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NURS 5315 – ADVANCED PATHOPHYSIOLOGY
EXAM 3 (UTA) – ACTUAL EXAM 2026
180 Case-Based Questions with Correct Correct Answers &
Rationales80 Questions with Correct Answers and Rationales|
GAURANTEED PASS WITH 70+ TEST BANK QUESTIONS 2026
CARRICULUM VERRIFIED TEST INSTANT PDF DOWNLOAD
1. A 68-year-old man with stage 4 CKD (eGFR 22 mL/min) presents
with fatigue, pallor, and dyspnea on exertion. Hb 8.5 g/dL, MCV 82 fL,
serum ferritin 500 ng/mL, TSAT 12%, serum creatinine 3.2 mg/dL.
What is the primary pathophysiologic mechanism of his anemia?
A) Absolute iron deficiency from poor intake
B) Erythropoietin deficiency with functional iron deficiency
C) Vitamin B12 malabsorption
D) Chronic hemolysis Correct Answer: B – In CKD, EPO production is
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inadequate. High ferritin with low TSAT indicates functional iron
deficiency due to hepcidin-mediated iron sequestration, not true
deficiency.
2. A 28-year-old pregnant woman at 12 weeks gestation has a history
of three first-trimester miscarriages and one DVT. Labs: aPTT 62 sec
(normal 26–36), mixing study does not correct, anti-beta-2
glycoprotein I antibodies positive. What is the most likely diagnosis?
A) Factor V Leiden mutation
B) Antiphospholipid syndrome
C) Protein S deficiency
D) Hemophilia A carrier
Correct Answer: B – Antiphospholipid syndrome causes thrombosis
and pregnancy loss. Lupus anticoagulant prolongs aPTT that does
not correct with mixing due to an inhibitor.
3. A 24-year-old African American man with sickle cell disease
(HbSS) presents with severe chest pain, fever (39°C), hypoxemia
(SpO2 88%), and a new right lower lobe infiltrate on CXR. Which
pathophysiologic process most directly causes acute chest
syndrome?
A) Fat embolism from bone marrow necrosis
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B) Intravascular hemolysis with nitric oxide scavenging
C) Bacterial pneumonia from encapsulated organisms
D) Pulmonary artery thrombosis
Correct Answer: B – Acute chest syndrome is driven by hemolysis →
free hemoglobin scavenges NO → pulmonary vasoconstriction + in
situ thrombosis + ventilation-perfusion mismatch.
4. A 55-year-old woman with rheumatoid arthritis on methotrexate
presents with fatigue and pallor. Hb 9.0 g/dL, MCV 105 fL, B12 450
pg/mL (normal 200–900), folate 2.0 ng/mL (normal >5.0). What is the
most likely mechanism?
A) Autoimmune destruction of gastric parietal cells
B) Methotrexate-induced folate antagonism
C) Chronic disease anemia
D) Iron deficiency from GI blood loss
Correct Answer: B – Methotrexate inhibits dihydrofolate reductase,
leading to folate deficiency and megaloblastic anemia.
5. A 72-year-old man with chronic lymphocytic leukemia (CLL)
presents with sudden-onset confusion, jaundice, dark urine, and Hb
drop from 11 to 6 g/dL over 24 hours. Direct Coombs test positive.
What is the mechanism?
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A) Cold agglutinin-mediated hemolysis
B) Warm autoimmune hemolytic anemia
C) Microangiopathic hemolytic anemia
D) Hypersplenism
Correct Answer: B – CLL is associated with warm AIHA (IgG
antibodies against RBCs), causing extravascular hemolysis. Direct
Coombs positive.
6. A 45-year-old woman with recurrent DVT and PE has normal aPTT,
PT, fibrinogen, and platelet count. Labs: low protein C activity,
normal protein S, normal antithrombin III. Genetic testing reveals a
point mutation in the PROC gene. What is the inheritance pattern?
A) Autosomal dominant with incomplete penetrance
B) Autosomal recessive
C) X-linked recessive
D) Mitochondrial
Correct Answer: A – Hereditary protein C deficiency is autosomal
dominant; heterozygotes have ~50% activity and increased
thrombosis risk.
7. A 30-year-old man presents with episodic abdominal pain,
jaundice, and dark urine after an upper respiratory infection. Labs:
NURS 5315 – ADVANCED PATHOPHYSIOLOGY
EXAM 3 (UTA) – ACTUAL EXAM 2026
180 Case-Based Questions with Correct Correct Answers &
Rationales80 Questions with Correct Answers and Rationales|
GAURANTEED PASS WITH 70+ TEST BANK QUESTIONS 2026
CARRICULUM VERRIFIED TEST INSTANT PDF DOWNLOAD
1. A 68-year-old man with stage 4 CKD (eGFR 22 mL/min) presents
with fatigue, pallor, and dyspnea on exertion. Hb 8.5 g/dL, MCV 82 fL,
serum ferritin 500 ng/mL, TSAT 12%, serum creatinine 3.2 mg/dL.
What is the primary pathophysiologic mechanism of his anemia?
A) Absolute iron deficiency from poor intake
B) Erythropoietin deficiency with functional iron deficiency
C) Vitamin B12 malabsorption
D) Chronic hemolysis Correct Answer: B – In CKD, EPO production is
,2|Page
inadequate. High ferritin with low TSAT indicates functional iron
deficiency due to hepcidin-mediated iron sequestration, not true
deficiency.
2. A 28-year-old pregnant woman at 12 weeks gestation has a history
of three first-trimester miscarriages and one DVT. Labs: aPTT 62 sec
(normal 26–36), mixing study does not correct, anti-beta-2
glycoprotein I antibodies positive. What is the most likely diagnosis?
A) Factor V Leiden mutation
B) Antiphospholipid syndrome
C) Protein S deficiency
D) Hemophilia A carrier
Correct Answer: B – Antiphospholipid syndrome causes thrombosis
and pregnancy loss. Lupus anticoagulant prolongs aPTT that does
not correct with mixing due to an inhibitor.
3. A 24-year-old African American man with sickle cell disease
(HbSS) presents with severe chest pain, fever (39°C), hypoxemia
(SpO2 88%), and a new right lower lobe infiltrate on CXR. Which
pathophysiologic process most directly causes acute chest
syndrome?
A) Fat embolism from bone marrow necrosis
,3|Page
B) Intravascular hemolysis with nitric oxide scavenging
C) Bacterial pneumonia from encapsulated organisms
D) Pulmonary artery thrombosis
Correct Answer: B – Acute chest syndrome is driven by hemolysis →
free hemoglobin scavenges NO → pulmonary vasoconstriction + in
situ thrombosis + ventilation-perfusion mismatch.
4. A 55-year-old woman with rheumatoid arthritis on methotrexate
presents with fatigue and pallor. Hb 9.0 g/dL, MCV 105 fL, B12 450
pg/mL (normal 200–900), folate 2.0 ng/mL (normal >5.0). What is the
most likely mechanism?
A) Autoimmune destruction of gastric parietal cells
B) Methotrexate-induced folate antagonism
C) Chronic disease anemia
D) Iron deficiency from GI blood loss
Correct Answer: B – Methotrexate inhibits dihydrofolate reductase,
leading to folate deficiency and megaloblastic anemia.
5. A 72-year-old man with chronic lymphocytic leukemia (CLL)
presents with sudden-onset confusion, jaundice, dark urine, and Hb
drop from 11 to 6 g/dL over 24 hours. Direct Coombs test positive.
What is the mechanism?
, 4|Page
A) Cold agglutinin-mediated hemolysis
B) Warm autoimmune hemolytic anemia
C) Microangiopathic hemolytic anemia
D) Hypersplenism
Correct Answer: B – CLL is associated with warm AIHA (IgG
antibodies against RBCs), causing extravascular hemolysis. Direct
Coombs positive.
6. A 45-year-old woman with recurrent DVT and PE has normal aPTT,
PT, fibrinogen, and platelet count. Labs: low protein C activity,
normal protein S, normal antithrombin III. Genetic testing reveals a
point mutation in the PROC gene. What is the inheritance pattern?
A) Autosomal dominant with incomplete penetrance
B) Autosomal recessive
C) X-linked recessive
D) Mitochondrial
Correct Answer: A – Hereditary protein C deficiency is autosomal
dominant; heterozygotes have ~50% activity and increased
thrombosis risk.
7. A 30-year-old man presents with episodic abdominal pain,
jaundice, and dark urine after an upper respiratory infection. Labs:
