WGU D236 OBJECTIVE ASSESSMENT
PATHOPHYSIOLOGY EXAM (LATEST
2026/2027 UPDATE) QUESTIONS AND
VERIFIED ANSWERS| GRADE A
WGU D236 OBJECTIVE ASSESSMENT
PATHOPHYSIOLOGY
WGU D236 Objective Assessment – Pathophysiology
1. What is a major consequence of prolonged hyperglycemia?
A. Decreased blood viscosity
B. Increased vascular permeability
C. Reduced capillary pressure
D. Enhanced endothelial repair
Rationale:
Chronic hyperglycemia leads to the formation of advanced glycation end products
(AGEs), which damage endothelial cells lining blood vessels. This damage disrupts
tight junctions, resulting in increased vascular permeability. As a result, plasma
proteins and fluids leak into surrounding tissues, contributing to complications such as
diabetic retinopathy, nephropathy, and peripheral edema. Vascular dysfunction is a
hallmark of long-term diabetes-related complications.
2. Which condition is most associated with an electrolyte imbalance
characterized by elevated calcium levels?
A. Hyperparathyroidism
B. Hypoparathyroidism
C. Addison disease
D. Syndrome of inappropriate antidiuretic hormone (SIADH)
,Rationale:
Hyperparathyroidism causes excessive secretion of parathyroid hormone (PTH), which
increases calcium resorption from bones and enhances calcium reabsorption in the
kidneys. At the same time, phosphate excretion is increased, leading to
hypophosphatemia. The resulting hypercalcemia can cause kidney stones, bone pain,
and neuromuscular symptoms. This electrolyte imbalance is a classic feature of the
disorder.
3. A 70-year-old male with chronic hypertension presents with
sudden severe chest pain radiating to the back. Aortic dissection is
suspected. What is the most common site of the tear?
A. Ascending aorta
B. Abdominal aorta
C. Aortic bifurcation
D. Descending thoracic aorta
Rationale:
The ascending aorta is the most common site for an intimal tear leading to aortic
dissection due to high shear stress and pressure. Chronic hypertension weakens the
vessel wall, particularly the tunica media. Once a tear occurs, blood enters the vessel
wall layers, creating a false lumen. This results in severe pain and can compromise
blood flow to vital organs.
4. Which of the following is a hallmark feature of cirrhosis?
A. Hypotension
B. Increased bile production
C. Portal hypertension
D. Enhanced protein synthesis
Rationale:
Cirrhosis causes extensive fibrosis and nodular regeneration within the liver,
disrupting normal blood flow. This obstruction increases resistance in the portal
venous system, leading to portal hypertension. Consequences include ascites,
splenomegaly, and esophageal varices. Portal hypertension is a defining
pathophysiologic feature of advanced liver disease.
5. What best describes the pathophysiology of emphysema?
,A. Destruction of alveolar walls and loss of elastic recoil
B. Thickening of bronchial walls with mucus plugging
C. Increased surfactant production
D. Acute inflammatory response in alveoli
Rationale:
Emphysema involves irreversible destruction of alveolar walls, leading to enlarged air
spaces and reduced surface area for gas exchange. Loss of elastic recoil makes it
difficult for air to be expelled during exhalation, causing air trapping. Smoking is the
primary risk factor, promoting chronic inflammation and protease activity. These
changes result in progressive dyspnea and impaired oxygenation.
6. What is a hallmark feature of chronic renal failure?
A. Decreased glomerular filtration rate (GFR)
B. Increased urine output
C. Reduced serum creatinine
D. Acute tubular necrosis
Rationale:
Chronic renal failure is defined by a gradual and irreversible decline in kidney function
over time. A decreased GFR reflects impaired filtration capacity of the glomeruli. As
kidney function declines, waste products such as urea and creatinine accumulate in
the bloodstream. This progressive loss leads to electrolyte imbalances, anemia, and
metabolic acidosis.
7. Which mechanism primarily contributes to edema formation in
heart failure?
A. Decreased capillary permeability
B. Increased hydrostatic pressure
C. Reduced sodium retention
D. Increased plasma oncotic pressure
Rationale:
In heart failure, impaired cardiac output leads to venous congestion and increased
hydrostatic pressure in capillaries. This pressure forces fluid out of the vascular space
into the interstitial tissues, resulting in edema. Sodium and water retention by the
kidneys further exacerbate fluid accumulation. Peripheral and pulmonary edema are
common clinical manifestations.
, 8. What is the primary pathophysiologic mechanism underlying
asthma?
A. Alveolar destruction
B. Reversible airway inflammation and bronchoconstriction
C. Loss of ciliary function
D. Pulmonary fibrosis
Rationale:
Asthma is characterized by chronic airway inflammation, bronchial
hyperresponsiveness, and reversible bronchoconstriction. Exposure to triggers such as
allergens or irritants leads to smooth muscle contraction and mucus secretion. These
changes narrow the airways and impede airflow. Unlike COPD, asthma airflow
obstruction is largely reversible with treatment.
9. Which hormone is deficient in Type 1 diabetes mellitus?
A. Glucagon
B. Cortisol
C. Insulin
D. Growth hormone
Rationale:
Type 1 diabetes mellitus results from autoimmune destruction of pancreatic beta cells.
These cells are responsible for insulin production, leading to an absolute insulin
deficiency. Without insulin, glucose cannot effectively enter cells, resulting in
hyperglycemia. Lifelong insulin replacement is required for survival.
10. What is the primary cause of metabolic acidosis in diabetic
ketoacidosis (DKA)?
A. Lactic acid accumulation
B. Excess ketone body production
C. Renal bicarbonate retention
D. Hypoventilation
Rationale:
In DKA, insulin deficiency leads to increased fat breakdown and the production of
ketone bodies such as acetoacetate and beta-hydroxybutyrate. These ketones are
acidic and accumulate in the blood, lowering pH. The resulting metabolic acidosis
triggers compensatory hyperventilation (Kussmaul respirations). This condition is a
medical emergency requiring prompt treatment.
PATHOPHYSIOLOGY EXAM (LATEST
2026/2027 UPDATE) QUESTIONS AND
VERIFIED ANSWERS| GRADE A
WGU D236 OBJECTIVE ASSESSMENT
PATHOPHYSIOLOGY
WGU D236 Objective Assessment – Pathophysiology
1. What is a major consequence of prolonged hyperglycemia?
A. Decreased blood viscosity
B. Increased vascular permeability
C. Reduced capillary pressure
D. Enhanced endothelial repair
Rationale:
Chronic hyperglycemia leads to the formation of advanced glycation end products
(AGEs), which damage endothelial cells lining blood vessels. This damage disrupts
tight junctions, resulting in increased vascular permeability. As a result, plasma
proteins and fluids leak into surrounding tissues, contributing to complications such as
diabetic retinopathy, nephropathy, and peripheral edema. Vascular dysfunction is a
hallmark of long-term diabetes-related complications.
2. Which condition is most associated with an electrolyte imbalance
characterized by elevated calcium levels?
A. Hyperparathyroidism
B. Hypoparathyroidism
C. Addison disease
D. Syndrome of inappropriate antidiuretic hormone (SIADH)
,Rationale:
Hyperparathyroidism causes excessive secretion of parathyroid hormone (PTH), which
increases calcium resorption from bones and enhances calcium reabsorption in the
kidneys. At the same time, phosphate excretion is increased, leading to
hypophosphatemia. The resulting hypercalcemia can cause kidney stones, bone pain,
and neuromuscular symptoms. This electrolyte imbalance is a classic feature of the
disorder.
3. A 70-year-old male with chronic hypertension presents with
sudden severe chest pain radiating to the back. Aortic dissection is
suspected. What is the most common site of the tear?
A. Ascending aorta
B. Abdominal aorta
C. Aortic bifurcation
D. Descending thoracic aorta
Rationale:
The ascending aorta is the most common site for an intimal tear leading to aortic
dissection due to high shear stress and pressure. Chronic hypertension weakens the
vessel wall, particularly the tunica media. Once a tear occurs, blood enters the vessel
wall layers, creating a false lumen. This results in severe pain and can compromise
blood flow to vital organs.
4. Which of the following is a hallmark feature of cirrhosis?
A. Hypotension
B. Increased bile production
C. Portal hypertension
D. Enhanced protein synthesis
Rationale:
Cirrhosis causes extensive fibrosis and nodular regeneration within the liver,
disrupting normal blood flow. This obstruction increases resistance in the portal
venous system, leading to portal hypertension. Consequences include ascites,
splenomegaly, and esophageal varices. Portal hypertension is a defining
pathophysiologic feature of advanced liver disease.
5. What best describes the pathophysiology of emphysema?
,A. Destruction of alveolar walls and loss of elastic recoil
B. Thickening of bronchial walls with mucus plugging
C. Increased surfactant production
D. Acute inflammatory response in alveoli
Rationale:
Emphysema involves irreversible destruction of alveolar walls, leading to enlarged air
spaces and reduced surface area for gas exchange. Loss of elastic recoil makes it
difficult for air to be expelled during exhalation, causing air trapping. Smoking is the
primary risk factor, promoting chronic inflammation and protease activity. These
changes result in progressive dyspnea and impaired oxygenation.
6. What is a hallmark feature of chronic renal failure?
A. Decreased glomerular filtration rate (GFR)
B. Increased urine output
C. Reduced serum creatinine
D. Acute tubular necrosis
Rationale:
Chronic renal failure is defined by a gradual and irreversible decline in kidney function
over time. A decreased GFR reflects impaired filtration capacity of the glomeruli. As
kidney function declines, waste products such as urea and creatinine accumulate in
the bloodstream. This progressive loss leads to electrolyte imbalances, anemia, and
metabolic acidosis.
7. Which mechanism primarily contributes to edema formation in
heart failure?
A. Decreased capillary permeability
B. Increased hydrostatic pressure
C. Reduced sodium retention
D. Increased plasma oncotic pressure
Rationale:
In heart failure, impaired cardiac output leads to venous congestion and increased
hydrostatic pressure in capillaries. This pressure forces fluid out of the vascular space
into the interstitial tissues, resulting in edema. Sodium and water retention by the
kidneys further exacerbate fluid accumulation. Peripheral and pulmonary edema are
common clinical manifestations.
, 8. What is the primary pathophysiologic mechanism underlying
asthma?
A. Alveolar destruction
B. Reversible airway inflammation and bronchoconstriction
C. Loss of ciliary function
D. Pulmonary fibrosis
Rationale:
Asthma is characterized by chronic airway inflammation, bronchial
hyperresponsiveness, and reversible bronchoconstriction. Exposure to triggers such as
allergens or irritants leads to smooth muscle contraction and mucus secretion. These
changes narrow the airways and impede airflow. Unlike COPD, asthma airflow
obstruction is largely reversible with treatment.
9. Which hormone is deficient in Type 1 diabetes mellitus?
A. Glucagon
B. Cortisol
C. Insulin
D. Growth hormone
Rationale:
Type 1 diabetes mellitus results from autoimmune destruction of pancreatic beta cells.
These cells are responsible for insulin production, leading to an absolute insulin
deficiency. Without insulin, glucose cannot effectively enter cells, resulting in
hyperglycemia. Lifelong insulin replacement is required for survival.
10. What is the primary cause of metabolic acidosis in diabetic
ketoacidosis (DKA)?
A. Lactic acid accumulation
B. Excess ketone body production
C. Renal bicarbonate retention
D. Hypoventilation
Rationale:
In DKA, insulin deficiency leads to increased fat breakdown and the production of
ketone bodies such as acetoacetate and beta-hydroxybutyrate. These ketones are
acidic and accumulate in the blood, lowering pH. The resulting metabolic acidosis
triggers compensatory hyperventilation (Kussmaul respirations). This condition is a
medical emergency requiring prompt treatment.
