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    Exam Review

    1. A nurse is reviewing complications of increased intracranial pressure (ICP). Which mechanism most directly results in brain herniation?
      A)
      Decreased cerebral perfusion.
      B)
      Displacement of brain tissue.
      C)
      Reduced cerebrospinal fluid (CSF) formation.
      D)
      Disruption of cerebral autoregulation.
    2. Which sequence correctly represents phagocytosis?
      A)
      Chemotaxis, engulfment, digestion, exocytosis.
      B)
      Digestion, chemotaxis, engulfment, exocytosis.
      C)
      Engulfment, digestion, chemotaxis, exocytosis.
      D)
      Engulfment, chemotaxis, digestion, exocytosis.
    3. Which finding indicates appropriate compensation for metabolic acidosis?
      A)
      Increased bicarbonate excretion.
      B)
      Decreased respiratory rate.
      C)
      Increased respiratory rate.
      D)
      Decreased oxygen saturation.
    4. A client with an acute bacterial infection has a marked increase in neutrophils. Which function best explains their role in the inflammatory response?
      A)
      Production of antibodies.
      B)
      Phagocytosis and destruction of pathogens.
      C)
      Direct destruction of infected host cells.
      D)
      Regulation of immune memory.
    Page 1 of 17

    Exam Review

    1. A client with metabolic alkalosis secondary to prolonged vomiting is at highest risk for which electrolyte imbalance?
      A)
      Hypophosphatemia.
      B)
      Hyponatremia.
      C)
      Hypocalcemia.
      D)
      Hypokalemia.
    2. A client is diagnosed with glaucoma. The nurse understands this condition is associated with which pathophysiologic changes?
      (SATA)
      A)
      Impaired aqueous humor drainage.
      B)
      Separation of the retina from the choroid.
      C)
      Gradual narrowing of the visual field.
      D)
      Loss of peripheral vision over time.
    3. Which finding suggests posterior pituitary dysfunction?
      A)
      Elevated TSH.
      B)
      Low ACTH.
      C)
      Excess ADH.
      D)
      Increased cortisol.
    4. Order: 150 mg PO. Available: 100 mg tablets. How many tablets will the nurse administer? . . .
      Correct Answer:1.5 tablets
    Page 2 of 17

    Exam Review

    1. The nurse is reviewing disorders of the immune system. Which scenario best represents an autoimmune disease?
      A)
      Activation of T lymphocytes in response to a viral infection.
      B)
      The immune system mounting a response against the body's own tissues.
      C)
      Antibodies attacking transfused red blood cells following a mismatched transfusion.
      D)
      Rapid onset of hives and bronchospasm after exposure to an allergen.
    2. A client with untreated otitis media develops mastoiditis. The nurse is most concerned about which complication?
      A)
      Inflammation limited to the external ear.
      B)
      Increased cerumen production.
      C)
      Spread of infection to brain.
      D)
      Temporary conductive hearing loss only.
    3. A patient reports difficulty hearing conversations but states that turning up the television improves hearing clarity. Which pathophysiologic condition is most likely responsible?
      A)
      Damage to the vestibular nerve.
      B)
      Degeneration of cochlear hair cells.
      C)
      Degeneration of the auditory cortex.
      D)
      Obstruction of sound transmission.
    4. Which mechanism best explains weight gain in hypothyroidism?
      A)
      Increased protein synthesis.
      B)
      Decreased basal metabolic rate.
      C)
      Increased glucose metabolism.
      D)
      Increased catecholamine sensitivity.
    Page 3 of 17

    Exam Review

    1. A client with type 1 diabetes mellitus presents to the emergency department with nausea, vomiting, and abdominal pain. Assessment findings include: Blood glucose: 420 mg/dL. Arterial pH: 7.25. Serum bicarbonate: 15 mEq/L. Respirations: deep and rapid. Breath odor: fruity. Which pathophysiologic process is primarily responsible for this client's condition?
      A)
      Decreased glucagon secretion resulting in metabolic alkalosis.
      B)
      Increased insulin production causing hypoglycemia.
      C)
      Inability to use glucose leading to fat breakdown and ketone production.
      D)
      Excess aldosterone secretion causing sodium retention.
    2. A patient with Addison disease presents with hyperpigmentation. What is the cause?
      A)
      Increased ACTH stimulating melanocytes.
      B)
      Increased thyroid hormone production.
      C)
      Decreased aldosterone levels.
      D)
      Increased melanin due to high cortisol.
    3. The nurse is reviewing factors that contribute to bacterial antibiotic resistance. Which mechanism most directly enables bacteria to survive antibiotic therapy?
      A)
      Mutation altering drug target sites.
      B)
      Increased phagocytic activity by host immune cells.
      C)
      Increased inflammatory response at the site of infection.
      D)
      Enhanced production of antibodies by the host.
    4. A patient with untreated Graves' disease develops fever, tachycardia, and confusion. What is the underlying pathophysiology?
      A)
      Autoimmune destruction of thyroid tissue.
      B)
      Sudden decrease in thyroid hormone production.
      C)
      Excessive release of thyroid hormones causing hypermetabolic state.
      D)
      Decreased TSH secretion from the pituitary.
    Page 4 of 17

    Exam Review

    1. A nurse is assessing a client with a recent tissue injury. Which finding most clearly indicates the client is experiencing a systemic inflammatory response rather than a localized response?
      A)
      Erythema and warmth confined to the incision site.
      B)
      Elevated temperature of 38.9 degrees Celsius (102 degrees Fahrenheit).
      C)
      Serous drainage noted at the wound edges.
      D)
      Edema and tenderness surrounding the affected tissue.
    2. A patient with a pituitary adenoma secreting excess ACTH is evaluated. Which finding best demonstrates disruption of normal negative feedback?
      A)
      Fluctuating cortisol levels with normal ACTH.
      B)
      Elevated cortisol levels suppressing ACTH secretion.
      C)
      Persistently elevated ACTH despite high cortisol levels.
      D)
      Decreased cortisol levels despite elevated ACTH.
    3. A client with a T6 spinal cord injury suddenly develops severe hypertension, headache, flushed skin above the level of injury, and cool, pale lower extremities. Which pathophysiologic mechanism best explains these findings?
      A)
      Uncontrolled sympathetic response below the level of injury.
      B)
      Decreased norepinephrine release causing systemic hypotension.
      C)
      Increased intracranial pressure causing reflex bradycardia.
      D)
      Loss of parasympathetic control leading to widespread vasodilation.
    4. A client is diagnosed with a mild traumatic brain injury (concussion). Which finding is most expected?
      A)
      Severe motor deficits and paralysis.
      B)
      Persistent coma lasting several days.
      C)
      Unequal pupils with no response to light.
      D)
      Brief loss of consciousness and confusion.
    Page 5 of 17

    Exam Review

    1. Which function is specific to B lymphocytes?
      A)
      Activation of macrophages.
      B)
      Recognition of MHC I molecules.
      C)
      Direct killing of infected cells.
      D)
      Production of antibodies.
    2. A client with chronic kidney disease presents with: pH 7.25, PaCO2 36 mmHg, HCO3 16 mEq/L, and Potassium 5.8 mEq/L. Which complication should the nurse prioritize?
      A)
      Seizure activity.
      B)
      Cardiac dysrhythmias.
      C)
      Respiratory acidosis.
      D)
      Metabolic alkalosis.
    3. A client with diabetic ketoacidosis (DKA) has Kussmaul respirations. What is the primary purpose of this breathing pattern?
      A)
      Increase oxygen delivery.
      B)
      Retain CO2 to increase pH.
      C)
      Eliminate CO2 to decrease acidity.
      D)
      Compensate for metabolic alkalosis.
    4. Which situation would increase permeability of the blood-brain barrier?
      A)
      Stable blood pressure.
      B)
      Oxygen saturations above 95
      C)
      Glucose level of 90.
      D)
      Inflammation and infection.
    Page 6 of 17