Page 1 of 103
NSG 3850: PATHOPHYSIOLOGY FOR NURSES II (GALEN COLLEGE OF
NURSING) EXAM — COMPREHENSIVE —EXAM QUESTIONS LATEST
EDITION 2026 – 2027 VERSION SOLVED QUESTIONS & ANSWERS
1. A nursing student is reviewing the distribution of body fluids. Which statement
accurately describes the composition of the intracellular fluid (ICF) compartment?
A) High in sodium and chloride; low in potassium
B) High in potassium, magnesium, and phosphate; low in sodium and chloride
C) Equal concentrations of sodium and potassium
D) High in sodium and bicarbonate; low in protein
Answer: B
Rationale: The ICF is rich in potassium, magnesium, and phosphate, and low in sodium
and chloride, reflecting the ionic composition required for cellular metabolism and
enzyme function.
2. The nurse is teaching a patient about fluid balance. Which hormone is primarily
responsible for sodium and water retention by the kidneys?
A) Antidiuretic hormone (ADH)
B) Aldosterone
C) Atrial natriuretic peptide (ANP)
, Page 2 of 103
D) Brain natriuretic peptide (BNP)
Answer: B
Rationale: Aldosterone, released from the adrenal cortex, promotes sodium and water
reabsorption in the kidneys, increasing blood volume; ADH primarily regulates water
reabsorption, while ANP and BNP promote fluid excretion.
3. An older adult patient is at higher risk for dehydration due to age-related
changes. Which physiological change contributes to this increased risk?
A) Increased total body water percentage
B) Decreased thirst sensation and decreased glomerular filtration rate (GFR)
C) Increased glomerular filtration rate (GFR)
D) Enhanced renal concentrating ability
Answer: B
Rationale: Older adults have decreased total body water, a blunted thirst response, and
decreased GFR, all of which increase the risk of fluid volume deficits.
4. A patient with severe vomiting is at risk for which acid-base and electrolyte
disturbance?
A) Metabolic acidosis with hyperkalemia
B) Metabolic alkalosis with hypokalemia
C) Respiratory acidosis with hypernatremia
D) Respiratory alkalosis with hypocalcemia
Answer: B
Rationale: Vomiting causes loss of gastric hydrochloric acid and potassium, leading to
metabolic alkalosis and hypokalemia.
, Page 3 of 103
5. A patient with severe diarrhea develops metabolic acidosis. Which ABG finding is
most consistent with this condition?
A) Elevated pH and elevated HCO3
B) Decreased pH and decreased HCO3
C) Elevated pH and decreased PaCO2
D) Decreased pH and elevated PaCO2
Answer: B
Rationale: Severe diarrhea causes loss of bicarbonate-rich intestinal fluid, leading to
metabolic acidosis characterized by low pH and low bicarbonate.
6. A patient with an opioid overdose develops respiratory acidosis. Which ABG
pattern is expected?
A) pH 7.30, PaCO2 60, HCO3 26
B) pH 7.48, PaCO2 30, HCO3 24
C) pH 7.36, PaCO2 40, HCO3 24
D) pH 7.50, PaCO2 40, HCO3 30
Answer: A
Rationale: Opioid-induced hypoventilation causes CO2 retention, leading to respiratory
acidosis with a low pH and elevated PaCO2.
7. A patient with hyperventilation due to anxiety develops respiratory alkalosis.
Which finding is most characteristic?
A) Elevated pH with decreased PaCO2
B) Decreased pH with elevated PaCO2
C) Elevated pH with elevated HCO3
, Page 4 of 103
D) Decreased pH with decreased HCO3
Answer: A
Rationale: Hyperventilation eliminates excessive CO2, leading to respiratory alkalosis
characterized by elevated pH and decreased PaCO2.
8. A patient with syndrome of inappropriate antidiuretic hormone (SIADH) develops
hyponatremia. Which mechanism explains this finding?
A) Excess ADH causes excessive water reabsorption, leading to dilutional hyponatremia
B) ADH deficiency causes free water loss
C) Excess aldosterone causes sodium retention
D) Cortisol deficiency causes sodium loss
Answer: A
Rationale: SIADH is characterized by excessive ADH secretion, causing the kidneys to
reabsorb too much water, which leads to dilutional hyponatremia.
9. A patient with diabetes insipidus presents with hypernatremia and polyuria.
Which mechanism explains these findings?
A) Deficiency of ADH or renal resistance to ADH prevents water reabsorption
B) Excess ADH causes water retention
C) Excess aldosterone causes sodium retention
D) Insulin deficiency causes hyperglycemia
Answer: A
Rationale: Diabetes insipidus results from deficient ADH secretion or renal resistance,
leading to impaired water reabsorption, hypernatremia, and polyuria.
NSG 3850: PATHOPHYSIOLOGY FOR NURSES II (GALEN COLLEGE OF
NURSING) EXAM — COMPREHENSIVE —EXAM QUESTIONS LATEST
EDITION 2026 – 2027 VERSION SOLVED QUESTIONS & ANSWERS
1. A nursing student is reviewing the distribution of body fluids. Which statement
accurately describes the composition of the intracellular fluid (ICF) compartment?
A) High in sodium and chloride; low in potassium
B) High in potassium, magnesium, and phosphate; low in sodium and chloride
C) Equal concentrations of sodium and potassium
D) High in sodium and bicarbonate; low in protein
Answer: B
Rationale: The ICF is rich in potassium, magnesium, and phosphate, and low in sodium
and chloride, reflecting the ionic composition required for cellular metabolism and
enzyme function.
2. The nurse is teaching a patient about fluid balance. Which hormone is primarily
responsible for sodium and water retention by the kidneys?
A) Antidiuretic hormone (ADH)
B) Aldosterone
C) Atrial natriuretic peptide (ANP)
, Page 2 of 103
D) Brain natriuretic peptide (BNP)
Answer: B
Rationale: Aldosterone, released from the adrenal cortex, promotes sodium and water
reabsorption in the kidneys, increasing blood volume; ADH primarily regulates water
reabsorption, while ANP and BNP promote fluid excretion.
3. An older adult patient is at higher risk for dehydration due to age-related
changes. Which physiological change contributes to this increased risk?
A) Increased total body water percentage
B) Decreased thirst sensation and decreased glomerular filtration rate (GFR)
C) Increased glomerular filtration rate (GFR)
D) Enhanced renal concentrating ability
Answer: B
Rationale: Older adults have decreased total body water, a blunted thirst response, and
decreased GFR, all of which increase the risk of fluid volume deficits.
4. A patient with severe vomiting is at risk for which acid-base and electrolyte
disturbance?
A) Metabolic acidosis with hyperkalemia
B) Metabolic alkalosis with hypokalemia
C) Respiratory acidosis with hypernatremia
D) Respiratory alkalosis with hypocalcemia
Answer: B
Rationale: Vomiting causes loss of gastric hydrochloric acid and potassium, leading to
metabolic alkalosis and hypokalemia.
, Page 3 of 103
5. A patient with severe diarrhea develops metabolic acidosis. Which ABG finding is
most consistent with this condition?
A) Elevated pH and elevated HCO3
B) Decreased pH and decreased HCO3
C) Elevated pH and decreased PaCO2
D) Decreased pH and elevated PaCO2
Answer: B
Rationale: Severe diarrhea causes loss of bicarbonate-rich intestinal fluid, leading to
metabolic acidosis characterized by low pH and low bicarbonate.
6. A patient with an opioid overdose develops respiratory acidosis. Which ABG
pattern is expected?
A) pH 7.30, PaCO2 60, HCO3 26
B) pH 7.48, PaCO2 30, HCO3 24
C) pH 7.36, PaCO2 40, HCO3 24
D) pH 7.50, PaCO2 40, HCO3 30
Answer: A
Rationale: Opioid-induced hypoventilation causes CO2 retention, leading to respiratory
acidosis with a low pH and elevated PaCO2.
7. A patient with hyperventilation due to anxiety develops respiratory alkalosis.
Which finding is most characteristic?
A) Elevated pH with decreased PaCO2
B) Decreased pH with elevated PaCO2
C) Elevated pH with elevated HCO3
, Page 4 of 103
D) Decreased pH with decreased HCO3
Answer: A
Rationale: Hyperventilation eliminates excessive CO2, leading to respiratory alkalosis
characterized by elevated pH and decreased PaCO2.
8. A patient with syndrome of inappropriate antidiuretic hormone (SIADH) develops
hyponatremia. Which mechanism explains this finding?
A) Excess ADH causes excessive water reabsorption, leading to dilutional hyponatremia
B) ADH deficiency causes free water loss
C) Excess aldosterone causes sodium retention
D) Cortisol deficiency causes sodium loss
Answer: A
Rationale: SIADH is characterized by excessive ADH secretion, causing the kidneys to
reabsorb too much water, which leads to dilutional hyponatremia.
9. A patient with diabetes insipidus presents with hypernatremia and polyuria.
Which mechanism explains these findings?
A) Deficiency of ADH or renal resistance to ADH prevents water reabsorption
B) Excess ADH causes water retention
C) Excess aldosterone causes sodium retention
D) Insulin deficiency causes hyperglycemia
Answer: A
Rationale: Diabetes insipidus results from deficient ADH secretion or renal resistance,
leading to impaired water reabsorption, hypernatremia, and polyuria.
