NURS 6501 – WEEK 6 MIDTERM EXAM
ADVANCED PATHOPHYSIOLOGY ACTUAL
QUESTIONS WITH VERIFIED ANSWERS |
SCORE PASS MARK
Overview:
This midterm exam consists of clinically realistic, scenario-based questions designed to assess
advanced understanding of pathophysiology, immunology, hematology, inflammation, necrosis
types, hypersensitivity reactions, autoimmune disorders, and chronic disease mechanisms. Each
question includes a detailed rationale to reinforce critical thinking and clinical application. The
exam is formatted to mimic real-world nursing decision-making, requiring integration of
laboratory findings, imaging results, patient history, and pathophysiologic principles to
select the correct answer.
Focus Areas:
o Inflammatory and immune responses
o Hematologic disorders and anemia
o Autoimmune disease mechanisms
o Types of necrosis
o Hypersensitivity reactions (Type I–IV)
o Chronic disease pathophysiology
Answer Key: Correct answers are bolded with rationale provided for each question
1.
A 68-year-old male with a history of hypertension and hyperlipidemia presents
with sudden-onset chest pain radiating to the jaw. ECG shows ST-segment
elevation, and serum troponin I is elevated.
Which type of necrosis is most likely occurring in his myocardium?
A. Liquefactive
B. Coagulative
,C. Caseous
D. Fat
Correct Answer: B
Rationale: Coagulative necrosis occurs in ischemic injury of solid organs like
the heart, preserving the tissue architecture initially.
2.
A 25-year-old female presents with severe urticaria, wheezing, and hypotension
after eating shrimp. She reports a previous mild peanut allergy.
Which immune mechanism is responsible for her reaction?
A. IgG-mediated cytotoxicity
B. T-cell–mediated delayed hypersensitivity
C. IgE-mediated mast cell degranulation
D. Immune complex deposition
Correct Answer: C
Rationale: Type I hypersensitivity is mediated by IgE binding to mast cells,
leading to histamine release and systemic anaphylaxis.
3.
A 40-year-old patient presents with chronic cough and dyspnea. Bronchoscopy
shows replacement of ciliated columnar epithelium with stratified squamous
epithelium.
What type of cellular adaptation is this?
A. Hyperplasia
B. Metaplasia
,C. Dysplasia
D. Hypertrophy
Correct Answer: B
Rationale: Metaplasia is the reversible replacement of one mature cell type with
another, often in response to chronic irritation such as cigarette smoke.
4.
A 55-year-old female presents with fatigue, bone pain, and recurrent infections.
Laboratory results reveal hypercalcemia and elevated M-protein. Bone marrow
biopsy shows plasma cell proliferation.
What explains her symptoms?
A. Autoimmune destruction of plasma cells
B. Malignant proliferation of plasma cells causing bone resorption and
immunodeficiency
C. Viral-induced apoptosis of B cells
D. Chronic inflammatory cytokine overproduction
Correct Answer: B
Rationale: Multiple myeloma features malignant plasma cells producing M-
protein, causing bone lesions, hypercalcemia, and immunosuppression.
5.
A 70-year-old male presents with fever, tachycardia, hypotension, and
confusion. Blood cultures are positive for gram-negative bacteria.
Which mediator is primarily responsible for hypotension in sepsis?
A. Epinephrine
B. TNF-α
, C. Insulin
D. IL-10
Correct Answer: B
Rationale: TNF-α and other pro-inflammatory cytokines induce systemic
vasodilation and increased capillary permeability, leading to hypotension.
6.
A 32-year-old female presents with fatigue and pallor. Labs reveal hemoglobin 8
g/dL, hematocrit 25%, and microcytic hypochromic RBCs. She reports heavy
menstrual periods.
Which mechanism explains her anemia?
A. Hemolysis
B. Iron deficiency due to chronic blood loss
C. Megaloblastic anemia from B12 deficiency
D. Decreased erythropoietin
Correct Answer: B
Rationale: Chronic blood loss depletes iron stores, causing microcytic,
hypochromic anemia.
7.
A 40-year-old female presents with butterfly-shaped rash, joint pain, and fatigue.
Labs reveal positive anti-dsDNA antibodies and decreased complement.
Which hypersensitivity type is involved?
A. Type I
B. Type II
ADVANCED PATHOPHYSIOLOGY ACTUAL
QUESTIONS WITH VERIFIED ANSWERS |
SCORE PASS MARK
Overview:
This midterm exam consists of clinically realistic, scenario-based questions designed to assess
advanced understanding of pathophysiology, immunology, hematology, inflammation, necrosis
types, hypersensitivity reactions, autoimmune disorders, and chronic disease mechanisms. Each
question includes a detailed rationale to reinforce critical thinking and clinical application. The
exam is formatted to mimic real-world nursing decision-making, requiring integration of
laboratory findings, imaging results, patient history, and pathophysiologic principles to
select the correct answer.
Focus Areas:
o Inflammatory and immune responses
o Hematologic disorders and anemia
o Autoimmune disease mechanisms
o Types of necrosis
o Hypersensitivity reactions (Type I–IV)
o Chronic disease pathophysiology
Answer Key: Correct answers are bolded with rationale provided for each question
1.
A 68-year-old male with a history of hypertension and hyperlipidemia presents
with sudden-onset chest pain radiating to the jaw. ECG shows ST-segment
elevation, and serum troponin I is elevated.
Which type of necrosis is most likely occurring in his myocardium?
A. Liquefactive
B. Coagulative
,C. Caseous
D. Fat
Correct Answer: B
Rationale: Coagulative necrosis occurs in ischemic injury of solid organs like
the heart, preserving the tissue architecture initially.
2.
A 25-year-old female presents with severe urticaria, wheezing, and hypotension
after eating shrimp. She reports a previous mild peanut allergy.
Which immune mechanism is responsible for her reaction?
A. IgG-mediated cytotoxicity
B. T-cell–mediated delayed hypersensitivity
C. IgE-mediated mast cell degranulation
D. Immune complex deposition
Correct Answer: C
Rationale: Type I hypersensitivity is mediated by IgE binding to mast cells,
leading to histamine release and systemic anaphylaxis.
3.
A 40-year-old patient presents with chronic cough and dyspnea. Bronchoscopy
shows replacement of ciliated columnar epithelium with stratified squamous
epithelium.
What type of cellular adaptation is this?
A. Hyperplasia
B. Metaplasia
,C. Dysplasia
D. Hypertrophy
Correct Answer: B
Rationale: Metaplasia is the reversible replacement of one mature cell type with
another, often in response to chronic irritation such as cigarette smoke.
4.
A 55-year-old female presents with fatigue, bone pain, and recurrent infections.
Laboratory results reveal hypercalcemia and elevated M-protein. Bone marrow
biopsy shows plasma cell proliferation.
What explains her symptoms?
A. Autoimmune destruction of plasma cells
B. Malignant proliferation of plasma cells causing bone resorption and
immunodeficiency
C. Viral-induced apoptosis of B cells
D. Chronic inflammatory cytokine overproduction
Correct Answer: B
Rationale: Multiple myeloma features malignant plasma cells producing M-
protein, causing bone lesions, hypercalcemia, and immunosuppression.
5.
A 70-year-old male presents with fever, tachycardia, hypotension, and
confusion. Blood cultures are positive for gram-negative bacteria.
Which mediator is primarily responsible for hypotension in sepsis?
A. Epinephrine
B. TNF-α
, C. Insulin
D. IL-10
Correct Answer: B
Rationale: TNF-α and other pro-inflammatory cytokines induce systemic
vasodilation and increased capillary permeability, leading to hypotension.
6.
A 32-year-old female presents with fatigue and pallor. Labs reveal hemoglobin 8
g/dL, hematocrit 25%, and microcytic hypochromic RBCs. She reports heavy
menstrual periods.
Which mechanism explains her anemia?
A. Hemolysis
B. Iron deficiency due to chronic blood loss
C. Megaloblastic anemia from B12 deficiency
D. Decreased erythropoietin
Correct Answer: B
Rationale: Chronic blood loss depletes iron stores, causing microcytic,
hypochromic anemia.
7.
A 40-year-old female presents with butterfly-shaped rash, joint pain, and fatigue.
Labs reveal positive anti-dsDNA antibodies and decreased complement.
Which hypersensitivity type is involved?
A. Type I
B. Type II
