NURS 5220: ADVANCED
PATHOPHYSIOLOGY
COMPREHENSIVE EXAM QUESTIONS
AND CORRECT ANSWERS WITH
EXPLANATIONS JUST RELEASED
1. A patient is diagnosed with metabolic acidosis. Which of the following is the most
immediate compensatory mechanism initiated by the body?
A. Renal excretion of hydrogen ions
B. Hyperventilation to decrease PaCO2
C. Intracellular buffering by moving potassium into the cells
D. Renal reabsorption of bicarbonate
Answer: B
Conceptual Explanation: The respiratory system compensates for metabolic acidosis
within minutes by increasing the rate and depth of respirations (Kussmaul breathing) to
blow off CO2. Renal compensation takes hours to days.
2. Which pathophysiological process occurs in the early stages of septic shock?
A. Massive vasoconstriction resulting in hypertension
B. Excessive release of proinflammatory cytokines leading to vasodilation
,C. Increased systemic vascular resistance (SVR)
D. Decreased capillary permeability
Answer: B
Conceptual Explanation: In septic shock, the body releases large amounts of cytokines
(TNF-alpha, IL-1), which lead to systemic vasodilation, increased capillary permeability,
and decreased SVR.
3. In the context of Starling’s Law of the Capillaries, which factor is primarily responsible for
pulling water back into the vascular space at the venous end?
A. Capillary hydrostatic pressure
B. Plasma oncotic pressure
C. Interstitial hydrostatic pressure
D. Interstitial oncotic pressure
Answer: B
Conceptual Explanation: Plasma oncotic pressure, exerted mainly by albumin, creates the
suction force that pulls fluid back into the capillary from the interstitial space.
4. A patient with chronic kidney disease (CKD) presents with secondary hyperparathyroidism.
What is the initiating factor?
A. Excessive excretion of calcium by the kidneys
B. Hypocalcemia due to vitamin D deficiency and phosphate retention
, C. Hypophosphatemia
D. Direct stimulation of the parathyroid gland by urea
Answer: B
Conceptual Explanation: In CKD, the kidneys cannot activate Vitamin D or excrete
phosphate. High phosphate binds calcium, leading to hypocalcemia, which stimulates the
parathyroid glands to release PTH.
5. Which type of hypersensitivity reaction is mediated by IgE and involves mast cell
degranulation?
A. Type IV
B. Type II
C. Type III
D. Type I
Answer: D
Conceptual Explanation: Type I hypersensitivity is immediate and mediated by IgE
antibodies binding to mast cells, triggering the release of histamine.
6. What is the primary pathophysiology behind Multiple Sclerosis (MS)?
A. Depletion of dopamine in the basal ganglia
B. Destruction of acetylcholine receptors at the neuromuscular junction
C. Autoimmune-mediated demyelination of the central nervous system
PATHOPHYSIOLOGY
COMPREHENSIVE EXAM QUESTIONS
AND CORRECT ANSWERS WITH
EXPLANATIONS JUST RELEASED
1. A patient is diagnosed with metabolic acidosis. Which of the following is the most
immediate compensatory mechanism initiated by the body?
A. Renal excretion of hydrogen ions
B. Hyperventilation to decrease PaCO2
C. Intracellular buffering by moving potassium into the cells
D. Renal reabsorption of bicarbonate
Answer: B
Conceptual Explanation: The respiratory system compensates for metabolic acidosis
within minutes by increasing the rate and depth of respirations (Kussmaul breathing) to
blow off CO2. Renal compensation takes hours to days.
2. Which pathophysiological process occurs in the early stages of septic shock?
A. Massive vasoconstriction resulting in hypertension
B. Excessive release of proinflammatory cytokines leading to vasodilation
,C. Increased systemic vascular resistance (SVR)
D. Decreased capillary permeability
Answer: B
Conceptual Explanation: In septic shock, the body releases large amounts of cytokines
(TNF-alpha, IL-1), which lead to systemic vasodilation, increased capillary permeability,
and decreased SVR.
3. In the context of Starling’s Law of the Capillaries, which factor is primarily responsible for
pulling water back into the vascular space at the venous end?
A. Capillary hydrostatic pressure
B. Plasma oncotic pressure
C. Interstitial hydrostatic pressure
D. Interstitial oncotic pressure
Answer: B
Conceptual Explanation: Plasma oncotic pressure, exerted mainly by albumin, creates the
suction force that pulls fluid back into the capillary from the interstitial space.
4. A patient with chronic kidney disease (CKD) presents with secondary hyperparathyroidism.
What is the initiating factor?
A. Excessive excretion of calcium by the kidneys
B. Hypocalcemia due to vitamin D deficiency and phosphate retention
, C. Hypophosphatemia
D. Direct stimulation of the parathyroid gland by urea
Answer: B
Conceptual Explanation: In CKD, the kidneys cannot activate Vitamin D or excrete
phosphate. High phosphate binds calcium, leading to hypocalcemia, which stimulates the
parathyroid glands to release PTH.
5. Which type of hypersensitivity reaction is mediated by IgE and involves mast cell
degranulation?
A. Type IV
B. Type II
C. Type III
D. Type I
Answer: D
Conceptual Explanation: Type I hypersensitivity is immediate and mediated by IgE
antibodies binding to mast cells, triggering the release of histamine.
6. What is the primary pathophysiology behind Multiple Sclerosis (MS)?
A. Depletion of dopamine in the basal ganglia
B. Destruction of acetylcholine receptors at the neuromuscular junction
C. Autoimmune-mediated demyelination of the central nervous system
