NURS 5315 Final Exam V1 | NURS 5315
Advanced Pathophysiology | Actual Q&A
with Rationale (NURS5315 Final Exam) |
The University of Texas at Arlington
1. When a practitioner is evaluating a patient with long-standing uncontrolled hypertension,
they note myocardial thickening. Which cellular adaptation is primarily responsible for this
change?
A. Cellular atrophy
B. Metaplasia of myocytes
C. Hypertrophy of cardiomyocytes
D. Hyperplasia of the myocardium
Answer: C
Rationale: Hypertrophy represents an increase in the size of individual cells in response to
an increased workload or mechanical stress. In hypertension, the left ventricle must
generate more pressure to overcome systemic resistance, leading to the enlargement of
heart muscle cells. This adaptive process differs from hyperplasia, which involves an
increase in the actual number of cells through division.
2. A practitioner is reviewing the genetic profile of a female patient with short stature and a
webbed neck. Which chromosomal finding is consistent with Turner Syndrome?
A. 47, XXY
,B. 47, XY, +21
C. 46, XX, del(5p)
D. 45, X
Answer: D
Rationale: Turner Syndrome is characterized by the complete or partial absence of one X
chromosome in females, resulting in a 45, X karyotype. This monosomy leads to specific
phenotypic traits such as ovarian dysgenesis and congenital lymphedema. Understanding
this chromosomal abnormality is critical for diagnosing the various endocrine and
developmental issues associated with the condition.
3. Which pathophysiological mechanism explains the development of edema in a patient with
severe liver failure and hypoalbuminemia?
A. Decreased plasma oncotic pressure
B. Increased capillary hydrostatic pressure
C. Increased interstitial oncotic pressure
D. Lymphatic obstruction
Answer: A
Rationale: Albumin is the primary protein responsible for maintaining the oncotic
pressure that keeps fluid within the intravascular space. When liver synthesis of albumin
declines, the reduction in plasma oncotic pressure allows fluid to leak into the interstitial
,tissues. This mechanism is a foundational concept in understanding fluid shifts and third-
spacing in chronic disease states.
4. During an assessment of a patient with suspected SIADH, which electrolyte imbalance
should the practitioner anticipate?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Answer: D
Rationale: The Syndrome of Inappropriate Antidiuretic Hormone (SIADH) results in
excessive water reabsorption by the kidneys regardless of serum osmolality. This excess
water dilutes the sodium concentration in the blood, leading to dilutional hyponatremia.
Clinical manifestations often include neurological changes such as confusion or seizures as
water shifts into the brain cells.
5. A practitioner is treating a patient with chronic kidney disease who exhibits a high serum
potassium level. Which mechanism explains why insulin is administered to treat
hyperkalemia?
A. Insulin increases renal excretion of potassium
B. Insulin facilitates the shift of potassium into the intracellular space
C. Insulin binds to potassium in the plasma
, D. Insulin blocks the absorption of potassium in the gut
Answer: B
Rationale: Insulin stimulates the sodium-potassium ATPase pump, which moves
potassium from the extracellular fluid into the cells. This provides a rapid, albeit
temporary, reduction in serum potassium levels to prevent cardiac dysrhythmias. This
intervention is typically paired with glucose to prevent hypoglycemia during the acute
management of hyperkalemia.
6. Which arterial blood gas result is indicative of partially compensated respiratory acidosis?
A. pH 7.32, PaCO2 50, HCO3 24
B. pH 7.45, PaCO2 30, HCO3 20
C. pH 7.36, PaCO2 55, HCO3 30
D. pH 7.30, PaCO2 52, HCO3 28
Answer: D
Rationale: Respiratory acidosis is characterized by a low pH and an elevated PaCO2 level.
Partial compensation occurs when the kidneys begin to retain bicarbonate (HCO3) to raise
the pH, but the pH has not yet returned to the normal range. If the pH was within the
normal range but on the acidic side, it would be considered fully compensated.
7. In Type I hypersensitivity reactions, which antibody isotype is primarily responsible for the
degranulation of mast cells?
A. IgG
Advanced Pathophysiology | Actual Q&A
with Rationale (NURS5315 Final Exam) |
The University of Texas at Arlington
1. When a practitioner is evaluating a patient with long-standing uncontrolled hypertension,
they note myocardial thickening. Which cellular adaptation is primarily responsible for this
change?
A. Cellular atrophy
B. Metaplasia of myocytes
C. Hypertrophy of cardiomyocytes
D. Hyperplasia of the myocardium
Answer: C
Rationale: Hypertrophy represents an increase in the size of individual cells in response to
an increased workload or mechanical stress. In hypertension, the left ventricle must
generate more pressure to overcome systemic resistance, leading to the enlargement of
heart muscle cells. This adaptive process differs from hyperplasia, which involves an
increase in the actual number of cells through division.
2. A practitioner is reviewing the genetic profile of a female patient with short stature and a
webbed neck. Which chromosomal finding is consistent with Turner Syndrome?
A. 47, XXY
,B. 47, XY, +21
C. 46, XX, del(5p)
D. 45, X
Answer: D
Rationale: Turner Syndrome is characterized by the complete or partial absence of one X
chromosome in females, resulting in a 45, X karyotype. This monosomy leads to specific
phenotypic traits such as ovarian dysgenesis and congenital lymphedema. Understanding
this chromosomal abnormality is critical for diagnosing the various endocrine and
developmental issues associated with the condition.
3. Which pathophysiological mechanism explains the development of edema in a patient with
severe liver failure and hypoalbuminemia?
A. Decreased plasma oncotic pressure
B. Increased capillary hydrostatic pressure
C. Increased interstitial oncotic pressure
D. Lymphatic obstruction
Answer: A
Rationale: Albumin is the primary protein responsible for maintaining the oncotic
pressure that keeps fluid within the intravascular space. When liver synthesis of albumin
declines, the reduction in plasma oncotic pressure allows fluid to leak into the interstitial
,tissues. This mechanism is a foundational concept in understanding fluid shifts and third-
spacing in chronic disease states.
4. During an assessment of a patient with suspected SIADH, which electrolyte imbalance
should the practitioner anticipate?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Answer: D
Rationale: The Syndrome of Inappropriate Antidiuretic Hormone (SIADH) results in
excessive water reabsorption by the kidneys regardless of serum osmolality. This excess
water dilutes the sodium concentration in the blood, leading to dilutional hyponatremia.
Clinical manifestations often include neurological changes such as confusion or seizures as
water shifts into the brain cells.
5. A practitioner is treating a patient with chronic kidney disease who exhibits a high serum
potassium level. Which mechanism explains why insulin is administered to treat
hyperkalemia?
A. Insulin increases renal excretion of potassium
B. Insulin facilitates the shift of potassium into the intracellular space
C. Insulin binds to potassium in the plasma
, D. Insulin blocks the absorption of potassium in the gut
Answer: B
Rationale: Insulin stimulates the sodium-potassium ATPase pump, which moves
potassium from the extracellular fluid into the cells. This provides a rapid, albeit
temporary, reduction in serum potassium levels to prevent cardiac dysrhythmias. This
intervention is typically paired with glucose to prevent hypoglycemia during the acute
management of hyperkalemia.
6. Which arterial blood gas result is indicative of partially compensated respiratory acidosis?
A. pH 7.32, PaCO2 50, HCO3 24
B. pH 7.45, PaCO2 30, HCO3 20
C. pH 7.36, PaCO2 55, HCO3 30
D. pH 7.30, PaCO2 52, HCO3 28
Answer: D
Rationale: Respiratory acidosis is characterized by a low pH and an elevated PaCO2 level.
Partial compensation occurs when the kidneys begin to retain bicarbonate (HCO3) to raise
the pH, but the pH has not yet returned to the normal range. If the pH was within the
normal range but on the acidic side, it would be considered fully compensated.
7. In Type I hypersensitivity reactions, which antibody isotype is primarily responsible for the
degranulation of mast cells?
A. IgG
