NSG 5140 ADVANCED PATHOPHYSIOLOGY FINAL EXAM QUESTIONS COMPREHENSIVE REVIEW QUESTIONS 200 COMPLETE WITH 100% VERIFIED ANSWERS AND RATIONALES

NSG 5140 ADVANCED PATHOPHYSIOLOGY FINAL EXAM QUESTIONS COMPREHENSIVE REVIEW QUESTIONS 200 COMPLETE WITH 100% VERIFIED ANSWERS AND RATIONALES Q1. A patient with chronic liver disease develops ascites and peripheral edema. Which pathophysiologic mechanism primarily contributes to fluid accumulation in this patient? A. Increased plasma oncotic pressure B. Decreased hepatic synthesis of albumin C. Increased antidiuretic hormone secretion D. Renal artery vasodilation B. Decreased hepatic synthesis of albumin RATIONALE: The liver synthesizes albumin, which maintains plasma oncotic pressure. In chronic liver disease, decreased albumin production reduces oncotic pressure, allowing fluid to leak into interstitial spaces and peritoneal cavity, resulting in edema and ascites. ________________________________________ Q2. A 45-year-old patient with type 1 diabetes mellitus presents with deep, rapid respirations and a fruity odor to their breath. Arterial blood gas reveals pH 7.20, PaCO2 25 mmHg, and HCO3- 12 mEq/L. What is the primary acid-base disturbance? A. Metabolic acidosis with respiratory compensation B. Respiratory acidosis with metabolic compensation C. Metabolic alkalosis with respiratory compensation D. Respiratory alkalosis with metabolic compensation A. Metabolic acidosis with respiratory compensation RATIONALE: The low pH (acidemia), low bicarbonate (HCO3-), and low PaCO2 indicate metabolic acidosis with respiratory compensation (Kussmaul respirations). The low PaCO2 represents hyperventilation attempting to compensate for the metabolic acidosis seen in diabetic ketoacidosis. ________________________________________ Q3. Which cellular adaptation is characterized by an increase in cell size and functional capacity in response to increased workload? A. Hyperplasia B. Atrophy C. Metaplasia D. Hypertrophy D. Hypertrophy RATIONALE: Hypertrophy is an increase in cell size due to increased synthesis of structural proteins and organelles. It occurs in response to increased workload, such as cardiac muscle hypertrophy in hypertension or skeletal muscle hypertrophy from exercise. ________________________________________ Q4. A patient with systemic lupus erythematosus develops glomerulonephritis. Which type of hypersensitivity reaction is most likely responsible? A. Type I hypersensitivity B. Type II hypersensitivity C. Type III hypersensitivity D. Type IV hypersensitivity C. Type III hypersensitivity RATIONALE: Systemic lupus erythematosus causes immune complex deposition (Type III hypersensitivity) in glomeruli, leading to inflammation and glomerulonephritis. Immune complexes form when antibodies bind to self-antigens and deposit in tissues. ________________________________________ Q5. A 70-year-old patient with chronic heart failure develops hyponatremia. Which mechanism best explains this electrolyte disturbance? A. Increased sodium excretion by the kidneys B. Decreased dietary sodium intake C. Syndrome of inappropriate antidiuretic hormone secretion D. Increased aldosterone secretion C. Syndrome of inappropriate antidiuretic hormone secretion RATIONALE: In chronic heart failure, decreased effective arterial blood volume stimulates non-osmotic release of ADH, causing water retention and dilutional hyponatremia. The kidneys retain water while excreting sodium, leading to low serum sodium levels. ________________________________________ Q6. During an acute asthma exacerbation, which pathophysiologic process primarily causes airway obstruction? A. Increased mucus production with smooth muscle constriction B. Destruction of alveolar walls C. Collapse of small airways D. Pulmonary fibrosis A. Increased mucus production with smooth muscle constriction RATIONALE: Asthma is characterized by bronchial hyperresponsiveness causing smooth muscle constriction, inflammation, and increased mucus production. These factors collectively narrow airways, increasing resistance and causing wheezing and dyspnea. ________________________________________ Q7. A patient with acute kidney injury develops metabolic acidosis. Which mechanism is most responsible? A. Increased bicarbonate reabsorption B. Decreased excretion of hydrogen ions C. Increased production of lactic acid D. Decreased production of carbonic acid B. Decreased excretion of hydrogen ions RATIONALE: The kidneys maintain acid-base balance by excreting hydrogen ions and reabsorbing bicarbonate. In acute kidney injury, impaired renal function reduces hydrogen ion excretion, leading to accumulation of acids and metabolic acidosis. ________________________________________