NR 507 Exam 1 Actual Exam V3 | NR 507 Advanced Pathophysiology
(NR507 Exam 1) [PDF] | Chamberlain University
1. A 65-year-old male with a history of chronic untreated hypertension presents with an
enlarged heart on X-ray. Which cellular adaptation is most likely occurring in his left
ventricle?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Answer: A
Rationale: Hypertrophy refers to an increase in the size of cells resulting in an increase in
the size of the organ. In the heart, myocytes respond to increased workload from
hypertension by increasing protein synthesis and the number of organelles. This is a
pathological adaptation because the increase in size eventually compromises cardiac
function.
2. A patient with chronic gastroesophageal reflux disease (GERD) undergoes an endoscopy
that reveals a change from squamous epithelium to columnar epithelium in the distal
esophagus. This is an example of:
A. Metaplasia
B. Dysplasia
C. Anaplasia
D. Hyperplasia
Answer: A
Rationale: Metaplasia is a reversible change in which one adult cell type is replaced by
another adult cell type. In Barrett’s esophagus, the normal squamous cells are replaced by
columnar cells to better withstand the acidic environment. While it is a protective
mechanism, it can predispose the individual to malignant transformation.
3. During an inflammatory response, which mediator is primarily responsible for increasing
vascular permeability and causing vasodilation immediately after injury?
A. Histamine
B. Interleukin-1
C. Leukotrienes
,D. Complement C3b
Answer: A
Rationale: Histamine is a potent vasodilator and increases capillary permeability, leading
to the classic signs of inflammation like redness and swelling. It is released rapidly from
mast cell granules in response to various stimuli. This early phase of inflammation is
crucial for recruiting leukocytes to the site of injury.
4. A patient is diagnosed with an autosomal dominant disorder. If one parent is heterozygous
for the trait and the other parent is unaffected, what is the probability that their child will
inherit the disorder?
A. 50%
B. 25%
C. 0%
D. 100%
Answer: A
Rationale: In autosomal dominant inheritance, only one copy of the mutated gene is
necessary for the disease to be expressed. A heterozygous parent has a 50 percent chance
of passing the dominant allele to each offspring. The presence of the unaffected parent
ensures that the child will either be heterozygous (affected) or homozygous recessive
(unaffected).
5. A patient presents with severe peripheral edema and a low serum albumin level. Which
force is primarily responsible for the movement of fluid into the interstitial space?
A. Increased capillary hydrostatic pressure
B. Decreased capillary oncotic pressure
C. Increased interstitial oncotic pressure
D. Decreased lymphatic drainage
Answer: B
Rationale: Albumin is the primary protein responsible for maintaining capillary oncotic
pressure, which pulls fluid back into the blood vessels. When albumin levels are low, this
pulling force decreases, allowing fluid to leak into the tissues. This imbalance between
hydrostatic and oncotic forces leads to the clinical presentation of edema.
6. In the context of acid-base balance, how does the body compensate for metabolic acidosis?
A. Hypoventilation to retain CO2
B. Decreased renal excretion of hydrogen ions
, C. Hyperventilation to blow off CO2
D. Increased renal reabsorption of chloride
Answer: C
Rationale: Metabolic acidosis involves a decrease in bicarbonate or an increase in non-
volatile acids. To compensate, the respiratory center is stimulated to increase the rate and
depth of breathing, known as Kussmaul respirations. This process lowers the partial
pressure of carbon dioxide (PCO2), which helps return the pH toward a normal range.
7. A 24-year-old female presents with facial rash, joint pain, and protein in her urine.
Laboratory tests show positive antinuclear antibodies (ANA). This pathophysiology involves:
A. Type III hypersensitivity
B. Type II hypersensitivity
C. Type I hypersensitivity
D. Type IV hypersensitivity
Answer: A
Rationale: Systemic Lupus Erythematosus (SLE) is a classic example of Type III
hypersensitivity, which involves the formation of antigen-antibody complexes. These
complexes deposit in various tissues, such as the kidneys and joints, and trigger the
complement system. The resulting inflammatory response causes tissue damage and the
clinical symptoms observed.
8. Which of the following describes the physiological response to a state of chronic
hypoxemia, such as in high-altitude living?
A. Secondary polycythemia
B. Relative anemia
C. Decreased erythropoietin production
D. Reduced hemoglobin affinity for oxygen
Answer: A
Rationale: Chronic hypoxemia stimulates the kidneys to produce more erythropoietin,
which in turn acts on the bone marrow to increase red blood cell production. This adaptive
response is known as secondary polycythemia and is intended to increase the oxygen-
carrying capacity of the blood. It helps maintain homeostasis in environments where
oxygen tension is low.
9. A patient’s blood gas results show pH 7.25, PaCO2 55 mmHg, and HCO3 26 mEq/L. This
indicates:
A. Metabolic Acidosis
(NR507 Exam 1) [PDF] | Chamberlain University
1. A 65-year-old male with a history of chronic untreated hypertension presents with an
enlarged heart on X-ray. Which cellular adaptation is most likely occurring in his left
ventricle?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Metaplasia
Answer: A
Rationale: Hypertrophy refers to an increase in the size of cells resulting in an increase in
the size of the organ. In the heart, myocytes respond to increased workload from
hypertension by increasing protein synthesis and the number of organelles. This is a
pathological adaptation because the increase in size eventually compromises cardiac
function.
2. A patient with chronic gastroesophageal reflux disease (GERD) undergoes an endoscopy
that reveals a change from squamous epithelium to columnar epithelium in the distal
esophagus. This is an example of:
A. Metaplasia
B. Dysplasia
C. Anaplasia
D. Hyperplasia
Answer: A
Rationale: Metaplasia is a reversible change in which one adult cell type is replaced by
another adult cell type. In Barrett’s esophagus, the normal squamous cells are replaced by
columnar cells to better withstand the acidic environment. While it is a protective
mechanism, it can predispose the individual to malignant transformation.
3. During an inflammatory response, which mediator is primarily responsible for increasing
vascular permeability and causing vasodilation immediately after injury?
A. Histamine
B. Interleukin-1
C. Leukotrienes
,D. Complement C3b
Answer: A
Rationale: Histamine is a potent vasodilator and increases capillary permeability, leading
to the classic signs of inflammation like redness and swelling. It is released rapidly from
mast cell granules in response to various stimuli. This early phase of inflammation is
crucial for recruiting leukocytes to the site of injury.
4. A patient is diagnosed with an autosomal dominant disorder. If one parent is heterozygous
for the trait and the other parent is unaffected, what is the probability that their child will
inherit the disorder?
A. 50%
B. 25%
C. 0%
D. 100%
Answer: A
Rationale: In autosomal dominant inheritance, only one copy of the mutated gene is
necessary for the disease to be expressed. A heterozygous parent has a 50 percent chance
of passing the dominant allele to each offspring. The presence of the unaffected parent
ensures that the child will either be heterozygous (affected) or homozygous recessive
(unaffected).
5. A patient presents with severe peripheral edema and a low serum albumin level. Which
force is primarily responsible for the movement of fluid into the interstitial space?
A. Increased capillary hydrostatic pressure
B. Decreased capillary oncotic pressure
C. Increased interstitial oncotic pressure
D. Decreased lymphatic drainage
Answer: B
Rationale: Albumin is the primary protein responsible for maintaining capillary oncotic
pressure, which pulls fluid back into the blood vessels. When albumin levels are low, this
pulling force decreases, allowing fluid to leak into the tissues. This imbalance between
hydrostatic and oncotic forces leads to the clinical presentation of edema.
6. In the context of acid-base balance, how does the body compensate for metabolic acidosis?
A. Hypoventilation to retain CO2
B. Decreased renal excretion of hydrogen ions
, C. Hyperventilation to blow off CO2
D. Increased renal reabsorption of chloride
Answer: C
Rationale: Metabolic acidosis involves a decrease in bicarbonate or an increase in non-
volatile acids. To compensate, the respiratory center is stimulated to increase the rate and
depth of breathing, known as Kussmaul respirations. This process lowers the partial
pressure of carbon dioxide (PCO2), which helps return the pH toward a normal range.
7. A 24-year-old female presents with facial rash, joint pain, and protein in her urine.
Laboratory tests show positive antinuclear antibodies (ANA). This pathophysiology involves:
A. Type III hypersensitivity
B. Type II hypersensitivity
C. Type I hypersensitivity
D. Type IV hypersensitivity
Answer: A
Rationale: Systemic Lupus Erythematosus (SLE) is a classic example of Type III
hypersensitivity, which involves the formation of antigen-antibody complexes. These
complexes deposit in various tissues, such as the kidneys and joints, and trigger the
complement system. The resulting inflammatory response causes tissue damage and the
clinical symptoms observed.
8. Which of the following describes the physiological response to a state of chronic
hypoxemia, such as in high-altitude living?
A. Secondary polycythemia
B. Relative anemia
C. Decreased erythropoietin production
D. Reduced hemoglobin affinity for oxygen
Answer: A
Rationale: Chronic hypoxemia stimulates the kidneys to produce more erythropoietin,
which in turn acts on the bone marrow to increase red blood cell production. This adaptive
response is known as secondary polycythemia and is intended to increase the oxygen-
carrying capacity of the blood. It helps maintain homeostasis in environments where
oxygen tension is low.
9. A patient’s blood gas results show pH 7.25, PaCO2 55 mmHg, and HCO3 26 mEq/L. This
indicates:
A. Metabolic Acidosis
