Page 1 of 79
NSG 3850 PATHOPHYSIOLOGY II: COMPREHENSIVE EXAM
STUDY GUIDE EXAM LATEST VERSION QUESTIONS AND
ANSWERS 2026 EDITION
NSG 3850 Pathophysiology II: Comprehensive Exam Study Guide
250 Questions with Verified Answers and Rationales
SECTION 1: FLUID, ELECTROLYTE, AND ACID-BASE BALANCE (Questions 1-45)
1. The fraction of total body water (TBW) contained in the intracellular space in
adult males is approximately:
A. One-third
B. One-half
C. Two-thirds
D. Three-fourths
Answer: C. Two-thirds
Rationale: Approximately two-thirds of total body water is located inside cells
(intracellular fluid). The remaining one-third is extracellular (interstitial, intravascular,
and transcellular fluids) .
2. What age group has a larger volume of extracellular fluid than intracellular fluid?
A. Infants
B. Adolescents
C. Young adults
D. Older adults
Answer: A. Infants
Rationale: Infants have a larger volume of extracellular fluid than intracellular fluid. This
is due to their higher total body water content and immature renal function, making
them more susceptible to dehydration .
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3. The fluid contained within specialized body compartments such as
cerebrospinal, pleural, and synovial cavities is termed:
A. Interstitial fluid
B. Intracellular fluid
C. Transcellular fluid
D. Plasma
Answer: C. Transcellular fluid
Rationale: Transcellular fluid is the fluid contained within specialized body
compartments such as cerebrospinal, pleural, and synovial cavities. It is secreted by
epithelial cells and is distinct from the primary body fluids .
4. Which electrolyte has a higher concentration in the extracellular fluid than in the
intracellular fluid?
A. Potassium
B. Phosphate
C. Magnesium
D. Sodium
Answer: D. Sodium
Rationale: Sodium is the primary extracellular cation, with a concentration of
approximately 135-145 mEq/L in the extracellular fluid. Potassium is the primary
intracellular cation .
5. Which event is most likely to lead to hyponatremia?
A. Insufficient ADH secretion
B. Excess aldosterone secretion
C. Administration of intravenous normal saline
D. Frequent nasogastric tube irrigation with water
Answer: D. Frequent nasogastric tube irrigation with water
Rationale: Frequent NG tube irrigation with water can lead to dilutional hyponatremia
because water is absorbed, diluting serum sodium. Normal saline administration would
not cause hyponatremia .
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6. An increase in the resting membrane potential (hyperpolarization) is associated
with:
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypercalcemia
Answer: A. Hypokalemia
Rationale: Hypokalemia causes hyperpolarization of the cell membrane, making it more
difficult to reach threshold and leading to muscle weakness. Hyperkalemia causes
depolarization .
7. Abnormalities in intracellular regulation of enzyme activity and cellular
production of ATP are associated with:
A. Hyponatremia
B. Hypocalcemia
C. Hypophosphatemia
D. Hypokalemia
Answer: C. Hypophosphatemia
Rationale: Phosphate is essential for ATP production and enzyme function.
Hypophosphatemia impairs cellular energy metabolism and can lead to multiple organ
dysfunction .
8. Clinical manifestations of severe symptomatic hypophosphatemia are caused
by:
A. Excess proteins
B. Renal damage
C. Deficiency of ATP
D. Hypercalcemia
Answer: C. Deficiency of ATP
Rationale: Severe hypophosphatemia leads to ATP depletion, affecting cellular energy
metabolism, which can cause muscle weakness, respiratory failure, and hemolysis .
9. Which electrolyte imbalances cause increased neuromuscular excitability?
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A. Hypokalemia and hyperphosphatemia
B. Hyperkalemia and hypophosphatemia
C. Hypocalcemia and hypomagnesemia
D. Hypercalcemia and hypermagnesemia
Answer: C. Hypocalcemia and hypomagnesemia
Rationale: Calcium and magnesium are important for nerve conduction and muscle
contraction. Low levels of these ions increase neuromuscular excitability, leading to
tetany, muscle spasms, and seizures .
10. A person who overuses magnesium-aluminum antacids for a long period is
likely to develop:
A. Hypomagnesemia
B. Hypermagnesemia
C. Hypophosphatemia
D. Hyperphosphatemia
Answer: C. Hypophosphatemia
Rationale: Magnesium-aluminum antacids bind phosphate in the GI tract, reducing
absorption and causing hypophosphatemia with chronic use .
11. The osmotic pressure exerted by proteins in the blood is termed:
A. Hydrostatic pressure
B. Oncotic pressure
C. Osmotic pressure
D. Interstitial pressure
Answer: B. Oncotic pressure
Rationale: Oncotic pressure (colloid osmotic pressure) is the osmotic pressure exerted
by plasma proteins, primarily albumin. Reduced albumin in cirrhosis leads to decreased
oncotic pressure and edema .
12. A person who has hyperparathyroidism is likely to develop:
A. Hypocalcemia
B. Hypercalcemia
C. Hypophosphatemia only
D. Vitamin D deficiency only
NSG 3850 PATHOPHYSIOLOGY II: COMPREHENSIVE EXAM
STUDY GUIDE EXAM LATEST VERSION QUESTIONS AND
ANSWERS 2026 EDITION
NSG 3850 Pathophysiology II: Comprehensive Exam Study Guide
250 Questions with Verified Answers and Rationales
SECTION 1: FLUID, ELECTROLYTE, AND ACID-BASE BALANCE (Questions 1-45)
1. The fraction of total body water (TBW) contained in the intracellular space in
adult males is approximately:
A. One-third
B. One-half
C. Two-thirds
D. Three-fourths
Answer: C. Two-thirds
Rationale: Approximately two-thirds of total body water is located inside cells
(intracellular fluid). The remaining one-third is extracellular (interstitial, intravascular,
and transcellular fluids) .
2. What age group has a larger volume of extracellular fluid than intracellular fluid?
A. Infants
B. Adolescents
C. Young adults
D. Older adults
Answer: A. Infants
Rationale: Infants have a larger volume of extracellular fluid than intracellular fluid. This
is due to their higher total body water content and immature renal function, making
them more susceptible to dehydration .
, Page 2 of 79
3. The fluid contained within specialized body compartments such as
cerebrospinal, pleural, and synovial cavities is termed:
A. Interstitial fluid
B. Intracellular fluid
C. Transcellular fluid
D. Plasma
Answer: C. Transcellular fluid
Rationale: Transcellular fluid is the fluid contained within specialized body
compartments such as cerebrospinal, pleural, and synovial cavities. It is secreted by
epithelial cells and is distinct from the primary body fluids .
4. Which electrolyte has a higher concentration in the extracellular fluid than in the
intracellular fluid?
A. Potassium
B. Phosphate
C. Magnesium
D. Sodium
Answer: D. Sodium
Rationale: Sodium is the primary extracellular cation, with a concentration of
approximately 135-145 mEq/L in the extracellular fluid. Potassium is the primary
intracellular cation .
5. Which event is most likely to lead to hyponatremia?
A. Insufficient ADH secretion
B. Excess aldosterone secretion
C. Administration of intravenous normal saline
D. Frequent nasogastric tube irrigation with water
Answer: D. Frequent nasogastric tube irrigation with water
Rationale: Frequent NG tube irrigation with water can lead to dilutional hyponatremia
because water is absorbed, diluting serum sodium. Normal saline administration would
not cause hyponatremia .
, Page 3 of 79
6. An increase in the resting membrane potential (hyperpolarization) is associated
with:
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypercalcemia
Answer: A. Hypokalemia
Rationale: Hypokalemia causes hyperpolarization of the cell membrane, making it more
difficult to reach threshold and leading to muscle weakness. Hyperkalemia causes
depolarization .
7. Abnormalities in intracellular regulation of enzyme activity and cellular
production of ATP are associated with:
A. Hyponatremia
B. Hypocalcemia
C. Hypophosphatemia
D. Hypokalemia
Answer: C. Hypophosphatemia
Rationale: Phosphate is essential for ATP production and enzyme function.
Hypophosphatemia impairs cellular energy metabolism and can lead to multiple organ
dysfunction .
8. Clinical manifestations of severe symptomatic hypophosphatemia are caused
by:
A. Excess proteins
B. Renal damage
C. Deficiency of ATP
D. Hypercalcemia
Answer: C. Deficiency of ATP
Rationale: Severe hypophosphatemia leads to ATP depletion, affecting cellular energy
metabolism, which can cause muscle weakness, respiratory failure, and hemolysis .
9. Which electrolyte imbalances cause increased neuromuscular excitability?
, Page 4 of 79
A. Hypokalemia and hyperphosphatemia
B. Hyperkalemia and hypophosphatemia
C. Hypocalcemia and hypomagnesemia
D. Hypercalcemia and hypermagnesemia
Answer: C. Hypocalcemia and hypomagnesemia
Rationale: Calcium and magnesium are important for nerve conduction and muscle
contraction. Low levels of these ions increase neuromuscular excitability, leading to
tetany, muscle spasms, and seizures .
10. A person who overuses magnesium-aluminum antacids for a long period is
likely to develop:
A. Hypomagnesemia
B. Hypermagnesemia
C. Hypophosphatemia
D. Hyperphosphatemia
Answer: C. Hypophosphatemia
Rationale: Magnesium-aluminum antacids bind phosphate in the GI tract, reducing
absorption and causing hypophosphatemia with chronic use .
11. The osmotic pressure exerted by proteins in the blood is termed:
A. Hydrostatic pressure
B. Oncotic pressure
C. Osmotic pressure
D. Interstitial pressure
Answer: B. Oncotic pressure
Rationale: Oncotic pressure (colloid osmotic pressure) is the osmotic pressure exerted
by plasma proteins, primarily albumin. Reduced albumin in cirrhosis leads to decreased
oncotic pressure and edema .
12. A person who has hyperparathyroidism is likely to develop:
A. Hypocalcemia
B. Hypercalcemia
C. Hypophosphatemia only
D. Vitamin D deficiency only
