NURS 5359 EXAM 1 — ANTIPSYCHOTIC MEDICATIONS
AND GENERAL PATHOLOGY / PATHOPHYSIOLOGY
INSTRUCTIONS: Each question is multiple choice with one best answer.
Correct answers and rationales appear directly below each question in the
format: >> ANSWER: ... and >> RATIONALE:
====================================================
SECTION 1: GENERAL PATHOLOGY & PATHOPHYSIOLOGY
(Questions 1–58)
====================================================
1. A 54-year-old man with a 25-year history of heavy alcohol use undergoes
liver biopsy. Histology reveals hepatocytes with clear cytoplasmic vacuoles
displacing nuclei to the periphery. Which process best accounts for this
finding?
A. Glycogen storage due to impaired glucose metabolism
B. Triglyceride accumulation from disrupted lipid handling
C. Cytokeratin aggregates from misfolded intermediate filaments
D. Iron deposition from chronic hemolysis
,ANSWER: B
RATIONALE: Chronic alcohol exposure shifts hepatic lipid metabolism toward
increased fatty acid synthesis and reduced oxidation, producing steatosis —
triglyceride-filled vacuoles within hepatocytes. Glycogen produces a
different appearance, cytokeratin aggregates form Mallory bodies, and iron
deposits appear as hemosiderin.
---
2. A patient with a 30-year history of alcohol use presents with jaundice
and hepatomegaly. Biopsy shows fat accumulation within hepatocytes without
significant inflammation or fibrosis. This finding is most consistent with:
A. Cirrhosis
B. Steatosis
C. Hemochromatosis
D. Glycogen storage disease
ANSWER: B
RATIONALE: Steatosis (fatty liver) is defined by triglyceride accumulation
in hepatocytes and is reversible with abstinence. Cirrhosis involves fibrosis
and architectural distortion, hemochromatosis involves iron overload, and
glycogen storage disease involves abnormal glycogen deposition.
---
,3. An arterial blood gas shows pH 7.20 and PaCO2 62 mmHg. How should this
be interpreted?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
ANSWER: B
RATIONALE: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg points
to a respiratory cause — alveolar hypoventilation with retained carbon dioxide
— producing respiratory acidosis.
---
4. A patient has a pH of 7.48 and a PaCO2 of 30 mmHg. This ABG finding is
most consistent with:
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
ANSWER: D
, RATIONALE: A pH above 7.45 indicates alkalosis, and a PaCO2 below 35 mmHg
indicates a respiratory cause (hyperventilation with excessive CO2
elimination), consistent with respiratory alkalosis.
---
5. Chronic gastroesophageal reflux causes the distal esophageal epithelium
to change from stratified squamous to columnar cells. Which cellular
adaptation does this represent?
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
ANSWER: C
RATIONALE: Metaplasia is the reversible substitution of one mature
epithelial cell type for another, typically in response to chronic irritation.
In Barrett esophagus, squamous epithelium is replaced by columnar epithelium.
---
6. A smoker's bronchial epithelium shifts from ciliated columnar to
stratified squamous cells after years of irritation. This change is best
classified as:
AND GENERAL PATHOLOGY / PATHOPHYSIOLOGY
INSTRUCTIONS: Each question is multiple choice with one best answer.
Correct answers and rationales appear directly below each question in the
format: >> ANSWER: ... and >> RATIONALE:
====================================================
SECTION 1: GENERAL PATHOLOGY & PATHOPHYSIOLOGY
(Questions 1–58)
====================================================
1. A 54-year-old man with a 25-year history of heavy alcohol use undergoes
liver biopsy. Histology reveals hepatocytes with clear cytoplasmic vacuoles
displacing nuclei to the periphery. Which process best accounts for this
finding?
A. Glycogen storage due to impaired glucose metabolism
B. Triglyceride accumulation from disrupted lipid handling
C. Cytokeratin aggregates from misfolded intermediate filaments
D. Iron deposition from chronic hemolysis
,ANSWER: B
RATIONALE: Chronic alcohol exposure shifts hepatic lipid metabolism toward
increased fatty acid synthesis and reduced oxidation, producing steatosis —
triglyceride-filled vacuoles within hepatocytes. Glycogen produces a
different appearance, cytokeratin aggregates form Mallory bodies, and iron
deposits appear as hemosiderin.
---
2. A patient with a 30-year history of alcohol use presents with jaundice
and hepatomegaly. Biopsy shows fat accumulation within hepatocytes without
significant inflammation or fibrosis. This finding is most consistent with:
A. Cirrhosis
B. Steatosis
C. Hemochromatosis
D. Glycogen storage disease
ANSWER: B
RATIONALE: Steatosis (fatty liver) is defined by triglyceride accumulation
in hepatocytes and is reversible with abstinence. Cirrhosis involves fibrosis
and architectural distortion, hemochromatosis involves iron overload, and
glycogen storage disease involves abnormal glycogen deposition.
---
,3. An arterial blood gas shows pH 7.20 and PaCO2 62 mmHg. How should this
be interpreted?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
ANSWER: B
RATIONALE: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg points
to a respiratory cause — alveolar hypoventilation with retained carbon dioxide
— producing respiratory acidosis.
---
4. A patient has a pH of 7.48 and a PaCO2 of 30 mmHg. This ABG finding is
most consistent with:
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
ANSWER: D
, RATIONALE: A pH above 7.45 indicates alkalosis, and a PaCO2 below 35 mmHg
indicates a respiratory cause (hyperventilation with excessive CO2
elimination), consistent with respiratory alkalosis.
---
5. Chronic gastroesophageal reflux causes the distal esophageal epithelium
to change from stratified squamous to columnar cells. Which cellular
adaptation does this represent?
A. Atrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
ANSWER: C
RATIONALE: Metaplasia is the reversible substitution of one mature
epithelial cell type for another, typically in response to chronic irritation.
In Barrett esophagus, squamous epithelium is replaced by columnar epithelium.
---
6. A smoker's bronchial epithelium shifts from ciliated columnar to
stratified squamous cells after years of irritation. This change is best
classified as:
