Understanding the commonly tested pathophysiology questions is very important as it gives you insight on the kind of questions that you will be examined and how to answer them.
Fundamentally, pathophysiology exams heavily emphasizes on key diseases and disorder in each body system. In all the exam questions reviewed during this study, we identified that the leading commonly tested topics are the cardiovascular and respiratory systems, Renal and Electrolyte Disorders, Endocrine and Metabolic Disorders, Neurological Disorders, Gastrointestinal and Hepatic Disorders, Hematologic and Immune Disorders and Integumentary disorders respectively. Now let’s dive into the commonly tested questions in the mentioned topics. In this guide, we will examine the topics, patterns in different types of questions and tips for answering the questions.
The cardiovascular system
Cardiovascular questions are among the most frequently tested topics in pathophysiology exams, especially if you’re studying from widely used textbooks like Understanding Pathophysiology by Huether and Pathophysiology: The Biologic Basis for Disease in Adults and Children by McCance. This emphasis is also evident in their accompanying test banks.
Key areas often covered include heart failure, myocardial infarction, dysrhythmias, various types of shock, and hypertension. For instance, if you’re asked to define heart failure in an exam, most test banks describe it as the heart’s inability to pump effectively to meet the body’s metabolic needs, resulting in reduced cardiac output and fluid buildup in the lungs and peripheral veins.
Other frequently tested concepts include systolic vs. diastolic heart failure, compensatory mechanisms like RAAS activation, and clinical signs such as pulmonary edema. Expect questions on acute and chronic valvular disorders, cardiogenic shock, and atherosclerosis—especially coronary artery disease, with an emphasis on plaque rupture and ischemia as underlying mechanisms.
Shock is a recurring exam topic and may appear in multiple forms, such as hypovolemic, cardiogenic, or septic. In nursing, shock is defined as a life-threatening state of tissue hypoperfusion that leads to cellular dysfunction and eventual organ failure if not promptly treated.
Example Questions and Answers
Question 1. Mutations in the encoding of histone-modifying proteins have been shown to influence the development of what congenial condition?
a. Cleft palate
b. Acephalous
c. Heart disease
d. Webbed digits
ANS: C
Why heart disease is the correct Answer
Mutations in genes that encode histone-modifying proteins have been implicated in congenital heart disease. Research has yet to provide a relationship between abnormal histone-modifying proteins and cleft palate, acephalous, and webbed digits.
Question 2. When planning care for a cardiac patient, the nurse knows that in response to an increased workload, cardiac myocardial cells will experience hypertrophy which is an: a. increase in size.
b. decrease in length.
c. increase in excitability.
d. decrease in number.
ANS: A
Also Read: ACLS Pharmacology Exam Answers + Rationales
Why decrease in length is the correct Answer
Hypertrophy is a compensatory increase in the size of cells in response to mechanical stimuli (also called mechanical load or stress, such as from stretching, repetitive, chronic, pressure, or volume overload) and consequently increases the size of the affected organ. The cells of the heart and kidneys are particularly prone to enlargement. A decrease in length is not associated with hypertrophy. A deficiency of electrolytes or minerals could lead to an increase in excitability; it is not due to increased workload or related to hypertrophy. A decrease in cell numbers is referred to as hypoplasia.
Respiratory System
When preparing for respiratory-focused pathophysiology exams, expect to encounter questions on high-yield conditions such as asthma, chronic obstructive pulmonary disease (COPD), pneumonia, pulmonary embolism (PE), and acute respiratory distress syndrome (ARDS). A quick review of any reputable pathophysiology test bank confirms the frequency of these topics.
Starting with the basics, asthma is commonly defined in exams as reversible airway narrowing caused by inflammation and bronchospasm. Questions often explore triggers (e.g., allergens, exercise), the inflammatory cascade, and treatment strategies—including bronchodilators vs. anti-inflammatory agents.
COPD, which includes chronic bronchitis and emphysema, is another major topic, particularly in patient cases with a smoking history. It is characterized by persistent airflow obstruction and progressive lung damage. Exams frequently test on its pathogenesis (e.g., smoking-induced inflammation, mucus hypersecretion, alveolar wall destruction) and hallmark symptoms such as chronic cough and dyspnea.
Pneumonia—a frequent topic—refers to the acute inflammation of lung parenchyma due to infection. Commonly tested areas include causative agents (e.g., Streptococcus pneumoniae for community-acquired cases), clinical signs (fever, productive cough, crackles), diagnostic findings (chest X-ray infiltrates, elevated WBC count), and complications like hypoxemia and sepsis.
According to the 2nd Canadian edition test bank of Understanding Pathophysiology, respiratory disorders like COPD, asthma, pneumonia, and pleural effusion dominate the question pool. Pulmonary embolism and ARDS also appear frequently, especially in questions about acute hypoxic conditions.
Additionally, expect exam questions on gas exchange, ventilation–perfusion (V/Q) mismatch, and mechanisms of hypoxemia—core concepts that underpin many respiratory pathologies.
Example Exam Questions
Question 1. A 55-year-old male with a 30-year history of smoking is examined for respiratory disturbance.
Examination of his airway (bronchial) reveals that stratified squamous epithelial cells have replaced the normal columnar ciliated cells. This type of cellular adaptation is called: a. anaplasia.
b. hyperplasia.
c. metaplasia.
d. dysplasia.
ANS: C
Why metaplasia is the correct answer
Metaplasia is the reversible replacement of one mature cell type by another, sometimes a less differentiated cell type. Anaplasia is loss of cellular differentiation. Hyperplasia is an increase in the number of cells resulting from an increased rate of cellular division. Dysplasia refers to abnormal changes in the size, shape, and organization of mature cells.
Renal and Electrolyte Disorders
Renal pathophysiology is often examined through acute kidney injury (AKI), chronic kidney disease (CKD), glomerulonephritis, nephrotic/nephritic syndromes, and common electrolyte imbalances. AKI (formerly acute renal failure) is defined as a rapid decline in kidney filtration function. Exam questions typically differentiate prerenal (hypovolemia), intrinsic (toxins, glomerular injury), and postrenal (obstruction) causes, and ask about resultant fluid/electrolyte changes (elevated BUN/creatinine, hyperkalemia, metabolic acidosis).
Chronic kidney disease questions cover progressive nephron loss, uremia, and complications (anemia of CKD, bone disease, hypertension). Disorders of acid–base balance (metabolic acidosis, alkalosis, respiratory disturbances) are also common subtopics. For example, rapid fluid resuscitation and acid–base calculations often appear in AKI scenarios.
Question 1. A 70-year-old male with chronic renal failure presents with edema. Which of the following is the most likely cause of this condition?
a. Increased capillary oncotic pressure.
b. Decreased interstitial oncotic pressure.
c. Increased capillary hydrostatic pressure.
d. Increased interstitial hydrostatic pressure.
ANS: C
Why Increased capillary hydrostatic pressure is the correct Answer
Increased capillary hydrostatic pressure would facilitate increased movement from the capillary to the interstitial space, leading to edema. Increased capillary (plasma) oncotic pressure attracts water from the interstitial space back into the capillary. Decreased interstitial oncotic pressure would keep water in the capillary. Increased interstitial hydrostatic pressure would facilitate increased water movement from the interstitial space into the capillary.
