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NSG 530 Exam 2 – Advanced Pathophysiology | Wilkes
University (2026) | Advanced/Hard Difficulty | Professional
Level | 100% Pass Guaranteed | Graded A+
1. A 45-year-old patient with a history of chronic alcohol use presents with jaundice, ascites,
and peripheral edema. Laboratory findings reveal elevated AST and ALT with an AST/ALT
ratio > 2. Which of the following is the most likely underlying pathophysiologic mechanism?
A. Hepatocellular necrosis due to acetaminophen toxicity
B. Bridging fibrosis and nodular regeneration with portal hypertension
C. Biliary obstruction from gallstone formation
D. Hepatic steatosis without inflammation
Correct Answer: B
Explanation: The patient's presentation is consistent with alcoholic cirrhosis. The AST/ALT
ratio > 2 is characteristic of alcoholic liver disease. The pathophysiology involves chronic
hepatocellular injury leading to bridging fibrosis, nodular regeneration, and portal hypertension,
which causes ascites, jaundice, and peripheral edema. Option A describes acute toxicity, C
describes obstructive jaundice, and D describes simple steatosis without the complications of
cirrhosis.
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2. Which of the following best describes the pathophysiology of type 1 diabetes mellitus?
A. Insulin resistance with compensatory hyperinsulinemia
B. Autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency
C. Impaired insulin secretion due to pancreatic amyloid deposition
D. Antibody-mediated blockade of insulin receptors
Correct Answer: B
Explanation: Type 1 diabetes mellitus is an autoimmune disorder characterized by the
destruction of pancreatic beta cells, leading to absolute insulin deficiency. Option A describes
type 2 diabetes. Option C describes amyloid deposition in type 2 diabetes. Option D is not a
recognized mechanism.
3. A 65-year-old patient with a history of hypertension presents with sudden onset of severe
chest pain radiating to the back. The pain is described as "tearing" in nature. Blood pressure
is 180/100 mmHg in the right arm and 140/80 mmHg in the left arm. Which pathophysiologic
process is most likely responsible?
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A. Atherosclerotic plaque rupture with coronary thrombosis
B. Dissection of the aortic intima with formation of a false lumen
C. Rupture of a cerebral aneurysm
D. Pulmonary embolism from a deep vein thrombosis
Correct Answer: B
Explanation: The clinical presentation is classic for aortic dissection, which involves a tear in
the aortic intima with blood entering the media, creating a false lumen. The blood pressure
difference between arms is a hallmark sign. Option A describes acute coronary syndrome, C
describes subarachnoid hemorrhage, and D describes pulmonary embolism.
4. In the context of cellular adaptation, which of the following describes metaplasia?
A. Decrease in cell size and organ volume
B. Increase in cell size and organ volume
C. Replacement of one differentiated cell type with another
D. Increase in the number of cells in an organ
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Correct Answer: C
Explanation: Metaplasia is a reversible change in which one differentiated cell type is
replaced by another cell type. Option A describes atrophy, B describes hypertrophy, and D
describes hyperplasia. Metaplasia is often a response to chronic irritation.
5. A 70-year-old patient with chronic obstructive pulmonary disease (COPD) presents with
worsening dyspnea, cyanosis, and peripheral edema. Arterial blood gas shows pH 7.32, PaCO₂
58 mmHg, and HCO₃⁻ 30 mEq/L. Which acid-base disorder is present?
A. Acute respiratory acidosis with metabolic compensation
B. Chronic respiratory acidosis with metabolic compensation
C. Metabolic acidosis with respiratory compensation
D. Mixed respiratory and metabolic acidosis
Correct Answer: B
Explanation: The pH is low (acidemia), PaCO₂ is elevated (respiratory acidosis), and HCO₃⁻
is elevated (metabolic compensation). In chronic respiratory acidosis, the kidneys retain
bicarbonate to compensate, resulting in an elevated HCO₃⁻. Option A would show a lower
NSG 530 Exam 2 – Advanced Pathophysiology | Wilkes
University (2026) | Advanced/Hard Difficulty | Professional
Level | 100% Pass Guaranteed | Graded A+
1. A 45-year-old patient with a history of chronic alcohol use presents with jaundice, ascites,
and peripheral edema. Laboratory findings reveal elevated AST and ALT with an AST/ALT
ratio > 2. Which of the following is the most likely underlying pathophysiologic mechanism?
A. Hepatocellular necrosis due to acetaminophen toxicity
B. Bridging fibrosis and nodular regeneration with portal hypertension
C. Biliary obstruction from gallstone formation
D. Hepatic steatosis without inflammation
Correct Answer: B
Explanation: The patient's presentation is consistent with alcoholic cirrhosis. The AST/ALT
ratio > 2 is characteristic of alcoholic liver disease. The pathophysiology involves chronic
hepatocellular injury leading to bridging fibrosis, nodular regeneration, and portal hypertension,
which causes ascites, jaundice, and peripheral edema. Option A describes acute toxicity, C
describes obstructive jaundice, and D describes simple steatosis without the complications of
cirrhosis.
,2
2. Which of the following best describes the pathophysiology of type 1 diabetes mellitus?
A. Insulin resistance with compensatory hyperinsulinemia
B. Autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency
C. Impaired insulin secretion due to pancreatic amyloid deposition
D. Antibody-mediated blockade of insulin receptors
Correct Answer: B
Explanation: Type 1 diabetes mellitus is an autoimmune disorder characterized by the
destruction of pancreatic beta cells, leading to absolute insulin deficiency. Option A describes
type 2 diabetes. Option C describes amyloid deposition in type 2 diabetes. Option D is not a
recognized mechanism.
3. A 65-year-old patient with a history of hypertension presents with sudden onset of severe
chest pain radiating to the back. The pain is described as "tearing" in nature. Blood pressure
is 180/100 mmHg in the right arm and 140/80 mmHg in the left arm. Which pathophysiologic
process is most likely responsible?
,3
A. Atherosclerotic plaque rupture with coronary thrombosis
B. Dissection of the aortic intima with formation of a false lumen
C. Rupture of a cerebral aneurysm
D. Pulmonary embolism from a deep vein thrombosis
Correct Answer: B
Explanation: The clinical presentation is classic for aortic dissection, which involves a tear in
the aortic intima with blood entering the media, creating a false lumen. The blood pressure
difference between arms is a hallmark sign. Option A describes acute coronary syndrome, C
describes subarachnoid hemorrhage, and D describes pulmonary embolism.
4. In the context of cellular adaptation, which of the following describes metaplasia?
A. Decrease in cell size and organ volume
B. Increase in cell size and organ volume
C. Replacement of one differentiated cell type with another
D. Increase in the number of cells in an organ
, 4
Correct Answer: C
Explanation: Metaplasia is a reversible change in which one differentiated cell type is
replaced by another cell type. Option A describes atrophy, B describes hypertrophy, and D
describes hyperplasia. Metaplasia is often a response to chronic irritation.
5. A 70-year-old patient with chronic obstructive pulmonary disease (COPD) presents with
worsening dyspnea, cyanosis, and peripheral edema. Arterial blood gas shows pH 7.32, PaCO₂
58 mmHg, and HCO₃⁻ 30 mEq/L. Which acid-base disorder is present?
A. Acute respiratory acidosis with metabolic compensation
B. Chronic respiratory acidosis with metabolic compensation
C. Metabolic acidosis with respiratory compensation
D. Mixed respiratory and metabolic acidosis
Correct Answer: B
Explanation: The pH is low (acidemia), PaCO₂ is elevated (respiratory acidosis), and HCO₃⁻
is elevated (metabolic compensation). In chronic respiratory acidosis, the kidneys retain
bicarbonate to compensate, resulting in an elevated HCO₃⁻. Option A would show a lower
