Pathophisiology

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Sample questions from Pathophisiology

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 68-year-old client in the emergency department has sudden right-sided weakness and aphasia that began 45 minutes ago. Blood glucose is 104 mg/dL, blood pressure is 178/96 mm Hg, and oxygen saturation is 97% on room air. Which action is the priority?

   • A.Obtain a noncontrast head CT
   • B.Administer aspirin immediately
   • C.Lower the blood pressure to below 140/90 mm Hg
   • D.Offer oral fluids to prevent dehydration

   Rationale: A noncontrast head CT is needed urgently to distinguish ischemic stroke from hemorrhage before treatment decisions. Aspirin is unsafe until intracranial bleeding is excluded, and rapid blood pressure reduction can worsen perfusion in acute ischemic stroke. Oral fluids are inappropriate because aphasia may accompany dysphagia and aspiration risk; the exam takeaway is to establish stroke type promptly.

2. 2.A 74-year-old client on a medical unit develops fever, cough, and confusion. The client has a temperature of 39.1 C (102.4 F), heart rate 122/min, blood pressure 82/46 mm Hg, and lactate 4.2 mmol/L. Which action should the nurse take first?

   • A.Obtain ordered blood cultures and begin broad-spectrum antibiotics promptly
   • B.Wait for culture results before administering antibiotics
   • C.Restrict fluids to prevent pulmonary edema
   • D.Give an antipyretic and reassess in 1 hour

   Rationale: The findings indicate septic shock, so cultures should be collected promptly if this does not delay broad-spectrum antibiotics and resuscitation. Waiting for results delays treatment, while fluid restriction can worsen tissue hypoperfusion. An antipyretic may improve comfort but does not address shock; the takeaway is to act rapidly on suspected sepsis.

3. 3.A 56-year-old client in the emergency department has crushing chest pain, diaphoresis, and nausea. ECG shows ST elevation in leads II, III, and aVF; blood pressure is 88/54 mm Hg. Which order should the nurse question?

   • A.Administer sublingual nitroglycerin
   • B.Obtain serial troponin levels
   • C.Establish IV access
   • D.Prepare for urgent reperfusion therapy

   Rationale: Inferior-wall myocardial infarction can involve the right ventricle, making cardiac output preload-dependent; nitroglycerin may worsen this client's hypotension. Serial troponins and IV access support assessment and treatment, and urgent reperfusion is essential. The exam takeaway is to assess blood pressure and infarct location before giving vasodilators.

4. 4.A 63-year-old client with chronic heart failure is admitted with worsening dyspnea, crackles, and an oxygen saturation of 86% on room air. Which pathophysiologic change best explains the crackles?

   • A.Increased left ventricular filling pressure causing pulmonary congestion
   • B.Reduced pulmonary capillary permeability causing alveolar collapse
   • C.Increased right ventricular output causing systemic venous pooling
   • D.Decreased hydrostatic pressure causing fluid to enter alveoli

   Answer and rationale are in the full material.

5. 5.A 71-year-old client with atrial fibrillation is admitted after reporting sudden severe abdominal pain that is greater than expected from the abdominal examination. The client is pale, and lactate is 5.1 mmol/L. Which complication should the nurse suspect?

   • A.Acute mesenteric ischemia from an arterial embolus
   • B.Acute pancreatitis from biliary obstruction
   • C.Bowel obstruction from adhesions
   • D.Diverticulitis with localized inflammation

   Answer and rationale are in the full material.