ADVANCED PATHOPHYSIOLOGY
MIDTERM NUR 6501 WALDEN
UNIVERSITY / COMPLETE ACTUAL
EXAM / 150+ QUESTIONS AND
CORRECT DETAILED ANSWERS /
2025/2026
Am4-year-
oldmchildmappearsmlistlessmformthemlastmweek.mHemcomplainsmofmpainmwhenmhemismpickedmupmbymhi
smmother,mandmhemismirritablemwhenmtouchingmhismarmsmormlegs.mSeveralmlargemecchymoticmlesions
mhavemappearedmonmhismrightmthighmandmleftmshoulder.mAmcompletembloodmcountmrevealsmamHgB=1
0.2,mHct=30.5%,mMCV=96fL,mplateletmcountmofm45,000/ML,mandmWBCmcountmofm13,990/ML.mExa
minationmofmthemperipheralmbloodmsmearmrevealsmnumerousmblasts.mThemblastsmlackmperoxidase-
positivemgranulesmbutmdomcontainmperiodicmacid-Schiffm(PAS)-
positivemaggregatesmandmstainmpositivelymformTdT.mFlowmcytometrymshowsmthemphenotypemofmblas
tsmtombemCD19+,mCD3-,mandmsIg-.mWhatmismthemmostmlikelymdiagnosis?
A.mAcutemlymphoblasticmleukemiam(ALL)
B.mChronicmlymphocyticmleukemiam(CLL)
C.mAcutemmyelogenousmleukemiam(AML)
D.mChronicmmyelogenousmleukemiam(CML)m-mCORRECTmANSWERmAcutemlymphblasticmleukemia
Am3-year-
oldmchildmofmItalianmancestrympresentsmwithmfailuremtomthrive.mPhysicalmexaminationmindicatesmhe
patosplenomegaly.mHismhemoglobinmconcentrationmism6mg/dL,mandmthemperipheralmbloodmsmearmr
evealsmseverelymhypochromicmmicrocyticmredmcells.mTotalmserummironmlevelmismnormal.mThemreticul
ocytemcountmism10%.mHemoglobinmelectrophoresismshowsmverymlittlemhemoglobinmA.mAmradiograp
hmofmthemskullmshowsmmaxillofacialmdeformities.mWhatmismthemprinciplemcausemofmanemiamandmoth
ermabnormalitiesminmthismpatient?
A.mReducedmsynthesismofmhemoglobinmF
,B.mReducedmredmbloodmcellmsurvivalmfrommimbalanceminmthemproductionmofmalphamandmbetamglobi
nmchains
C.mRelativemdeficiencymofmvitaminmB12
D.mIncreasedmfragilitymofmthemerythrocytemmembranem-
mCORRECTmANSWERmReducedmsynthesismofmhemoglobinmF
Am68-year-
oldmpreviouslymhealthymfemalemhasmbeenmfeelingmincreasinglymtiredmandmweakmformseveralmmonth
s.mShemstatesmthatmshemhasmhadmblack,mtarrymstoolsmformseveralmweeks.mShemismfoundmtombemanemi
cmwithmamhemoglobinmconcentrationmofm9.3g/dL.mThemperipheralmbloodmsmearmrevealsmmicrocytic
mandmhypochromicmbloodmcells.mWhichmofmthemfollowingmconditionsmshouldmbemsuspectedmasmthem
mostmlikelymofmhermconditionmasmindicatedmbymthemperipheralmbloodmsmear?
A.mAplasticmanemia
B.mBetamthalassemia
C.mGastrointestinalmbloodmloss
D.mPerniciousmanemiam-mCORRECTmANSWERmGastrointestinalmbloodmloss
Am76-year-
oldmfemalemnoticesmthatmsmall,mpinpointmtomblotchymareasmofmsuperficialmhemorrhagemhavemappe
aredmonmhermgumsmandmonmthemskinmofmhermarmsmandmlegsmovermseveralmweeks.mShemismfoundmtom
havemamnormalmprothrombinmtime(PT)mandmpartialmthromboplastinmtimem(PTT).mHermCBCmshowsm
hemoglobinmconcentrationmofm12.7mg/dL,mhematocritmofm37.2%.mMCVmofm80mfL/redmcell,mplateletm
countmofm276,000/microliter,mandmWBCmofm5600/microliter.mHermtemplatembleedingmtimemism3mmi
nutes.mHermfibrinogenmlevelmismnormal,mandmtheremaremnomfibrinmsplitmproductsmdetectable.mWhic
hmofmthemfollowingmconditionsmbestmexplainmthesemfindings?
A.mChronicmrenalmfailure
B.mMacronodularmcirrhosis
C.mVitaminmB12mdeficiency
,D.mVitaminmCmdeficiencym-mCORRECTmANSWERmVitaminmCmdeficiency
AmyoungmadultmpatientmhasmjustmbeenmdiagnosedmwithmVonmWillebrandmdisease.mWhichmofmthemfo
llowingmstatementsmshouldmyoummakemtomadvisemthempatientmofmpotentialmconsequencesmofmthism
disease?
A.mYoummaymneedmanmallogeneicmbonemmarrowmtransplant
B.mYoummaymhavemexcessivembleedingmfollowingmtoothmextraction
C.mAmsplenectomymmaymbemnecessarymtomcontrolmthemdisease
D.mExpectmincreasingmdifficultiesmwithmjointmmobilitym-
mCORRECTmANSWERmYoummaymhavemexcessivembleedingmfollowingmtoothmextraction
Lowmdosemaspirinmismcommonlymusedmtomreducemthemriskmofmarterialmthrombosisminmpatientsmwho
mhavemsufferedmammyocardialminfarction.mWhichmonemofmthemfollowingmstepsminmhomeostasismismin
hibitedmbymaspirin?
A.mSynthesismofmvonmWillebrandmfactor
B.mAggregationmofmplatelets
C.mActivationmofmfactormXa
D.mSynthesismofmantithrombinmIIIm-mCORRECTmANSWERmAggregationmofmplatelets
Am24-year-
oldmpresentsmtomthemofficemwithmfatigue.mOnmphysicalmexam,mthemNPmnoticesmthatmshemispalemwith
mthemfollowingmvitalmsigns:mHRm112,mBPm98/64,mrespm20,mO2msatsm99%.mHermCBCmshows:mWBC6,00
0,mHemoglobinm9.6,mHematocritm30.2,mMCVmismdecreasedmatm76.mWhatmismthemmostlymlikelymcause
ofmthismpatient'smanemia?
A.mIronmdeficiencymanemiamcausedmbymmenstruation
B.mBetamThalassemiamofmgeneticmorigin
, C.mPerniciousmanemiamcausedmbymdietarymdeficiency
D.mFolatemdeficiencymcausedmbymalcoholismm-
mCORRECTmANSWERmIronmdeficiencymanemiamcausedmbymmenstruation
Am65-year-
oldmfemalempresentsmtomyourmofficemcomplainingmofmfatigue.mShemhasmamlongmofmrheumatoidmarth
ritis.mAmCBCmrevealsmthemfollowing:mHgb=11.6mg/dL,mHct=34.8%,mMCV=87mfL/redmcell,mplateletmco
untmofm268,000/microliter,mandmWBCmcountmofm6800/microliter.mThemserummhaptoglobinmlevelmism
normal,mandmthemserummironmconcentrationmism20mmicrograms/dL.mThemtotalmironmbindingmcapaci
tymism195mmicrograms/dL,mandmthempercentmsaturationmism10.2.mThemserummferritinmconcentration
mism317mng/mL.mNomfibrinmsplitmproductsmaremdetected.mThemreticulocytemconcentrationmism1.1%.m
Whatmismthemmostmlikelymdiagnosis?
A.mBeta-mthalassemiammajor
B.mAnemiamofmchronicmdiseasem
C.mAcutembloodmlossmanemia
D.mIronmdeficiencymanemiam-mCORRECTmANSWERmAnemiamofmchronicmdisease
Am14-year-
oldmmalempresentsmwithmhighmfevermformtenmdays.mPhysicalmexaminationmrevealsmscatteredmpetech
ialmhemorrhagesmbutmismnegativemformenlargementmofmthemlivermormspleenmormlymphmnodes.mBone
mmarrowmexaminationmdoesmnotmshowmanymabnormalmcells.mThemcompletembloodmcountm(CBC)mde
monstratesmamhemoglobinmconcentrationm(HgB)mofm13.2mg/dL,mhematocritm(Hct)mofm38.9%,mmean
mcellmvolumem(MCV)mofm93mfL,mplateletmcountmofm175,000/microliter,mandmwhitembloodmcellm(WBC)
mcountmofm1850/microliter,mwithmthemdifferentialmcountmshowingm1msegmentedmneutrophil,m98mly
mphocytes,mandm1mmonocytemperm100mWBCs.mWhatmismthemmostmlikelymcausemofmthesemfindings?
A.mOverwhelmingmbacterialminfection
B.mAcutemlymphocyticm(ormlymphoblastic)mleukemia
C.mAcutemmyeloidmleukemia
D.mAplasticmanemiam-mCORRECTmANSWERmOverwhelmingmbacterialminfection
MIDTERM NUR 6501 WALDEN
UNIVERSITY / COMPLETE ACTUAL
EXAM / 150+ QUESTIONS AND
CORRECT DETAILED ANSWERS /
2025/2026
Am4-year-
oldmchildmappearsmlistlessmformthemlastmweek.mHemcomplainsmofmpainmwhenmhemismpickedmupmbymhi
smmother,mandmhemismirritablemwhenmtouchingmhismarmsmormlegs.mSeveralmlargemecchymoticmlesions
mhavemappearedmonmhismrightmthighmandmleftmshoulder.mAmcompletembloodmcountmrevealsmamHgB=1
0.2,mHct=30.5%,mMCV=96fL,mplateletmcountmofm45,000/ML,mandmWBCmcountmofm13,990/ML.mExa
minationmofmthemperipheralmbloodmsmearmrevealsmnumerousmblasts.mThemblastsmlackmperoxidase-
positivemgranulesmbutmdomcontainmperiodicmacid-Schiffm(PAS)-
positivemaggregatesmandmstainmpositivelymformTdT.mFlowmcytometrymshowsmthemphenotypemofmblas
tsmtombemCD19+,mCD3-,mandmsIg-.mWhatmismthemmostmlikelymdiagnosis?
A.mAcutemlymphoblasticmleukemiam(ALL)
B.mChronicmlymphocyticmleukemiam(CLL)
C.mAcutemmyelogenousmleukemiam(AML)
D.mChronicmmyelogenousmleukemiam(CML)m-mCORRECTmANSWERmAcutemlymphblasticmleukemia
Am3-year-
oldmchildmofmItalianmancestrympresentsmwithmfailuremtomthrive.mPhysicalmexaminationmindicatesmhe
patosplenomegaly.mHismhemoglobinmconcentrationmism6mg/dL,mandmthemperipheralmbloodmsmearmr
evealsmseverelymhypochromicmmicrocyticmredmcells.mTotalmserummironmlevelmismnormal.mThemreticul
ocytemcountmism10%.mHemoglobinmelectrophoresismshowsmverymlittlemhemoglobinmA.mAmradiograp
hmofmthemskullmshowsmmaxillofacialmdeformities.mWhatmismthemprinciplemcausemofmanemiamandmoth
ermabnormalitiesminmthismpatient?
A.mReducedmsynthesismofmhemoglobinmF
,B.mReducedmredmbloodmcellmsurvivalmfrommimbalanceminmthemproductionmofmalphamandmbetamglobi
nmchains
C.mRelativemdeficiencymofmvitaminmB12
D.mIncreasedmfragilitymofmthemerythrocytemmembranem-
mCORRECTmANSWERmReducedmsynthesismofmhemoglobinmF
Am68-year-
oldmpreviouslymhealthymfemalemhasmbeenmfeelingmincreasinglymtiredmandmweakmformseveralmmonth
s.mShemstatesmthatmshemhasmhadmblack,mtarrymstoolsmformseveralmweeks.mShemismfoundmtombemanemi
cmwithmamhemoglobinmconcentrationmofm9.3g/dL.mThemperipheralmbloodmsmearmrevealsmmicrocytic
mandmhypochromicmbloodmcells.mWhichmofmthemfollowingmconditionsmshouldmbemsuspectedmasmthem
mostmlikelymofmhermconditionmasmindicatedmbymthemperipheralmbloodmsmear?
A.mAplasticmanemia
B.mBetamthalassemia
C.mGastrointestinalmbloodmloss
D.mPerniciousmanemiam-mCORRECTmANSWERmGastrointestinalmbloodmloss
Am76-year-
oldmfemalemnoticesmthatmsmall,mpinpointmtomblotchymareasmofmsuperficialmhemorrhagemhavemappe
aredmonmhermgumsmandmonmthemskinmofmhermarmsmandmlegsmovermseveralmweeks.mShemismfoundmtom
havemamnormalmprothrombinmtime(PT)mandmpartialmthromboplastinmtimem(PTT).mHermCBCmshowsm
hemoglobinmconcentrationmofm12.7mg/dL,mhematocritmofm37.2%.mMCVmofm80mfL/redmcell,mplateletm
countmofm276,000/microliter,mandmWBCmofm5600/microliter.mHermtemplatembleedingmtimemism3mmi
nutes.mHermfibrinogenmlevelmismnormal,mandmtheremaremnomfibrinmsplitmproductsmdetectable.mWhic
hmofmthemfollowingmconditionsmbestmexplainmthesemfindings?
A.mChronicmrenalmfailure
B.mMacronodularmcirrhosis
C.mVitaminmB12mdeficiency
,D.mVitaminmCmdeficiencym-mCORRECTmANSWERmVitaminmCmdeficiency
AmyoungmadultmpatientmhasmjustmbeenmdiagnosedmwithmVonmWillebrandmdisease.mWhichmofmthemfo
llowingmstatementsmshouldmyoummakemtomadvisemthempatientmofmpotentialmconsequencesmofmthism
disease?
A.mYoummaymneedmanmallogeneicmbonemmarrowmtransplant
B.mYoummaymhavemexcessivembleedingmfollowingmtoothmextraction
C.mAmsplenectomymmaymbemnecessarymtomcontrolmthemdisease
D.mExpectmincreasingmdifficultiesmwithmjointmmobilitym-
mCORRECTmANSWERmYoummaymhavemexcessivembleedingmfollowingmtoothmextraction
Lowmdosemaspirinmismcommonlymusedmtomreducemthemriskmofmarterialmthrombosisminmpatientsmwho
mhavemsufferedmammyocardialminfarction.mWhichmonemofmthemfollowingmstepsminmhomeostasismismin
hibitedmbymaspirin?
A.mSynthesismofmvonmWillebrandmfactor
B.mAggregationmofmplatelets
C.mActivationmofmfactormXa
D.mSynthesismofmantithrombinmIIIm-mCORRECTmANSWERmAggregationmofmplatelets
Am24-year-
oldmpresentsmtomthemofficemwithmfatigue.mOnmphysicalmexam,mthemNPmnoticesmthatmshemispalemwith
mthemfollowingmvitalmsigns:mHRm112,mBPm98/64,mrespm20,mO2msatsm99%.mHermCBCmshows:mWBC6,00
0,mHemoglobinm9.6,mHematocritm30.2,mMCVmismdecreasedmatm76.mWhatmismthemmostlymlikelymcause
ofmthismpatient'smanemia?
A.mIronmdeficiencymanemiamcausedmbymmenstruation
B.mBetamThalassemiamofmgeneticmorigin
, C.mPerniciousmanemiamcausedmbymdietarymdeficiency
D.mFolatemdeficiencymcausedmbymalcoholismm-
mCORRECTmANSWERmIronmdeficiencymanemiamcausedmbymmenstruation
Am65-year-
oldmfemalempresentsmtomyourmofficemcomplainingmofmfatigue.mShemhasmamlongmofmrheumatoidmarth
ritis.mAmCBCmrevealsmthemfollowing:mHgb=11.6mg/dL,mHct=34.8%,mMCV=87mfL/redmcell,mplateletmco
untmofm268,000/microliter,mandmWBCmcountmofm6800/microliter.mThemserummhaptoglobinmlevelmism
normal,mandmthemserummironmconcentrationmism20mmicrograms/dL.mThemtotalmironmbindingmcapaci
tymism195mmicrograms/dL,mandmthempercentmsaturationmism10.2.mThemserummferritinmconcentration
mism317mng/mL.mNomfibrinmsplitmproductsmaremdetected.mThemreticulocytemconcentrationmism1.1%.m
Whatmismthemmostmlikelymdiagnosis?
A.mBeta-mthalassemiammajor
B.mAnemiamofmchronicmdiseasem
C.mAcutembloodmlossmanemia
D.mIronmdeficiencymanemiam-mCORRECTmANSWERmAnemiamofmchronicmdisease
Am14-year-
oldmmalempresentsmwithmhighmfevermformtenmdays.mPhysicalmexaminationmrevealsmscatteredmpetech
ialmhemorrhagesmbutmismnegativemformenlargementmofmthemlivermormspleenmormlymphmnodes.mBone
mmarrowmexaminationmdoesmnotmshowmanymabnormalmcells.mThemcompletembloodmcountm(CBC)mde
monstratesmamhemoglobinmconcentrationm(HgB)mofm13.2mg/dL,mhematocritm(Hct)mofm38.9%,mmean
mcellmvolumem(MCV)mofm93mfL,mplateletmcountmofm175,000/microliter,mandmwhitembloodmcellm(WBC)
mcountmofm1850/microliter,mwithmthemdifferentialmcountmshowingm1msegmentedmneutrophil,m98mly
mphocytes,mandm1mmonocytemperm100mWBCs.mWhatmismthemmostmlikelymcausemofmthesemfindings?
A.mOverwhelmingmbacterialminfection
B.mAcutemlymphocyticm(ormlymphoblastic)mleukemia
C.mAcutemmyeloidmleukemia
D.mAplasticmanemiam-mCORRECTmANSWERmOverwhelmingmbacterialminfection