WGU D115 ADVANCED PATHOPHYSIOLOGY OA
ACTUAL EXAM | ALL QUESTIONS AND
CORRECT DETAILED ANSWERS | RATED A + |
TOP RATED VERSION FOR 2026-2027 | NEW AND
REVISED
1. A patient develops edema due to decreased plasma oncotic
pressure. Which underlying mechanism most directly
explains this finding?
A. Increased capillary hydrostatic pressure
B. Lymphatic obstruction
C. Reduced serum albumin synthesis
D. Increased capillary permeability
rationale: Albumin is the primary contributor to plasma
oncotic pressure; reduced synthesis lowers oncotic pull,
allowing fluid to shift into the interstitial space.
2. During acute inflammation, which mediator is primarily
responsible for increased vascular permeability in the early
phase?
A. Prostaglandins
B. Leukotrienes
C. Histamine
D. Bradykinin
rationale: Histamine, released from mast cells, rapidly
, increases endothelial permeability during early
inflammation.
3. A client with chronic hypoxia develops polycythemia. This
response is best explained by increased production of:
A. Thrombopoietin
B. Renin
C. Erythropoietin
D. Cortisol
rationale: Chronic hypoxia stimulates renal
erythropoietin release, increasing red blood cell
production.
4. Which acid–base disturbance is expected in prolonged
vomiting?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
rationale: Loss of gastric acid leads to increased
bicarbonate concentration, causing metabolic alkalosis.
5. A patient in septic shock initially presents with warm,
flushed skin. This is primarily due to:
A. Decreased cardiac output
B. Peripheral vasodilation
C. Increased blood viscosity
D. Reduced capillary permeability
rationale: Early septic shock is characterized by
widespread vasodilation, leading to warm skin.
6. Which cytokine plays a central role in fever generation?
A. IL-10
B. IL-1
C. IL-4
, D. TGF-β
rationale: IL-1 acts on the hypothalamus to raise the
thermoregulatory set point, producing fever.
7. In left-sided heart failure, pulmonary edema occurs
primarily because of:
A. Decreased pulmonary oncotic pressure
B. Increased systemic vascular resistance
C. Elevated pulmonary capillary hydrostatic pressure
D. Reduced lymphatic drainage
rationale: Left ventricular failure causes blood backup
into pulmonary circulation, increasing hydrostatic
pressure.
8. Which electrolyte imbalance is most likely with prolonged
use of loop diuretics?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypercalcemia
rationale: Loop diuretics increase renal potassium
excretion, leading to hypokalemia.
9. A patient with uncontrolled diabetes mellitus develops
diabetic ketoacidosis. Which process is primarily
responsible for metabolic acidosis?
A. Lactic acid accumulation
B. Renal bicarbonate loss
C. Ketone body production
D. Respiratory compensation failure
rationale: Insulin deficiency leads to lipolysis and ketone
body accumulation, causing acidosis.
10. Which immunoglobulin is most involved in immediate
hypersensitivity reactions?
, A. IgG
B. IgM
C. IgA
D. IgE
rationale: IgE mediates type I hypersensitivity through
mast cell degranulation.
11. Atherosclerosis begins with endothelial injury
followed by accumulation of:
A. Platelets
B. Smooth muscle cells
C. Oxidized LDL
D. Fibrin
rationale: Oxidized LDL uptake by macrophages leads to
foam cell formation.
12. Which mechanism best explains anemia of chronic
disease?
A. Increased erythropoietin
B. Iron sequestration by inflammatory mediators
C. Hemolysis
D. Vitamin B12 deficiency
rationale: Inflammation increases hepcidin, reducing
iron availability for erythropoiesis.
13. In acute kidney injury, oliguria is primarily due to:
A. Increased GFR
B. Reduced renal perfusion or tubular obstruction
C. Increased aldosterone
D. Enhanced sodium reabsorption
rationale: AKI commonly results from impaired
perfusion or tubular damage, reducing urine output.
14. Which finding is most characteristic of right-sided
heart failure?
ACTUAL EXAM | ALL QUESTIONS AND
CORRECT DETAILED ANSWERS | RATED A + |
TOP RATED VERSION FOR 2026-2027 | NEW AND
REVISED
1. A patient develops edema due to decreased plasma oncotic
pressure. Which underlying mechanism most directly
explains this finding?
A. Increased capillary hydrostatic pressure
B. Lymphatic obstruction
C. Reduced serum albumin synthesis
D. Increased capillary permeability
rationale: Albumin is the primary contributor to plasma
oncotic pressure; reduced synthesis lowers oncotic pull,
allowing fluid to shift into the interstitial space.
2. During acute inflammation, which mediator is primarily
responsible for increased vascular permeability in the early
phase?
A. Prostaglandins
B. Leukotrienes
C. Histamine
D. Bradykinin
rationale: Histamine, released from mast cells, rapidly
, increases endothelial permeability during early
inflammation.
3. A client with chronic hypoxia develops polycythemia. This
response is best explained by increased production of:
A. Thrombopoietin
B. Renin
C. Erythropoietin
D. Cortisol
rationale: Chronic hypoxia stimulates renal
erythropoietin release, increasing red blood cell
production.
4. Which acid–base disturbance is expected in prolonged
vomiting?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
rationale: Loss of gastric acid leads to increased
bicarbonate concentration, causing metabolic alkalosis.
5. A patient in septic shock initially presents with warm,
flushed skin. This is primarily due to:
A. Decreased cardiac output
B. Peripheral vasodilation
C. Increased blood viscosity
D. Reduced capillary permeability
rationale: Early septic shock is characterized by
widespread vasodilation, leading to warm skin.
6. Which cytokine plays a central role in fever generation?
A. IL-10
B. IL-1
C. IL-4
, D. TGF-β
rationale: IL-1 acts on the hypothalamus to raise the
thermoregulatory set point, producing fever.
7. In left-sided heart failure, pulmonary edema occurs
primarily because of:
A. Decreased pulmonary oncotic pressure
B. Increased systemic vascular resistance
C. Elevated pulmonary capillary hydrostatic pressure
D. Reduced lymphatic drainage
rationale: Left ventricular failure causes blood backup
into pulmonary circulation, increasing hydrostatic
pressure.
8. Which electrolyte imbalance is most likely with prolonged
use of loop diuretics?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypercalcemia
rationale: Loop diuretics increase renal potassium
excretion, leading to hypokalemia.
9. A patient with uncontrolled diabetes mellitus develops
diabetic ketoacidosis. Which process is primarily
responsible for metabolic acidosis?
A. Lactic acid accumulation
B. Renal bicarbonate loss
C. Ketone body production
D. Respiratory compensation failure
rationale: Insulin deficiency leads to lipolysis and ketone
body accumulation, causing acidosis.
10. Which immunoglobulin is most involved in immediate
hypersensitivity reactions?
, A. IgG
B. IgM
C. IgA
D. IgE
rationale: IgE mediates type I hypersensitivity through
mast cell degranulation.
11. Atherosclerosis begins with endothelial injury
followed by accumulation of:
A. Platelets
B. Smooth muscle cells
C. Oxidized LDL
D. Fibrin
rationale: Oxidized LDL uptake by macrophages leads to
foam cell formation.
12. Which mechanism best explains anemia of chronic
disease?
A. Increased erythropoietin
B. Iron sequestration by inflammatory mediators
C. Hemolysis
D. Vitamin B12 deficiency
rationale: Inflammation increases hepcidin, reducing
iron availability for erythropoiesis.
13. In acute kidney injury, oliguria is primarily due to:
A. Increased GFR
B. Reduced renal perfusion or tubular obstruction
C. Increased aldosterone
D. Enhanced sodium reabsorption
rationale: AKI commonly results from impaired
perfusion or tubular damage, reducing urine output.
14. Which finding is most characteristic of right-sided
heart failure?
