NCLEX RN Style Exam Pathophysiology

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NCLEX-RN Sty le Exam: Pathophysiology (Ch. 1, 2, 3, 4, 7, 8, 9, 19)Instructions:Choose the best answer for each question.1. A client has a genetic mutation that prevents cellular apoptosis. Which of the following is themost likely complication?A. DehydrationB. InfectionC. CancerD. HypoglycemiaAnswer:C2.A nurse is explaining cellular adaptation to a patient Which is an example of hypertrophy?A. Uterine lining sheddingB. Skeletal muscle enlargement from weight trainingC. Liver shrinking after alcohol damageD.Cervical cell dysplasia from HPVAnswer:B3. A patient presents with severe hypoxia. Which compensatory response will the body initiate?A. Decreased respiratory rateB. Decreased erythropoiesisC. Increased ATP productionD.Increased red blood cell productionAnswer: D4.Which cellular change is most associated with precancerous conditions?A. AtrophyB. HypertrophyC. HyperplasiaD.DysplasiaAnswer: D

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5.Which mechanism is primarily responsible for the swelling that occurs during acuteinflammation?B.soconstnflfon of arteriolesC. Increased capillar’ permeabilityD. Red blood cell hemolysisAnswer:C6.The nurse knows that die hallmark signs of inflammation include all EXCEPT:A. RednessB. SwellingC. NumbnessD HeatAnswer:C7. Anurse caring for a bum patient knows that fluid shifts are caused by:A.Increased cardiac outputB. Decreased capillar.’ permeabilityC. Loss of protein through open woundsD. Vasoconstriction at the bum siteAnswer:C8.Which lab result would the nurse expect in a patient with chronic inflammation?A.Decreased white blood cell countB. Elevated C-reactive protein (CRP)C. Low erythrocyte sedimentation rate (ESR)D. Low neutrophilsAnswer:B9. What is the primarc function of mast cells in the immune response?A. Produce antibodiesB. Present antigens to T cellsC. Release histamine and other mediators

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D. Destroy7infected cellsAnswer:C10. Which patient would be at the highest risk for fluid volume excess?A.A patient with diarrheaB.Apatient receiving IV 0.9%NaCl rapidlyC. A patient with diabetes insipidus ,D. A patient with prolonged vomitingAnswer: B11. The nurse receives a patient with metabolic alkalosis. What is a possible cause?A. Diabetic ketoacidosisB. Chronic diarrheaC. Prolonged vomitingD.Respiratory failureAnswer:C12.Which arterial blood gas (AEG) value represents respiratory alkalosis?A.pH 7.48. PaCOz 28 mm HgB. pH 7.35. PaCO: 45 mm HgC. pH 7.29, HCOz 19 mEqLD. pH 7.42, HCOz 24 mEqLAnswer: A13. The nurse is reviewing an ABG with the following values: pH 7.31, PaCOz 51, HCOa 24.What is the interpretation9A.Metabolic alkalosisB. Respiratory alkalosisC. Metabolic acidosisD. Respiratory acidosisAnswer:D

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14. Which of the foilowing tumors would most likely be classified as benign?A. AdenocarciijajnaB.TipnsarcgpiaC. OsteomaD. Melanoma.Answer:C15.A client asks what makes cancer cells different. The nurse responds:A.''They die more quickly than healthy cells.1’B. ’’They grow in a regulated and limited manner.”C. ''They have uncontrolled growth and abnormal differentiation."D. "They do not use energy like normal cells."Answer:C16. A nurse is teaching about cancer warning signs. Which should be included9A. Loss of appetite after exerciseB. Sudden change in vision during a coldC. A mole that becomes irregular in shape and colorD. Muscle soreness after weight liftingAnswer:C17. Which cancer is associated with the Epstein-Barr virus?A.Cervical cancerB. Hodgkin lymphomaC. Lung cancerD. Prostate cancerAnswer:B18. What is the purpose of tumor suppressor genes?A. Promote cell divisionB. Trigger angiogenesisC. Prevent uncontrolled cell growth

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D.Enhance DNxA replicationAnswer:C19.Which condition involves widespread muscle and bone degeneration in aging?ASarcopeniaB.KyphosisC. GoutD.ScoliosisAnswer: A20. What is the most common cancer type in children?A.LeukemiaB. Colon cancerC. Breast cancerD. Lung cancer.Answer: A21. A client has high levels of tumor necrosis factor (TNF). The nurse should monitor for:A. Hyperglycemia and increased energyB. Tissue wasting and weight lossC. Hj.’povolemia and bradycardiaD. Excessive hair growthAnswer:B22. Which electrolyte imbalance is most concerning in a patient with renal failure?A. HypocalcemiaB. HyperkalemiaC. HyponatremiaD. HypomagnesemiaAnswerA23. Which patient is at highest risk for developing osteoporosis?

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A. A 22-year-old pregnant womanB.A50-year-old male athleteC.A65-year-old woman with low calcium intakeD. A 30-year-old male construction workerAnswer:24.The nurse understands that cell injury caused by ischemia is primarily due to:A. Increased DNA productionB. Decreased oxygen and ATP supplyC. Increased glucose metabolismD. Hyperkalemia in cellsAnswer:b25.A patient is receiving chemotherapy. Which lab result should the nurse report immediately?A. WBC 12:( W m m3B. Hemoglobin 13 g dLC. Platelet count 45,000 mm3D. Potassium 4.1 mEqLAnswe26.Which term best describes the loss of cell differentiation seen in malignant tumors?A. AutonomyB. AnaplasiaC. AngiogenesisD. DysplasiaAnswer27. Which complication should the nurse monitor for in a patient with a burn injury?A.Hypothermia from fluid retentionB. Hypernatremia due to fluid lossC. Hypovolemia from fluid shiftD.Hypercalcemia from tissue deathAnswerji®

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28.Which clinical finding is most consistent with fluid volume deficit0A. Edema and jugular vein distensionB. CracklesinlungsandhypertensionC. Tachycardia and dry mucous membranesD. Bounding pulse and decreased hematocritAnswer:£29. The nurse receives ABG results for a patient: pH 7.30,HCO=18, PaCO: 35.X\Tuchconditionis most likely?A.Respiratory acidosisB. Respiratory alkalosisC. Metabolic acidosisD. Metabolic alkalosisAnswer:30.What causes fever in cancer patients?A. DehydrationB. Low WBC countC. Tumor secretion of pyrogensD.Radiation therapyAnswer!31.Which immunecell isprimarily responsible for creating antibodies?A. T-helper cellsB.BlymphocylesC. Mast cellsD.Natural killer cellsAnswer;32.Which lab value is consistent with dehydration?

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A. Low hematocritB. Increased serum sodiumC. Decreased BUND. Decreased urine specific gravity33.Which electrolyte imbalance is commonly seen in a client with hyperaldosteronism0A. HypokalemiaB. HypercalcemiaC. HyponatremiaD. HypermagnesemiaAnswer:34.What is the most common mechanism of cancer metastasis?A. Sweat glandsB. Lymphatic systemC. Digestive systemD. Skin contactAnswer:35.A client with leukemia reports frequent infections. What is the cause?A. Increased mature neutrophilsB. Decreased red blood cellsC. Immature WBCs that cannot function properlyD. Overproduction of plateletsAnswer: f3d.Which acid-base imbalance is likely inaclient with chronic vomiting?A. Metabolic acidosisB. Respiratory alkalosisC. Metabolic alkalosisD. Respiratory acidosisAnswer: £

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37.Which lab value supportsadiagnosisofinflammation9A.Hemoglobin 15gdLB. C-reactive protein 12m g LC. Sodium 140 mEqLD. Glucose 90 mg dLAnswer:f t38.Apatient with Cushing's syndrome has muscle weakness. Which pathophysiologicmechanism explains this?A.HypercalcemiaB. Protein breakdown due to cortisolC. Increased insulin productionD. Decreased sodium levelsAnswer:f t39. What electrolyte imbalance is associated with diarrhea?A.HyperkalemiaB. HypokalemiaC. HypercalcemiaD. HypernatremiaAnswer:f t40. Which symptom is most concerning inapatient with brain cancer?A. Visual changesB. Low-grade feverC. NauseaD. FatigueAnswer:J41. Which of the following is most likely to stimulate angiogenesis in a tumor?

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A. HypoxiaB. HyperplasiaC. DysplasiaD. AcidosisAnswer:42. Which statement best describes apoptosis?A. Uncontrolled cell divisionB. Programmed cell deathC. Cell rupture from traumaD. Genetic mutationAnswer:flt43. A client with colorectal cancer reports constipation and narrow stools. This suggests:A. Liver metastasisB. Tumor obstructionC. RenfrdysfunctionD.PancreatitisAnswer44. What feature is most typical of benign tumors?A.Metastasize to nearby tissuesB. Poorly differentiatedC. Resemble tissue of originD. Rapid angiogenesisAnswer:45. The nurse notes lymphadenopathy in a client. Wliich cancer may be suspected?A.Basal cell carcinomaB. LeukemiaC. Colon cancerD. Hodgkin lymphomaAnswer:

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46.Which electrolyte imbalance causes tetany and muscle cramps?A. HyperkalemiaB. HypocalcemiaC. HypermagnesemiaD. HypernatremiaAnswer:A47. Which process occurs in the promotion stage of carcinogenesis?A.Mutation of the geneB. Tumor becomes benignC. Cell growth in response to promoterD. Tumor spreads to distant organsAnswer:48.What is the best indicator that chemotherapy is suppressing bone marrow?A.ElevatedB U NB. Low platelet countC. Decreased ALTD. High hemoglobinAnswer:f49.A client wi± anemia asks why they are so tired. The nurse replies:A."Your lungs aren't expanding well."B. "Your body lacks enough red blood cells to carry oxygen."C. "Your WBC count is too high."D. "Your electrolytes are out of balance."Answer:50.A nurse teaching about cancer prevention includes which statement?A. "Only genetics cause cancer."B. "Avoiding tobacco and maintaining a healthy weight helps lower your risk.

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C. "Cancer can be prevented with antibiotics."D. "Radiation from the sun doesn't affect your skin much.Answer: *Alright Shalom — let's begin yourExam 1 NCLEX-RN style question setbased on:SChapters 1,2 , 3 , 4 ,7 , 8 , 9 , 19( J Patho topics:Cellinjury &. death,immunity,inflammation, acid-base, fluids electrolytes,cancer, musculoskeletal, agingCd LippincottAVoLters Kluwer stylef a Includescase studies, priority, SATA, Bowtie formatsf a Hard levelto mimic real examssEvery question has a clearrationale♦QUESTION 1 — Clinical Judgment (Case-Based)A 72-year-old male presents with confusion, dry mucous membranes, and decreased urineoutput. Labs: Na'151,K~3.8, Cl'115, HCOr 25, BUN30,Creatinine 1.1.He has a recenthistory’ of flu with poor oral intake.Which intervention should the nurse anticipate FIRST?A. Administer 0.45% NS IVB. Encourage oral fluid intakeC. Administer potassium supplementsD. Administer sodium polystyrene sulfonateCorrect .Answer: A. Administer 0.45% NS IVRationale:The patient shows signs ofhypernatremia due to fluid volume deficitlikely frominsensible losses and decreased intake. Hypotonic fluids like 0.45% NS help correct sodiumslowly. Oral fluids are not safe if the patient is confused.vQUESTION 2 — S A T AAAliich of the following are clinical signs of metabolic acidosis?(Select all that apply)A. Kussmaul respirationsB. Restlessness and confusionC. Muscle crampsD. Decreased serum potassiumE. Warm, flushed skin

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Correct Answers: A, B, ERationale:•A:Kussmaul respirations help compensate for acidosis.•B: CNS symptoms like confusion are common.•E: Vasodilation leads to flushed skin.•C: More typical in alkalosis due to low calcium.•D:Potassium is usuallyelevated;notdecreased.<Q U E S T I O N 3 — Knowledge RecallXUhich acid-base disturbance is expected in a patient withprolonged vomiting0A.Metabolic acidosisB. Respiratory acidosisC. Metabolic, alkalosisD. Respiratory alkalosisCorrect Answer: C. Metabolic alkalosisRationale:Loss of stomachacid (HC1)leadstobicarbonate excess.QUESTION 4 — Bowtie (Clinical Reasoning)Patient Presentation:A 5S-year-old female undergoing chemotherapy7for breast cancer presents with fatigue, pallor,tachycardia, and Hgb of 7.4 g dL.Identify the likely condition:—* AnemiaKey Findings to support your choice:(Pick 2)•Pale conjunctiva.Hgb 7.4 g'dL•Increased appetite•Jaundice•Low BUNAnticipated interventions:(Pick 2)Administer PRBCsEncourage iron-rich foods

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