MARYVILLE PATHO NURS 611 EXAM 4 COMPREHENSIVE FINAL EXAM
2026/2027 PRACTICE QUESTIONS AND A CURRENT UPDATED STUDY
GUIDE COMPLETE ACCURATE EXAM REAL QUESTIONS WITH WELL
ELABORATED ANSWERS AND RATIONALES (100% CORRECT VERIFIED
SOLUTIONS) NEWEST UPDATED VERSION 2026 EDITION
|GUARANTEED PASS A+ (BRAND NEW!) FULL REVISED MARYVILLE
PATHO NURS 611 EXAM 4 APPROVED FINAL EXAM |GUARANTEED
PASS A+ |JUST RELEASED
1. A patient presents with severe right upper quadrant abdominal pain that radiates
to the right scapula. During deep palpation under the right costal margin, the
patient abruptly stops inhaling due to pain. Which sign is positive and what
condition does it indicate?
A) McBurney's sign; acute appendicitis
B) Murphy's sign; acute cholecystitis
C) Rovsing's sign; acute pancreatitis
D) Cullen's sign; ruptured ectopic pregnancy
Correct Answer: B) Murphy's sign; acute cholecystitis
Rationale: A positive Murphy's sign occurs when sharp gallbladder tenderness
halts inspiration during deep palpation of the right upper quadrant. This clinical
finding is highly specific for acute cholecystitis. McBurney's and Rovsing's signs
evaluate for appendicitis, while Cullen's sign indicates intra-abdominal
hemorrhage .
2. A 58-year-old patient with type 2 diabetes presents for follow-up. Which
laboratory test best reflects glycemic control over the previous 2-3 months?
,A) Fasting plasma glucose
B) Random blood glucose
C) Hemoglobin A1c
D) Oral glucose tolerance test
Correct Answer: C) Hemoglobin A1c
Rationale: Hemoglobin A1c reflects average blood glucose levels over
approximately 8-12 weeks (2-3 months) and is the standard measure of long-
term glycemic control. Fasting and random glucose levels only provide a
snapshot of current glucose status .
3. A patient with a spinal cord injury at the T5 level suddenly develops paroxysmal
hypertension (systolic BP 280 mmHg), a pounding headache, bradycardia (HR 32
bpm), and flushing above the level of the lesion. What is the most likely diagnosis?
A) Autonomic dysreflexia
B) Orthostatic hypotension
C) Neurogenic shock
D) Hypertensive crisis
Correct Answer: A) Autonomic dysreflexia
Rationale: Autonomic dysreflexia is characterized by paroxysmal hypertension
(up to 300 mmHg systolic), pounding headache, blurred vision, sweating above
the lesion level with flushing, nasal congestion, nausea, piloerection, and
bradycardia (30-40 bpm). This condition occurs in individuals with spinal cord
lesions at or above the T5-T6 level. The intact autonomic nervous system
reflexively responds to a noxious stimulus below the level of injury with
,arteriolar spasm and hypertension, but efferent impulses cannot pass through
the cord to allow vasodilation .
4. The parasympathetic nervous system is primarily responsible for which of the
following functions?
A) Preparing the body for "fight or flight" responses
B) Conserving energy and maintaining body resources
C) Redirecting blood flow to skeletal muscles during stress
D) Increasing heart rate and blood pressure during emergencies
Correct Answer: B) Conserving energy and maintaining body resources
Rationale: The parasympathetic nervous system is responsible for conserving
energy and the body's resources, supporting "rest and digest" functions such as
digestion, metabolism, and maintenance of day-to-day homeostasis. The
sympathetic nervous system is responsible for the "fight or flight" response,
including redirecting blood flow to muscles and increasing heart rate .
5. A patient is experiencing an autoimmune response where antibodies are directed
against acetylcholine receptors at the neuromuscular junction. Which condition is
most consistent with this pathophysiology?
A) Multiple sclerosis
B) Guillain-Barré syndrome
C) Myasthenia gravis
D) Parkinson disease
, Correct Answer: C) Myasthenia gravis
Rationale: Myasthenia gravis is a chronic autoimmune disease mediated by
antibodies that attack acetylcholine (ACh) receptors at the neuromuscular
junction. These antibodies prevent normal ACh binding and muscle contraction,
leading to characteristic muscle weakness that worsens with activity and
improves with rest. Multiple sclerosis involves autoimmune demyelination in the
central nervous system. Guillain-Barré syndrome is an autoimmune attack on
peripheral nerves, often triggered by infection. Parkinson disease results from
dopamine deficiency in the basal ganglia .
6. What is the single greatest risk factor for stroke?
A) Diabetes mellitus
B) Hyperlipidemia
C) Hypertension
D) Atrial fibrillation
Correct Answer: C) Hypertension
Rationale: Hypertension is the single greatest risk factor for stroke, accounting
for approximately 87% of occurrences. Other common risk factors include
insulin resistance and diabetes mellitus, elevated cholesterol or low HDL,
elevated lipoprotein-A level, hyperhomocysteinemia, congestive heart disease and
PVD, asymptomatic carotid stenosis, polycythemia and thrombocythemia, atrial
fibrillation, postmenopausal hormone therapy, high sodium intake above 2300
mg, low potassium intake less than 4700 mg, smoking, lack of physical activity,
obesity, and chronic sleep deprivation .
2026/2027 PRACTICE QUESTIONS AND A CURRENT UPDATED STUDY
GUIDE COMPLETE ACCURATE EXAM REAL QUESTIONS WITH WELL
ELABORATED ANSWERS AND RATIONALES (100% CORRECT VERIFIED
SOLUTIONS) NEWEST UPDATED VERSION 2026 EDITION
|GUARANTEED PASS A+ (BRAND NEW!) FULL REVISED MARYVILLE
PATHO NURS 611 EXAM 4 APPROVED FINAL EXAM |GUARANTEED
PASS A+ |JUST RELEASED
1. A patient presents with severe right upper quadrant abdominal pain that radiates
to the right scapula. During deep palpation under the right costal margin, the
patient abruptly stops inhaling due to pain. Which sign is positive and what
condition does it indicate?
A) McBurney's sign; acute appendicitis
B) Murphy's sign; acute cholecystitis
C) Rovsing's sign; acute pancreatitis
D) Cullen's sign; ruptured ectopic pregnancy
Correct Answer: B) Murphy's sign; acute cholecystitis
Rationale: A positive Murphy's sign occurs when sharp gallbladder tenderness
halts inspiration during deep palpation of the right upper quadrant. This clinical
finding is highly specific for acute cholecystitis. McBurney's and Rovsing's signs
evaluate for appendicitis, while Cullen's sign indicates intra-abdominal
hemorrhage .
2. A 58-year-old patient with type 2 diabetes presents for follow-up. Which
laboratory test best reflects glycemic control over the previous 2-3 months?
,A) Fasting plasma glucose
B) Random blood glucose
C) Hemoglobin A1c
D) Oral glucose tolerance test
Correct Answer: C) Hemoglobin A1c
Rationale: Hemoglobin A1c reflects average blood glucose levels over
approximately 8-12 weeks (2-3 months) and is the standard measure of long-
term glycemic control. Fasting and random glucose levels only provide a
snapshot of current glucose status .
3. A patient with a spinal cord injury at the T5 level suddenly develops paroxysmal
hypertension (systolic BP 280 mmHg), a pounding headache, bradycardia (HR 32
bpm), and flushing above the level of the lesion. What is the most likely diagnosis?
A) Autonomic dysreflexia
B) Orthostatic hypotension
C) Neurogenic shock
D) Hypertensive crisis
Correct Answer: A) Autonomic dysreflexia
Rationale: Autonomic dysreflexia is characterized by paroxysmal hypertension
(up to 300 mmHg systolic), pounding headache, blurred vision, sweating above
the lesion level with flushing, nasal congestion, nausea, piloerection, and
bradycardia (30-40 bpm). This condition occurs in individuals with spinal cord
lesions at or above the T5-T6 level. The intact autonomic nervous system
reflexively responds to a noxious stimulus below the level of injury with
,arteriolar spasm and hypertension, but efferent impulses cannot pass through
the cord to allow vasodilation .
4. The parasympathetic nervous system is primarily responsible for which of the
following functions?
A) Preparing the body for "fight or flight" responses
B) Conserving energy and maintaining body resources
C) Redirecting blood flow to skeletal muscles during stress
D) Increasing heart rate and blood pressure during emergencies
Correct Answer: B) Conserving energy and maintaining body resources
Rationale: The parasympathetic nervous system is responsible for conserving
energy and the body's resources, supporting "rest and digest" functions such as
digestion, metabolism, and maintenance of day-to-day homeostasis. The
sympathetic nervous system is responsible for the "fight or flight" response,
including redirecting blood flow to muscles and increasing heart rate .
5. A patient is experiencing an autoimmune response where antibodies are directed
against acetylcholine receptors at the neuromuscular junction. Which condition is
most consistent with this pathophysiology?
A) Multiple sclerosis
B) Guillain-Barré syndrome
C) Myasthenia gravis
D) Parkinson disease
, Correct Answer: C) Myasthenia gravis
Rationale: Myasthenia gravis is a chronic autoimmune disease mediated by
antibodies that attack acetylcholine (ACh) receptors at the neuromuscular
junction. These antibodies prevent normal ACh binding and muscle contraction,
leading to characteristic muscle weakness that worsens with activity and
improves with rest. Multiple sclerosis involves autoimmune demyelination in the
central nervous system. Guillain-Barré syndrome is an autoimmune attack on
peripheral nerves, often triggered by infection. Parkinson disease results from
dopamine deficiency in the basal ganglia .
6. What is the single greatest risk factor for stroke?
A) Diabetes mellitus
B) Hyperlipidemia
C) Hypertension
D) Atrial fibrillation
Correct Answer: C) Hypertension
Rationale: Hypertension is the single greatest risk factor for stroke, accounting
for approximately 87% of occurrences. Other common risk factors include
insulin resistance and diabetes mellitus, elevated cholesterol or low HDL,
elevated lipoprotein-A level, hyperhomocysteinemia, congestive heart disease and
PVD, asymptomatic carotid stenosis, polycythemia and thrombocythemia, atrial
fibrillation, postmenopausal hormone therapy, high sodium intake above 2300
mg, low potassium intake less than 4700 mg, smoking, lack of physical activity,
obesity, and chronic sleep deprivation .
