NR283 Exam 2 Actual Exam Style V2 | NR
283 Pathophysiology | Chamberlain
1. A patient is admitted with a potassium level of 6.2 mEq/L. Which of the following ECG
changes is the nurse most likely to observe?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Widened QRS complex
Answer: C
Rationale: Hyperkalemia, defined as a potassium level above 5.0 mEq/L, directly affects
the repolarization phase of the cardiac action potential. The most classic early ECG finding
is the presence of tall, peaked T waves. If the potassium continues to rise, it can lead to
dangerous arrhythmias like ventricular fibrillation or cardiac arrest.
2. Which clinical manifestation is most characteristic of right-sided heart failure?
A. Crackles in the lungs
B. Paroxysmal nocturnal dyspnea
C. Orthopnea
D. Jugular venous distention (JVD)
,Answer: D
Rationale: Right-sided heart failure causes blood to back up into the systemic circulation
rather than the lungs. This results in increased pressure in the venous system, manifesting
as JVD, peripheral edema, and hepatomegaly. Pulmonary symptoms like crackles and
orthopnea are typically associated with left-sided heart failure.
3. A patient with chronic obstructive pulmonary disease (COPD) is at high risk for which acid-
base imbalance?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Answer: D
Rationale: COPD patients often experience chronic hypoventilation and air trapping, which
prevents them from effectively exhaling carbon dioxide (CO2). The accumulation of CO2
leads to an increase in carbonic acid, resulting in a drop in blood pH. This condition is
known as respiratory acidosis and is a common finding in end-stage lung disease.
4. Which of the following is the primary cause of anemia in patients with chronic kidney
disease (CKD)?
A. Loss of blood through hemodialysis
B. Decreased production of erythropoietin
, C. Iron deficiency due to poor diet
D. Increased destruction of red blood cells
Answer: B
Rationale: The kidneys are responsible for producing erythropoietin, a hormone that
stimulates the bone marrow to produce red blood cells. In CKD, the damaged kidneys
cannot produce enough of this hormone, leading to a decrease in RBC production. This
results in the characteristic normochromic, normocytic anemia found in renal failure
patients.
5. A patient presents with massive proteinuria, hypoalbuminemia, and generalized edema.
Which condition is most likely?
A. Acute Glomerulonephritis
B. Pyelonephritis
C. Nephrotic Syndrome
D. Cystitis
Answer: C
Rationale: Nephrotic syndrome is characterized by heavy protein loss in the urine, often
exceeding 3.5 grams per day. This loss of protein leads to low albumin levels in the blood,
which reduces oncotic pressure and causes fluid to shift into the tissues. This sequence of
events results in severe, generalized edema across the body.
283 Pathophysiology | Chamberlain
1. A patient is admitted with a potassium level of 6.2 mEq/L. Which of the following ECG
changes is the nurse most likely to observe?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Widened QRS complex
Answer: C
Rationale: Hyperkalemia, defined as a potassium level above 5.0 mEq/L, directly affects
the repolarization phase of the cardiac action potential. The most classic early ECG finding
is the presence of tall, peaked T waves. If the potassium continues to rise, it can lead to
dangerous arrhythmias like ventricular fibrillation or cardiac arrest.
2. Which clinical manifestation is most characteristic of right-sided heart failure?
A. Crackles in the lungs
B. Paroxysmal nocturnal dyspnea
C. Orthopnea
D. Jugular venous distention (JVD)
,Answer: D
Rationale: Right-sided heart failure causes blood to back up into the systemic circulation
rather than the lungs. This results in increased pressure in the venous system, manifesting
as JVD, peripheral edema, and hepatomegaly. Pulmonary symptoms like crackles and
orthopnea are typically associated with left-sided heart failure.
3. A patient with chronic obstructive pulmonary disease (COPD) is at high risk for which acid-
base imbalance?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Answer: D
Rationale: COPD patients often experience chronic hypoventilation and air trapping, which
prevents them from effectively exhaling carbon dioxide (CO2). The accumulation of CO2
leads to an increase in carbonic acid, resulting in a drop in blood pH. This condition is
known as respiratory acidosis and is a common finding in end-stage lung disease.
4. Which of the following is the primary cause of anemia in patients with chronic kidney
disease (CKD)?
A. Loss of blood through hemodialysis
B. Decreased production of erythropoietin
, C. Iron deficiency due to poor diet
D. Increased destruction of red blood cells
Answer: B
Rationale: The kidneys are responsible for producing erythropoietin, a hormone that
stimulates the bone marrow to produce red blood cells. In CKD, the damaged kidneys
cannot produce enough of this hormone, leading to a decrease in RBC production. This
results in the characteristic normochromic, normocytic anemia found in renal failure
patients.
5. A patient presents with massive proteinuria, hypoalbuminemia, and generalized edema.
Which condition is most likely?
A. Acute Glomerulonephritis
B. Pyelonephritis
C. Nephrotic Syndrome
D. Cystitis
Answer: C
Rationale: Nephrotic syndrome is characterized by heavy protein loss in the urine, often
exceeding 3.5 grams per day. This loss of protein leads to low albumin levels in the blood,
which reduces oncotic pressure and causes fluid to shift into the tissues. This sequence of
events results in severe, generalized edema across the body.
