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NCLEX RN Style Exam Pathophysiology

Focuses on cellular adaptation, hypoxia, apoptosis, and precancerous changes to help nursing students prepare for licensure exams.

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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 the most likely complication? A. Dehydration B. Infection C. Cancer D. Hypoglycemia Answer: C 2. A nurse is explaining cellular adaptation to a patient Which is an example of hypertrophy? A. Uterine lining shedding B. Skeletal muscle enlargement from weight training C. Liver shrinking after alcohol damage D. Cervical cell dysplasia from HPV Answer: B 3. A patient presents with severe hypoxia. Which compensatory response will the body initiate? A. Decreased respiratory rate B. Decreased erythropoiesis C. Increased ATP production D. Increased red blood cell production Answer: D 4. Which cellular change is most associated with precancerous conditions? A. Atrophy B. Hypertrophy C. Hyperplasia D. Dysplasia Answer: D

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    5. Which mechanism is primarily responsible for the swelling that occurs during acute inflammation? B. soconstnflfon of arterioles C. Increased capillar’ permeability D. Red blood cell hemolysis Answer: C 6. The nurse knows that die hallmark signs of inflammation include all EXCEPT: A. Redness B. Swelling C. Numbness D Heat Answer: C 7. A nurse caring for a bum patient knows that fluid shifts are caused by: A. Increased cardiac output B. Decreased capillar.’ permeability C. Loss of protein through open wounds D. Vasoconstriction at the bum site Answer: C 8. Which lab result would the nurse expect in a patient with chronic inflammation? A. Decreased white blood cell count B. Elevated C-reactive protein (CRP) C. Low erythrocyte sedimentation rate (ESR) D. Low neutrophils Answer: B 9. What is the primarc function of mast cells in the immune response? A. Produce antibodies B. Present antigens to T cells C. Release histamine and other mediators

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    D. Destroy 7 infected cells Answer: C 10. Which patient would be at the highest risk for fluid volume excess? A. A patient with diarrhea B. A patient receiving IV 0.9%NaCl rapidly C. A patient with diabetes insipidus , D. A patient with prolonged vomiting Answer: B 11. The nurse receives a patient with metabolic alkalosis. What is a possible cause? A. Diabetic ketoacidosis B. Chronic diarrhea C. Prolonged vomiting D. Respiratory failure Answer: C 12. Which arterial blood gas (AEG) value represents respiratory alkalosis? A. pH 7.48. PaCOz 28 mm Hg B. pH 7.35. PaCO: 45 mm Hg C. pH 7.29, HCOz 19 mEqL D. pH 7.42, HCOz 24 mEqL Answer: A 13. The nurse is reviewing an ABG with the following values: pH 7.31, PaCOz 51, HCOa 24. What is the interpretation 9 A. Metabolic alkalosis B. Respiratory alkalosis C. Metabolic acidosis D. Respiratory acidosis Answer: D

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    14. Which of the foilowing tumors would most likely be classified as benign? A. Adenocarciijajna B. T ipnsarcgpia C. Osteoma D. Melanoma. Answer: C 15. 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: C 16. A nurse is teaching about cancer warning signs. Which should be included 9 A. Loss of appetite after exercise B. Sudden change in vision during a cold C. A mole that becomes irregular in shape and color D. Muscle soreness after weight lifting Answer: C 17. Which cancer is associated with the Epstein-Barr virus? A. Cervical cancer B. Hodgkin lymphoma C. Lung cancer D. Prostate cancer Answer: B 18. What is the purpose of tumor suppressor genes? A. Promote cell division B. Trigger angiogenesis C. Prevent uncontrolled cell growth

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    D. Enhance DNxA replication Answer: C 19. Which condition involves widespread muscle and bone degeneration in aging? A Sarcopenia B. Kyphosis C. Gout D. Scoliosis Answer: A 20. What is the most common cancer type in children? A. Leukemia B. Colon cancer C. Breast cancer D. Lung cancer .Answer: A 21. A client has high levels of tumor necro sis factor (TNF). The nurse should monitor for: A. Hyperglycemia and increased energy B. Tissue wasting and weight loss C. Hj.’povolemia and bradycardia D. Excessive hair growth Answer: B 22. Which electrolyte imbalance is most concerning in a patient with renal failure? A. Hypocalcemia B. Hyperkalemia C. Hyponatremia D. Hypomagnesemia Answer A 23. Which patient is at highest risk for developing osteoporosis?

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    A. A 22-year-old pregnant woman B. A 50-year-old male athlete C. A 65-year-old woman with low calcium intake D. A 30-year-old male construction worker Answer: 24. The nurse understands that cell injury caused by ischemia is primarily due to: A. Increased DNA production B. Decreased oxygen and ATP supply C. Increased glucose metabolism D. Hyperkalemia in cells Answer: b 25. A patient is receiving chemotherapy. Which lab result should the nurse report immediately? A. WBC 12 : ( W m m 3 B. Hemoglobin 13 g dL C. Platelet count 45,000 mm 3 D. Potassium 4.1 mEqL Answe 26. Which term best describes the loss of cell differentiation seen in malignant tumors? A. Autonomy B. Anaplasia C. Angiogenesis D. Dysplasia Answer 27. Which complication should the nurse monitor for in a patient with a burn injury? A. Hypothermia from fluid retention B. Hypernatremia due to fluid loss C. Hypovolemia from fluid shift D. Hypercalcemia from tissue death Answerji®

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    28. Which clinical finding is most consistent with fluid volume deficit 0 A. Edema and jugular vein distension B. Crackles in lungs and hypertension C. Tachycardia and dry mucous membranes D. Bounding pulse and decreased hematocrit Answer: £ 29. The nurse receives ABG results for a patient: pH 7.30, HCO= 18, PaCO: 35. X\Tuch condition is most likely? A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis Answer: 30. What causes fever in cancer patients? A. Dehydration B. Low WBC count C. Tumor secretion of pyrogens D. Radiation therapy Answer ! 31. Which immune cell is primarily responsible for creating antibodies? A. T-helper cells B. B lymphocyles C. Mast cells D. Natural killer cells Answer; 32. Which lab value is consistent with dehydration?

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    A. Low hematocrit B. Increased serum sodium C. Decreased BUN D. Decreased urine specific gravity 33. Which electrolyte imbalance is commonly seen in a client with hyperaldosteronism 0 A. Hypokalemia B. Hypercalcemia C. Hyponatremia D. Hypermagnesemia Answer: 34. What is the most common mechanism of cancer metastasis? A. Sweat glands B. Lymphatic system C. Digestive system D. Skin contact Answer: 35. A client with leukemia reports frequent infections. What is the cause? A. Increased mature neutrophils B. Decreased red blood cells C. Immature WBCs that cannot function properly D. Overproduction of platelets Answer: f 3d. Which acid-base imbalance is likely in a client with chronic vomiting? A. Metabolic acidosis B. Respiratory alkalosis C. Metabolic alkalosis D. Respiratory acidosis Answer: £

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    37. Which lab value supports a diagnosis of inflammation 9 A. Hemoglobin 15 g dL B. C-reactive protein 12 m g L C. Sodium 140 mEq L D. Glucose 90 mg dL Answer: f t 38. A patient with Cushing's syndrome has muscle weakness. Which pathophysiologic mechanism explains this? A. Hypercalcemia B. Protein breakdown due to cortisol C. Increased insulin production D. Decreased sodium levels Answer: f t 39. What electrolyte imbalance is associated with diarrhea? A. Hyperkalemia B. Hypokalemia C. Hypercalcemia D. Hypernatremia Answer: f t 40. Which symptom is most concerning in a patient with brain cancer? A. Visual changes B. Low-grade fever C. Nausea D. Fatigue Answer: J 41. Which of the following is most likely to stimulate angiogenesis in a tumor?

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    A. Hypoxia B. Hyperplasia C. Dysplasia D. Acidosis Answer: 42. Which statement best describes apoptosis? A. Uncontrolled cell division B. Programmed cell death C. Cell rupture from trauma D. Genetic mutation Answer:flt 43. A client with colorectal cancer reports constipation and narrow stools. This suggests: A. Liver metastasis B. Tumor obstruction C. Renfrdysfunction D. Pancreatitis Answer 44. What feature is most typical of benign tumors? A. Metastasize to nearby tissues B. Poorly differentiated C. Resemble tissue of origin D. Rapid angiogenesis Answer: 45. The nurse notes lymphadenopathy in a client. Wliich cancer may be suspected? A. Basal cell carcinoma B. Leukemia C. Colon cancer D. Hodgkin lymphoma Answer:

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    46. Which electrolyte imbalance causes tetany and muscle cramps? A. Hyperkalemia B. Hypocalcemia C. Hypermagnesemia D. Hypernatremia Answer:A 47. Which process occurs in the promotion stage of carcinogenesis? A. Mutation of the gene B. Tumor becomes benign C. Cell growth in response to promoter D. Tumor spreads to distant organs Answer: 48. What is the best indicator that chemotherapy is suppressing bone marrow? A. Elevated B U N B. Low platelet count C. Decreased ALT D. High hemoglobin Answer: f 49. 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 your Exam 1 NCLEX-RN style question set based on: S Chapters 1, 2 , 3 , 4 , 7 , 8 , 9 , 19 ( J Patho topics: Cell injury &. death, immunity, inflammation, acid-base, fluids electrolytes, cancer, musculoskeletal, aging Cd LippincottAVoLters Kluwer style f a Includes case studies, priority, SATA, Bowtie formats f a Hard level to mimic real exams s Every question has a clear rationale ♦ QUESTION 1 — Clinical Judgment (Case-Based) A 72-year-old male presents with confusion, dry mucous membranes, and decreased urine output. Labs: Na' 15 1, K~ 3.8, Cl' 1 15, HCOr 25, BUN 30, Creatinine 1 .1. He has a recent history’ of flu with poor oral intake. Which intervention should the nurse anticipate FIRST? A. Administer 0.45% NS IV B. Encourage oral fluid intake C. Administer potassium supplements D. Administer sodium polystyrene sulfonate Correct .Answer: A. Administer 0.45% NS IV Rationale: The patient shows signs of hypernatremia due to fluid volume deficit likely from insensible losses and decreased intake. Hypotonic fluids like 0.45% NS help correct sodium slowly. Oral fluids are not safe if the patient is confused. v QUESTION 2 — S A T A AAliich of the following are clinical signs of metabolic acidosis? (Select all that apply) A. Kussmaul respirations B. Restlessness and confusion C. Muscle cramps D. Decreased serum potassium E. Warm, flushed skin

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    Correct Answers: A, B, E Rationale: • 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 usually elevated ; not decreased. < Q U E S T I O N 3 — Knowledge Recall XUhich acid-base disturbance is expected in a patient with prolonged vomiting 0 A. Metabolic acidosis B. Respiratory acidosis C. Metabolic, alkalosis D. Respiratory alkalosis Correct Answer: C. Metabolic alkalosis Rationale: Loss of stomach acid (HC1) leads to bicarbonate excess. QUESTION 4 — Bowtie (Clinical Reasoning) Patient Presentation: A 5S-year-old female undergoing chemotherapy 7 for breast cancer presents with fatigue, pallor, tachycardia, and Hgb of 7.4 g dL. Identify the likely condition: —* Anemia Key Findings to support your choice: (Pick 2) • Pale conjunctiva . Hgb 7.4 g'dL • Increased appetite • Jaundice • Low BUN Anticipated interventions: (Pick 2) Administer PRBCs Encourage iron-rich foods

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