NR 507 NP Midterm Exam (2026) Chamberlain Pathophysiology Actual
Questions and Answers (PDF).
1. A 10-year-old male is stung by a bee and immediately develops difficulty
breathing, urticaria, and hypotension. This reaction is primarily mediated by
which immunoglobulin?
A) IgG
B) IgM
C) IgA
D) IgE
Answer: D) IgE
Rationale: A severe, immediate allergic reaction like anaphylaxis is a classic Type I
hypersensitivity reaction. It is mediated by Immunoglobulin E (IgE) , which binds
to mast cells and basophils, triggering the release of histamine and other
inflammatory mediators .
,2. A patient with a history of COPD has pulmonary function tests that show a
reduced FEV1, reduced FVC, and a normal FEV1/FVC ratio. How should the NP
interpret these results?
A) Obstructive lung disease
B) Restrictive lung disease
C) Combined obstructive-restrictive disease
D) Normal lung function
Answer: B) Restrictive lung disease
Rationale: In restrictive lung diseases (e.g., pulmonary fibrosis), lung expansion is
limited, which reduces both the FEV1 and FVC proportionally. Because both
numbers are reduced by a similar degree, the FEV1/FVC ratio remains normal or
even elevated .
3. Which of the following is the primary pathophysiological mechanism causing
anemia of chronic disease (ACD)?
,A) Excessive blood loss from chronic inflammation
B) Bone marrow failure due to autoimmune destruction
C) Defective erythropoiesis due to inflammatory cytokines
D) Intravascular hemolysis from immune complexes
Answer: C) Defective erythropoiesis due to inflammatory cytokines
Rationale: Anemia of chronic disease is driven by inflammation. Cytokines like
interleukin-6 (IL-6) increase hepcidin levels, which traps iron in storage sites,
making it unavailable for red blood cell production. This leads to a defective
erythropoiesis and a normocytic, normochromic anemia .
4. A patient with a recent diagnosis of systemic lupus erythematosus (SLE)
presents with proteinuria and hematuria. This renal involvement is primarily due
to which type of hypersensitivity reaction?
A) Type I
, B) Type II
C) Type III
D) Type IV
Answer: C) Type III
Rationale: SLE is the prototype for a Type III hypersensitivity reaction. In this
process, antibodies bind to self-antigens, forming circulating immune complexes.
These complexes deposit in small blood vessels, such as the glomeruli of the
kidneys, where they activate complement and cause inflammation and tissue
damage .
5. A 45-year-old male with a history of alcohol use disorder presents with fatigue
and shortness of breath on exertion. His lab results show a macrocytic anemia
(high MCV) with a low serum folate level but a normal vitamin B12 level. What is
the most likely cause of his anemia?
A) Pernicious anemia
B) Chronic blood loss
Questions and Answers (PDF).
1. A 10-year-old male is stung by a bee and immediately develops difficulty
breathing, urticaria, and hypotension. This reaction is primarily mediated by
which immunoglobulin?
A) IgG
B) IgM
C) IgA
D) IgE
Answer: D) IgE
Rationale: A severe, immediate allergic reaction like anaphylaxis is a classic Type I
hypersensitivity reaction. It is mediated by Immunoglobulin E (IgE) , which binds
to mast cells and basophils, triggering the release of histamine and other
inflammatory mediators .
,2. A patient with a history of COPD has pulmonary function tests that show a
reduced FEV1, reduced FVC, and a normal FEV1/FVC ratio. How should the NP
interpret these results?
A) Obstructive lung disease
B) Restrictive lung disease
C) Combined obstructive-restrictive disease
D) Normal lung function
Answer: B) Restrictive lung disease
Rationale: In restrictive lung diseases (e.g., pulmonary fibrosis), lung expansion is
limited, which reduces both the FEV1 and FVC proportionally. Because both
numbers are reduced by a similar degree, the FEV1/FVC ratio remains normal or
even elevated .
3. Which of the following is the primary pathophysiological mechanism causing
anemia of chronic disease (ACD)?
,A) Excessive blood loss from chronic inflammation
B) Bone marrow failure due to autoimmune destruction
C) Defective erythropoiesis due to inflammatory cytokines
D) Intravascular hemolysis from immune complexes
Answer: C) Defective erythropoiesis due to inflammatory cytokines
Rationale: Anemia of chronic disease is driven by inflammation. Cytokines like
interleukin-6 (IL-6) increase hepcidin levels, which traps iron in storage sites,
making it unavailable for red blood cell production. This leads to a defective
erythropoiesis and a normocytic, normochromic anemia .
4. A patient with a recent diagnosis of systemic lupus erythematosus (SLE)
presents with proteinuria and hematuria. This renal involvement is primarily due
to which type of hypersensitivity reaction?
A) Type I
, B) Type II
C) Type III
D) Type IV
Answer: C) Type III
Rationale: SLE is the prototype for a Type III hypersensitivity reaction. In this
process, antibodies bind to self-antigens, forming circulating immune complexes.
These complexes deposit in small blood vessels, such as the glomeruli of the
kidneys, where they activate complement and cause inflammation and tissue
damage .
5. A 45-year-old male with a history of alcohol use disorder presents with fatigue
and shortness of breath on exertion. His lab results show a macrocytic anemia
(high MCV) with a low serum folate level but a normal vitamin B12 level. What is
the most likely cause of his anemia?
A) Pernicious anemia
B) Chronic blood loss
