NR507 FINAL EXAM – COMPREHENSIVE ADVANCED
PATHOPHYSIOLOGY REVIEW QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES
GRADED A+ LATEST
Questions
1. A patient with chronic hypertension develops left ventricular hypertrophy. The
primary pathophysiologic mechanism driving this change is:
A. Increased preload from volume overload
B. Myocardial ischemia causing myocyte death
C. Pressure overload leading to myocardial remodeling
D. Neurohormonal suppression of cardiac output
Correct Answer: C
Rationale: Chronic pressure overload from hypertension stimulates adaptive
myocardial hypertrophy to reduce wall stress.
2. In heart failure with reduced ejection fraction (HFrEF), decreased cardiac output
most directly activates which compensatory mechanism?
A. Parasympathetic stimulation
B. Renin–angiotensin–aldosterone system (RAAS) activation
C. Decreased antidiuretic hormone secretion
D. Increased natriuretic peptide degradation
Correct Answer: B
Rationale: Reduced renal perfusion activates RAAS, increasing sodium retention
and vasoconstriction.
3. Which electrolyte abnormality is most associated with ventricular arrhythmias in
acute myocardial infarction?
A. Hyponatremia
B. Hypercalcemia
C. Hypokalemia
D. Hypermagnesemia
,Correct Answer: C
Rationale: Low potassium increases myocardial excitability and risk of
arrhythmias.
4. A patient presents with exertional dyspnea and orthopnea. Which finding is most
consistent with left-sided heart failure?
A. Hepatomegaly
B. Peripheral edema
C. Pulmonary crackles
D. Jugular venous distention
Correct Answer: C
Rationale: Left-sided failure causes pulmonary congestion and crackles.
5. The hallmark pathophysiologic feature of asthma is:
A. Irreversible airway obstruction
B. Alveolar destruction
C. Chronic bronchial inflammation with hyperresponsiveness
D. Loss of surfactant
Correct Answer: C
Rationale: Asthma involves reversible airway obstruction due to inflammation and
hyperreactivity.
6. In emphysema, dyspnea primarily results from:
A. Bronchospasm
B. Loss of alveolar surface area and elastic recoil
C. Increased mucus production
D. Upper airway obstruction
Correct Answer: B
Rationale: Alveolar destruction reduces gas exchange and elastic recoil.
,7. Which arterial blood gas pattern is expected in early acute respiratory distress
syndrome (ARDS)?
A. Respiratory acidosis with metabolic compensation
B. Metabolic alkalosis
C. Hypoxemia refractory to oxygen therapy
D. Hypercapnia with normal oxygenation
Correct Answer: C
Rationale: ARDS causes severe shunting and hypoxemia unresponsive to
supplemental oxygen.
8. The primary driver of hypercapnia in chronic obstructive pulmonary disease
(COPD) is:
A. Increased oxygen consumption
B. Alveolar hypoventilation
C. Increased dead space ventilation
D. Decreased hemoglobin affinity for oxygen
Correct Answer: B
Rationale: Inadequate ventilation leads to CO₂ retention.
9. Which mechanism best explains edema formation in nephrotic syndrome?
A. Increased hydrostatic pressure
B. Decreased plasma oncotic pressure
C. Lymphatic obstruction
D. Sodium loss
Correct Answer: B
Rationale: Proteinuria leads to hypoalbuminemia, reducing oncotic pressure.
10. Acute kidney injury from hypovolemia is classified as:
A. Intrinsic
B. Postrenal
C. Prerenal
D. Chronic
Correct Answer: C
Rationale: Reduced renal perfusion causes prerenal AKI.
, 11. Which hormone is primarily responsible for increasing renal sodium
reabsorption in the distal tubules?
A. Antidiuretic hormone
B. Aldosterone
C. Atrial natriuretic peptide
D. Cortisol
Correct Answer: B
Rationale: Aldosterone promotes sodium reabsorption and potassium excretion.
12. Diabetic nephropathy initially results from:
A. Renal artery stenosis
B. Immune complex deposition
C. Glomerular hyperfiltration and basement membrane thickening
D. Tubular necrosis
Correct Answer: C
Rationale: Early hyperfiltration leads to structural glomerular damage.
13. A patient with liver cirrhosis develops ascites primarily due to:
A. Increased plasma albumin
B. Portal hypertension and sodium retention
C. Decreased capillary permeability
D. Increased lymphatic drainage
Correct Answer: B
Rationale: Portal hypertension and RAAS activation cause fluid accumulation.
14. Which laboratory finding is most consistent with acute pancreatitis?
A. Decreased lipase
B. Elevated amylase and lipase
C. Elevated bilirubin only
D. Decreased hematocrit
Correct Answer: B
Rationale: Pancreatic enzyme leakage elevates serum amylase and lipase.
PATHOPHYSIOLOGY REVIEW QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES
GRADED A+ LATEST
Questions
1. A patient with chronic hypertension develops left ventricular hypertrophy. The
primary pathophysiologic mechanism driving this change is:
A. Increased preload from volume overload
B. Myocardial ischemia causing myocyte death
C. Pressure overload leading to myocardial remodeling
D. Neurohormonal suppression of cardiac output
Correct Answer: C
Rationale: Chronic pressure overload from hypertension stimulates adaptive
myocardial hypertrophy to reduce wall stress.
2. In heart failure with reduced ejection fraction (HFrEF), decreased cardiac output
most directly activates which compensatory mechanism?
A. Parasympathetic stimulation
B. Renin–angiotensin–aldosterone system (RAAS) activation
C. Decreased antidiuretic hormone secretion
D. Increased natriuretic peptide degradation
Correct Answer: B
Rationale: Reduced renal perfusion activates RAAS, increasing sodium retention
and vasoconstriction.
3. Which electrolyte abnormality is most associated with ventricular arrhythmias in
acute myocardial infarction?
A. Hyponatremia
B. Hypercalcemia
C. Hypokalemia
D. Hypermagnesemia
,Correct Answer: C
Rationale: Low potassium increases myocardial excitability and risk of
arrhythmias.
4. A patient presents with exertional dyspnea and orthopnea. Which finding is most
consistent with left-sided heart failure?
A. Hepatomegaly
B. Peripheral edema
C. Pulmonary crackles
D. Jugular venous distention
Correct Answer: C
Rationale: Left-sided failure causes pulmonary congestion and crackles.
5. The hallmark pathophysiologic feature of asthma is:
A. Irreversible airway obstruction
B. Alveolar destruction
C. Chronic bronchial inflammation with hyperresponsiveness
D. Loss of surfactant
Correct Answer: C
Rationale: Asthma involves reversible airway obstruction due to inflammation and
hyperreactivity.
6. In emphysema, dyspnea primarily results from:
A. Bronchospasm
B. Loss of alveolar surface area and elastic recoil
C. Increased mucus production
D. Upper airway obstruction
Correct Answer: B
Rationale: Alveolar destruction reduces gas exchange and elastic recoil.
,7. Which arterial blood gas pattern is expected in early acute respiratory distress
syndrome (ARDS)?
A. Respiratory acidosis with metabolic compensation
B. Metabolic alkalosis
C. Hypoxemia refractory to oxygen therapy
D. Hypercapnia with normal oxygenation
Correct Answer: C
Rationale: ARDS causes severe shunting and hypoxemia unresponsive to
supplemental oxygen.
8. The primary driver of hypercapnia in chronic obstructive pulmonary disease
(COPD) is:
A. Increased oxygen consumption
B. Alveolar hypoventilation
C. Increased dead space ventilation
D. Decreased hemoglobin affinity for oxygen
Correct Answer: B
Rationale: Inadequate ventilation leads to CO₂ retention.
9. Which mechanism best explains edema formation in nephrotic syndrome?
A. Increased hydrostatic pressure
B. Decreased plasma oncotic pressure
C. Lymphatic obstruction
D. Sodium loss
Correct Answer: B
Rationale: Proteinuria leads to hypoalbuminemia, reducing oncotic pressure.
10. Acute kidney injury from hypovolemia is classified as:
A. Intrinsic
B. Postrenal
C. Prerenal
D. Chronic
Correct Answer: C
Rationale: Reduced renal perfusion causes prerenal AKI.
, 11. Which hormone is primarily responsible for increasing renal sodium
reabsorption in the distal tubules?
A. Antidiuretic hormone
B. Aldosterone
C. Atrial natriuretic peptide
D. Cortisol
Correct Answer: B
Rationale: Aldosterone promotes sodium reabsorption and potassium excretion.
12. Diabetic nephropathy initially results from:
A. Renal artery stenosis
B. Immune complex deposition
C. Glomerular hyperfiltration and basement membrane thickening
D. Tubular necrosis
Correct Answer: C
Rationale: Early hyperfiltration leads to structural glomerular damage.
13. A patient with liver cirrhosis develops ascites primarily due to:
A. Increased plasma albumin
B. Portal hypertension and sodium retention
C. Decreased capillary permeability
D. Increased lymphatic drainage
Correct Answer: B
Rationale: Portal hypertension and RAAS activation cause fluid accumulation.
14. Which laboratory finding is most consistent with acute pancreatitis?
A. Decreased lipase
B. Elevated amylase and lipase
C. Elevated bilirubin only
D. Decreased hematocrit
Correct Answer: B
Rationale: Pancreatic enzyme leakage elevates serum amylase and lipase.
