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NSG 1700 PATHOPHYSIOLOGY FINAL EXAM 1 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2025 GALEN COLLEGE OF NURSING
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1. A patient with left-sided heart failure is most likely to exhibit which symptom? a. Peripheral edema b. Pulmonary congestion c. Jugular vein distention d. Hepatomegaly Rationale: Left-sided heart failure results in fluid backing up into the lungs, leading to pulmonary congestion such as crackles, dyspnea, and orthopnea.
2. Which hormone is primarily responsible for lowering blood glucose levels? a. Glucagon b. Insulin c. Cortisol d. Epinephrine Rationale: Insulin facilitates the uptake of glucose into cells and decreases blood glucose levels. 3. What is the primary pathological mechanism in emphysema? a. Increased mucus production b. Bronchospasm c. Destruction of alveolar walls d. Infection of lung tissue Rationale: Emphysema involves permanent damage to the alveoli, decreasing surface area for gas exchange. 4. Which lab value is most indicative of renal function? a. Hematocrit b. Creatinine c. Hemoglobin d. Potassium Rationale: Serum creatinine is a key indicator of glomerular filtration and renal function.
8. What is the hallmark symptom of appendicitis? a. Left lower quadrant pain b. Generalized abdominal bloating c. Right lower quadrant pain d. Epigastric discomfort Rationale: RLQ pain at McBurney’s point is a classic sign of appendicitis. 9. Which electrolyte imbalance is most associated with cardiac dysrhythmias? a. Hypocalcemia b. Hyponatremia c. Hyperkalemia d. Hypomagnesemia Rationale: High potassium disrupts cardiac conduction and may lead to fatal arrhythmias. 10. What is the pathophysiology of Type 1 Diabetes Mellitus? a. Cellular insulin resistance b. Autoimmune destruction of beta cells c. Excess cortisol production d. Excessive carbohydrate intake Rationale: Type 1 DM results from immune-mediated destruction of pancreatic beta cells, halting insulin production.
11. Which condition involves chronic systemic inflammation and joint destruction? a. Osteoarthritis b. Rheumatoid arthritis c. Gout d. Bursitis Rationale: RA is an autoimmune disease causing joint inflammation and destruction. 12. What is the most common cause of peptic ulcer disease? a. NSAID overuse b. Alcohol abuse c. Helicobacter pylori infection d. Stress Rationale: H. pylori weakens the stomach lining, allowing ulcers to form. 13. In Parkinson’s disease, which neurotransmitter is deficient? a. Acetylcholine b. Serotonin c. Dopamine d. GABA Rationale: Parkinson's disease is caused by degeneration of dopamine- producing neurons in the substantia nigra. 14. Which respiratory disorder causes airway hyperresponsiveness and reversible obstruction?
17. What is the main cause of cellular injury during hypoxia? a. Increased protein synthesis b. Decreased intracellular calcium c. Decreased ATP production d. Increased sodium pump activity Rationale: Without oxygen, cells switch to anaerobic metabolism, reducing ATP and impairing cell function. 18. Which lab value is elevated in pancreatitis? a. ALT b. AST c. Amylase d. Bilirubin Rationale: Amylase and lipase are digestive enzymes elevated in pancreatitis. 19. Which disorder is associated with chronic elevation of cortisol? a. Addison’s disease b. Cushing’s syndrome c. Graves’ disease d. SIADH Rationale: Cushing’s involves excessive cortisol, leading to weight gain, moon face, and purple striae. 20. Which type of anemia is due to vitamin B12 deficiency? a. Iron-deficiency anemia
b. Aplastic anemia c. Pernicious anemia d. Hemolytic anemia Rationale: Pernicious anemia is caused by impaired absorption of B12 due to intrinsic factor deficiency.
21. What is the priority intervention in a patient with suspected stroke? a. Administer aspirin b. Begin heparin infusion c. Perform a CT scan d. Start IV fluids Rationale: A CT is needed to determine ischemic vs. hemorrhagic stroke before initiating treatment. 22. In SIADH, which electrolyte imbalance is commonly observed? a. Hyperkalemia b. Hyponatremia c. Hypernatremia d. Hypocalcemia Rationale: In SIADH, excessive ADH causes water retention, diluting sodium. 23. Which condition presents with a butterfly-shaped rash? a. Psoriasis b. Dermatitis
d. Obstruction of ureters Rationale: Glomerulonephritis is caused by antigen-antibody complexes damaging glomerular capillaries.
27. What is the best indicator of oxygenation in a patient with COPD? a. Capillary refill b. Heart rate c. Arterial blood gas d. Pulse oximetry Rationale: ABGs provide direct measurement of oxygen and carbon dioxide levels in the blood. 28. What is the key symptom of nephrotic syndrome? a. Hematuria b. Proteinuria c. Polyuria d. Azotemia Rationale: Nephrotic syndrome is marked by massive protein loss in the urine due to glomerular damage. 29. Which complication is most associated with long-term uncontrolled hypertension? a. Hyperthyroidism b. Pancreatitis c. Left ventricular hypertrophy d. Asthma
Rationale: High afterload from HTN causes the left ventricle to enlarge and thicken.
30. Which symptom is most characteristic of aortic stenosis? a. Productive cough b. Peripheral edema c. Systolic murmur d. Wheezing Rationale: Aortic stenosis creates turbulent flow during systole, producing a loud murmur. 31. Which condition is caused by a mutation affecting hemoglobin structure? a. Thalassemia b. Sickle cell anemia c. Hemophilia d. Pernicious anemia Rationale: In sickle cell anemia, a mutation in the beta-globin gene results in abnormal hemoglobin that distorts red blood cell shape under low oxygen. 32. Which compensatory mechanism is activated during hypovolemic shock? a. Decreased cardiac output b. Sympathetic nervous system activation
d. Increased bilirubin Rationale: Elevated lipase is a specific marker for pancreatic inflammation.
36. Which process best describes osteoarthritis? a. Degeneration of articular cartilage b. Autoimmune synovial destruction c. Infectious joint damage d. Bone marrow inflammation Rationale: OA is a wear-and-tear condition that breaks down cartilage in weight-bearing joints. 37. A patient with acute kidney injury (AKI) is most at risk for which electrolyte imbalance? a. Hypoglycemia b. Hypocalcemia c. Hyperkalemia d. Hypernatremia Rationale: Impaired kidney function prevents excretion of potassium, increasing serum levels. 38. Which disorder causes inflammation and ulceration of the colon’s mucosa? a. Crohn’s disease b. Ulcerative colitis c. IBS d. Diverticulitis
Rationale: Ulcerative colitis affects the colon’s mucosal layer, causing ulcers and bleeding.
39. What is the primary mechanism of injury in Guillain-Barré syndrome? a. Viral encephalitis b. Demyelination of peripheral nerves c. Ischemic stroke d. Spinal cord compression Rationale: Guillain-Barré is an autoimmune disease that targets peripheral myelin, causing motor weakness. 40. Which symptom is commonly associated with right-sided heart failure? a. Crackles in lungs b. Peripheral edema c. Dyspnea d. S3 heart sound Rationale: Right-sided HF leads to systemic venous congestion, causing swelling in the legs and abdomen. 41. Which hormone regulates water reabsorption in the kidneys? a. Aldosterone b. Antidiuretic hormone (ADH) c. Cortisol d. Parathyroid hormone
Rationale: Meningitis causes inflammation of the meninges, leading to increased pressure and sensitivity to light.
45. Which blood test is most indicative of myocardial infarction? a. BNP b. C-reactive protein c. Troponin I d. D-dimer Rationale: Troponin I is released into the bloodstream when myocardial cells are damaged. 46. What is the cause of diabetic ketoacidosis (DKA)? a. Too much insulin b. Lack of insulin leading to fat breakdown c. Dehydration d. Infection Rationale: In DKA, lack of insulin leads to the breakdown of fats for energy, producing ketones. 47. What is a common finding in chronic obstructive pulmonary disease (COPD)? a. Increased lung elasticity b. Hyperresponsive bronchi c. Air trapping and barrel chest d. Pulmonary embolism
Rationale: COPD leads to air trapping and overinflated lungs, resulting in a barrel chest appearance.
48. Which lab value is elevated in a patient with liver failure? a. Creatinine b. Troponin c. Ammonia d. Glucose Rationale: The failing liver cannot detoxify ammonia, leading to elevated serum levels and encephalopathy. 49. Which condition is linked to destruction of the adrenal cortex? a. Hyperthyroidism b. SIADH c. Addison’s disease d. Cushing’s syndrome Rationale: Addison’s is caused by autoimmune destruction of adrenal cortex, leading to cortisol and aldosterone deficiency. 50. A patient with metabolic acidosis will have which compensatory change? a. Decreased respiratory rate b. Increased respiratory rate c. Decreased urine output d. Bradycardia
Rationale: Rectal bleeding or blood in the stool is often the first noticeable symptom.
54. In peritonitis, what is the primary cause of rigid abdomen? a. Peristalsis b. Organ rupture c. Inflammation of the peritoneum d. Constipation Rationale: Infection or perforation causes severe inflammation, resulting in guarding and rigidity. 55. Which blood disorder causes increased bleeding time? a. Polycythemia b. Leukemia c. Thrombocytopenia d. Sickle cell disease Rationale: A low platelet count impairs clot formation, leading to prolonged bleeding. 56. Which condition leads to exophthalmos? a. Cushing’s syndrome b. Addison’s disease c. Graves’ disease d. Hashimoto’s thyroiditis Rationale: Graves’ is a hyperthyroid condition that causes protruding eyes due to inflammation and edema.
57. Which assessment finding suggests increased intracranial pressure? a. Tachycardia b. Hyperactivity c. Widened pulse pressure d. Hypotension Rationale: Cushing’s triad includes bradycardia, hypertension (widened PP), and irregular respirations. 58. What is the primary cause of GERD? a. Hiatal hernia b. Pyloric stenosis c. Lower esophageal sphincter dysfunction d. Esophageal cancer Rationale: GERD occurs when the LES weakens, allowing stomach acid to reflux into the esophagus. 59. Which symptom is typical of BPH (benign prostatic hyperplasia)? a. Testicular pain b. Difficulty initiating urination c. Hematuria d. Nocturnal emissions Rationale: BPH compresses the urethra, making it difficult to begin and maintain urine flow. 60. Which acid-base imbalance results from opioid overdose? a. Respiratory alkalosis
