NSG 120 PATHOPHYSIOLOGY EXAM 300 ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH RATIONALE
LATEST UPDATE ALREADY GRADED A+
This NSG 120 Pathophysiology Final Exam simulator provides a
comprehensive assessment of disease processes across all major body systems.
Content covers cellular adaptation, fluid and electrolyte imbalances, acid-base
disorders, and the pathophysiological mechanisms behind cardiovascular,
respiratory, renal, endocrine, neurologic, gastrointestinal, and hematologic
conditions. The exam emphasizes clinical application, requiring students to
connect laboratory findings, physical assessment data, and diagnostic imaging
to specific disease states. Key topics include myocardial infarction, stroke,
diabetes mellitus, chronic kidney disease, pulmonary embolism, liver
cirrhosis, and metabolic disturbances. Each question tests the ability to
interpret abnormal values, recognize complications, and understand the
underlying pathophysiology driving patient presentations.
Question 1
A client is diagnosed with metabolic alkalosis. Which laboratory value would the
nurse expect to see?
A. Serum pH 7.32, bicarbonate 18 mEq/L
B. Serum pH 7.48, bicarbonate 32 mEq/L
C. Serum pH 7.25, PaCO2 55 mmHg
D. Serum pH 7.50, PaCO2 30 mmHg
Answer: B
Rationale: Metabolic alkalosis is defined by an elevated serum pH (above 7.45)
and elevated bicarbonate (above 26 mEq/L). Option A represents metabolic
acidosis, option C represents respiratory acidosis, and option D represents
respiratory alkalosis.
Question 2
A client with heart failure is prescribed furosemide. The nurse should monitor for
which electrolyte imbalance?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
,D. Hypermagnesemia
Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting in the distal
tubule. Hypokalemia is a common side effect. Hyperkalemia, hypercalcemia, and
hypermagnesemia are not typical with loop diuretics.
Question 3
In sickle cell anemia, the abnormal hemoglobin is designated as:
A. Hb A
B. Hb F
C. Hb S
D. Hb C
Answer: C
Rationale: Sickle cell anemia is caused by hemoglobin S (Hb S), which results
from a point mutation in the beta-globin gene. Hb A is normal adult hemoglobin,
Hb F is fetal hemoglobin, and Hb C is another abnormal variant.
Question 4
A client with a history of cirrhosis presents with ascites and spider angiomas. The
nurse recognizes these findings as consistent with:
A. Portal hypertension
B. Renal failure
C. Hepatic encephalopathy
D. Splenic sequestration
Answer: A
Rationale: Ascites and spider angiomas are manifestations of portal hypertension, a
complication of cirrhosis. Renal failure would present with oliguria and elevated
creatinine, hepatic encephalopathy with confusion, and splenic sequestration with
abdominal pain and anemia.
Question 5
Which cardiac enzyme is the most specific for myocardial infarction?
A. Creatine kinase-MB
B. Troponin I
C. Lactate dehydrogenase
D. Aspartate aminotransferase
Answer: B
Rationale: Troponin I and T are the most cardiac-specific biomarkers for
myocardial infarction. CK-MB is also used but is less specific. LDH and AST are
older markers with lower specificity.
,Question 6
A client with chronic obstructive pulmonary disease has a PaCO2 of 60 mmHg.
Which acid-base imbalance is expected?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: C
Rationale: PaCO2 is the respiratory component. An elevated PaCO2 (above 45
mmHg) indicates respiratory acidosis due to hypoventilation. Metabolic
imbalances involve bicarbonate changes.
Question 7
In type 1 diabetes mellitus, the underlying pathophysiology is:
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells
C. Excessive glucose production by the liver
D. Decreased glucagon secretion
Answer: B
Rationale: Type 1 diabetes is an autoimmune disorder resulting in destruction of
the insulin-producing beta cells in the pancreas. Insulin resistance is characteristic
of type 2 diabetes, and glucagon secretion is not primarily affected.
Question 8
A client with acute pancreatitis has a serum lipase level of 600 U/L. The nurse
understands that this elevation indicates:
A. Gallbladder disease
B. Pancreatic injury
C. Liver cell damage
D. Renal insufficiency
Answer: B
Rationale: Lipase is a pancreatic enzyme; elevated levels indicate pancreatic injury
or inflammation. Normal lipase is typically below 60 U/L. Gallbladder disease
elevates bilirubin and alkaline phosphatase, liver damage elevates transaminases,
and renal insufficiency elevates creatinine and BUN.
Question 9
A client with a tumor in the anterior pituitary gland is at risk for which hormonal
excess?
, A. Antidiuretic hormone
B. Prolactin
C. Oxytocin
D. Cortisol from the adrenal medulla
Answer: B
Rationale: The anterior pituitary secretes prolactin, growth hormone, ACTH, TSH,
FSH, and LH. Tumors can cause excess prolactin. ADH and oxytocin come from
the posterior pituitary, and cortisol comes from the adrenal cortex, not the medulla.
Question 10
Which finding is characteristic of a thrombotic stroke versus a hemorrhagic stroke?
A. Sudden severe headache
B. Gradual onset of symptoms over hours
C. Nuchal rigidity
D. Hypertension on admission
Answer: B
Rationale: Thrombotic strokes typically have a gradual or stepwise onset over
hours to days as a clot forms. Hemorrhagic strokes often present with a sudden
severe headache, nuchal rigidity, and marked hypertension.
Question 11
A client with chronic kidney disease has a serum creatinine of 8.5 mg/dL. This
indicates:
A. Mild renal impairment
B. Moderate renal impairment
C. Severe renal impairment
D. Normal renal function
Answer: C
Rationale: Normal creatinine is 0.6–1.2 mg/dL. A level of 8.5 mg/dL indicates
severe renal impairment, likely end-stage renal disease. Levels above 5.0 generally
indicate significant loss of kidney function.
Question 12
The primary pathophysiological mechanism of asthma is:
A. Destruction of alveolar walls
B. Reversible airway inflammation and bronchospasm
C. Loss of elastic recoil in the lungs
D. Pulmonary fibrosis
Answer: B
QUESTIONS AND CORRECT ANSWERS WITH RATIONALE
LATEST UPDATE ALREADY GRADED A+
This NSG 120 Pathophysiology Final Exam simulator provides a
comprehensive assessment of disease processes across all major body systems.
Content covers cellular adaptation, fluid and electrolyte imbalances, acid-base
disorders, and the pathophysiological mechanisms behind cardiovascular,
respiratory, renal, endocrine, neurologic, gastrointestinal, and hematologic
conditions. The exam emphasizes clinical application, requiring students to
connect laboratory findings, physical assessment data, and diagnostic imaging
to specific disease states. Key topics include myocardial infarction, stroke,
diabetes mellitus, chronic kidney disease, pulmonary embolism, liver
cirrhosis, and metabolic disturbances. Each question tests the ability to
interpret abnormal values, recognize complications, and understand the
underlying pathophysiology driving patient presentations.
Question 1
A client is diagnosed with metabolic alkalosis. Which laboratory value would the
nurse expect to see?
A. Serum pH 7.32, bicarbonate 18 mEq/L
B. Serum pH 7.48, bicarbonate 32 mEq/L
C. Serum pH 7.25, PaCO2 55 mmHg
D. Serum pH 7.50, PaCO2 30 mmHg
Answer: B
Rationale: Metabolic alkalosis is defined by an elevated serum pH (above 7.45)
and elevated bicarbonate (above 26 mEq/L). Option A represents metabolic
acidosis, option C represents respiratory acidosis, and option D represents
respiratory alkalosis.
Question 2
A client with heart failure is prescribed furosemide. The nurse should monitor for
which electrolyte imbalance?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
,D. Hypermagnesemia
Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting in the distal
tubule. Hypokalemia is a common side effect. Hyperkalemia, hypercalcemia, and
hypermagnesemia are not typical with loop diuretics.
Question 3
In sickle cell anemia, the abnormal hemoglobin is designated as:
A. Hb A
B. Hb F
C. Hb S
D. Hb C
Answer: C
Rationale: Sickle cell anemia is caused by hemoglobin S (Hb S), which results
from a point mutation in the beta-globin gene. Hb A is normal adult hemoglobin,
Hb F is fetal hemoglobin, and Hb C is another abnormal variant.
Question 4
A client with a history of cirrhosis presents with ascites and spider angiomas. The
nurse recognizes these findings as consistent with:
A. Portal hypertension
B. Renal failure
C. Hepatic encephalopathy
D. Splenic sequestration
Answer: A
Rationale: Ascites and spider angiomas are manifestations of portal hypertension, a
complication of cirrhosis. Renal failure would present with oliguria and elevated
creatinine, hepatic encephalopathy with confusion, and splenic sequestration with
abdominal pain and anemia.
Question 5
Which cardiac enzyme is the most specific for myocardial infarction?
A. Creatine kinase-MB
B. Troponin I
C. Lactate dehydrogenase
D. Aspartate aminotransferase
Answer: B
Rationale: Troponin I and T are the most cardiac-specific biomarkers for
myocardial infarction. CK-MB is also used but is less specific. LDH and AST are
older markers with lower specificity.
,Question 6
A client with chronic obstructive pulmonary disease has a PaCO2 of 60 mmHg.
Which acid-base imbalance is expected?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: C
Rationale: PaCO2 is the respiratory component. An elevated PaCO2 (above 45
mmHg) indicates respiratory acidosis due to hypoventilation. Metabolic
imbalances involve bicarbonate changes.
Question 7
In type 1 diabetes mellitus, the underlying pathophysiology is:
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells
C. Excessive glucose production by the liver
D. Decreased glucagon secretion
Answer: B
Rationale: Type 1 diabetes is an autoimmune disorder resulting in destruction of
the insulin-producing beta cells in the pancreas. Insulin resistance is characteristic
of type 2 diabetes, and glucagon secretion is not primarily affected.
Question 8
A client with acute pancreatitis has a serum lipase level of 600 U/L. The nurse
understands that this elevation indicates:
A. Gallbladder disease
B. Pancreatic injury
C. Liver cell damage
D. Renal insufficiency
Answer: B
Rationale: Lipase is a pancreatic enzyme; elevated levels indicate pancreatic injury
or inflammation. Normal lipase is typically below 60 U/L. Gallbladder disease
elevates bilirubin and alkaline phosphatase, liver damage elevates transaminases,
and renal insufficiency elevates creatinine and BUN.
Question 9
A client with a tumor in the anterior pituitary gland is at risk for which hormonal
excess?
, A. Antidiuretic hormone
B. Prolactin
C. Oxytocin
D. Cortisol from the adrenal medulla
Answer: B
Rationale: The anterior pituitary secretes prolactin, growth hormone, ACTH, TSH,
FSH, and LH. Tumors can cause excess prolactin. ADH and oxytocin come from
the posterior pituitary, and cortisol comes from the adrenal cortex, not the medulla.
Question 10
Which finding is characteristic of a thrombotic stroke versus a hemorrhagic stroke?
A. Sudden severe headache
B. Gradual onset of symptoms over hours
C. Nuchal rigidity
D. Hypertension on admission
Answer: B
Rationale: Thrombotic strokes typically have a gradual or stepwise onset over
hours to days as a clot forms. Hemorrhagic strokes often present with a sudden
severe headache, nuchal rigidity, and marked hypertension.
Question 11
A client with chronic kidney disease has a serum creatinine of 8.5 mg/dL. This
indicates:
A. Mild renal impairment
B. Moderate renal impairment
C. Severe renal impairment
D. Normal renal function
Answer: C
Rationale: Normal creatinine is 0.6–1.2 mg/dL. A level of 8.5 mg/dL indicates
severe renal impairment, likely end-stage renal disease. Levels above 5.0 generally
indicate significant loss of kidney function.
Question 12
The primary pathophysiological mechanism of asthma is:
A. Destruction of alveolar walls
B. Reversible airway inflammation and bronchospasm
C. Loss of elastic recoil in the lungs
D. Pulmonary fibrosis
Answer: B
