NURS 6501 - ADVANCED PATHOPHYSIOLOGY MIDTERM EXAM
| COMPLETE ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS 2025/2026
WALDEN UNIVERSITY
QUESTIONS ANSWERS
A 4-year-old child appears listless for the last week. He Acute lymphblastic leukemia
complains of pain when he is picked up by his mother,
and he is irritable when touching his arms or legs. Several
large ecchymotic lesions have appeared on his right
thigh and left shoulder. A complete blood count reveals a
HgB=10.2, Hct=30.5%, MCV=96fL, platelet count of
45,000/ML, and WBC count of 13,990/ML. Examination of
the peripheral blood smear reveals numerous blasts. The
blasts lack peroxidase-positive granules but do contain
periodic acid-Schiff (PAS)-positive aggregates and stain
positively for TdT. Flow cytometry shows the phenotype
of blasts to be CD19+, CD3-, and sIg-. What is the most
likely diagnosis?
A. Acute lymphoblastic leukemia (ALL)
B. Chronic lymphocytic leukemia (CLL)
C. Acute myelogenous leukemia (AML)
D. Chronic myelogenous leukemia (CML)
,A 3-year-old child of Italian ancestry presents with failure Reduced synthesis of hemoglobin F
to thrive. Physical examination indicates
hepatosplenomegaly. His hemoglobin concentration is 6
g/dL, and the peripheral blood smear reveals severely
hypochromic microcytic red cells. Total serum iron level
is normal. The reticulocyte count is 10%. Hemoglobin
electrophoresis shows very little hemoglobin A. A
radiograph of the skull shows maxillofacial deformities.
What is the principle cause of anemia and other
abnormalities in this patient?
A. Reduced synthesis of hemoglobin F
B. Reduced red blood cell survival from imbalance in the
production of alpha and beta globin chains
C. Relative deficiency of vitamin B12
D. Increased fragility of the erythrocyte membrane
A 68-year-old previously healthy female has been feeling Gastrointestinal blood loss
increasingly tired and weak for several months. She states
that she has had black, tarry stools for several weeks. She
is found to be anemic with a hemoglobin concentration
of 9.3g/dL. The peripheral blood smear reveals microcytic
and hypochromic blood cells. Which of the following
conditions should be suspected as the most likely of her
condition as indicated by the peripheral blood smear?
A. Aplastic anemia
B. Beta thalassemia
C. Gastrointestinal blood loss
D. Pernicious anemia
A 76-year-old female notices that small, pinpoint to Vitamin C deficiency
blotchy areas of superficial hemorrhage have appeared
on her gums and on the skin of her arms and legs over
several weeks. She is found to have a normal prothrombin
time(PT) and partial thromboplastin time (PTT). Her CBC
shows hemoglobin concentration of 12.7 g/dL, hematocrit
of 37.2%. MCV of 80 fL/red cell, platelet count of
276,000/microliter, and WBC of 5600/microliter. Her
template bleeding time is 3 minutes. Her fibrinogen level
is normal, and there are no fibrin split products
detectable. Which of the following conditions best
explain these findings?
A. Chronic renal failure
B. Macronodular cirrhosis
C. Vitamin B12 deficiency
D. Vitamin C deficiency
, A young adult patient has just been diagnosed with Von You may have excessive bleeding following tooth extraction
Willebrand disease. Which of the following statements
should you make to advise the patient of potential
consequences of this disease?
A. You may need an allogeneic bone marrow transplant
B. You may have excessive bleeding following tooth
extraction
C. A splenectomy may be necessary to control the
disease
D. Expect increasing difficulties with joint mobility
Low dose aspirin is commonly used to reduce the risk of Aggregation of platelets
arterial thrombosis in patients who have suffered a
myocardial infarction. Which one of the following steps in
homeostasis is inhibited by aspirin?
A. Synthesis of von Willebrand factor
B. Aggregation of platelets
C. Activation of factor Xa
D. Synthesis of antithrombin III
A 24-year-old presents to the office with fatigue. On Iron deficiency anemia caused by menstruation
physical exam, the NP notices that she ispale with the
following vital signs: HR 112, BP 98/64, resp 20, O2 sats
99%. Her CBC shows: WBC6,000, Hemoglobin 9.6,
Hematocrit 30.2, MCV is decreased at 76. What is the
mostly likely causeof this patient's anemia?
A. Iron deficiency anemia caused by menstruation
B. Beta Thalassemia of genetic origin
C. Pernicious anemia caused by dietary deficiency
D. Folate deficiency caused by alcoholism
A 65-year-old female presents to your office complaining Anemia of chronic disease
of fatigue. She has a long of rheumatoid arthritis. A CBC
reveals the following: Hgb=11.6 g/dL, Hct=34.8%, MCV=87
fL/red cell, platelet count of 268,000/microliter, and WBC
count of 6800/microliter. The serum haptoglobin level is
normal, and the serum iron concentration is 20
micrograms/dL. The total iron binding capacity is 195
micrograms/dL, and the percent saturation is 10.2. The
serum ferritin concentration is 317 ng/mL. No fibrin split
products are detected. The reticulocyte concentration is
1.1%. What is the most likely diagnosis?
A. Beta- thalassemia major
B. Anemia of chronic disease
C. Acute blood loss anemia
D. Iron deficiency anemia
| COMPLETE ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS 2025/2026
WALDEN UNIVERSITY
QUESTIONS ANSWERS
A 4-year-old child appears listless for the last week. He Acute lymphblastic leukemia
complains of pain when he is picked up by his mother,
and he is irritable when touching his arms or legs. Several
large ecchymotic lesions have appeared on his right
thigh and left shoulder. A complete blood count reveals a
HgB=10.2, Hct=30.5%, MCV=96fL, platelet count of
45,000/ML, and WBC count of 13,990/ML. Examination of
the peripheral blood smear reveals numerous blasts. The
blasts lack peroxidase-positive granules but do contain
periodic acid-Schiff (PAS)-positive aggregates and stain
positively for TdT. Flow cytometry shows the phenotype
of blasts to be CD19+, CD3-, and sIg-. What is the most
likely diagnosis?
A. Acute lymphoblastic leukemia (ALL)
B. Chronic lymphocytic leukemia (CLL)
C. Acute myelogenous leukemia (AML)
D. Chronic myelogenous leukemia (CML)
,A 3-year-old child of Italian ancestry presents with failure Reduced synthesis of hemoglobin F
to thrive. Physical examination indicates
hepatosplenomegaly. His hemoglobin concentration is 6
g/dL, and the peripheral blood smear reveals severely
hypochromic microcytic red cells. Total serum iron level
is normal. The reticulocyte count is 10%. Hemoglobin
electrophoresis shows very little hemoglobin A. A
radiograph of the skull shows maxillofacial deformities.
What is the principle cause of anemia and other
abnormalities in this patient?
A. Reduced synthesis of hemoglobin F
B. Reduced red blood cell survival from imbalance in the
production of alpha and beta globin chains
C. Relative deficiency of vitamin B12
D. Increased fragility of the erythrocyte membrane
A 68-year-old previously healthy female has been feeling Gastrointestinal blood loss
increasingly tired and weak for several months. She states
that she has had black, tarry stools for several weeks. She
is found to be anemic with a hemoglobin concentration
of 9.3g/dL. The peripheral blood smear reveals microcytic
and hypochromic blood cells. Which of the following
conditions should be suspected as the most likely of her
condition as indicated by the peripheral blood smear?
A. Aplastic anemia
B. Beta thalassemia
C. Gastrointestinal blood loss
D. Pernicious anemia
A 76-year-old female notices that small, pinpoint to Vitamin C deficiency
blotchy areas of superficial hemorrhage have appeared
on her gums and on the skin of her arms and legs over
several weeks. She is found to have a normal prothrombin
time(PT) and partial thromboplastin time (PTT). Her CBC
shows hemoglobin concentration of 12.7 g/dL, hematocrit
of 37.2%. MCV of 80 fL/red cell, platelet count of
276,000/microliter, and WBC of 5600/microliter. Her
template bleeding time is 3 minutes. Her fibrinogen level
is normal, and there are no fibrin split products
detectable. Which of the following conditions best
explain these findings?
A. Chronic renal failure
B. Macronodular cirrhosis
C. Vitamin B12 deficiency
D. Vitamin C deficiency
, A young adult patient has just been diagnosed with Von You may have excessive bleeding following tooth extraction
Willebrand disease. Which of the following statements
should you make to advise the patient of potential
consequences of this disease?
A. You may need an allogeneic bone marrow transplant
B. You may have excessive bleeding following tooth
extraction
C. A splenectomy may be necessary to control the
disease
D. Expect increasing difficulties with joint mobility
Low dose aspirin is commonly used to reduce the risk of Aggregation of platelets
arterial thrombosis in patients who have suffered a
myocardial infarction. Which one of the following steps in
homeostasis is inhibited by aspirin?
A. Synthesis of von Willebrand factor
B. Aggregation of platelets
C. Activation of factor Xa
D. Synthesis of antithrombin III
A 24-year-old presents to the office with fatigue. On Iron deficiency anemia caused by menstruation
physical exam, the NP notices that she ispale with the
following vital signs: HR 112, BP 98/64, resp 20, O2 sats
99%. Her CBC shows: WBC6,000, Hemoglobin 9.6,
Hematocrit 30.2, MCV is decreased at 76. What is the
mostly likely causeof this patient's anemia?
A. Iron deficiency anemia caused by menstruation
B. Beta Thalassemia of genetic origin
C. Pernicious anemia caused by dietary deficiency
D. Folate deficiency caused by alcoholism
A 65-year-old female presents to your office complaining Anemia of chronic disease
of fatigue. She has a long of rheumatoid arthritis. A CBC
reveals the following: Hgb=11.6 g/dL, Hct=34.8%, MCV=87
fL/red cell, platelet count of 268,000/microliter, and WBC
count of 6800/microliter. The serum haptoglobin level is
normal, and the serum iron concentration is 20
micrograms/dL. The total iron binding capacity is 195
micrograms/dL, and the percent saturation is 10.2. The
serum ferritin concentration is 317 ng/mL. No fibrin split
products are detected. The reticulocyte concentration is
1.1%. What is the most likely diagnosis?
A. Beta- thalassemia major
B. Anemia of chronic disease
C. Acute blood loss anemia
D. Iron deficiency anemia
