NURS 6501N Exam 2 V3 | NURS 6501N
Advanced Pathophysiology | Actual Q&A
with Rationale (NURS6501N Exam 2) |
Walden University
1. A patient is diagnosed with pernicious anemia. Which underlying mechanism is most likely
responsible for this condition?
A. Chronic blood loss leading to iron depletion
B. Impaired DNA synthesis caused by folic acid deficiency
C. A deficiency of intrinsic factor due to gastric mucosal atrophy
D. Bone marrow failure resulting in pancytopenia
Answer: C
Rationale: Pernicious anemia is a macrocytic-normochromic anemia caused by a lack of
intrinsic factor from the gastric parietal cells. Intrinsic factor is essential for the absorption
of vitamin B12 in the terminal ileum. Without sufficient B12, DNA synthesis in red blood
cells is impaired, leading to the production of large, immature megaloblasts.
2. Which type of leukemia is characterized by the presence of the Philadelphia chromosome
(a translocation between chromosomes 9 and 22)?
A. Chronic myelogenous leukemia (CML)
B. Acute myelogenous leukemia (AML)
,C. Acute lymphocytic leukemia (ALL)
D. Chronic lymphocytic leukemia (CLL)
Answer: A
Rationale: The Philadelphia chromosome is a specific genetic abnormality found in the
leukemic cells of patients with Chronic Myelogenous Leukemia (CML). This translocation
results in the BCR-ABL fusion oncogene, which produces a tyrosine kinase that promotes
unregulated cell proliferation. Identifying this marker is crucial for both diagnosis and
targeted therapy using tyrosine kinase inhibitors.
3. In the pathophysiology of disseminated intravascular coagulation (DIC), what is the primary
initiator of the coagulation cascade?
A. Release of plasminogen activator
B. Widespread release of tissue factor (TF) into the circulation
C. Activation of the complement system
D. Severe depletion of platelets and clotting factors
Answer: B
Rationale: DIC is characterized by the systemic activation of coagulation, typically
triggered by the widespread release of tissue factor due to endothelial damage or sepsis.
This leads to excessive thrombin generation and microvascular thrombosis throughout the
body. Paradoxically, the consumption of clotting factors and platelets eventually leads to
profuse hemorrhage.
, 4. A patient with chronic kidney disease (CKD) presents with significant anemia. What is the
most likely cause of this hematologic complication?
A. Reduced lifespan of red blood cells due to uremic toxins
B. Inadequate dietary intake of iron and B12
C. Deficiency of erythropoietin production by the kidneys
D. Chronic occult gastrointestinal bleeding
Answer: C
Rationale: The kidneys are the primary site for the production of erythropoietin, the
hormone that stimulates red blood cell production in the bone marrow. As renal function
declines in CKD, the peritubular fibroblasts fail to produce sufficient erythropoietin,
resulting in a normocytic-normochromic anemia. Management often involves the
administration of recombinant human erythropoietin to maintain hemoglobin levels.
5. Which clinical manifestation is a hallmark of multiple myeloma?
A. Splenomegaly and hepatomegaly
B. Painless lymphadenopathy in the neck
C. Bence-Jones proteins in the urine
D. Elevated white blood cell count with immature blasts
Answer: C
Advanced Pathophysiology | Actual Q&A
with Rationale (NURS6501N Exam 2) |
Walden University
1. A patient is diagnosed with pernicious anemia. Which underlying mechanism is most likely
responsible for this condition?
A. Chronic blood loss leading to iron depletion
B. Impaired DNA synthesis caused by folic acid deficiency
C. A deficiency of intrinsic factor due to gastric mucosal atrophy
D. Bone marrow failure resulting in pancytopenia
Answer: C
Rationale: Pernicious anemia is a macrocytic-normochromic anemia caused by a lack of
intrinsic factor from the gastric parietal cells. Intrinsic factor is essential for the absorption
of vitamin B12 in the terminal ileum. Without sufficient B12, DNA synthesis in red blood
cells is impaired, leading to the production of large, immature megaloblasts.
2. Which type of leukemia is characterized by the presence of the Philadelphia chromosome
(a translocation between chromosomes 9 and 22)?
A. Chronic myelogenous leukemia (CML)
B. Acute myelogenous leukemia (AML)
,C. Acute lymphocytic leukemia (ALL)
D. Chronic lymphocytic leukemia (CLL)
Answer: A
Rationale: The Philadelphia chromosome is a specific genetic abnormality found in the
leukemic cells of patients with Chronic Myelogenous Leukemia (CML). This translocation
results in the BCR-ABL fusion oncogene, which produces a tyrosine kinase that promotes
unregulated cell proliferation. Identifying this marker is crucial for both diagnosis and
targeted therapy using tyrosine kinase inhibitors.
3. In the pathophysiology of disseminated intravascular coagulation (DIC), what is the primary
initiator of the coagulation cascade?
A. Release of plasminogen activator
B. Widespread release of tissue factor (TF) into the circulation
C. Activation of the complement system
D. Severe depletion of platelets and clotting factors
Answer: B
Rationale: DIC is characterized by the systemic activation of coagulation, typically
triggered by the widespread release of tissue factor due to endothelial damage or sepsis.
This leads to excessive thrombin generation and microvascular thrombosis throughout the
body. Paradoxically, the consumption of clotting factors and platelets eventually leads to
profuse hemorrhage.
, 4. A patient with chronic kidney disease (CKD) presents with significant anemia. What is the
most likely cause of this hematologic complication?
A. Reduced lifespan of red blood cells due to uremic toxins
B. Inadequate dietary intake of iron and B12
C. Deficiency of erythropoietin production by the kidneys
D. Chronic occult gastrointestinal bleeding
Answer: C
Rationale: The kidneys are the primary site for the production of erythropoietin, the
hormone that stimulates red blood cell production in the bone marrow. As renal function
declines in CKD, the peritubular fibroblasts fail to produce sufficient erythropoietin,
resulting in a normocytic-normochromic anemia. Management often involves the
administration of recombinant human erythropoietin to maintain hemoglobin levels.
5. Which clinical manifestation is a hallmark of multiple myeloma?
A. Splenomegaly and hepatomegaly
B. Painless lymphadenopathy in the neck
C. Bence-Jones proteins in the urine
D. Elevated white blood cell count with immature blasts
Answer: C
