,NSG 530 Advanced Pathophysiology – Wilkes
University | Complete Study Guide | Latest 2026–2027
Update | Instant PDF Download Already graded A+!!
1. A 65yearold male reports fatigue, pallor, and shortness of breath. His complete blood count
reveals pancytopenia with 40% blast cells. Which process best explains these findings?
A. Overproduction of platelets causing vessel occlusion
B. Crowding out of normal precursors in the bone marrow by abnormal blast cells
C. Autoimmune destruction of red blood cells in the spleen
D. Increased apoptosis of mature white blood cells in circulation
CORRECT ANSWER: B. Crowding out of normal precursors in the bone marrow by
abnormal blast cells
The patient's symptoms and pancytopenia in acute leukemia result from malignant blast cells
replacing normal bone marrow elements, inhibiting healthy hematopoiesis.
2. A community health nurse notes that 15 new cases of West Nile virus were reported in the
county this summer. Which term accurately describes this measure of disease?
A. Prevalence rate
B. Endemic index
C. Incidence rate
D. Pandemic proportion
CORRECT ANSWER: C. Incidence rate
Incidence measures newly diagnosed cases during a specific time period, conveying the risk of
contracting the disease, unlike prevalence which counts all existing cases.
3. A 70yearold female with a history of hypertension presents with a blood pressure of 180/110
mmHg after missing her medications for three days. Her body attempts to return to its ideal set
point. This process is best defined as:
A. Allostatic overload
B. Homeostasis
C. Exhaustion
D. Adaptation
CORRECT ANSWER: B. Homeostasis
Homeostasis is the state in which all systems are in balance around a particular ideal set
point, which the body attempts to maintain despite stressors.
4. A 45yearold male with chronic kidney disease has a serum potassium level of 6.8 mEq/L. How
does this electrolyte imbalance affect the resting membrane potential?
A. Hyperpolarizes the cell, making it more negative
B. Depolarizes the cell, making it less negative
C. No change because sodium dominates resting potential
D. It only affects action potential amplitude, not resting potential
,CORRECT ANSWER: B. Depolarizes the cell, making it less negative
Hyperkalemia depolarizes the resting membrane potential because the increased extracellular
K+ reduces the concentration gradient, making the inside less negative.
5. A 30yearold pregnant woman asks about the test that will evaluate her fetus for chromosomal
abnormalities at 16 weeks. Which procedure obtains amniotic fluid to culture fibroblasts?
A. Chorionic villus sampling
B. Fetal cells in maternal blood analysis
C. Amniocentesis
D. Wholegenome sequencing of maternal serum
CORRECT ANSWER: C. Amniocentesis
Amniocentesis performed around 16 weeks gestation obtains amniotic fluid containing fetal
fibroblasts for culture and chromosomal analysis.
6. A 55yearold male has had a persistent cough for 20 years due to smoking. A bronchial biopsy
shows replacement of normal ciliated columnar epithelium with stratified squamous epithelium.
This change is best described as:
A. Dysplasia
B. Hyperplasia
C. Metaplasia
D. Anaplasia
CORRECT ANSWER: C. Metaplasia
Metaplasia is the reversible replacement of one differentiated cell type with another better
suited to tolerate persistent injury, such as from chronic smoking.
7. A 6monthold infant of Ashkenazi Jewish descent presents with progressive motor
incoordination, lethargy, muscle flaccidity, and a cherryred spot on retinal exam. Which enzyme
deficiency is most likely?
A. Phenylalanine hydroxylase
B. Hexosaminidase A
C. CFTR chloride channel
D. Fibrillin 1
CORRECT ANSWER: B. Hexosaminidase A
TaySachs disease, common in Ashkenazi Jews, results from hexosaminidase A deficiency
causing ganglioside accumulation in neurons, with the cherryred spot being diagnostic.
8. A patient receives a bee sting and within 10 minutes develops hives, wheezing, and throat
constriction. Which immunoglobulin and cell type primarily mediate this reaction?
A. IgG and neutrophils
B. IgM and macrophages
C. IgE and mast cells
D. IgA and T lymphocytes
CORRECT ANSWER: C. IgE and mast cells
Type I immediate hypersensitivity is mediated by IgE binding to mast cells and basophils,
causing degranulation and release of histamine and other mediators.
, 9. A 25yearold male with tall stature, long arms and legs, long thin fingers, and a dilated aortic
root is diagnosed with a connective tissue disorder. This autosomal dominant condition is caused
by a mutation in which gene?
A. CFTR on chromosome 7
B. Fibrillin 1 on chromosome 15
C. Hexosaminidase A on chromosome 15
D. BRCA1 on chromosome 17
CORRECT ANSWER: B. Fibrillin 1 on chromosome 15
Marfan syndrome, an autosomal dominant disorder, results from fibrillin 1 gene mutation on
chromosome 15, causing weak connective tissue and aortic dilation risk.
10. A nursing student asks why a patient with cystic fibrosis produces thick secretions. The best
explanation involves a defect in which transmembrane protein?
A. Sodiumpotassium ATPase
B. CFTR chloride channel
C. Calcium voltagegated channel
D. Glucose transporter type 4
CORRECT ANSWER: B. CFTR chloride channel
Cystic fibrosis results from mutations in the CFTR chloride transporter, leading to defective
chloride transport and abnormally thick, dehydrated secretions.
11. A 72yearold male with a 50packyear smoking history has a lung biopsy showing cells with
large, hyperchromatic nuclei and loss of normal tissue architecture. The tumor has invaded local
lymph nodes. This cancer is best characterized as:
A. Benign with low malignant potential
B. Malignant due to invasive nature and anaplasia
C. Dysplastic but not cancerous
D. Metaplastic with reversible changes
CORRECT ANSWER: B. Malignant due to invasive nature and anaplasia
Malignant cancers are confirmed by their invasive or metastasizing nature and show
tissuespecific differentiation loss with anaplasia indicating aggressive potential.
12. A 4yearold child presents with fever, bone pain, bruising, and refusal to walk. A bone marrow
aspirate shows 45% lymphoblasts. Which leukemia is most likely?
A. Acute lymphoid leukemia
B. Chronic myeloid leukemia
C. Acute myeloid leukemia
D. Hairy cell leukemia
CORRECT ANSWER: A. Acute lymphoid leukemia
Acute lymphoblastic leukemia commonly presents in children with bone pain, bruising, fever,
and >20% lymphoblasts in the bone marrow aspirate.
13. A patient with systemic lupus erythematosus develops glomerulonephritis due to deposition
of antigenantibody complexes in the glomerular capillary wall. Which hypersensitivity type is
responsible?
University | Complete Study Guide | Latest 2026–2027
Update | Instant PDF Download Already graded A+!!
1. A 65yearold male reports fatigue, pallor, and shortness of breath. His complete blood count
reveals pancytopenia with 40% blast cells. Which process best explains these findings?
A. Overproduction of platelets causing vessel occlusion
B. Crowding out of normal precursors in the bone marrow by abnormal blast cells
C. Autoimmune destruction of red blood cells in the spleen
D. Increased apoptosis of mature white blood cells in circulation
CORRECT ANSWER: B. Crowding out of normal precursors in the bone marrow by
abnormal blast cells
The patient's symptoms and pancytopenia in acute leukemia result from malignant blast cells
replacing normal bone marrow elements, inhibiting healthy hematopoiesis.
2. A community health nurse notes that 15 new cases of West Nile virus were reported in the
county this summer. Which term accurately describes this measure of disease?
A. Prevalence rate
B. Endemic index
C. Incidence rate
D. Pandemic proportion
CORRECT ANSWER: C. Incidence rate
Incidence measures newly diagnosed cases during a specific time period, conveying the risk of
contracting the disease, unlike prevalence which counts all existing cases.
3. A 70yearold female with a history of hypertension presents with a blood pressure of 180/110
mmHg after missing her medications for three days. Her body attempts to return to its ideal set
point. This process is best defined as:
A. Allostatic overload
B. Homeostasis
C. Exhaustion
D. Adaptation
CORRECT ANSWER: B. Homeostasis
Homeostasis is the state in which all systems are in balance around a particular ideal set
point, which the body attempts to maintain despite stressors.
4. A 45yearold male with chronic kidney disease has a serum potassium level of 6.8 mEq/L. How
does this electrolyte imbalance affect the resting membrane potential?
A. Hyperpolarizes the cell, making it more negative
B. Depolarizes the cell, making it less negative
C. No change because sodium dominates resting potential
D. It only affects action potential amplitude, not resting potential
,CORRECT ANSWER: B. Depolarizes the cell, making it less negative
Hyperkalemia depolarizes the resting membrane potential because the increased extracellular
K+ reduces the concentration gradient, making the inside less negative.
5. A 30yearold pregnant woman asks about the test that will evaluate her fetus for chromosomal
abnormalities at 16 weeks. Which procedure obtains amniotic fluid to culture fibroblasts?
A. Chorionic villus sampling
B. Fetal cells in maternal blood analysis
C. Amniocentesis
D. Wholegenome sequencing of maternal serum
CORRECT ANSWER: C. Amniocentesis
Amniocentesis performed around 16 weeks gestation obtains amniotic fluid containing fetal
fibroblasts for culture and chromosomal analysis.
6. A 55yearold male has had a persistent cough for 20 years due to smoking. A bronchial biopsy
shows replacement of normal ciliated columnar epithelium with stratified squamous epithelium.
This change is best described as:
A. Dysplasia
B. Hyperplasia
C. Metaplasia
D. Anaplasia
CORRECT ANSWER: C. Metaplasia
Metaplasia is the reversible replacement of one differentiated cell type with another better
suited to tolerate persistent injury, such as from chronic smoking.
7. A 6monthold infant of Ashkenazi Jewish descent presents with progressive motor
incoordination, lethargy, muscle flaccidity, and a cherryred spot on retinal exam. Which enzyme
deficiency is most likely?
A. Phenylalanine hydroxylase
B. Hexosaminidase A
C. CFTR chloride channel
D. Fibrillin 1
CORRECT ANSWER: B. Hexosaminidase A
TaySachs disease, common in Ashkenazi Jews, results from hexosaminidase A deficiency
causing ganglioside accumulation in neurons, with the cherryred spot being diagnostic.
8. A patient receives a bee sting and within 10 minutes develops hives, wheezing, and throat
constriction. Which immunoglobulin and cell type primarily mediate this reaction?
A. IgG and neutrophils
B. IgM and macrophages
C. IgE and mast cells
D. IgA and T lymphocytes
CORRECT ANSWER: C. IgE and mast cells
Type I immediate hypersensitivity is mediated by IgE binding to mast cells and basophils,
causing degranulation and release of histamine and other mediators.
, 9. A 25yearold male with tall stature, long arms and legs, long thin fingers, and a dilated aortic
root is diagnosed with a connective tissue disorder. This autosomal dominant condition is caused
by a mutation in which gene?
A. CFTR on chromosome 7
B. Fibrillin 1 on chromosome 15
C. Hexosaminidase A on chromosome 15
D. BRCA1 on chromosome 17
CORRECT ANSWER: B. Fibrillin 1 on chromosome 15
Marfan syndrome, an autosomal dominant disorder, results from fibrillin 1 gene mutation on
chromosome 15, causing weak connective tissue and aortic dilation risk.
10. A nursing student asks why a patient with cystic fibrosis produces thick secretions. The best
explanation involves a defect in which transmembrane protein?
A. Sodiumpotassium ATPase
B. CFTR chloride channel
C. Calcium voltagegated channel
D. Glucose transporter type 4
CORRECT ANSWER: B. CFTR chloride channel
Cystic fibrosis results from mutations in the CFTR chloride transporter, leading to defective
chloride transport and abnormally thick, dehydrated secretions.
11. A 72yearold male with a 50packyear smoking history has a lung biopsy showing cells with
large, hyperchromatic nuclei and loss of normal tissue architecture. The tumor has invaded local
lymph nodes. This cancer is best characterized as:
A. Benign with low malignant potential
B. Malignant due to invasive nature and anaplasia
C. Dysplastic but not cancerous
D. Metaplastic with reversible changes
CORRECT ANSWER: B. Malignant due to invasive nature and anaplasia
Malignant cancers are confirmed by their invasive or metastasizing nature and show
tissuespecific differentiation loss with anaplasia indicating aggressive potential.
12. A 4yearold child presents with fever, bone pain, bruising, and refusal to walk. A bone marrow
aspirate shows 45% lymphoblasts. Which leukemia is most likely?
A. Acute lymphoid leukemia
B. Chronic myeloid leukemia
C. Acute myeloid leukemia
D. Hairy cell leukemia
CORRECT ANSWER: A. Acute lymphoid leukemia
Acute lymphoblastic leukemia commonly presents in children with bone pain, bruising, fever,
and >20% lymphoblasts in the bone marrow aspirate.
13. A patient with systemic lupus erythematosus develops glomerulonephritis due to deposition
of antigenantibody complexes in the glomerular capillary wall. Which hypersensitivity type is
responsible?
