NURS 5461 Advanced Pathophysiology Exam 1 Questions and
Correct Answers & Rationales | New Update 2026-2027
1. A certain disease is currently found in 1 of every 10 people in the country and
1,000 people contract the disease yearly. The population of the country is
4,500,000. Which of the following statements is correct?
a. The prevalence of the disease is 10% and the incidence is .02%.
b. The prevalence of the disease is .02% and the incidence is 10%.
c. Neither is correct.
d. There is insufficient data
• Correct Answer: a. The prevalence of the disease is 10% and the incidence
is .02%.
• Rationale:
𝟏
o Prevalence measuring existing total cases: 𝟏 in 𝟏𝟎 = = 𝟏𝟎%.
𝟏𝟎
o Incidence measuring new cases per year relative to population:
𝟏,𝟎𝟎𝟎
× 𝟏𝟎𝟎 = 𝟎. 𝟎𝟐𝟐% ≈ 𝟎. 𝟎𝟐%.
𝟒,𝟓𝟎𝟎,𝟎𝟎𝟎
2. In relation to disease development, the term "etiology" refers to which of the
following?
a. number of people with the disease
b. cause of the disease
c. definition of the disease
d. outcome of the disease
• Correct Answer: b. cause of the disease
• Rationale: Etiology refers specifically to the underlying cause or causative
agent of a disease or condition (e.g., biological, genetic, environmental).
3. Which of the following is(are) true about "symptoms"?
,a. objective and measurable
b. the same as "signs"
c. both of the above
d. neither of the above
• Correct Answer: d. neither of the above
• Rationale: Symptoms are subjective experiences reported directly by the
patient (e.g., pain, nausea, fatigue), whereas signs are objective,
measurable observations made by a clinician (e.g., fever, blood pressure,
laboratory values).
4. In 1992, there were 980 deaths in a Midwestern city with a population of
1,000,000. At the beginning of that year, 900 cases of AIDS existed in this
population. During the year, 250 new cases of AIDS were diagnosed, and 75
people died of the disease in 1992. Using the data given above, what was the
incidence rate (per 100,000 population) at the end of 1992 for AIDS?
a. 6
b. 25
c. 88
d. 116
• Correct Answer: b. 25
• Rationale: Incidence rate calculates new cases over the total population at
risk:
New Cases 𝟐𝟓𝟎
Incidence Rate = ( ) × 𝟏𝟎𝟎, 𝟎𝟎𝟎 = ( ) × 𝟏𝟎𝟎, 𝟎𝟎𝟎
Total Population 𝟏, 𝟎𝟎𝟎, 𝟎𝟎𝟎
= 𝟐𝟓 per 𝟏𝟎𝟎, 𝟎𝟎𝟎
5. What level of prevention is a blood pressure screening program for high
school students who are pregnant?
a. primary
b. secondary
,c. tertiary
• Correct Answer: b. secondary
• Rationale: Screenings aim at early detection and prompt intervention of
asymptomatic disease processes (such as preeclampsia/gestational
hypertension) before severe complications occur, fitting the definition of
secondary prevention.
6. Blockage of the right coronary artery can lead to myocardial cell injury
because it results in which of the following?
a. bilirubin accumulation in myocardial cells
b. alteration in the genetic material of myocardial cells
c. reduced energy production in myocardial cells
d. activation of the complement system
• Correct Answer: c. reduced energy production in myocardial cells
• Rationale: Coronary artery blockage impairs blood flow (ischemia),
depriving cardiac muscle of oxygen. Hypoxia inhibits oxidative
phosphorylation in mitochondria, drastically reducing cellular ATP
production.
7. When myocardial cells are injured, the function of the Na-K membrane pump
may be impaired. Which of the following may then result?
a. intracellular sodium will increase
b. extracellular potassium will decrease
c. cell volume will decrease
d. all of the above
• Correct Answer: a. intracellular sodium will increase
• Rationale: The Na+ /K+ ATPase pump requires ATP to pump Na+ out and
K+ in. When ATP drops, the pump fails, causing Na+ to accumulate inside
the cell (followed by water, leading to cell swelling).
, 8. Mr. Forbes' CPK-MB and LDH1, enzymes associated with myocardial cells, are
significantly elevated. What is the best explanation for this?
a. It is a sign that necrotic myocardial cells have released their cytoplasmic
contents into the blood.
b. It is a sign of reversible fatty accumulation in the myocardial cells
c. It is a sign that the myocardial cells are undergoing hypertrophy.
d. None of the above.
• Correct Answer: a. It is a sign that necrotic myocardial cells have released
their cytoplasmic contents into the blood.
• Rationale: Lethal cell injury damages plasma membrane integrity, causing
intracellular enzymes (like CPK-MB and LDH1) to leak into surrounding
interstitial space and blood circulation.
9. If a tissue specimen of myocardial cells were obtained for examination from
Mr. Forbes, which of the following findings would indicate irreversible cell
injury?
a. cellular swelling
b. decreased ATP production
c. decreased intracellular calcium
d. dissolution of nuclear material
• Correct Answer: d. dissolution of nuclear material
• Rationale: Irreversible cell injury is marked by severe membrane
breakdown and nuclear changes (pyknosis, karyorrhexis, karyolysis /
dissolution of chromatin). Swelling and ATP drop are reversible stages.
10. The accumulation of lactic acid that occurs with impaired energy production
results from which of the following?
a. increased intracellular glucose
b. increased anaerobic metabolism
Correct Answers & Rationales | New Update 2026-2027
1. A certain disease is currently found in 1 of every 10 people in the country and
1,000 people contract the disease yearly. The population of the country is
4,500,000. Which of the following statements is correct?
a. The prevalence of the disease is 10% and the incidence is .02%.
b. The prevalence of the disease is .02% and the incidence is 10%.
c. Neither is correct.
d. There is insufficient data
• Correct Answer: a. The prevalence of the disease is 10% and the incidence
is .02%.
• Rationale:
𝟏
o Prevalence measuring existing total cases: 𝟏 in 𝟏𝟎 = = 𝟏𝟎%.
𝟏𝟎
o Incidence measuring new cases per year relative to population:
𝟏,𝟎𝟎𝟎
× 𝟏𝟎𝟎 = 𝟎. 𝟎𝟐𝟐% ≈ 𝟎. 𝟎𝟐%.
𝟒,𝟓𝟎𝟎,𝟎𝟎𝟎
2. In relation to disease development, the term "etiology" refers to which of the
following?
a. number of people with the disease
b. cause of the disease
c. definition of the disease
d. outcome of the disease
• Correct Answer: b. cause of the disease
• Rationale: Etiology refers specifically to the underlying cause or causative
agent of a disease or condition (e.g., biological, genetic, environmental).
3. Which of the following is(are) true about "symptoms"?
,a. objective and measurable
b. the same as "signs"
c. both of the above
d. neither of the above
• Correct Answer: d. neither of the above
• Rationale: Symptoms are subjective experiences reported directly by the
patient (e.g., pain, nausea, fatigue), whereas signs are objective,
measurable observations made by a clinician (e.g., fever, blood pressure,
laboratory values).
4. In 1992, there were 980 deaths in a Midwestern city with a population of
1,000,000. At the beginning of that year, 900 cases of AIDS existed in this
population. During the year, 250 new cases of AIDS were diagnosed, and 75
people died of the disease in 1992. Using the data given above, what was the
incidence rate (per 100,000 population) at the end of 1992 for AIDS?
a. 6
b. 25
c. 88
d. 116
• Correct Answer: b. 25
• Rationale: Incidence rate calculates new cases over the total population at
risk:
New Cases 𝟐𝟓𝟎
Incidence Rate = ( ) × 𝟏𝟎𝟎, 𝟎𝟎𝟎 = ( ) × 𝟏𝟎𝟎, 𝟎𝟎𝟎
Total Population 𝟏, 𝟎𝟎𝟎, 𝟎𝟎𝟎
= 𝟐𝟓 per 𝟏𝟎𝟎, 𝟎𝟎𝟎
5. What level of prevention is a blood pressure screening program for high
school students who are pregnant?
a. primary
b. secondary
,c. tertiary
• Correct Answer: b. secondary
• Rationale: Screenings aim at early detection and prompt intervention of
asymptomatic disease processes (such as preeclampsia/gestational
hypertension) before severe complications occur, fitting the definition of
secondary prevention.
6. Blockage of the right coronary artery can lead to myocardial cell injury
because it results in which of the following?
a. bilirubin accumulation in myocardial cells
b. alteration in the genetic material of myocardial cells
c. reduced energy production in myocardial cells
d. activation of the complement system
• Correct Answer: c. reduced energy production in myocardial cells
• Rationale: Coronary artery blockage impairs blood flow (ischemia),
depriving cardiac muscle of oxygen. Hypoxia inhibits oxidative
phosphorylation in mitochondria, drastically reducing cellular ATP
production.
7. When myocardial cells are injured, the function of the Na-K membrane pump
may be impaired. Which of the following may then result?
a. intracellular sodium will increase
b. extracellular potassium will decrease
c. cell volume will decrease
d. all of the above
• Correct Answer: a. intracellular sodium will increase
• Rationale: The Na+ /K+ ATPase pump requires ATP to pump Na+ out and
K+ in. When ATP drops, the pump fails, causing Na+ to accumulate inside
the cell (followed by water, leading to cell swelling).
, 8. Mr. Forbes' CPK-MB and LDH1, enzymes associated with myocardial cells, are
significantly elevated. What is the best explanation for this?
a. It is a sign that necrotic myocardial cells have released their cytoplasmic
contents into the blood.
b. It is a sign of reversible fatty accumulation in the myocardial cells
c. It is a sign that the myocardial cells are undergoing hypertrophy.
d. None of the above.
• Correct Answer: a. It is a sign that necrotic myocardial cells have released
their cytoplasmic contents into the blood.
• Rationale: Lethal cell injury damages plasma membrane integrity, causing
intracellular enzymes (like CPK-MB and LDH1) to leak into surrounding
interstitial space and blood circulation.
9. If a tissue specimen of myocardial cells were obtained for examination from
Mr. Forbes, which of the following findings would indicate irreversible cell
injury?
a. cellular swelling
b. decreased ATP production
c. decreased intracellular calcium
d. dissolution of nuclear material
• Correct Answer: d. dissolution of nuclear material
• Rationale: Irreversible cell injury is marked by severe membrane
breakdown and nuclear changes (pyknosis, karyorrhexis, karyolysis /
dissolution of chromatin). Swelling and ATP drop are reversible stages.
10. The accumulation of lactic acid that occurs with impaired energy production
results from which of the following?
a. increased intracellular glucose
b. increased anaerobic metabolism
