NRNP/NURS 6501: ADVANCED PATHOPHYSIOLOGY
FINAL EXAM WALDEN UNIVERSITY ACTUAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS WITH
RATIONALES || 100% GUARANTEED PASS!!
LATEST
1. A patient develops acute renal ischemia following prolonged hypotension.
Within minutes, the affected renal tubular cells begin to swell. Which intracellular
change most directly explains this early morphologic alteration?
A. Increased protein synthesis
B. Failure of the sodium-potassium ATPase pump
C. Increased DNA replication
D. Activation of lysosomal enzymes
Answer: B
Rationale: Hypoxia caused by ischemia reduces oxidative phosphorylation and
ATP production. ATP depletion impairs the sodium-potassium ATPase pump,
resulting in intracellular sodium and water accumulation and cellular swelling.
This is a characteristic early manifestation of reversible cellular injury.
,2. A patient with chronic gastroesophageal reflux disease has undergone years of
repeated exposure of the lower esophageal epithelium to gastric acid. A biopsy
demonstrates replacement of the normal squamous epithelium with a columnar
epithelium containing goblet cells. Which cellular adaptation has occurred?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Answer: C
Rationale: Metaplasia is a potentially reversible adaptive process in which one
differentiated mature cell type is replaced by another mature cell type better able to
tolerate a persistent stressor. Chronic reflux-associated changes in the esophagus
are a classic example.
3. Two siblings inherit the same pathogenic mutation associated with
neurofibromatosis. One sibling has numerous large neurofibromas and neurologic
complications, whereas the other has only a few small skin lesions. Which genetic
concept best explains the difference in severity?
A. Anticipation
B. Variable expressivity
C. Genomic imprinting
D. Incomplete penetrance
Answer: B
Rationale: Variable expressivity refers to differences in the severity or specific
manifestations of a genetic disorder among individuals who possess the same
disease-causing genotype.
,4. A newborn develops recurrent pulmonary infections, pancreatic insufficiency,
and persistently thick respiratory secretions. Genetic testing identifies pathogenic
variants affecting the CFTR gene on both chromosomes. Which inheritance pattern
is most consistent with this disorder?
A. Autosomal dominant
B. X-linked dominant
C. Autosomal recessive
D. Mitochondrial inheritance
Answer: C
Rationale: Cystic fibrosis is an autosomal recessive disorder caused by pathogenic
variants in the CFTR gene. Clinical disease generally develops when an individual
inherits disease-causing variants from both parents.
5. A critically ill patient has a serum albumin concentration of 1.8 g/dL and
develops generalized peripheral edema despite no evidence of acute heart failure.
Which mechanism best accounts for the fluid shift?
A. Increased plasma oncotic pressure
B. Decreased plasma oncotic pressure
C. Decreased capillary hydrostatic pressure
D. Increased intracellular osmotic pressure
Answer: B
Rationale: Albumin is the major contributor to plasma colloid oncotic pressure.
When circulating albumin falls substantially, the force retaining water within the
vascular compartment decreases, favoring movement of fluid into the interstitial
space and producing edema.
, 6. A patient with persistent vomiting has the following arterial blood gas results:
pH: 7.51
PaCO₂: 43 mmHg
HCO₃⁻: 33 mEq/L
Which acid-base disorder is present?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Metabolic acidosis
Answer: C
Rationale: The elevated pH indicates alkalemia. The bicarbonate level is elevated,
identifying a metabolic cause. Persistent vomiting causes loss of gastric
hydrochloric acid and can produce metabolic alkalosis.
7. A patient is admitted with severe diarrhea that has persisted for several days.
ABG analysis reveals:
pH: 7.29
PaCO₂: 31 mmHg
HCO₃⁻: 15 mEq/L
Which interpretation is most appropriate?
A. Uncompensated respiratory alkalosis
B. Metabolic acidosis with respiratory compensation
C. Respiratory acidosis with metabolic compensation
D. Metabolic alkalosis with respiratory compensation
Answer: B
Rationale: The low pH indicates acidemia, and the markedly decreased
bicarbonate identifies a metabolic process. The decreased PaCO₂ reflects
compensatory hyperventilation as the lungs attempt to eliminate carbon dioxide.
FINAL EXAM WALDEN UNIVERSITY ACTUAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS WITH
RATIONALES || 100% GUARANTEED PASS!!
LATEST
1. A patient develops acute renal ischemia following prolonged hypotension.
Within minutes, the affected renal tubular cells begin to swell. Which intracellular
change most directly explains this early morphologic alteration?
A. Increased protein synthesis
B. Failure of the sodium-potassium ATPase pump
C. Increased DNA replication
D. Activation of lysosomal enzymes
Answer: B
Rationale: Hypoxia caused by ischemia reduces oxidative phosphorylation and
ATP production. ATP depletion impairs the sodium-potassium ATPase pump,
resulting in intracellular sodium and water accumulation and cellular swelling.
This is a characteristic early manifestation of reversible cellular injury.
,2. A patient with chronic gastroesophageal reflux disease has undergone years of
repeated exposure of the lower esophageal epithelium to gastric acid. A biopsy
demonstrates replacement of the normal squamous epithelium with a columnar
epithelium containing goblet cells. Which cellular adaptation has occurred?
A. Hypertrophy
B. Hyperplasia
C. Metaplasia
D. Dysplasia
Answer: C
Rationale: Metaplasia is a potentially reversible adaptive process in which one
differentiated mature cell type is replaced by another mature cell type better able to
tolerate a persistent stressor. Chronic reflux-associated changes in the esophagus
are a classic example.
3. Two siblings inherit the same pathogenic mutation associated with
neurofibromatosis. One sibling has numerous large neurofibromas and neurologic
complications, whereas the other has only a few small skin lesions. Which genetic
concept best explains the difference in severity?
A. Anticipation
B. Variable expressivity
C. Genomic imprinting
D. Incomplete penetrance
Answer: B
Rationale: Variable expressivity refers to differences in the severity or specific
manifestations of a genetic disorder among individuals who possess the same
disease-causing genotype.
,4. A newborn develops recurrent pulmonary infections, pancreatic insufficiency,
and persistently thick respiratory secretions. Genetic testing identifies pathogenic
variants affecting the CFTR gene on both chromosomes. Which inheritance pattern
is most consistent with this disorder?
A. Autosomal dominant
B. X-linked dominant
C. Autosomal recessive
D. Mitochondrial inheritance
Answer: C
Rationale: Cystic fibrosis is an autosomal recessive disorder caused by pathogenic
variants in the CFTR gene. Clinical disease generally develops when an individual
inherits disease-causing variants from both parents.
5. A critically ill patient has a serum albumin concentration of 1.8 g/dL and
develops generalized peripheral edema despite no evidence of acute heart failure.
Which mechanism best accounts for the fluid shift?
A. Increased plasma oncotic pressure
B. Decreased plasma oncotic pressure
C. Decreased capillary hydrostatic pressure
D. Increased intracellular osmotic pressure
Answer: B
Rationale: Albumin is the major contributor to plasma colloid oncotic pressure.
When circulating albumin falls substantially, the force retaining water within the
vascular compartment decreases, favoring movement of fluid into the interstitial
space and producing edema.
, 6. A patient with persistent vomiting has the following arterial blood gas results:
pH: 7.51
PaCO₂: 43 mmHg
HCO₃⁻: 33 mEq/L
Which acid-base disorder is present?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Metabolic acidosis
Answer: C
Rationale: The elevated pH indicates alkalemia. The bicarbonate level is elevated,
identifying a metabolic cause. Persistent vomiting causes loss of gastric
hydrochloric acid and can produce metabolic alkalosis.
7. A patient is admitted with severe diarrhea that has persisted for several days.
ABG analysis reveals:
pH: 7.29
PaCO₂: 31 mmHg
HCO₃⁻: 15 mEq/L
Which interpretation is most appropriate?
A. Uncompensated respiratory alkalosis
B. Metabolic acidosis with respiratory compensation
C. Respiratory acidosis with metabolic compensation
D. Metabolic alkalosis with respiratory compensation
Answer: B
Rationale: The low pH indicates acidemia, and the markedly decreased
bicarbonate identifies a metabolic process. The decreased PaCO₂ reflects
compensatory hyperventilation as the lungs attempt to eliminate carbon dioxide.
