Wgu D115 Advanced Pathophysiology for the Advanced
Practice Nurse Objective Assessment Advanced Practice
Competency Exam 2025-2026.
1. Which of the following is the primary cause of hypertension in the general
population?
a) Renal failure
b) Genetic factors
c) Essential (primary) hypertension
d) Endocrine disorders
Answer: c) Essential (primary) hypertension
Rationale: The majority of hypertension cases are classified as essential
hypertension, where no specific cause can be identified. It is influenced by a
combination of genetic, environmental, and lifestyle factors.
2. A patient presents with a history of chronic hyperglycemia, polyuria, and
blurred vision. What condition is most likely being described?
a) Diabetes mellitus type 1
b) Diabetes mellitus type 2
c) Hyperthyroidism
d) Cushing's disease
Answer: b) Diabetes mellitus type 2
Rationale: Diabetes mellitus type 2 is characterized by insulin resistance and
progressive pancreatic beta-cell dysfunction. The classic symptoms include
hyperglycemia, polyuria, and blurred vision.
,3. Which of the following is a key feature of asthma pathophysiology?
a) Chronic inflammation of the airway
b) Pulmonary fibrosis
c) Alveolar destruction
d) Mucous plugging in the bronchioles
Answer: a) Chronic inflammation of the airway
Rationale: Asthma is characterized by chronic inflammation of the airways,
leading to bronchoconstriction, mucus production, and airway
hyperresponsiveness. This inflammatory process is a key feature in asthma's
pathophysiology.
4. Which of the following is associated with the pathophysiology of
congestive heart failure (CHF)?
a) Increased left ventricular ejection fraction
b) Impaired myocardial contractility
c) Decreased blood volume
d) Increased preload and afterload
Answer: b) Impaired myocardial contractility
Rationale: CHF often results from impaired myocardial contractility, leading
to reduced cardiac output and a backup of blood into the lungs or systemic
circulation, causing symptoms such as dyspnea and edema.
5. In patients with chronic obstructive pulmonary disease (COPD), which of
the following is most commonly observed?
a) Alveolar damage and loss of surface area
b) Increased production of surfactant
c) Decreased mucus production
d) Increased airway compliance
,Answer: a) Alveolar damage and loss of surface area
Rationale: COPD is characterized by progressive alveolar damage (in
emphysema) and chronic bronchitis. This leads to decreased surface area for
gas exchange and airflow limitation, contributing to symptoms like chronic
cough and dyspnea.
6. What is the hallmark pathophysiological feature of myocardial infarction
(MI)?
a) Occlusion of a coronary artery
b) Hypertrophy of the myocardial cells
c) Formation of a blood clot in the left atrium
d) Decreased preload
Answer: a) Occlusion of a coronary artery
Rationale: A myocardial infarction occurs when a coronary artery becomes
occluded, leading to ischemia and necrosis of myocardial tissue. This results
from a rupture of an atherosclerotic plaque and the formation of a blood clot.
7. Which of the following is most associated with the pathophysiology of
acute renal failure (ARF)?
a) Decreased glomerular filtration rate (GFR)
b) Increased renal perfusion
c) Decreased tubular reabsorption
d) Increased erythropoiesis
Answer: a) Decreased glomerular filtration rate (GFR)
Rationale: In ARF, renal function is impaired, leading to a reduction in the
glomerular filtration rate (GFR), which results in the accumulation of waste
products in the blood and fluid retention.
, 8. In patients with hyperthyroidism, which of the following would you expect
to find on physical examination?
a) Weight gain and cold intolerance
b) Tachycardia and tremors
c) Hyporeflexia and lethargy
d) Bradycardia and constipation
Answer: b) Tachycardia and tremors
Rationale: Hyperthyroidism leads to an overproduction of thyroid hormones,
which accelerates metabolism, resulting in symptoms like tachycardia,
tremors, weight loss, and heat intolerance.
9. What is the underlying cause of osteoarthritis?
a) Autoimmune destruction of joints
b) Cartilage degeneration and joint wear
c) Bacterial infection in the joint
d) Excessive calcium deposition in the bones
Answer: b) Cartilage degeneration and joint wear
Rationale: Osteoarthritis is a degenerative joint disease primarily caused by
the wear and tear of cartilage, leading to joint pain, stiffness, and decreased
mobility. It is not caused by an autoimmune response.
10. A patient with chronic liver disease develops ascites. What is the most
likely pathophysiological cause?
a) Increased production of albumin
b) Portal hypertension and hypoalbuminemia
c) Increased renal blood flow
d) Decreased bilirubin production
Answer: b) Portal hypertension and hypoalbuminemia
Rationale: In chronic liver disease, liver dysfunction leads to
Practice Nurse Objective Assessment Advanced Practice
Competency Exam 2025-2026.
1. Which of the following is the primary cause of hypertension in the general
population?
a) Renal failure
b) Genetic factors
c) Essential (primary) hypertension
d) Endocrine disorders
Answer: c) Essential (primary) hypertension
Rationale: The majority of hypertension cases are classified as essential
hypertension, where no specific cause can be identified. It is influenced by a
combination of genetic, environmental, and lifestyle factors.
2. A patient presents with a history of chronic hyperglycemia, polyuria, and
blurred vision. What condition is most likely being described?
a) Diabetes mellitus type 1
b) Diabetes mellitus type 2
c) Hyperthyroidism
d) Cushing's disease
Answer: b) Diabetes mellitus type 2
Rationale: Diabetes mellitus type 2 is characterized by insulin resistance and
progressive pancreatic beta-cell dysfunction. The classic symptoms include
hyperglycemia, polyuria, and blurred vision.
,3. Which of the following is a key feature of asthma pathophysiology?
a) Chronic inflammation of the airway
b) Pulmonary fibrosis
c) Alveolar destruction
d) Mucous plugging in the bronchioles
Answer: a) Chronic inflammation of the airway
Rationale: Asthma is characterized by chronic inflammation of the airways,
leading to bronchoconstriction, mucus production, and airway
hyperresponsiveness. This inflammatory process is a key feature in asthma's
pathophysiology.
4. Which of the following is associated with the pathophysiology of
congestive heart failure (CHF)?
a) Increased left ventricular ejection fraction
b) Impaired myocardial contractility
c) Decreased blood volume
d) Increased preload and afterload
Answer: b) Impaired myocardial contractility
Rationale: CHF often results from impaired myocardial contractility, leading
to reduced cardiac output and a backup of blood into the lungs or systemic
circulation, causing symptoms such as dyspnea and edema.
5. In patients with chronic obstructive pulmonary disease (COPD), which of
the following is most commonly observed?
a) Alveolar damage and loss of surface area
b) Increased production of surfactant
c) Decreased mucus production
d) Increased airway compliance
,Answer: a) Alveolar damage and loss of surface area
Rationale: COPD is characterized by progressive alveolar damage (in
emphysema) and chronic bronchitis. This leads to decreased surface area for
gas exchange and airflow limitation, contributing to symptoms like chronic
cough and dyspnea.
6. What is the hallmark pathophysiological feature of myocardial infarction
(MI)?
a) Occlusion of a coronary artery
b) Hypertrophy of the myocardial cells
c) Formation of a blood clot in the left atrium
d) Decreased preload
Answer: a) Occlusion of a coronary artery
Rationale: A myocardial infarction occurs when a coronary artery becomes
occluded, leading to ischemia and necrosis of myocardial tissue. This results
from a rupture of an atherosclerotic plaque and the formation of a blood clot.
7. Which of the following is most associated with the pathophysiology of
acute renal failure (ARF)?
a) Decreased glomerular filtration rate (GFR)
b) Increased renal perfusion
c) Decreased tubular reabsorption
d) Increased erythropoiesis
Answer: a) Decreased glomerular filtration rate (GFR)
Rationale: In ARF, renal function is impaired, leading to a reduction in the
glomerular filtration rate (GFR), which results in the accumulation of waste
products in the blood and fluid retention.
, 8. In patients with hyperthyroidism, which of the following would you expect
to find on physical examination?
a) Weight gain and cold intolerance
b) Tachycardia and tremors
c) Hyporeflexia and lethargy
d) Bradycardia and constipation
Answer: b) Tachycardia and tremors
Rationale: Hyperthyroidism leads to an overproduction of thyroid hormones,
which accelerates metabolism, resulting in symptoms like tachycardia,
tremors, weight loss, and heat intolerance.
9. What is the underlying cause of osteoarthritis?
a) Autoimmune destruction of joints
b) Cartilage degeneration and joint wear
c) Bacterial infection in the joint
d) Excessive calcium deposition in the bones
Answer: b) Cartilage degeneration and joint wear
Rationale: Osteoarthritis is a degenerative joint disease primarily caused by
the wear and tear of cartilage, leading to joint pain, stiffness, and decreased
mobility. It is not caused by an autoimmune response.
10. A patient with chronic liver disease develops ascites. What is the most
likely pathophysiological cause?
a) Increased production of albumin
b) Portal hypertension and hypoalbuminemia
c) Increased renal blood flow
d) Decreased bilirubin production
Answer: b) Portal hypertension and hypoalbuminemia
Rationale: In chronic liver disease, liver dysfunction leads to
