NSG 5140 ADVANCED PATHOPHYSIOLOGY
FINAL EXAM REVIEW ACTUAL PREP
QUESTIONS AND WELL REVISED ANSWERS -
LATEST AND COMPLETE UPDATE WITH
VERIFIED SOLUTIONS – ASSURED PASS
1. A 65-year-old patient presents with shortness of breath, orthopnea, and
peripheral edema. Lab results show elevated BNP and reduced ejection
fraction on echocardiogram. Which pathophysiological mechanism primarily
explains these findings?
A. Pulmonary embolism causing increased pulmonary vascular resistance
B. Left ventricular systolic dysfunction leading to increased preload and
pulmonary congestion
C. Right ventricular hypertrophy causing systemic venous congestion
D. Acute myocardial infarction causing localized myocardial necrosis
Rationale: The hallmark of heart failure with reduced ejection fraction is left
ventricular systolic dysfunction, which leads to elevated preload, pulmonary
congestion, and clinical signs like orthopnea and edema.
2. A patient with chronic kidney disease develops hyperkalemia. Which
cellular mechanism is most responsible for the risk of cardiac arrhythmias in
this patient?
A. Increased intracellular sodium causing depolarization
B. Increased calcium influx into myocytes
C. Reduced potassium efflux leading to prolonged depolarization and
, altered cardiac conduction
D. Decreased chloride channels in the myocardium
Rationale: Hyperkalemia reduces the resting membrane potential, impairs
repolarization, and predisposes cardiac myocytes to arrhythmias.
3. Which inflammatory mediator is most directly responsible for the fever seen
in bacterial infections?
A. Histamine
B. Interleukin-1 (IL-1)
C. Prostaglandin E1
D. Tumor necrosis factor-beta
Rationale: IL-1 acts on the hypothalamus to reset the thermoregulatory set point,
leading to fever.
4. A 52-year-old patient is diagnosed with type 2 diabetes mellitus. Which
pathophysiologic mechanism primarily contributes to hyperglycemia in this
patient?
A. Insulin resistance in peripheral tissues with relative beta-cell
dysfunction
B. Absolute lack of insulin production due to autoimmune destruction
C. Excess glucagon secretion causing hepatic glycogen depletion
D. Increased renal glucose reabsorption
Rationale: Type 2 diabetes involves peripheral insulin resistance and eventual
beta-cell dysfunction, leading to chronic hyperglycemia.
, 5. A patient with chronic obstructive pulmonary disease (COPD) presents with
cyanosis and polycythemia. Which physiological compensation explains
these findings?
A. Reduced alveolar ventilation increasing CO2 retention
B. Chronic hypoxemia stimulating erythropoietin production
C. Increased pulmonary surfactant production
D. Systemic vasodilation due to hypercapnia
Rationale: Chronic hypoxemia triggers renal erythropoietin release, leading to
polycythemia; cyanosis results from increased deoxygenated hemoglobin.
6. A patient with severe sepsis develops hypotension despite adequate fluid
resuscitation. Which mechanism primarily contributes to this shock state?
A. Cardiogenic shock due to myocardial infarction
B. Vasodilation and increased capillary permeability due to systemic
inflammatory response
C. Obstructive shock due to pulmonary embolism
D. Hypovolemic shock from blood loss
Rationale: Septic shock results from widespread vasodilation, capillary leak, and
relative hypoperfusion, independent of fluid volume status.
7. Which of the following best describes the pathophysiology of rheumatoid
arthritis?
A. Degeneration of articular cartilage due to aging
B. Autoimmune-mediated synovial inflammation with pannus
formation leading to joint destruction
, C. Post-infectious deposition of urate crystals
D. Trauma-induced joint degeneration
Rationale: Rheumatoid arthritis is characterized by autoimmune synovitis,
formation of pannus, and subsequent erosion of cartilage and bone.
8. A 40-year-old patient presents with jaundice and pruritus. Labs show
elevated alkaline phosphatase and conjugated bilirubin. Which type of liver
injury does this pattern suggest?
A. Cholestatic (obstructive) pattern
B. Hepatocellular necrosis
C. Ischemic hepatitis
D. Alcohol-induced fatty liver
Rationale: Elevated alkaline phosphatase with conjugated hyperbilirubinemia
indicates cholestasis rather than primary hepatocellular injury.
9. A patient with chronic hypertension develops left ventricular hypertrophy.
Which adaptation initially allows maintenance of cardiac output?
A. Increased heart rate
B. Concentric hypertrophy reducing wall stress
C. Ventricular dilation
D. Increased myocardial apoptosis
Rationale: Concentric hypertrophy thickens the ventricular wall, maintaining
wall tension and cardiac output despite elevated afterload.
10.A 30-year-old patient presents with polyuria, polydipsia, and hypernatremia.
Urine osmolality is low. What is the most likely pathophysiologic
FINAL EXAM REVIEW ACTUAL PREP
QUESTIONS AND WELL REVISED ANSWERS -
LATEST AND COMPLETE UPDATE WITH
VERIFIED SOLUTIONS – ASSURED PASS
1. A 65-year-old patient presents with shortness of breath, orthopnea, and
peripheral edema. Lab results show elevated BNP and reduced ejection
fraction on echocardiogram. Which pathophysiological mechanism primarily
explains these findings?
A. Pulmonary embolism causing increased pulmonary vascular resistance
B. Left ventricular systolic dysfunction leading to increased preload and
pulmonary congestion
C. Right ventricular hypertrophy causing systemic venous congestion
D. Acute myocardial infarction causing localized myocardial necrosis
Rationale: The hallmark of heart failure with reduced ejection fraction is left
ventricular systolic dysfunction, which leads to elevated preload, pulmonary
congestion, and clinical signs like orthopnea and edema.
2. A patient with chronic kidney disease develops hyperkalemia. Which
cellular mechanism is most responsible for the risk of cardiac arrhythmias in
this patient?
A. Increased intracellular sodium causing depolarization
B. Increased calcium influx into myocytes
C. Reduced potassium efflux leading to prolonged depolarization and
, altered cardiac conduction
D. Decreased chloride channels in the myocardium
Rationale: Hyperkalemia reduces the resting membrane potential, impairs
repolarization, and predisposes cardiac myocytes to arrhythmias.
3. Which inflammatory mediator is most directly responsible for the fever seen
in bacterial infections?
A. Histamine
B. Interleukin-1 (IL-1)
C. Prostaglandin E1
D. Tumor necrosis factor-beta
Rationale: IL-1 acts on the hypothalamus to reset the thermoregulatory set point,
leading to fever.
4. A 52-year-old patient is diagnosed with type 2 diabetes mellitus. Which
pathophysiologic mechanism primarily contributes to hyperglycemia in this
patient?
A. Insulin resistance in peripheral tissues with relative beta-cell
dysfunction
B. Absolute lack of insulin production due to autoimmune destruction
C. Excess glucagon secretion causing hepatic glycogen depletion
D. Increased renal glucose reabsorption
Rationale: Type 2 diabetes involves peripheral insulin resistance and eventual
beta-cell dysfunction, leading to chronic hyperglycemia.
, 5. A patient with chronic obstructive pulmonary disease (COPD) presents with
cyanosis and polycythemia. Which physiological compensation explains
these findings?
A. Reduced alveolar ventilation increasing CO2 retention
B. Chronic hypoxemia stimulating erythropoietin production
C. Increased pulmonary surfactant production
D. Systemic vasodilation due to hypercapnia
Rationale: Chronic hypoxemia triggers renal erythropoietin release, leading to
polycythemia; cyanosis results from increased deoxygenated hemoglobin.
6. A patient with severe sepsis develops hypotension despite adequate fluid
resuscitation. Which mechanism primarily contributes to this shock state?
A. Cardiogenic shock due to myocardial infarction
B. Vasodilation and increased capillary permeability due to systemic
inflammatory response
C. Obstructive shock due to pulmonary embolism
D. Hypovolemic shock from blood loss
Rationale: Septic shock results from widespread vasodilation, capillary leak, and
relative hypoperfusion, independent of fluid volume status.
7. Which of the following best describes the pathophysiology of rheumatoid
arthritis?
A. Degeneration of articular cartilage due to aging
B. Autoimmune-mediated synovial inflammation with pannus
formation leading to joint destruction
, C. Post-infectious deposition of urate crystals
D. Trauma-induced joint degeneration
Rationale: Rheumatoid arthritis is characterized by autoimmune synovitis,
formation of pannus, and subsequent erosion of cartilage and bone.
8. A 40-year-old patient presents with jaundice and pruritus. Labs show
elevated alkaline phosphatase and conjugated bilirubin. Which type of liver
injury does this pattern suggest?
A. Cholestatic (obstructive) pattern
B. Hepatocellular necrosis
C. Ischemic hepatitis
D. Alcohol-induced fatty liver
Rationale: Elevated alkaline phosphatase with conjugated hyperbilirubinemia
indicates cholestasis rather than primary hepatocellular injury.
9. A patient with chronic hypertension develops left ventricular hypertrophy.
Which adaptation initially allows maintenance of cardiac output?
A. Increased heart rate
B. Concentric hypertrophy reducing wall stress
C. Ventricular dilation
D. Increased myocardial apoptosis
Rationale: Concentric hypertrophy thickens the ventricular wall, maintaining
wall tension and cardiac output despite elevated afterload.
10.A 30-year-old patient presents with polyuria, polydipsia, and hypernatremia.
Urine osmolality is low. What is the most likely pathophysiologic
