Galen NSG 3280 Pathophysiology for Nurses I: Final Exam
(Comprehensive) - Questions with Correct Answers
100 questions
1. Hyperkalemia is often caused by which medication class?
A. Loop diuretics
B. Thiazide diuretics
C. Beta-2 agonists
D. ACE inhibitors and potassium-sparing diuretics
Correct Answer: D. ACE inhibitors and potassium-sparing diuretics
Rationale: ACE inhibitors, ARBs and spironolactone reduce aldosterone effects, causing potassium
retention, especially in kidney disease. Loop and thiazide diuretics cause potassium loss, and beta-2
agonists shift potassium into cells.
2. Administering a hypotonic IV solution causes water to move:
A. Out of the cells, causing them to shrink
B. Only into the plasma
C. Nowhere, because it is isotonic
D. Into the cells, causing them to swell
Correct Answer: D. Into the cells, causing them to swell
Rationale: A hypotonic solution lowers extracellular osmolality, so water moves into cells by osmosis.
This is why hypotonic fluids are avoided in patients at risk for increased intracranial pressure. Hypertonic
solutions pull water out of cells.
3. A patient with an opioid overdose has a respiratory rate of 6. The expected acid-base
imbalance is:
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Correct Answer: D. Respiratory acidosis
Rationale: Opioids depress the respiratory center, causing hypoventilation and CO2 retention, which
forms carbonic acid. Respiratory alkalosis results from hyperventilation. Metabolic disorders originate in
bicarbonate or fixed acids.
,4. A shift of the oxyhemoglobin dissociation curve to the right means:
A. Hemoglobin releases oxygen more readily to tissues
B. Hemoglobin holds oxygen more tightly
C. Less oxygen reaches tissues
D. Carbon monoxide is bound
Correct Answer: A. Hemoglobin releases oxygen more readily to tissues
Rationale: A right shift, caused by acidosis, high CO2, fever and increased 2,3-DPG, lowers
hemoglobin's oxygen affinity, helping unload oxygen in active tissues. Alkalosis, hypothermia and carbon
monoxide shift the curve left, impairing oxygen release.
5. C-reactive protein is an acute phase reactant produced by the:
A. Bone marrow
B. Spleen
C. Kidneys
D. Liver in response to IL-6
Correct Answer: D. Liver in response to IL-6
Rationale: IL-6 stimulates hepatocytes to produce CRP, fibrinogen and other acute phase proteins; CRP
rises within hours of inflammation and acts as an opsonin. It is a nonspecific marker. The marrow, spleen
and kidneys do not produce it.
6. The primary purpose of the inflammatory response is to:
A. Produce antibodies against specific antigens
B. Limit tissue damage, destroy invaders, remove debris, and prepare for healing
C. Create memory cells
D. Prevent all fever
Correct Answer: B. Limit tissue damage, destroy invaders, remove debris, and prepare for
healing
Rationale: Inflammation is rapid, nonspecific and does not require prior exposure; it contains injury and
begins repair. Antibody production and memory are features of adaptive immunity. Fever is often part of
the inflammatory response rather than prevented by it.
,7. A patient receives hepatitis B immune globulin after a needle-stick. This provides:
A. Artificial passive immunity that is immediate but temporary
B. Artificial active immunity that is lifelong
C. Natural active immunity
D. Natural passive immunity
Correct Answer: A. Artificial passive immunity that is immediate but temporary
Rationale: Immune globulin delivers preformed antibodies, giving immediate protection lasting weeks to
months without memory. The hepatitis B vaccine, given at the same time, produces active immunity.
Natural passive immunity comes from mother to baby.
8. A hapten is a small molecule that becomes immunogenic only when it:
A. Enters the bloodstream
B. Is phagocytosed
C. Binds to a larger carrier protein
D. Is filtered by the kidneys
Correct Answer: C. Binds to a larger carrier protein
Rationale: Haptens such as penicillin are too small alone but can bind host proteins and trigger immune
responses, explaining many drug allergies. Simply entering the blood or being filtered does not make
them immunogenic.
9. The first-line treatment for anaphylaxis is:
A. Oral antihistamine
B. Intramuscular epinephrine
C. Oral corticosteroid
D. Inhaled albuterol alone
Correct Answer: B. Intramuscular epinephrine
Rationale: Epinephrine reverses vasodilation, bronchoconstriction and mucosal edema through alpha
and beta effects, and delays increase mortality. Antihistamines and steroids are adjuncts that act too
slowly to prevent death. Albuterol treats bronchospasm only.
, 10. Hyperacute rejection of a transplanted kidney occurs:
A. Weeks after transplant from T cells
B. Within minutes to hours, from preformed recipient antibodies against donor antigens
C. Months to years later from chronic vascular damage
D. Only in liver transplants
Correct Answer: B. Within minutes to hours, from preformed recipient antibodies against
donor antigens
Rationale: Preformed antibodies, such as against ABO or HLA antigens, activate complement and cause
immediate thrombosis; crossmatching prevents it. Acute rejection is T-cell mediated and occurs within
weeks to months, and chronic rejection develops over years.
11. Culture and sensitivity testing is performed to:
A. Measure white blood cell count
B. Identify the organism and determine which antibiotics will be effective
C. Diagnose allergies
D. Measure antibody levels
Correct Answer: B. Identify the organism and determine which antibiotics will be effective
Rationale: Cultures identify the pathogen, and susceptibility testing guides targeted therapy, allowing
narrowing from broad-spectrum empiric antibiotics. Specimens should be collected before antibiotics
when possible.
12. A patient's reservoir of infection could include:
A. Only sick humans
B. People, animals, soil, water, or contaminated equipment
C. Only blood products
D. Only insects
Correct Answer: B. People, animals, soil, water, or contaminated equipment
Rationale: A reservoir is where a pathogen lives and multiplies; carriers without symptoms can also be
reservoirs. Environmental reservoirs include soil (tetanus) and water (Legionella). Reservoirs are not
limited to sick humans.
(Comprehensive) - Questions with Correct Answers
100 questions
1. Hyperkalemia is often caused by which medication class?
A. Loop diuretics
B. Thiazide diuretics
C. Beta-2 agonists
D. ACE inhibitors and potassium-sparing diuretics
Correct Answer: D. ACE inhibitors and potassium-sparing diuretics
Rationale: ACE inhibitors, ARBs and spironolactone reduce aldosterone effects, causing potassium
retention, especially in kidney disease. Loop and thiazide diuretics cause potassium loss, and beta-2
agonists shift potassium into cells.
2. Administering a hypotonic IV solution causes water to move:
A. Out of the cells, causing them to shrink
B. Only into the plasma
C. Nowhere, because it is isotonic
D. Into the cells, causing them to swell
Correct Answer: D. Into the cells, causing them to swell
Rationale: A hypotonic solution lowers extracellular osmolality, so water moves into cells by osmosis.
This is why hypotonic fluids are avoided in patients at risk for increased intracranial pressure. Hypertonic
solutions pull water out of cells.
3. A patient with an opioid overdose has a respiratory rate of 6. The expected acid-base
imbalance is:
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Correct Answer: D. Respiratory acidosis
Rationale: Opioids depress the respiratory center, causing hypoventilation and CO2 retention, which
forms carbonic acid. Respiratory alkalosis results from hyperventilation. Metabolic disorders originate in
bicarbonate or fixed acids.
,4. A shift of the oxyhemoglobin dissociation curve to the right means:
A. Hemoglobin releases oxygen more readily to tissues
B. Hemoglobin holds oxygen more tightly
C. Less oxygen reaches tissues
D. Carbon monoxide is bound
Correct Answer: A. Hemoglobin releases oxygen more readily to tissues
Rationale: A right shift, caused by acidosis, high CO2, fever and increased 2,3-DPG, lowers
hemoglobin's oxygen affinity, helping unload oxygen in active tissues. Alkalosis, hypothermia and carbon
monoxide shift the curve left, impairing oxygen release.
5. C-reactive protein is an acute phase reactant produced by the:
A. Bone marrow
B. Spleen
C. Kidneys
D. Liver in response to IL-6
Correct Answer: D. Liver in response to IL-6
Rationale: IL-6 stimulates hepatocytes to produce CRP, fibrinogen and other acute phase proteins; CRP
rises within hours of inflammation and acts as an opsonin. It is a nonspecific marker. The marrow, spleen
and kidneys do not produce it.
6. The primary purpose of the inflammatory response is to:
A. Produce antibodies against specific antigens
B. Limit tissue damage, destroy invaders, remove debris, and prepare for healing
C. Create memory cells
D. Prevent all fever
Correct Answer: B. Limit tissue damage, destroy invaders, remove debris, and prepare for
healing
Rationale: Inflammation is rapid, nonspecific and does not require prior exposure; it contains injury and
begins repair. Antibody production and memory are features of adaptive immunity. Fever is often part of
the inflammatory response rather than prevented by it.
,7. A patient receives hepatitis B immune globulin after a needle-stick. This provides:
A. Artificial passive immunity that is immediate but temporary
B. Artificial active immunity that is lifelong
C. Natural active immunity
D. Natural passive immunity
Correct Answer: A. Artificial passive immunity that is immediate but temporary
Rationale: Immune globulin delivers preformed antibodies, giving immediate protection lasting weeks to
months without memory. The hepatitis B vaccine, given at the same time, produces active immunity.
Natural passive immunity comes from mother to baby.
8. A hapten is a small molecule that becomes immunogenic only when it:
A. Enters the bloodstream
B. Is phagocytosed
C. Binds to a larger carrier protein
D. Is filtered by the kidneys
Correct Answer: C. Binds to a larger carrier protein
Rationale: Haptens such as penicillin are too small alone but can bind host proteins and trigger immune
responses, explaining many drug allergies. Simply entering the blood or being filtered does not make
them immunogenic.
9. The first-line treatment for anaphylaxis is:
A. Oral antihistamine
B. Intramuscular epinephrine
C. Oral corticosteroid
D. Inhaled albuterol alone
Correct Answer: B. Intramuscular epinephrine
Rationale: Epinephrine reverses vasodilation, bronchoconstriction and mucosal edema through alpha
and beta effects, and delays increase mortality. Antihistamines and steroids are adjuncts that act too
slowly to prevent death. Albuterol treats bronchospasm only.
, 10. Hyperacute rejection of a transplanted kidney occurs:
A. Weeks after transplant from T cells
B. Within minutes to hours, from preformed recipient antibodies against donor antigens
C. Months to years later from chronic vascular damage
D. Only in liver transplants
Correct Answer: B. Within minutes to hours, from preformed recipient antibodies against
donor antigens
Rationale: Preformed antibodies, such as against ABO or HLA antigens, activate complement and cause
immediate thrombosis; crossmatching prevents it. Acute rejection is T-cell mediated and occurs within
weeks to months, and chronic rejection develops over years.
11. Culture and sensitivity testing is performed to:
A. Measure white blood cell count
B. Identify the organism and determine which antibiotics will be effective
C. Diagnose allergies
D. Measure antibody levels
Correct Answer: B. Identify the organism and determine which antibiotics will be effective
Rationale: Cultures identify the pathogen, and susceptibility testing guides targeted therapy, allowing
narrowing from broad-spectrum empiric antibiotics. Specimens should be collected before antibiotics
when possible.
12. A patient's reservoir of infection could include:
A. Only sick humans
B. People, animals, soil, water, or contaminated equipment
C. Only blood products
D. Only insects
Correct Answer: B. People, animals, soil, water, or contaminated equipment
Rationale: A reservoir is where a pathogen lives and multiplies; carriers without symptoms can also be
reservoirs. Environmental reservoirs include soil (tetanus) and water (Legionella). Reservoirs are not
limited to sick humans.
