: B
Expert Explanation: The barrel chest seen in emphysema is caused by the permanent
enlargement of the gas-exchange airways. Loss of elastic recoil prevents the lungs from
fully exhaling, leading to air trapping. Over time, the increased residual volume forces the
rib cage to expand outward to accommodate the trapped air.
5. What is the primary mechanism behind the development of cardiogenic shock?
A. Failure of the heart to pump effectively
B. Severe systemic vasodilation
C. Significant loss of blood volume
D. Obstruction of blood flow through the lungs
Correct Answer: A
Expert Explanation: Cardiogenic shock occurs when the heart is unable to maintain
sufficient cardiac output to meet the metabolic demands of the tissues. This is usually the
result of extensive myocardial damage, such as a large myocardial infarction. The decrease
in stroke volume leads to systemic hypoperfusion despite adequate intravascular volume.
