Ace the Advanced Pathophysiology Midterm (NUR 6501) at Walden University with the most comprehensive exam preparation guide available. This resource contains 200+ actual exam questions with verified answers (all graded A+) covering every topic tested in this core nurse practitioner course.
What's Inside:
Cellular Biology & Pathophysiology:
Anaerobic glycolysis – facilitates continued muscle performance when oxygen is depleted.
Action potential initiation – sodium gates open, sodium rushes into cell, changing membrane potential from negative to positive.
Sodium and water accumulation in injured cell – decreased ATP production.
Potassium diffusion across cell membrane – resting plasma membrane is more permeable to potassium.
Sodium/potassium transport – by adenosine triphosphate enzyme (ATPase).
Predominant extracellular cation – sodium.
Early endoplasmic reticulum swelling – reduced protein synthesis.
Oncotic pressure (colloid osmotic pressure) – determined by plasma proteins.
Symport transport – Na+ and Ca2+ moving simultaneously in same direction.
Distinguishing aging from disease – difficult because both result from cell injury.
Genetics & Chromosomal Disorders:
Klinefelter syndrome – karyotype XXY.
Turner syndrome – absent homologous X chromosome (single X); features: short stature, widely spaced nipples, reduced carrying angle, sparse body hair.
Down syndrome – most common cause: maternal nondisjunction; risk factor: pregnancy in women over age 35.
Tetraploidy – 92 chromosomes (stillborn fetus).
Cystic fibrosis – caused by autosomal recessive gene.
Huntington disease – delayed age of onset.
Neurofibromatosis – varying degrees of disease = expressivity.
Proband – person first diagnosed with a genetic disease (on pedigree chart).
DNA replication in eukaryotic cell – most genetic information contained in nucleolus.
Cytokines role in cell reproduction – provide growth factor for tissue growth and development.
Albinism – inability to convert tyrosine to DOPA.
Endocrine Disorders:
Hypothyroidism – decreased T3/T4, elevated TSH; everything slows: metabolism, sympathetic nervous system (drowsy, lethargic), constipation, weight gain, decreased body temp.
Hyperthyroidism – increased T3/T4, decreased TSH; weight loss, heat intolerance, diarrhea, increased HR/BP.
Thyroid hormones (T3, T4) – regulate metabolism, temperature, growth and development; require iodine.
TSH produced by anterior pituitary gland.
Cushing's disease (internal) vs. Cushing's syndrome (external – e.g., steroid treatment).
Cushing's symptoms: "UP, UP, UP, DOWN, UP" – hypernatremia, hypertension, increased blood volume, hypokalemia, hyperglycemia; truncal obesity, moon face, buffalo hump, striae, excessive hair.
Addison's disease – autoimmune disorder attacking adrenal cortex; decreased cortisol and aldosterone; symptoms: hyperpigmentation, hyponatremia, hyperkalemia, hypoglycemia, low BP, vascular collapse risk.
Adrenal cortex – secretes cortisol, aldosterone, sex hormones.
Aldosterone – retains sodium/water, secretes potassium; regulates BP.
Cortisol – stress hormone; increases blood glucose, breaks down fats/proteins/carbs.
Negative feedback loop: Hypothalamus (CRH) → Pituitary (ACTH) → Adrenal cortex (cortisol).
SIADH – increased antidiuretic hormone (ADH) production.
Diabetes Insipidus – decreased ADH production.
ADH (vasopressin) – made by hypothalamus, stored in posterior pituitary; regulates water conservation.
Pheochromocytoma – benign adrenal medulla tumor secreting catecholamines (epinephrine, norepinephrine); causes hypertension, headache, sweating, panic attack symptoms.
Cardiovascular Disorders:
Hypertension – BP 130; BP = cardiac output × total peripheral vascular resistance.
Left-sided heart failure – dyspnea, crackles, oliguria, frothy sputum, displaced apical pulse (hypertrophy).
Right-sided heart failure – jugular vein distention, ascending dependent edema, weight gain, hepatomegaly.
Coronary artery disease – dyslipidemia (abnormal serum lipoproteins); increased LDL = coronary risk.
Stable angina – chest pain relieved by nitrates; sensation described as "clenching fist over left sternal border."
Myocardial infarction (MI) – death of myocardial tissue from coronary artery occlusion; chest/upper body pain, SOB, diaphoresis, nausea.
Pericarditis – inflammation of pericardium, often with pericardial effusion.
Cardiac tamponade – fluid accumulation compressing heart → impairs cardiac filling → low cardiac output.
Infective endocarditis – inflammation of endothelium lining heart and valves (most commonly mitral valve, then aortic, tricuspid).
Myocarditis – inflammation of myocardium with necrosis of cardiac myocytes; inflammatory infiltrate on biopsy.
Aortic stenosis – calcification of aortic valve cusps restricting forward flow during systole.
Aortic regurgitation (insufficiency) – backward flow from aorta into left ventricle during diastole.
Mitral stenosis – narrowing of mitral valve orifice impeding flow from left atrium to left ventricle.
Mitral regurgitation – incompetent mitral valve allowing backflow from left ventricle to left atrium during systole.
Mitral valve prolapse – billowing of mitral valve leaflets into left atrium during systole.
Pulmonic stenosis – narrowing of pulmonary outflow tract obstructing flow from right ventricle to pulmonary artery during systole.
Pulmonic regurgitation – backflow from pulmonary artery into right ventricle during diastole.
Tricuspid regurgitation – holosystolic murmur loudest at tricuspid area; enhanced by inspiration.
Deep vein thrombosis (DVT) – blood clot in lower limb from impaired venous return, endothelial injury, or hypercoagulability; thrombi consist of thrombin, fibrin, RBCs (few platelets).
Peripheral artery disease (PAD) – atherosclerotic disease of arteries perfusing limbs (especially lower extremities); can cause intermittent claudication.
Pulmonary Disorders:
Ventilation – movement of air in/out of lungs; controlled by parasympathetic and sympathetic nervous system.
Gas exchange in lungs – via diffusion (O2 into blood, CO2 out of blood).
Lung compliance – determined by adequate surfactant production and elastic recoil.
Airway resistance – increases as airway diameter decreases.
Spirometer – measures volume of air inhaled/exhaled and time per breath.
Dyspnea – shortness of breath.
Orthopnea – difficulty breathing when lying down.
Paroxysmal nocturnal dyspnea – awakening from sleep with SOB, needing to be upright.
Aspiration – breathing fluid, food, vomitus, or object into lungs.
Atelectasis – collapsed lung; incomplete expansion of alveoli.
Bronchiectasis – dilation of bronchi secondary to infection or chronic inflammation.
Bronchiolitis – inflammation of bronchioles; usually in children 2 years; often caused by RSV.
Pulmonary edema – fluid accumulation in lungs; common cause = left heart failure.
ARDS (Acute Respiratory Distress Syndrome) – respiratory insufficiency marked by progressive hypoxia.
Asthma – chronic allergic disorder with episodes of breathing difficulty, coughing, wheezing.
COPD (Chronic Obstructive Pulmonary Disease) – group of lung diseases blocking airflow (bronchitis and emphysema).
Chronic bronchitis – chronic bronchial inflammation causing airway obstruction from smooth muscle hypertrophy.
Emphysema – damaged/enlarged air sacs causing breathlessness.
Renal & Urinary Disorders:
Kidney function – filter blood and produce urine.
Renal blood flow – mL/min.
GFR (Glomerular Filtration Rate) – 90-120 mL/min.
Nephron function – regulate water and soluble substances; filter blood, reabsorb needed, excrete rest.
Proximal convoluted tubule – reabsorbs 60-70% of filtered sodium and water.
Distal tubules – transport, reabsorb, and secrete glomerular filtrate.
Creatinine – 0.6-1.2 mg/dL.
BUN (Blood Urea Nitrogen) – 10-20 mg/dL; indicator of hydration status.
UTI (Urinary Tract Infection) – presence of organism in urinary tract.
Pyelonephritis – inflammation of renal pelvis and kidney.
Acute glomerulonephritis (AGN) – immune disease after strep infection; decreases GFR; symptoms: oliguria, edema, hematuria ("tea-colored"), mild HTN, proteinuria; usually follows strep infection by 10 days.
Lupus erythematosus – autoimmune disease; butterfly-shaped rash over nose and cheeks; can affect heart, lungs, kidneys (SLE).
Acute Kidney Injury (AKI) – abrupt loss of kidney function.
Prerenal – decreased renal blood flow (hypotension, hypoperfusion).
Intrarenal – injury to renal tissue from toxins/ischemia (edema, glomerulonephritis).
Postrenal – obstruction of urine flow.
Oliguric phase – 500 mL urine output in 24 hours.
Chronic Kidney Disease (CKD) – staged 1 (mild) to 5 (ESRD requiring dialysis or transplant).
Gastrointestinal & Hepatobiliary Disorders:
Duodenum – chemical digestion of carbs, proteins, and lipids.
Bile – bitter greenish-brown alkaline fluid; secreted by liver, stored in gallbladder.
Liver functions – metabolism of fats/proteins/carbohydrates; bilirubin excretion; enzyme activation; glycogen/vitamin/mineral storage; plasma protein synthesis (albumin, clotting factors); blood detoxification; bile production.
Hepatic portal vein – connects intestinal capillaries to liver capillaries.
Bilirubin – orange-yellow pigment formed from hemoglobin breakdown; excreted in bile.
Gallbladder – stores and concentrates bile.
Pancreas – exocrine (digestive enzymes, bicarbonate) and endocrine (insulin, glucagon).
Anorexia – loss of appetite.
Vomiting (emesis) – expelling stomach contents.
Primary constipation – lifestyle factors (inactivity, inadequate fiber/fluid, ignoring urge).
Diarrhea causes – bacteria (E. coli), viruses, toxins, drugs, laxative abuse, malabsorption, IBD, stress, anxiety.
GI bleeding symptoms – abdominal pain, hematemesis, hematochezia, melena, altered LOC, signs of shock, tachycardia.
Peptic Ulcer Disease (PUD) – break in mucosal lining of lower esophagus, stomach, or duodenum.
Duodenal ulcer – increased parietal cells, increased gastric levels, rapid gastric emptying.
Gastric ulcer – persistent upper abdominal burning pain, relieved by bland foods, hematemesis or melena.
Zollinger-Ellison syndrome – hypersecretion of gastric acid from non-beta-cell pancreatic islet tumor.
Stress ulcers – gastric mucosal lesions in critically ill patients (trauma, shock, hemorrhage, sepsis, burns, ARDS, major surgery).
Cushing ulcer – increased vagus nerve stimulation from increased ICP → increased acid production.
Dumping syndrome – increase fat/protein, small frequent meals, lie down after meals.
Ulcerative colitis – chronic inflammation of rectum and large intestine with ulcers and irritation.
Crohn's disease – chronic inflammatory bowel disease affecting lining of digestive tract.
Irritable Bowel Syndrome (IBS) – intermittent cramping, abdominal pain, bloating, constipation, diarrhea.
Diverticulitis – inflammation of diverticula.
Appendicitis – inflammation of appendix.
Portal hypertension – liver damage from chronic alcoholism; obstructs venous flow; causes vein engorgement around umbilicus.
Splenomegaly – enlargement of spleen.
Ascites – excess fluid in peritoneal cavity.
Hepatic encephalopathy – impaired ammonia metabolism causing cerebral edema; symptoms: change in LOC, memory loss, asterixis (flapping tremor), hyperventilation with respiratory alkalosis; treatment: lactulose, low protein.
Hepatitis – inflammation of liver (viral, fever, loss of appetite, jaundice, fatigue).
Hepatitis B – transmitted through any body fluid (vaginal secretions, semen, blood).
Hepatitis C – bloodborne (blood exposure, sharing needles, mother to infant); rarely sexual contact.
Hepatitis D – only exists with hepatitis B; HBV vaccine offers protection.
Viral hepatitis symptoms – fatigue, myalgia/arthralgia, mild fever, N/V, abdominal pain, aversion to smoking, hepatosplenomegaly, dark urine, jaundice.
Cirrhosis causes – alcoholism (most common), nutritional deprivation, hepatitis.
Cholecystitis – inflammation of gallbladder (usually with gallstones).
Chronic pancreatitis – caused by ETOH (adults), cystic fibrosis (children).
LDL cholesterol – "bad" cholesterol; delivers plaque to arterial walls (100 mg/dL).
HDL cholesterol – "good" cholesterol; high protein, low fat.
GERD (Gastroesophageal Reflux Disease) – stomach acid or bile irritates food pipe lining.
Diabetes & Metabolism:
Type 1 diabetes – pancreatic cells fail to produce insulin; autoimmune destruction.
Type 2 diabetes – insulin resistance with impaired insulin utilization; often in obese adults.
Three P's of diabetes – Polyuria (excessive urination), Polydipsia (excessive thirst), Polyphagia (excessive hunger).
DKA (Diabetic Ketoacidosis) – hyperglycemia, hyperketonemia, metabolic acidosis; occurs mostly in type 1 diabetes; causes nausea, vomiting, abdominal pain; can progress to cerebral edema, coma, death.
DKA pathophysiology – hyperglycemia from insulin deficiency causes osmotic diuresis; urinary ketones cause sodium and potassium loss.
Why This Guide is Different:
200+ Actual Exam Questions – real NUR 6501 midterm content.
Verified Correct Answers (ANS....) – all answers A+ graded.
Walden University Specific – tailored to this exact course.
Quick Reference – perfect for last-minute review before exam day.
Content preview
ADVANCED PATHOPHYSIOLOGY MIDTERM 6501 WALDEN
UNIVERSITY EXAM QUESTIONS AND VERIFIED ANSWERS
|ALL GRADED A+
A runner has depleted all the oxygen available for muscle energy. Which of
the following will facilitate his continued muscle performance? - ANS.... -
Answer: Anaerobic glycolysis
What causes the rapid change in the resting membrane potential that
initiates an action potential? - ANS.... -Answer: Sodium gates open, and
sodium rushes into the cell, changing the membrane potential from
negative to positive.
A 12-year-old male is diagnosed with Klinefelter syndrome. His karyotype
would reveal which of the following? - ANS.... -Answer: XXY
A nurse is reviewing the pedigree chart. When checking for a proband,
what is the nurse looking for? - ANS.... -Answer: The person who is first
diagnosed with a genetic disease
An aide asks the nurse why people who have neurofibromatosis will show
varying degrees of the disease. Which genetic principle should the nurse
explain to the aide? - ANS.... -Answer: Expressivity
In teaching a patient with cirrhosis, which information should the nurse
include regarding cholesterol? - ANS.... -Answer: Cholesterol decreases
the membrane fluidity of the erythrocyte, which reduces its ability to carry
oxygen.
,When a patient asks what causes cystic fibrosis, how should the nurse
respond? Cystic fibrosis is caused by a _____ gene - ANS.... -Answer:
Autosomal recessive
How are potassium and sodium transported across plasma membranes? -
ANS.... -Answer: By adenosine triphosphate enzyme (ATPase)
The nurse would be correct in identifying the predominant extracellular
cation as: - ANS.... -Answer: Sodium
The early dilation (swelling) of the cell's endoplasmic reticulum results in: -
ANS.... -Answer: Reduced protein synthesis
What principle should the nurse remember when trying to distinguish aging
from diseases? - ANS.... -Answer: It is difficult to tell the difference because
both processes are believed to result from cell injury.
What is the diagnosis of a 13-year-old female who has a karyotype that
reveals an absent homologous X chromosome with only a single X
chromosome present? Her features include a short stature, widely spaced
nipples, reduced carrying angle at the elbow, and sparse body hair. -
ANS.... -Answer: Turner syndrome
A eukaryotic cell is undergoing DNA replication. In which region of the cell
would most of the genetic information be contained? - ANS.... -Answer:
Nucleolus
, The nurse is teaching staff about the most common cause of Down
syndrome. What is the nurse describing? - ANS.... -Answer: Maternal
nondisjunction
A 50-year-old male was recently diagnosed with Huntington disease.
Transmission of this disease is associated with: - ANS.... -Answer: Delayed
age of onset
A patient wants to know the risk factors for Down syndrome. What is the
nurse's best response? - ANS.... -Answer: Pregnancy in women over age
35
What is the role of cytokines in cell reproduction? - ANS.... -Answer:
Provide growth factor for tissue growth and development
A newborn male is diagnosed with albinism based on skin, eye, and hair
appearance. Which finding will support this diagnosis? - ANS.... -Answer:
Inability to convert tyrosine to DOPA (3,4 dihydroxyphenylalanine)
Sodium and water accumulation in an injured cell are a direct result of: -
ANS.... -Answer: Decreased ATP production
A nurse is reading a chart and sees the term oncotic pressure. The nurse
recalls that oncotic pressure (colloid osmotic pressure) is determined by: -
ANS.... -Answer: Plasma proteins
The ion transporter that moves Na + and Ca 2+ simultaneously in the same
direction is an example of which of the following types of transport? -
ANS.... -Answer: Symport