NSG 3113 Pathophysiology Success Bundle | Exam 1, Exam 2 &
Final Exam Review 2026/2027 questions and detailed answers
newest
Question 1
A nurse is reviewing cellular adaptations in a client who smokes
cigarettes chronically. The pseudostratified ciliated columnar epithelium
of the bronchi is replaced by stratified squamous epithelium. Which
cellular adaptation does this represent?
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Correct Answer: C. Metaplasia
Detailed Rationale: Metaplasia is the reversible replacement of one
adult cell type by another adult cell type, often in response to chronic
irritation or stress, such as cigarette smoke exposure in the respiratory
tract.
Question 2
A client with severe, continuous vomiting for three days presents with
lethargy, muscle cramps, and slow, shallow respirations. Which primary
acid-base imbalance should the nurse expect?
A. Metabolic acidosis
,B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Correct Answer: B. Metabolic alkalosis
Detailed Rationale: Prolonged vomiting results in the loss of
hydrochloric acid from the stomach, leading to an excess of bicarbonate
in the extracellular fluid and metabolic alkalosis. The respiratory system
compensates by hypoventilating (slow, shallow respirations) to retain
carbon dioxide.
Question 3
A client is admitted with a serum potassium level of 6.2 mEq/L. Which
of the following electrocardiogram (ECG) changes should the nurse
anticipate?
A. Flattened T waves and prominent U waves
B. Tall, peaked T waves and widened QRS complexes
C. Prolonged PR interval with sinus bradycardia only
D. Shortened QT interval with ST-segment depression
Correct Answer: B. Tall, peaked T waves and widened QRS complexes
Detailed Rationale: Hyperkalemia alters the resting membrane
potential of cardiac cells. Early ECG manifestations include tall, peaked T
waves, followed by prolongation of the PR interval and widening of the
QRS complex, which can progress to ventricular fibrillation if untreated.
Question 4
,A nurse is caring for a client who sustained severe full-thickness burns
covering 40% of their total body surface area 12 hours ago. Which of
the following pathophysiological responses should the nurse expect
during this acute phase?
A. Massive fluid shift from the intravascular space into the interstitial
tissues causing hypovolemic shock
B. Rapid movement of interstitial fluid into the vascular system causing
severe hypertension
C. Primary intracellular accumulation of sodium and water within
skeletal muscle cells
D. Hyperkalemia caused exclusively by decreased renal filtration rate
Correct Answer: A. Massive fluid shift from the intravascular space into
the interstitial tissues causing hypovolemic shock
Detailed Rationale: Major thermal burns induce a systemic
inflammatory response that dramatically increases capillary
permeability. Plasma proteins and fluids leak out of the vascular space
into the interstitial tissues, causing generalized edema and hypovolemic
burn shock.
Question 5
What is the primary pathophysiological difference between stable
angina and unstable angina?
A. Stable angina is caused by complete permanent coronary artery
occlusion, whereas unstable angina is caused by transient coronary
spasm.
, B. Stable angina occurs with predictable physical exertion and is
relieved by rest or nitroglycerin, whereas unstable angina involves
unpredictable plaque rupture and thrombosis that occurs at rest.
C. Stable angina involves irreversible myocardial necrosis, whereas
unstable angina involves temporary ischemia without necrosis.
D. Stable angina is caused by microvascular coronary disease, whereas
unstable angina is strictly caused by left ventricular hypertrophy.
Correct Answer: B. Stable angina occurs with predictable physical
exertion and is relieved by rest or nitroglycerin, whereas unstable
angina involves unpredictable plaque rupture and thrombosis that
occurs at rest.
Detailed Rationale: Stable angina is predictable chest pain triggered by
increased myocardial oxygen demand that exceeds a fixed
atherosclerotic supply, resolving with rest. Unstable angina features
sudden plaque disruption, partial thrombosis, and ischemia occurring at
rest, representing an acute coronary syndrome.
Question 6
A client with chronic left-sided heart failure exhibits bilateral pedal
edema, jugular venous distention, and hepatomegaly. What
pathophysiological process links left-sided heart failure to these right-
sided clinical signs?
A. Direct compression of the inferior vena cava by an enlarged left
ventricle
Final Exam Review 2026/2027 questions and detailed answers
newest
Question 1
A nurse is reviewing cellular adaptations in a client who smokes
cigarettes chronically. The pseudostratified ciliated columnar epithelium
of the bronchi is replaced by stratified squamous epithelium. Which
cellular adaptation does this represent?
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Correct Answer: C. Metaplasia
Detailed Rationale: Metaplasia is the reversible replacement of one
adult cell type by another adult cell type, often in response to chronic
irritation or stress, such as cigarette smoke exposure in the respiratory
tract.
Question 2
A client with severe, continuous vomiting for three days presents with
lethargy, muscle cramps, and slow, shallow respirations. Which primary
acid-base imbalance should the nurse expect?
A. Metabolic acidosis
,B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Correct Answer: B. Metabolic alkalosis
Detailed Rationale: Prolonged vomiting results in the loss of
hydrochloric acid from the stomach, leading to an excess of bicarbonate
in the extracellular fluid and metabolic alkalosis. The respiratory system
compensates by hypoventilating (slow, shallow respirations) to retain
carbon dioxide.
Question 3
A client is admitted with a serum potassium level of 6.2 mEq/L. Which
of the following electrocardiogram (ECG) changes should the nurse
anticipate?
A. Flattened T waves and prominent U waves
B. Tall, peaked T waves and widened QRS complexes
C. Prolonged PR interval with sinus bradycardia only
D. Shortened QT interval with ST-segment depression
Correct Answer: B. Tall, peaked T waves and widened QRS complexes
Detailed Rationale: Hyperkalemia alters the resting membrane
potential of cardiac cells. Early ECG manifestations include tall, peaked T
waves, followed by prolongation of the PR interval and widening of the
QRS complex, which can progress to ventricular fibrillation if untreated.
Question 4
,A nurse is caring for a client who sustained severe full-thickness burns
covering 40% of their total body surface area 12 hours ago. Which of
the following pathophysiological responses should the nurse expect
during this acute phase?
A. Massive fluid shift from the intravascular space into the interstitial
tissues causing hypovolemic shock
B. Rapid movement of interstitial fluid into the vascular system causing
severe hypertension
C. Primary intracellular accumulation of sodium and water within
skeletal muscle cells
D. Hyperkalemia caused exclusively by decreased renal filtration rate
Correct Answer: A. Massive fluid shift from the intravascular space into
the interstitial tissues causing hypovolemic shock
Detailed Rationale: Major thermal burns induce a systemic
inflammatory response that dramatically increases capillary
permeability. Plasma proteins and fluids leak out of the vascular space
into the interstitial tissues, causing generalized edema and hypovolemic
burn shock.
Question 5
What is the primary pathophysiological difference between stable
angina and unstable angina?
A. Stable angina is caused by complete permanent coronary artery
occlusion, whereas unstable angina is caused by transient coronary
spasm.
, B. Stable angina occurs with predictable physical exertion and is
relieved by rest or nitroglycerin, whereas unstable angina involves
unpredictable plaque rupture and thrombosis that occurs at rest.
C. Stable angina involves irreversible myocardial necrosis, whereas
unstable angina involves temporary ischemia without necrosis.
D. Stable angina is caused by microvascular coronary disease, whereas
unstable angina is strictly caused by left ventricular hypertrophy.
Correct Answer: B. Stable angina occurs with predictable physical
exertion and is relieved by rest or nitroglycerin, whereas unstable
angina involves unpredictable plaque rupture and thrombosis that
occurs at rest.
Detailed Rationale: Stable angina is predictable chest pain triggered by
increased myocardial oxygen demand that exceeds a fixed
atherosclerotic supply, resolving with rest. Unstable angina features
sudden plaque disruption, partial thrombosis, and ischemia occurring at
rest, representing an acute coronary syndrome.
Question 6
A client with chronic left-sided heart failure exhibits bilateral pedal
edema, jugular venous distention, and hepatomegaly. What
pathophysiological process links left-sided heart failure to these right-
sided clinical signs?
A. Direct compression of the inferior vena cava by an enlarged left
ventricle
