Pathophysiology Exam Two Practice Exam

As was mentioned on the last practice exam, this is a student made mock exam to assist in
preparing for the actual exam. This was created prior to completing the exam so it will not
indicate your success on the actual exam.

Once again, this is student made and does not represent the actual exam. There may be errors in
some questions, if you notice any please reach out :)

Week Six: Alterations of Pulmonary Function

1. A disease in question has high infectivity but low communicability. This would mean…
a. It spreads easily from person to person but does not multiply well in the host
b. Causes disease easily but does not spread easily from person to person
c. Has low potency but causes disease easily
d. Multiplies easily in a host but does not spread easily from person to person

2. A potent disease means it has…

a. High Virulence
b. Low Infectivity
c. High Infectivity
d. Low Virulence

3. A disease has an ID50 of 1000000, this would mean…

a. It requires 1000000 cells to effectively infect 50% of a population
b. It requires 1000000 cells to produce infection in 50% of a population
c. It requires 1000000 cells to produce death in 50% of infected people

4. Correctly order the stages of viral infection of a host cell (b,f,a,e,c,d,g)

a. Uncoating of viral genome
b. Recognition and attachment of a host cell
c. Translation of viral genome
d. Assembly of virus
e. Replication of viral genome
f. Penetration of the host cell
g. Release of virus in cell

5. Which statement by a client recently infected with COVID shows an understanding?

a. “Sure I was infected but I’m not showing any symptoms so I’m fine”
b. “I need to wear and mask and wipe down any surfaces to prevent the spread”
c. “Levels of COVID are highest in sputum, urine, and feces”
 d. “I’ll isolate until 7 days after I start symptoms because I won’t be as
transmissible”

6. COVID-19 can result in a hyperinflammatory response known as a “cytokine storm”

a. True
b. False

7. Which statements surrounding COVID are correct? SATA

a. Approximately 25% of cases are asymptomatic
b. Respiratory failure and septic shock are rare outcomes
c. Thrombotic events are the leading cause of mortality
d. Most recover after 3-4 weeks of infection
e. Damage to neuro, cardiac, endocrine, hepatic, and renal systems are possible

8. COVID binds to the — receptor in the body which is found primarily in the —.
a. ACE2; heart, lungs, pancreas
b. SARS; lungs, brain, fat
c. ACE2; lungs, brain, fat
d. SARS; heart, lungs, pancreas

9. Which laboratory tests would be expected for a patient diagnosed with COVID? SATA
a. Unilateral lung infiltrates on a CT
b. Decreased lymphocytes
c. Increased lymphocytes
d. Elevated inflammatory cytokines
e. Decreased D-dimer

10. An mRNA use modified version of one virus as a vector to deliver genetic material
coding into hosts’ cells to elicit immune response to virus
a. True
b. False

11. Tixagevimab and Cilgavimab are examples of monoclonal antibodies. They are
administered as…
a. One 6.0 mL IM injection
b. 100 mg of Tixagevimab, 300 mg of Cilgavimab taken orally
c. 300 mg of Tixagevimab, 100 mg of Cilgavimab taken orally
d. Two 3.0 mL IM injection

12. Which client would be prescribed Tixagevimab and Cilgavimab?

a. A 10 year old with a compromised immune system exposed to COVID
 b. A 20 year old with a healthy immune system not yet exposed to COVID
c. A 50 year old with a compromised immune system not yet exposed to COVID
d. An infant with a healthy immune system not yet exposed to COVID

13. Nirmatrelvir/Ritonavir (also called Paxlovid) have the following criteria… SATA
a. 60 years or older
b. Unconfirmed COVID diagnosis
c. 18-59 with a high risk of severe COVID
d. Last vaccine dose was less than 6 months prior
e. Unvaccinated/partial vaccination status
f. Any age if immunocompromised

14. What is the mechanism of action of Nirmatrelvir

a. Inhibits SARS-CoV-2’s main protease disrupting viral replication
b. Inhibits cytochrome P450-mediated metabolism of Ritonavir
c. Destroys the bacterial cell wall causing cell lysis

15. Which statement by a patient recently prescribed Dexamethasone would indicate a

correct understanding of the medication?
a. “I may experience hypertension and seizures while on this medication, but that's
normal and I should not report it”
b. “If I need to stop taking this medication I should be tapered off of it”
c. “I may need to carry candies with me to combat hypoglycemia”
d. “Edema may occur due to an increased permeability of my capillaries”

16. Your patient has an acute onset of bilateral infiltrates on chest x-ray and low oxygen
saturation. Upon giving them supplemental oxygen their saturation is still low. The nurse
should expect…
a. Severe COVID
b. Pneumonia
c. ARDS
d. Systemic Inflammation

17. Which of the following are clinical manifestations of PARDS? SATA

a. Pulmonary edema
b. Severe hypoxemia
c. Sudden respiratory distress
d. Pulmonary Atresia
e. Increased pulmonary compliance
f. Pulmonary infiltrates
18. Match each stage of ARDS with their description. SATA
a. Exudative; Membrane damage, pulmonary edema
b. Proliferative; Resolution of pulmonary edema
c. Fibrotic; Severe left to right shunting
d. Exudative; Occurs within 12 hours
e. Proliferative; Acute respiratory failure
f. Fibrotic; Remodeling and fibrosis of lung tissue

19. An individual with ARDS may experience dyspnea, hypoxemia, respiratory alkalosis,
metabolic acidosis, increased work of breathing, and hypoventilation.
a. True
b. False

20. What are the three major criteria for diagnosis for ARDS. SATA
a. New or worsening respiratory symptoms
b. Blood gas analysis of respiratory acidosis and PaCO2 is
≥50
c. Bilateral opacities not explained by effusions, lobar/lung collapse, or nodules
d. Respiratory failure not fully explained by cardiac failure
e. O2 Saturation below 90% even with supplemental oxygen

21. A parent tells the nurse their 4 year old child has been diagnosed with viral croup and is
unsure how this happened. What health teaching can the nurse provide?
a. “Your child is too old to get viral croup, it must be another illness”
b. “This can occur from various viruses, you should look them up”
c. “The most common cause is RSV, but rubella, rhinovirus, and atypical bacteria
can cause it as well”
d. “There is a high chance it was from parainfluenza, if not other viruses such
as RSV or rubella can cause it”

22. A child with viral croup may present with which clinical manifestations? SATA
a. Sore throat
b. Pulmonary Edema
c. Barking cough
d. Stridor
e. Blurry Vision

23. Which statement from a nursing student would indicate an understanding of

bronchiolitis?
a. “RSV is the most common cause and it occurs mainly in adolescence”
 b. “Infants will have a very runny nose and a dry cough, then respiratory
distress”
c. “This is the leading cause of adult hospitalization”
d. “Few children also present with conjunctivitis or otitis media”
e. “May result from atelectasis, ventilation-perfusion mismatch, or obstructed
airway”

24. What health teaching can a nurse provide to a parent worried about preventing
bronchiolitis? SATA
a. Wash your hands with soap or an alcohol based cleanser regularly
b. Prevent your child from being exposed to tobacco smoke
c. Place a humidifier near your child’s bedroom
d. Introduce your child to potential viral sources to build tolerance

Week Seven: Gastrointestinal

25. A simple obstruction of the intestines is most likely to be found in the —-- because it is
—---.
a. Large intestine, Narrower
b. Small intestine, Narrower
c. Large intestine, Longer
d. Small intestine, Longer

26. An infolding of one part of the intestine into another is also known as a…
a. Intussusception
b. Adhesion
c. Herniation
d. Volvulus

27. Your patient has a distended abdomen and complains of hypogastric pain. You should
suspect an obstruction in the…
a. Small Intestine
b. Large Intestine
c. Gallbladder
d. Stomach

28. What statement from a nursing student requires follow up in regards to treatment for
intestinal obstructions.
a. “It is important to replace the patient’s electrolytes and fluid”
b. “If there is strangulation or a complete blockage, they will need surgery”
c. “The patient may need laxatives to remove any packed fecal matter ”
d. “Gastric suctioning may be necessary”
29. Inflammation of the projection of the apex of the cecum is also known as…
a. Appendicitis
b. Pancreatitis
c. Choleothiasis

30. Possible causes of appendicitis include; SATA

a. Obstruction
b. Infection
c. Decompression
d. Inflammation
e. Ischemia
f. Decreased Intraluminal Pressure
g. Increased Intraluminal Pressure

31. Your patient has been diagnosed with appendicitis, they don’t think it is a concern. How
should you respond as the nurse?
a. “Appendicitis can develop into pancreatitis if you do not treat it in time”
b. “This is a serious concern, you can develop further infection and
perforation”
c. “You don't know what you’re talking about, it can seriously harm you”
d. “You’re right, your body will heal naturally with rest”

32. The pancreas produces many important digestive enzymes. Match the following enzymes
with their respective macromolecules. SATA
a. Trypsin; Protein
b. Lipase; Lipids
c. Amylase; Carbohydrates
d. Chymotrypsin; Lipids

33. The primary mechanism of cell injury in pancreatitis is;

a. Autodigestion due to pancreatic enzymes
b. Intracellular calcium overload
c. Activation of proinflammatory pathways
d. Ischemia due to edema and vessel permeability

34. Which of the following are complications of acute pancreatitis;

a. Inflammation
b. Cholithiasis
c. Paralytic Ileus
d. Sepsis
 e. AARDS
f. Nephrolithiasis
g. Renal Failure
h. Heart Failure

35. Choose the incorrect statement surrounding acute pancreatitis.

a. “Lipase is the primary diagnostic marker”
b. “Lower abdominal pain is a common finding”
c. “Narcotics and NSAIDs may be given during treatment”
d. “The patient may need nasogastric suctioning”

36. Your patient is ordered crystalloid fluids. What health teaching would you consider
providing?
a. “The doctor prescribed these to increase your plasma volume”
b. “You were at risk of potassium overload so we are giving you lactated ringer”
c. “These fluids will help rebalance your electrolytes”

37. Select the fluids below that would be classified as colloid. SATA
a. Normal Saline
b. Plasma-Lytes
c. Albumin
d. Hetastarch
e. Lactated Ringer

38. Your patient has choleolithiasis, this is a result of — being supersaturated with —
a. Bile; Cholesterol
b. Bile; Lipase
c. Calcium, Bile
d. Calcium; Cholesterol

39. Which of the following may increase the risk of choleolithiasis formation? SATA
a. Increased cholesterol synthesis
b. Increased secretion of bile acid
c. Gallbladder hypomotility
d. Increased resorption of bile salts
e. Genetic predisposition
f. Increased secretion of gallbladder mucin

40. What is true of black pigmented stones in choleolithiasis?

a. They are a result of bacterial infection
b. They form outside the gallbladder and are composed of calcium bilirubinate
 c. They are associated with chronic liver disease and hemolytic disease
d. They are associated with biliary stasis and biliary parasites

41. Which of the following might a patient with choleolithiasis show signs of? SATA
a. Right hypochondrium pain
b. Left hypochondrium pain
c. Biliary Atresia
d. Biliary Colic
e. Jaundice
f. Fatty Food Preference

42. A patient with choleolithiasis has concerns about their treatment plan, which statement by
the physician may require follow up from the nurse.
a. “We can discuss transluminal endoscopic surgery for your care”
b. “Laparoscopic cholecystectomy is the preferred treatment”
c. “An alternative form of treatment is bile acid chenodeoxycholic acid”
d. “Your stones are small so we will need to order a lithotripsy”

43. What health teaching should you provide your patient who has recently been prescribed
Ketorolac for treatment of their choleocystitis? SATA
a. “You have been given this synthetic glucocorticoid to reduce your inflammation”
b. “Notify your physician if you notice an upset stomach or excess bruising”
c. “This should reduce the pain associated with your gallbladder stones”
d. “Reduce your alcohol intake while taking these medications to reduce
damage to the liver and kidney”

44. Your patient is taking Cefotaxime for cholecystitis, the nurse should monitor for which
adverse reactions? SATA
a. Upset GI System
b. Disulfiram effect with alcohol
c. Metallic Taste in Mouth
d. Reduced Prothrombin Levels

45. Metronidazole is a nitroimidazole antibiotic which enters bacterial cells and…

a. Breaks down the cell wall leading to cell lysis
b. Inhibits cell wall synthesis leading to cell lysis
c. Disrupts DNA and protein synthesis leading to cell death
d. Fills a cell’s nucleus with nitrogen leading to cell death

46. The most common site for intussusception is the ileum invaginating into the cecum.
a. True
 b. False

47. If left untreated, intussusception may lead to… SATA

a. Bleeding
b. Necrosis
c. Clotting
d. Gangrene
e. Perforation

48. Necrotizing enterocolitis is an — which causes —. If left untreated it can cause death.
a. Ischemic Condition; Bowel Necrosis
b. Infectious Condition; Sepsis
c. Ischemic Condition; Sepsis
d. Infectious Condition; Bowel Necrosis

49. Which of the following are clinical manifestations of necrotizing enterocolitis? SATA
a. Feed intolerance
b. Bloody stools
c. Rising Platelets
d. Septicemia
e. Decreased WBC
f. Tachycardia
g. Apnea

Week Eight: Renal Disorders

50. What are the following normal functions of the kidney? SATA
a. Homeostasis of the body fluids
b. Convert 1 L of fluids into urine per day
c. Regulate plasma osmolality
d. Fluid gas exchange

51. Nephrolithiasis are also known as — and commonly form in the —-.
a. Gallbladder Stone; Gallbladder
b. Kidney Stones; Renal Calyces, Renal Pelvis
c. Kidney Stones; Unilateral Kidney

52. A client has a diet that is high in purines, what is the primary material of nephrolithiasis
they are most at risk for?
a. Calcium oxalate
b. Calcium phosphate
 c. Struvite
d. Ammonium
e. Uric acid

53. Which client is at highest risk for Nephroliathis?

a. A 60 year old white woman working from home
b. A 21 year old who drinks plenty of alcohol and little water
c. An 80 year old woman who is bed bound with a catheter in place
d. A 60 year old man working as a nurse in the summer

54. Match the correct form of kidney stone formation with its explanation. SATA
a. Supersaturation; higher concentration of salts than can dissolve
b. Precipitation; solid from liquid reaction
c. Crystallization; large crystals from smaller ones
d. Supersaturation; lower concentration of salts than can dissolve
e. Precipitation; liquid from solid reaction
f. Crystallization; small crystals form larger ones

55. Which of the following conditions increase kidney stone formation?

a. Hypocalciuria, Hyperoxaluria, Hyperuricosuria, Hypocitraturia
b. Hypercalciuria, Hyperoxaluria, Hypouricosuria, Hypercitraturia
c. Hypercalciuria, Hyperoxaluria, Hyperuricosuria, Hypocitraturia

56. Staghorn calculi are small and fill the major and minor clayces.
a. True
b. False

57. A patient complains of renal pain, urgency, and incontinence. The nurse should suspect
that the kidney stone is in the….
a. Renal Pelvis
b. Mid Ureter
c. Lower ureter
d. Upper Ureter

58. An obstructing kidney stone and a suspected UTI is — requiring —.

a. An emergency; Stone Removal, NSAIDs, Antibiotics
b. An emergency; Stone Removal, Antibiotics, Decompression
c. High Concern; Stone Removal, Antibiotics, Decompression
d. Low Concern; Stone Removal, NSAIDs, Antibiotics

59. The most common underlying risk factors for Acute Pyelonephritis are… Pick Two.
 a. Urinary Obstruction
b. Catheter Usage
c. Reflux of Urine
d. Diabetes
e. Current UTI

60. Additional risk factors for Acute Pyelonephritis are… SATA

a. Diabetes
b. Current UTI
c. Spermicide Usage
d. Sex Without a Condom
e. Pubertal Children
f. Pregnant Woman

61. A patient would complain of which symptoms if they have Acute Pyelonephritis? SATA
a. Oliguria
b. Flank Pain
c. Dehydration
d. Excess Drinking
e. Mild, tender back
f. Tachycardia

62. A female client is taking Ciprofloxacin for uncomplicated acute pyelonephritis, which
statement by the client requires action from the nurse?
a. “This medication is an antibiotic, so I should take it with food”
b. “I can continue taking my iron supplement as normal”
c. “I should not take this medication if I am pregnant”
d. “I should avoid taking antacids while taking this medication”

63. What health teaching should a nurse provide for a patient on Ciprofloxacin? SATA
a. “You may notice sleep disturbances while on the medication”
b. “Speak to your physician before taking OTC pain medication”
c. “You were prescribed this to treat your Complicated Acute Pyelonephritis”
d. “You should continue to take your gastric reflux medicine as normal”

64. Sulfonamides work by:

a. Inhibiting sequential steps in bacterial folic acid synthesis
b. Inhibiting DNA gyrase and topoisomerase IV
c. Inhibiting bacterial protein synthesis and causes the synthesis of abnormal
proteins
d. Disrupting the cell walls of bacteria, leading to their death
65. Which of the following are examples of Secondary glomerular injury SATA
a. Ischemia
b. Hypertension
c. Infection
d. Congestive heart failure
e. HIV-related kidney disease
f. Vascular disorders

66. Which of the following would NOT be an adverse reaction from taking Gentamicin?
a. Hearing loss
b. Kidney injury
c. Muscle weakness
d. Apnea
e. Dysrhythmias

67. Which of the following are findings in a client with acute glomerulonephritis? SATA
a. Proteinuria
b. Elevated white blood cell count
c. Reduced creatinine concentrations
d. Elevated plasma urea
e. Elevated cystatin C
f. Reduced renal creatinine clearance

68. All of the following are clinical manifestations of Acute Glomerulonephritis besides...
a. Hematuria with red blood cell cast
b. Low serum albumin
c. Hypertension
d. Polyuria
e. Proteinuria of 3-5g

69. Which of the following statements indicate a nurse understands the treatment orders for
Acute Glomerulonephritis? SATA
a. “Antibiotics are used to treat any contributing infections”
b. “Corticosteroids are used to reduce the associated inflammation”
c. “Anticoagulants combat platelet aggregation and glomerular thrombosis”
d. “ACE Inhibitors inhibits excess sympathetic nervous system activation”

70. A patient on Prednisone may receive the following health teaching from the nurse…
a. “This medication is a synthetic glucocorticoid”
 b. “You were prescribed this to reduce your inflammation pathways in
response to your acute glomerulonephritis”
c. “You may notice fluid retention, this is common and not a concern”
d. “If you have asthma notify your physician as you can’t be on this medication”

71. A mother exclaims that her child was sick with a respiratory tract infection about 1-2
weeks prior and now her child has edema, hematuria, headache, vomiting, and an
enlarged tender liver. As a nurse you should suspect.
a. Acute poststreptococcal glomerulonephritis
b. IgA Vasculitis: Henoch-Schonlein Purpura
c. IgA Nephropathy
d. Hemolytic uremic syndrome

72. A parent states “My child is oscillating between having blood in his urine and not having
blood in his urine”. Which disorder is this indicative of?
a. Acute poststreptococcal glomerulonephritis
b. IgA Vasculitis: Henoch-Schonlein Purpura
c. IgA Nephropathy
d. Hemolytic uremic syndrome

73. A child undergoing kidney failure was prescribed lisinopril by the physician, what
diagnosis does the nurse suspect the child has?
a. Acute poststreptococcal glomerulonephritis
b. IgA Vasculitis: Henoch-Schonlein Purpura
c. IgA Nephropathy
d. Hemolytic uremic syndrome

74. Your client is experiencing costovertebral tenderness, this is a symptom of what renal
disorder?
a. Acute Pyelonephritis
b. Acute Glomerulonephritis
c. Nephrolithiasis
d. Hemolytic uremic syndrome

75. The Hemolytic Uremic Syndrome triad includes which of the following? SATA
a. Hemolytic anemia
b. Proteinuria
c. Thrombocytopenia
d. Renal insufficiency

76. Which of the following is NOT a treatment for Hemolytic uremic syndrome? SATA
a. Blood transfusion with packed red blood cells
b. Dialysis
c. Fluid and electrolyte management
d. Immunosuppressants
e. Lithotripsy