NSG 530 EXAM 4 ADVANCED PATHOPHYSIOLOGY –
WILKES ACTUAL QUESTIONS AND ANSWERS -
LATEST AND COMPLETE UPDATE WITH VERIFIED
SOLUTIONS – ASSURED PASS WITH ISTANT
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### 1. A 57-year-old male presents to his primary care provider for a red face,
hands, feet, ears, and headache and drowsiness. A blood smear reveals an
increased number of erythrocytes. This indicates:
- A) Leukemia
- B) Polycythemia vera (PV)
- C) Hemolytic anemia
- D) Thrombocytopenia
ANSWER: B) Polycythemia vera (PV)
- Explanation: Polycythemia vera is a myeloproliferative disorder characterized
by an increased number of erythrocytes (red blood cells). Symptoms such as facial
flushing and headaches can occur due to increased blood viscosity and
hypervolemia.
### 2. A 67-year-old female is admitted to the emergency department with a
diagnosis of polycythemia vera. Upon taking the history, the patient will most
likely report:
- A) Abdominal pain
- B) Chest pain
- C) Joint pain
- D) Blurred vision
ANSWER: B) Chest pain
, - Explanation: Patients with polycythemia vera often experience chest pain as a
result of increased blood viscosity, which can lead to altered hemodynamics and
ischemia.
### 3. Alpha and beta thalassemias are inherited disorders. They are considered:
- A) X-linked recessive
- B) Autosomal dominant
- C) Autosomal recessive
- D) Mitochondrial
ANSWER: C) Autosomal recessive
- Explanation: Both alpha and beta thalassemias are passed on through an
autosomal recessive inheritance pattern, requiring both parents to be carriers for a
child to express the disease.
### 4. What nutrient should the nurse encourage a woman in the early stages of
pregnancy to consume to prevent neural tube defects?
- A) Vitamin B12
- B) Folic acid
- C) Iron
- D) Calcium
ANSWER: B) Folic acid
- Explanation: Folic acid supplementation before and during early pregnancy is
essential to reduce the risk of neural tube defects, as it is critical for proper neural
development.
,### 5. Sickle cell disease is characterized by the presence of Hb S. A nurse is
trying to differentiate between Hb S and normal Hb. Which of the following amino
acids is present in Hb S and not present in normal Hb?
- A) Glutamic acid
- B) Valine
- C) Lysine
- D) Alanine
ANSWER: B) Valine
- Explanation: In sickle cell disease, the amino acid glutamic acid in the beta-
globulin chain is replaced by valine, which leads to abnormal hemoglobin structure
and function.
### 6. High blood glucose levels damage blood vessels in the kidneys, which over
time causes kidneys to become inefficient at filtering blood. The damage caused
then leads to a high level of what (upon testing)?
- A) Creatinine
- B) Urea
- C) Microalbuminuria in urine
- D) Glucose
ANSWER: C) Microalbuminuria in urine
- Explanation: Diabetic nephropathy is characterized by leakage of albumin into
urine, indicated by microalbuminuria, reflecting kidney damage caused by
prolonged high glucose levels.
### 7. One of the most important factors leading to insulin resistance and diabetes
is obesity. What are several important mechanisms that correlate with obesity that
cause these conditions?
, - A) Increase in leptin and decrease in ghrelin
- B) Alterations in insulin receptors, glucagon, adipokines, amylin, incretins, and
ghrelin
- C) Increase in thyroid hormones
- D) Decreased physical activity
ANSWER: B) Alterations in insulin receptors, glucagon, adipokines, amylin,
incretins, and ghrelin
- Explanation: Obesity leads to complex metabolic changes, including altered
secretion and action of hormones such as insulin and glucagon, which play critical
roles in glucose metabolism and insulin resistance.
### 8. When a patient asks what causes hyperglycemia in type 2 DM, how should
the nurse respond?
- A) Increased glucose production by the liver
- B) Hyperinsulinemia
- C) Decreased insulin sensitivity
- D) Increased carbohydrate intake
ANSWER: C) Decreased insulin sensitivity
- Explanation: In type 2 diabetes mellitus (DM), hyperglycemia is typically
caused by decreased insulin sensitivity, leading to inadequate glucose uptake by
tissues despite normal or elevated insulin levels.
### 9. Discuss the loss of beta cell insulin in type 2 DM:
- A) Increased beta cell mass and function
- B) Decreased beta cell mass and function
- C) Normal beta cell mass and function
WILKES ACTUAL QUESTIONS AND ANSWERS -
LATEST AND COMPLETE UPDATE WITH VERIFIED
SOLUTIONS – ASSURED PASS WITH ISTANT
DOWNLOAD PDF.
### 1. A 57-year-old male presents to his primary care provider for a red face,
hands, feet, ears, and headache and drowsiness. A blood smear reveals an
increased number of erythrocytes. This indicates:
- A) Leukemia
- B) Polycythemia vera (PV)
- C) Hemolytic anemia
- D) Thrombocytopenia
ANSWER: B) Polycythemia vera (PV)
- Explanation: Polycythemia vera is a myeloproliferative disorder characterized
by an increased number of erythrocytes (red blood cells). Symptoms such as facial
flushing and headaches can occur due to increased blood viscosity and
hypervolemia.
### 2. A 67-year-old female is admitted to the emergency department with a
diagnosis of polycythemia vera. Upon taking the history, the patient will most
likely report:
- A) Abdominal pain
- B) Chest pain
- C) Joint pain
- D) Blurred vision
ANSWER: B) Chest pain
, - Explanation: Patients with polycythemia vera often experience chest pain as a
result of increased blood viscosity, which can lead to altered hemodynamics and
ischemia.
### 3. Alpha and beta thalassemias are inherited disorders. They are considered:
- A) X-linked recessive
- B) Autosomal dominant
- C) Autosomal recessive
- D) Mitochondrial
ANSWER: C) Autosomal recessive
- Explanation: Both alpha and beta thalassemias are passed on through an
autosomal recessive inheritance pattern, requiring both parents to be carriers for a
child to express the disease.
### 4. What nutrient should the nurse encourage a woman in the early stages of
pregnancy to consume to prevent neural tube defects?
- A) Vitamin B12
- B) Folic acid
- C) Iron
- D) Calcium
ANSWER: B) Folic acid
- Explanation: Folic acid supplementation before and during early pregnancy is
essential to reduce the risk of neural tube defects, as it is critical for proper neural
development.
,### 5. Sickle cell disease is characterized by the presence of Hb S. A nurse is
trying to differentiate between Hb S and normal Hb. Which of the following amino
acids is present in Hb S and not present in normal Hb?
- A) Glutamic acid
- B) Valine
- C) Lysine
- D) Alanine
ANSWER: B) Valine
- Explanation: In sickle cell disease, the amino acid glutamic acid in the beta-
globulin chain is replaced by valine, which leads to abnormal hemoglobin structure
and function.
### 6. High blood glucose levels damage blood vessels in the kidneys, which over
time causes kidneys to become inefficient at filtering blood. The damage caused
then leads to a high level of what (upon testing)?
- A) Creatinine
- B) Urea
- C) Microalbuminuria in urine
- D) Glucose
ANSWER: C) Microalbuminuria in urine
- Explanation: Diabetic nephropathy is characterized by leakage of albumin into
urine, indicated by microalbuminuria, reflecting kidney damage caused by
prolonged high glucose levels.
### 7. One of the most important factors leading to insulin resistance and diabetes
is obesity. What are several important mechanisms that correlate with obesity that
cause these conditions?
, - A) Increase in leptin and decrease in ghrelin
- B) Alterations in insulin receptors, glucagon, adipokines, amylin, incretins, and
ghrelin
- C) Increase in thyroid hormones
- D) Decreased physical activity
ANSWER: B) Alterations in insulin receptors, glucagon, adipokines, amylin,
incretins, and ghrelin
- Explanation: Obesity leads to complex metabolic changes, including altered
secretion and action of hormones such as insulin and glucagon, which play critical
roles in glucose metabolism and insulin resistance.
### 8. When a patient asks what causes hyperglycemia in type 2 DM, how should
the nurse respond?
- A) Increased glucose production by the liver
- B) Hyperinsulinemia
- C) Decreased insulin sensitivity
- D) Increased carbohydrate intake
ANSWER: C) Decreased insulin sensitivity
- Explanation: In type 2 diabetes mellitus (DM), hyperglycemia is typically
caused by decreased insulin sensitivity, leading to inadequate glucose uptake by
tissues despite normal or elevated insulin levels.
### 9. Discuss the loss of beta cell insulin in type 2 DM:
- A) Increased beta cell mass and function
- B) Decreased beta cell mass and function
- C) Normal beta cell mass and function
