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NURS8022 ADVANCED PHYSIOLOGY AND
PATHOPHYSIOLOGY COMPREHENSIVE FINAL
ACTUAL EXAM PREP 2026 ALL QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT
FEEDBACK|NEW AND REVISED
1. A patient presents with tissue swelling, pain, and redness following a
bacterial infection. Which of the following BEST describes the
underlying cellular process?
A) Cellular atrophy
B) Acute inflammation
C) Cellular hyperplasia
D) Metaplasia
Rationale: Acute inflammation is a protective response to tissue injury
or infection, characterized by redness, heat, swelling, pain, and loss of
function. It is mediated by inflammatory cells and chemical mediators.
Atrophy, hyperplasia, and metaplasia are other cellular adaptations,
not inflammatory responses.
2. A 65-year-old patient with chronic heart failure has developed
bilateral pitting edema in the lower extremities. Which pathophysiologic
mechanism is MOST likely responsible?
A) Decreased capillary permeability
B) Increased plasma oncotic pressure
C) Increased hydrostatic pressure
D) Decreased lymphatic drainage
,2|P a g e
Rationale: In heart failure, reduced cardiac output leads to venous
congestion and increased capillary hydrostatic pressure. This forces
fluid out of the capillaries into the interstitial space, resulting in
edema. Decreased capillary permeability would reduce edema.
Increased plasma oncotic pressure would pull fluid into the capillaries.
Lymphatic dysfunction is a less common cause of generalized edema.
3. A patient with chronic obstructive pulmonary disease (COPD) has a
PaCO2 of 55 mmHg and a pH of 7.30. This acid-base disturbance is
BEST classified as:
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Rationale: Respiratory acidosis is characterized by an elevated PaCO2
(>45 mmHg) and decreased pH (<7.35) due to hypoventilation and
CO2 retention. COPD is a classic cause of chronic respiratory
acidosis. Metabolic acidosis involves a decreased bicarbonate level,
and respiratory alkalosis involves a decreased PaCO2.
4. The resting membrane potential of a typical neuron is approximately:
A) +30 mV
B) -70 mV
C) -55 mV
D) +40 mV
Rationale: The resting membrane potential of a typical neuron is
approximately -70 mV. This is maintained by the sodium-potassium
pump and the differential permeability of the membrane to potassium
and sodium ions. +30 mV is the approximate peak of an action
potential. -55 mV is the threshold potential for action potential
initiation.
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5. During the depolarization phase of an action potential, which ion
movement is primarily responsible?
A) Potassium efflux
B) Sodium influx
C) Calcium influx
D) Chloride influx
Rationale: Depolarization is caused by the rapid influx of sodium ions
through voltage-gated sodium channels. Potassium efflux is
responsible for repolarization. Calcium influx is important for
neurotransmitter release and cardiac muscle contraction. Chloride
influx typically hyperpolarizes the membrane.
6. A patient with a left-sided stroke exhibits right-sided hemiplegia and
aphasia. Which cerebral artery is MOST likely occluded?
A) Anterior cerebral artery
B) Middle cerebral artery
C) Posterior cerebral artery
D) Vertebral artery
Rationale: The middle cerebral artery (MCA) is the most common site
of occlusion in ischemic stroke. Occlusion of the left MCA typically
results in contralateral hemiplegia (right-sided weakness) and aphasia
due to involvement of language areas. The anterior cerebral artery
affects the contralateral leg. The posterior cerebral artery affects
vision. The vertebral artery affects the brainstem.
7. Which of the following describes the Frank-Starling law of the heart?
A) Increased ventricular filling leads to increased force of
contraction
B) Increased heart rate leads to increased cardiac output
C) Increased afterload leads to increased stroke volume
D) Decreased preload leads to increased contractility
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Rationale: The Frank-Starling law states that the force of ventricular
contraction is directly proportional to the end-diastolic volume
(preload). Increased filling stretches the cardiac muscle fibers,
resulting in a more forceful contraction. Increased afterload decreases
stroke volume. Decreased preload decreases contractility.
8. A patient with a history of chronic alcohol abuse presents with
confusion, ataxia, and ophthalmoplegia. This clinical triad is MOST
consistent with:
A) Korsakoff syndrome
B) Wernicke encephalopathy
C) Hepatic encephalopathy
D) Delirium tremens
Rationale: Wernicke encephalopathy is characterized by the triad of
confusion, ataxia, and ophthalmoplegia, and is caused by thiamine
(vitamin B1) deficiency, often associated with chronic alcohol abuse.
Korsakoff syndrome is a chronic complication with memory loss and
confabulation. Hepatic encephalopathy is associated with liver failure.
Delirium tremens is alcohol withdrawal with severe agitation.
9. In type 1 diabetes mellitus, the primary pathophysiologic defect is:
A) Insulin resistance
B) Autoimmune destruction of pancreatic beta cells
C) Impaired glucose uptake by muscle cells
D) Increased hepatic glucose production
Rationale: Type 1 diabetes is characterized by autoimmune destruction
of pancreatic beta cells, leading to absolute insulin deficiency. Insulin
resistance is the hallmark of type 2 diabetes. Impaired glucose uptake
and increased hepatic glucose production are features of type 2
diabetes.
10. The major cation in the intracellular fluid is:
NURS8022 ADVANCED PHYSIOLOGY AND
PATHOPHYSIOLOGY COMPREHENSIVE FINAL
ACTUAL EXAM PREP 2026 ALL QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT
FEEDBACK|NEW AND REVISED
1. A patient presents with tissue swelling, pain, and redness following a
bacterial infection. Which of the following BEST describes the
underlying cellular process?
A) Cellular atrophy
B) Acute inflammation
C) Cellular hyperplasia
D) Metaplasia
Rationale: Acute inflammation is a protective response to tissue injury
or infection, characterized by redness, heat, swelling, pain, and loss of
function. It is mediated by inflammatory cells and chemical mediators.
Atrophy, hyperplasia, and metaplasia are other cellular adaptations,
not inflammatory responses.
2. A 65-year-old patient with chronic heart failure has developed
bilateral pitting edema in the lower extremities. Which pathophysiologic
mechanism is MOST likely responsible?
A) Decreased capillary permeability
B) Increased plasma oncotic pressure
C) Increased hydrostatic pressure
D) Decreased lymphatic drainage
,2|P a g e
Rationale: In heart failure, reduced cardiac output leads to venous
congestion and increased capillary hydrostatic pressure. This forces
fluid out of the capillaries into the interstitial space, resulting in
edema. Decreased capillary permeability would reduce edema.
Increased plasma oncotic pressure would pull fluid into the capillaries.
Lymphatic dysfunction is a less common cause of generalized edema.
3. A patient with chronic obstructive pulmonary disease (COPD) has a
PaCO2 of 55 mmHg and a pH of 7.30. This acid-base disturbance is
BEST classified as:
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Rationale: Respiratory acidosis is characterized by an elevated PaCO2
(>45 mmHg) and decreased pH (<7.35) due to hypoventilation and
CO2 retention. COPD is a classic cause of chronic respiratory
acidosis. Metabolic acidosis involves a decreased bicarbonate level,
and respiratory alkalosis involves a decreased PaCO2.
4. The resting membrane potential of a typical neuron is approximately:
A) +30 mV
B) -70 mV
C) -55 mV
D) +40 mV
Rationale: The resting membrane potential of a typical neuron is
approximately -70 mV. This is maintained by the sodium-potassium
pump and the differential permeability of the membrane to potassium
and sodium ions. +30 mV is the approximate peak of an action
potential. -55 mV is the threshold potential for action potential
initiation.
,3|P a g e
5. During the depolarization phase of an action potential, which ion
movement is primarily responsible?
A) Potassium efflux
B) Sodium influx
C) Calcium influx
D) Chloride influx
Rationale: Depolarization is caused by the rapid influx of sodium ions
through voltage-gated sodium channels. Potassium efflux is
responsible for repolarization. Calcium influx is important for
neurotransmitter release and cardiac muscle contraction. Chloride
influx typically hyperpolarizes the membrane.
6. A patient with a left-sided stroke exhibits right-sided hemiplegia and
aphasia. Which cerebral artery is MOST likely occluded?
A) Anterior cerebral artery
B) Middle cerebral artery
C) Posterior cerebral artery
D) Vertebral artery
Rationale: The middle cerebral artery (MCA) is the most common site
of occlusion in ischemic stroke. Occlusion of the left MCA typically
results in contralateral hemiplegia (right-sided weakness) and aphasia
due to involvement of language areas. The anterior cerebral artery
affects the contralateral leg. The posterior cerebral artery affects
vision. The vertebral artery affects the brainstem.
7. Which of the following describes the Frank-Starling law of the heart?
A) Increased ventricular filling leads to increased force of
contraction
B) Increased heart rate leads to increased cardiac output
C) Increased afterload leads to increased stroke volume
D) Decreased preload leads to increased contractility
, 4|P a g e
Rationale: The Frank-Starling law states that the force of ventricular
contraction is directly proportional to the end-diastolic volume
(preload). Increased filling stretches the cardiac muscle fibers,
resulting in a more forceful contraction. Increased afterload decreases
stroke volume. Decreased preload decreases contractility.
8. A patient with a history of chronic alcohol abuse presents with
confusion, ataxia, and ophthalmoplegia. This clinical triad is MOST
consistent with:
A) Korsakoff syndrome
B) Wernicke encephalopathy
C) Hepatic encephalopathy
D) Delirium tremens
Rationale: Wernicke encephalopathy is characterized by the triad of
confusion, ataxia, and ophthalmoplegia, and is caused by thiamine
(vitamin B1) deficiency, often associated with chronic alcohol abuse.
Korsakoff syndrome is a chronic complication with memory loss and
confabulation. Hepatic encephalopathy is associated with liver failure.
Delirium tremens is alcohol withdrawal with severe agitation.
9. In type 1 diabetes mellitus, the primary pathophysiologic defect is:
A) Insulin resistance
B) Autoimmune destruction of pancreatic beta cells
C) Impaired glucose uptake by muscle cells
D) Increased hepatic glucose production
Rationale: Type 1 diabetes is characterized by autoimmune destruction
of pancreatic beta cells, leading to absolute insulin deficiency. Insulin
resistance is the hallmark of type 2 diabetes. Impaired glucose uptake
and increased hepatic glucose production are features of type 2
diabetes.
10. The major cation in the intracellular fluid is: