NEWEST NSG 5140 Advanced Pathophysiology – Final
Exam Review 2026| Questions with Answers &
Rationales | South College
1. Which of the following best describes the pathophysiology of type 1 diabetes mellitus?
A) Insulin resistance in peripheral tissues
B) Excessive hepatic glucose production
C) Autoimmune destruction of pancreatic beta cells
D) Overproduction of insulin
Answer: C) Autoimmune destruction of pancreatic beta cells
Rationale: Type 1 diabetes results from immune-mediated destruction of insulin-producing beta cells,
leading to absolute insulin deficiency.
2. In heart failure, which compensatory mechanism initially maintains cardiac output?
A) Decreased preload
B) Activation of the renin-angiotensin-aldosterone system (RAAS)
C) Decreased heart rate
D) Vasodilation
Answer: B) Activation of the renin-angiotensin-aldosterone system (RAAS)
Rationale: RAAS increases blood volume and systemic vascular resistance to maintain perfusion despite
reduced cardiac output.
3. Which electrolyte imbalance is commonly associated with chronic kidney disease (CKD)?
A) Hypokalemia
B) Hyponatremia
,C) Hyperkalemia
D) Hypocalcemia
Answer: C) Hyperkalemia
Rationale: CKD reduces potassium excretion, increasing risk of hyperkalemia.
4. Which cytokine is primarily responsible for the systemic inflammation seen in sepsis?
A) Interleukin-4 (IL-4)
B) Interleukin-10 (IL-10)
C) Tumor necrosis factor-alpha (TNF-α)
D) Interferon-beta (IFN-β)
Answer: C) Tumor necrosis factor-alpha (TNF-α)
Rationale: TNF-α triggers inflammation, vasodilation, and increased vascular permeability in sepsis.
5. Which type of shock is caused by severe infection?
A) Cardiogenic
B) Hypovolemic
C) Septic
D) Neurogenic
Answer: C) Septic
Rationale: Septic shock results from systemic infection causing vasodilation and hypotension.
6. Which heart valve is most commonly affected in rheumatic heart disease?
A) Tricuspid
B) Pulmonary
C) Mitral
D) Aortic
,Answer: C) Mitral
Rationale: Rheumatic fever often leads to mitral stenosis due to autoimmune inflammation of valve
tissue.
7. Which of the following is the hallmark of nephrotic syndrome?
A) Hematuria
B) Proteinuria >3.5 g/day
C) Polyuria
D) Hyperkalemia
Answer: B) Proteinuria >3.5 g/day
Rationale: Nephrotic syndrome is defined by heavy protein loss, hypoalbuminemia, edema, and
hyperlipidemia.
8. Which type of hypersensitivity reaction is mediated by IgE?
A) Type I
B) Type II
C) Type I
D) Type III
Answer: C) Type I
Rationale: Type I hypersensitivity (immediate) involves IgE antibodies binding to allergens, triggering
mast cell degranulation.
9. In chronic obstructive pulmonary disease (COPD), which physiologic change is typical?
A) Increased lung elasticity
B) Airflow limitation due to airway obstruction
C) Hypoventilation with normal oxygen levels
D) Decreased mucus production
, Answer: B) Airflow limitation due to airway obstruction
Rationale: COPD is characterized by progressive airflow limitation and difficulty exhaling.
10. Which hormone is deficient in Addison’s disease?
A) Insulin
B) Cortisol and aldosterone
C) Thyroxine
D) Parathyroid hormone
Answer: B) Cortisol and aldosterone
Rationale: Addison’s disease is primary adrenal insufficiency causing decreased glucocorticoid and
mineralocorticoid production.
11. Which type of anemia is caused by vitamin B12 deficiency?
A) Microcytic anemia
B) Normocytic anemia
C) Macrocytic anemia
D) Hemolytic anemia
Answer: C) Macrocytic anemia
Rationale: Vitamin B12 deficiency impairs DNA synthesis, leading to enlarged red blood cells
(macrocytosis).
12. What is the most common cause of hyperthyroidism?
A) Thyroid cancer
B) Hashimoto’s thyroiditis
C) Graves’ disease
D) Iodine deficiency
Exam Review 2026| Questions with Answers &
Rationales | South College
1. Which of the following best describes the pathophysiology of type 1 diabetes mellitus?
A) Insulin resistance in peripheral tissues
B) Excessive hepatic glucose production
C) Autoimmune destruction of pancreatic beta cells
D) Overproduction of insulin
Answer: C) Autoimmune destruction of pancreatic beta cells
Rationale: Type 1 diabetes results from immune-mediated destruction of insulin-producing beta cells,
leading to absolute insulin deficiency.
2. In heart failure, which compensatory mechanism initially maintains cardiac output?
A) Decreased preload
B) Activation of the renin-angiotensin-aldosterone system (RAAS)
C) Decreased heart rate
D) Vasodilation
Answer: B) Activation of the renin-angiotensin-aldosterone system (RAAS)
Rationale: RAAS increases blood volume and systemic vascular resistance to maintain perfusion despite
reduced cardiac output.
3. Which electrolyte imbalance is commonly associated with chronic kidney disease (CKD)?
A) Hypokalemia
B) Hyponatremia
,C) Hyperkalemia
D) Hypocalcemia
Answer: C) Hyperkalemia
Rationale: CKD reduces potassium excretion, increasing risk of hyperkalemia.
4. Which cytokine is primarily responsible for the systemic inflammation seen in sepsis?
A) Interleukin-4 (IL-4)
B) Interleukin-10 (IL-10)
C) Tumor necrosis factor-alpha (TNF-α)
D) Interferon-beta (IFN-β)
Answer: C) Tumor necrosis factor-alpha (TNF-α)
Rationale: TNF-α triggers inflammation, vasodilation, and increased vascular permeability in sepsis.
5. Which type of shock is caused by severe infection?
A) Cardiogenic
B) Hypovolemic
C) Septic
D) Neurogenic
Answer: C) Septic
Rationale: Septic shock results from systemic infection causing vasodilation and hypotension.
6. Which heart valve is most commonly affected in rheumatic heart disease?
A) Tricuspid
B) Pulmonary
C) Mitral
D) Aortic
,Answer: C) Mitral
Rationale: Rheumatic fever often leads to mitral stenosis due to autoimmune inflammation of valve
tissue.
7. Which of the following is the hallmark of nephrotic syndrome?
A) Hematuria
B) Proteinuria >3.5 g/day
C) Polyuria
D) Hyperkalemia
Answer: B) Proteinuria >3.5 g/day
Rationale: Nephrotic syndrome is defined by heavy protein loss, hypoalbuminemia, edema, and
hyperlipidemia.
8. Which type of hypersensitivity reaction is mediated by IgE?
A) Type I
B) Type II
C) Type I
D) Type III
Answer: C) Type I
Rationale: Type I hypersensitivity (immediate) involves IgE antibodies binding to allergens, triggering
mast cell degranulation.
9. In chronic obstructive pulmonary disease (COPD), which physiologic change is typical?
A) Increased lung elasticity
B) Airflow limitation due to airway obstruction
C) Hypoventilation with normal oxygen levels
D) Decreased mucus production
, Answer: B) Airflow limitation due to airway obstruction
Rationale: COPD is characterized by progressive airflow limitation and difficulty exhaling.
10. Which hormone is deficient in Addison’s disease?
A) Insulin
B) Cortisol and aldosterone
C) Thyroxine
D) Parathyroid hormone
Answer: B) Cortisol and aldosterone
Rationale: Addison’s disease is primary adrenal insufficiency causing decreased glucocorticoid and
mineralocorticoid production.
11. Which type of anemia is caused by vitamin B12 deficiency?
A) Microcytic anemia
B) Normocytic anemia
C) Macrocytic anemia
D) Hemolytic anemia
Answer: C) Macrocytic anemia
Rationale: Vitamin B12 deficiency impairs DNA synthesis, leading to enlarged red blood cells
(macrocytosis).
12. What is the most common cause of hyperthyroidism?
A) Thyroid cancer
B) Hashimoto’s thyroiditis
C) Graves’ disease
D) Iodine deficiency
