1
WGU D115 OA Advanced Pathophysiology Exam (Latest
2026) Actual 100 Questions with Detailed Answers and
OA Readiness Practice Exam
Practice Exam Questions (1-15)
1. Which cellular adaptation is characterized by an increase in cell size
and function in response to increased workload?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct : Correct Answer : B – Hypertrophy
Rationale: Hypertrophy is an increase in cell size and functional
capacity in response to increased demand. Hyperplasia (A) is an
increase in cell number. Atrophy (C) is a decrease in cell size.
Metaplasia (D) is replacement of one differentiated cell type with
another.
2. A 60-year-old male with a history of smoking presents with a
persistent cough and weight loss. A biopsy of a lung mass reveals
anaplastic cells with abnormal nuclei. This is characteristic of:
A) Benign tumor
B) Malignant tumor
C) Hyperplasia
D) Dysplasia
Correct : Correct Answer : B – Malignant tumor
pg. 1
,2
Rationale: Anaplasia refers to a lack of differentiation and is a hallmark
of malignancy. Benign tumors (A) are well-differentiated. Hyperplasia
(C) is increased cell number. Dysplasia (D) is disordered but not
necessarily malignant.
3. A patient with renal failure is noted to have a serum potassium level
of 6.2 mEq/L. This electrolyte imbalance predisposes the patient to
which cardiac complication?
A) Atrial fibrillation
B) Ventricular tachycardia
C) First-degree heart block
D) Sinus bradycardia
Correct : Correct Answer : B – Ventricular tachycardia
Rationale: Hyperkalemia (>5.5 mEq/L) can cause life-threatening
arrhythmias such as ventricular tachycardia, ventricular fibrillation, and
asystole. ECG findings include peaked T waves, widened QRS, and
eventual sine wave pattern. Atrial fibrillation (A) is more associated
with valvular disease. Heart block (C) and bradycardia (D) may occur
but are less characteristic.
4. In a patient with severe sepsis, which vasoactive mediator is most
responsible for the profound hypotension?
A) Endothelin
B) Nitric oxide
C) Angiotensin II
D) Norepinephrine
Correct : Correct Answer : B – Nitric oxide
pg. 2
,3
Rationale: In sepsis, bacterial products (e.g., lipopolysaccharide)
stimulate iNOS, leading to excessive nitric oxide production. NO causes
vasodilation and hypotension. Endothelin (A) is a vasoconstrictor.
Angiotensin II (C) and norepinephrine (D) are vasoconstrictors but are
overwhelmed in septic shock.
5. A patient with type 1 diabetes is admitted with nausea, vomiting, and
deep, rapid breathing (Kussmaul respirations). Which of the following is
the most likely underlying acid-base disturbance?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct : Correct Answer : A – Metabolic acidosis
Rationale: Diabetic ketoacidosis (DKA) results in metabolic acidosis due
to accumulation of ketone bodies. Kussmaul respirations are the body’s
compensatory hyperventilation to lower PaCO2. Respiratory alkalosis
(D) would be caused by hyperventilation from other causes (e.g.,
anxiety, pulmonary embolism). Metabolic alkalosis (B) is seen with
vomiting or diuretic use. Respiratory acidosis (C) occurs with
hypoventilation.
6. A 65-year-old female with a history of hypertension presents with
sudden, severe “tearing” chest pain radiating to the back. On
examination, blood pressure is 160/90 mmHg in the right arm and
110/70 mmHg in the left arm. Which of the following is the most likely
diagnosis?
A) Myocardial infarction
pg. 3
, 4
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis
Correct : Correct Answer : B – Aortic dissection
Rationale: Aortic dissection classically presents with sudden, severe,
tearing pain radiating to the back, often with a pulse deficit or blood
pressure differential between arms. Hypertension is the most common
risk factor. Immediate CT angiography is required for diagnosis.
7. A 25-year-old female presents with bilateral hilar lymphadenopathy
on chest X-ray and erythema nodosum on her shins. Which
autoimmune condition is most likely?
A) Systemic lupus erythematosus
B) Sarcoidosis
C) Rheumatoid arthritis
D) Sjögren’s syndrome
Correct : Correct Answer : B – Sarcoidosis
Rationale: Sarcoidosis is a multisystem granulomatous disorder of
unknown cause that frequently presents with bilateral hilar
lymphadenopathy (BHL) and erythema nodosum. It is more common in
young adults, especially African American females. SLE (A) typically
presents with malar rash, arthritis, and serositis. RA (C) presents with
symmetric polyarthritis. Sjögren’s syndrome (D) presents with dry eyes
and dry mouth.
8. A patient with sickle cell disease presents with acute chest pain,
fever, and hypoxemia. A chest X-ray shows a new pulmonary infiltrate.
pg. 4
WGU D115 OA Advanced Pathophysiology Exam (Latest
2026) Actual 100 Questions with Detailed Answers and
OA Readiness Practice Exam
Practice Exam Questions (1-15)
1. Which cellular adaptation is characterized by an increase in cell size
and function in response to increased workload?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Correct : Correct Answer : B – Hypertrophy
Rationale: Hypertrophy is an increase in cell size and functional
capacity in response to increased demand. Hyperplasia (A) is an
increase in cell number. Atrophy (C) is a decrease in cell size.
Metaplasia (D) is replacement of one differentiated cell type with
another.
2. A 60-year-old male with a history of smoking presents with a
persistent cough and weight loss. A biopsy of a lung mass reveals
anaplastic cells with abnormal nuclei. This is characteristic of:
A) Benign tumor
B) Malignant tumor
C) Hyperplasia
D) Dysplasia
Correct : Correct Answer : B – Malignant tumor
pg. 1
,2
Rationale: Anaplasia refers to a lack of differentiation and is a hallmark
of malignancy. Benign tumors (A) are well-differentiated. Hyperplasia
(C) is increased cell number. Dysplasia (D) is disordered but not
necessarily malignant.
3. A patient with renal failure is noted to have a serum potassium level
of 6.2 mEq/L. This electrolyte imbalance predisposes the patient to
which cardiac complication?
A) Atrial fibrillation
B) Ventricular tachycardia
C) First-degree heart block
D) Sinus bradycardia
Correct : Correct Answer : B – Ventricular tachycardia
Rationale: Hyperkalemia (>5.5 mEq/L) can cause life-threatening
arrhythmias such as ventricular tachycardia, ventricular fibrillation, and
asystole. ECG findings include peaked T waves, widened QRS, and
eventual sine wave pattern. Atrial fibrillation (A) is more associated
with valvular disease. Heart block (C) and bradycardia (D) may occur
but are less characteristic.
4. In a patient with severe sepsis, which vasoactive mediator is most
responsible for the profound hypotension?
A) Endothelin
B) Nitric oxide
C) Angiotensin II
D) Norepinephrine
Correct : Correct Answer : B – Nitric oxide
pg. 2
,3
Rationale: In sepsis, bacterial products (e.g., lipopolysaccharide)
stimulate iNOS, leading to excessive nitric oxide production. NO causes
vasodilation and hypotension. Endothelin (A) is a vasoconstrictor.
Angiotensin II (C) and norepinephrine (D) are vasoconstrictors but are
overwhelmed in septic shock.
5. A patient with type 1 diabetes is admitted with nausea, vomiting, and
deep, rapid breathing (Kussmaul respirations). Which of the following is
the most likely underlying acid-base disturbance?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct : Correct Answer : A – Metabolic acidosis
Rationale: Diabetic ketoacidosis (DKA) results in metabolic acidosis due
to accumulation of ketone bodies. Kussmaul respirations are the body’s
compensatory hyperventilation to lower PaCO2. Respiratory alkalosis
(D) would be caused by hyperventilation from other causes (e.g.,
anxiety, pulmonary embolism). Metabolic alkalosis (B) is seen with
vomiting or diuretic use. Respiratory acidosis (C) occurs with
hypoventilation.
6. A 65-year-old female with a history of hypertension presents with
sudden, severe “tearing” chest pain radiating to the back. On
examination, blood pressure is 160/90 mmHg in the right arm and
110/70 mmHg in the left arm. Which of the following is the most likely
diagnosis?
A) Myocardial infarction
pg. 3
, 4
B) Aortic dissection
C) Pulmonary embolism
D) Pericarditis
Correct : Correct Answer : B – Aortic dissection
Rationale: Aortic dissection classically presents with sudden, severe,
tearing pain radiating to the back, often with a pulse deficit or blood
pressure differential between arms. Hypertension is the most common
risk factor. Immediate CT angiography is required for diagnosis.
7. A 25-year-old female presents with bilateral hilar lymphadenopathy
on chest X-ray and erythema nodosum on her shins. Which
autoimmune condition is most likely?
A) Systemic lupus erythematosus
B) Sarcoidosis
C) Rheumatoid arthritis
D) Sjögren’s syndrome
Correct : Correct Answer : B – Sarcoidosis
Rationale: Sarcoidosis is a multisystem granulomatous disorder of
unknown cause that frequently presents with bilateral hilar
lymphadenopathy (BHL) and erythema nodosum. It is more common in
young adults, especially African American females. SLE (A) typically
presents with malar rash, arthritis, and serositis. RA (C) presents with
symmetric polyarthritis. Sjögren’s syndrome (D) presents with dry eyes
and dry mouth.
8. A patient with sickle cell disease presents with acute chest pain,
fever, and hypoxemia. A chest X-ray shows a new pulmonary infiltrate.
pg. 4
