NR283 Final Exam Actual Exam Style V2 |
NR 283 Pathophysiology | Chamberlain
1. A patient is diagnosed with metabolic acidosis. Which of the following laboratory results
would the nurse expect to find?
A. pH 7.50, HCO3- 30 mEq/L
B. pH 7.30, HCO3- 18 mEq/L
C. pH 7.32, PaCO2 50 mmHg
D. pH 7.45, HCO3- 24 mEq/L
Answer: B
Rationale: Metabolic acidosis is characterized by a low arterial pH and a low bicarbonate
level. A pH of 7.30 is acidic, and a bicarbonate level of 18 mEq/L is below the normal range
of 22 to 26 mEq/L. This combination confirms a primary metabolic disturbance causing the
acidosis.
2. Which cellular adaptation is characterized by the replacement of one mature cell type by
another mature cell type?
A. Atrophy
B. Hyperplasia
C. Metaplasia
,D. Dysplasia
Answer: C
Rationale: Metaplasia occurs when a stressor causes a cell to transform into a different
type of mature cell that is better able to survive the environment. For example, in smokers,
the ciliated columnar epithelial cells in the bronchi may change into stratified squamous
epithelial cells. This adaptation is usually reversible if the stimulus is removed.
3. A patient with chronic kidney disease (CKD) is at high risk for developing which of the
following electrolyte imbalances?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypophosphatemia
Answer: B
Rationale: In CKD, the kidneys lose their ability to effectively excrete potassium, leading to
its accumulation in the blood. Hyperkalemia is a dangerous condition because it can lead to
cardiac arrhythmias and sudden cardiac arrest. Nurses must monitor these patients’ serum
potassium levels and dietary intake strictly.
4. Which of the following is a characteristic clinical manifestation of right-sided heart failure?
A. Pulmonary edema
, B. Crackles in the lungs
C. Peripheral edema
D. Orthopnea
Answer: C
Rationale: Right-sided heart failure leads to a backup of blood into the systemic venous
circulation. This results in signs like peripheral edema, jugular venous distention, and
hepatomegaly. Pulmonary symptoms like crackles and orthopnea are more commonly
associated with left-sided heart failure.
5. What is the primary pathophysiology behind Type 1 Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Increased glucose production by the liver
C. Excessive glucagon secretion by alpha cells
D. Autoimmune destruction of pancreatic beta cells
Answer: D
Rationale: Type 1 Diabetes Mellitus is an autoimmune disorder where the immune system
attacks and destroys the insulin-producing beta cells in the Islets of Langerhans. This leads
to an absolute deficiency of insulin, requiring patients to rely on exogenous insulin for
survival. It usually develops in childhood or adolescence but can occur at any age.
NR 283 Pathophysiology | Chamberlain
1. A patient is diagnosed with metabolic acidosis. Which of the following laboratory results
would the nurse expect to find?
A. pH 7.50, HCO3- 30 mEq/L
B. pH 7.30, HCO3- 18 mEq/L
C. pH 7.32, PaCO2 50 mmHg
D. pH 7.45, HCO3- 24 mEq/L
Answer: B
Rationale: Metabolic acidosis is characterized by a low arterial pH and a low bicarbonate
level. A pH of 7.30 is acidic, and a bicarbonate level of 18 mEq/L is below the normal range
of 22 to 26 mEq/L. This combination confirms a primary metabolic disturbance causing the
acidosis.
2. Which cellular adaptation is characterized by the replacement of one mature cell type by
another mature cell type?
A. Atrophy
B. Hyperplasia
C. Metaplasia
,D. Dysplasia
Answer: C
Rationale: Metaplasia occurs when a stressor causes a cell to transform into a different
type of mature cell that is better able to survive the environment. For example, in smokers,
the ciliated columnar epithelial cells in the bronchi may change into stratified squamous
epithelial cells. This adaptation is usually reversible if the stimulus is removed.
3. A patient with chronic kidney disease (CKD) is at high risk for developing which of the
following electrolyte imbalances?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypophosphatemia
Answer: B
Rationale: In CKD, the kidneys lose their ability to effectively excrete potassium, leading to
its accumulation in the blood. Hyperkalemia is a dangerous condition because it can lead to
cardiac arrhythmias and sudden cardiac arrest. Nurses must monitor these patients’ serum
potassium levels and dietary intake strictly.
4. Which of the following is a characteristic clinical manifestation of right-sided heart failure?
A. Pulmonary edema
, B. Crackles in the lungs
C. Peripheral edema
D. Orthopnea
Answer: C
Rationale: Right-sided heart failure leads to a backup of blood into the systemic venous
circulation. This results in signs like peripheral edema, jugular venous distention, and
hepatomegaly. Pulmonary symptoms like crackles and orthopnea are more commonly
associated with left-sided heart failure.
5. What is the primary pathophysiology behind Type 1 Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Increased glucose production by the liver
C. Excessive glucagon secretion by alpha cells
D. Autoimmune destruction of pancreatic beta cells
Answer: D
Rationale: Type 1 Diabetes Mellitus is an autoimmune disorder where the immune system
attacks and destroys the insulin-producing beta cells in the Islets of Langerhans. This leads
to an absolute deficiency of insulin, requiring patients to rely on exogenous insulin for
survival. It usually develops in childhood or adolescence but can occur at any age.
