MARYVILLE PATHO NURS 611 EXAM 4 ADVANCED
PATHOPHYSIOLOGY -COMPREHENSIVE FINAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
LATEST 2026-2027 (VERIFIED ANSWERS) ALREADY
GRADED A+
1. A patient develops cellular swelling shortly after an acute myocardial infarction. Which
pathophysiologic event is primarily responsible for this reversible injury?
A. Increased ATP production
B. Failure of the sodium-potassium ATPase pump due to ATP depletion
C. Increased protein synthesis
D. Excess collagen deposition
Answer: B. Failure of the sodium-potassium ATPase pump due to ATP depletion
Rationale: Ischemia rapidly decreases ATP production. Without adequate ATP, the sodium-
potassium ATPase pump fails, causing intracellular sodium and water accumulation, resulting
in cellular swelling (hydropic change), one of the earliest reversible manifestations of cell
injury.
2. Which adaptation occurs when skeletal muscle enlarges following resistance training?
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Hypertrophy
Answer: D. Hypertrophy
Rationale: Hypertrophy is an increase in cell size due to increased synthesis of structural
proteins and organelles. Skeletal muscle responds to increased workload primarily through
hypertrophy rather than hyperplasia.
3. Which laboratory finding is most consistent with metabolic acidosis?
,A. Elevated pH with elevated bicarbonate
B. Decreased pH and decreased bicarbonate concentration
C. Elevated pH with decreased PaCO₂
D. Elevated bicarbonate with elevated PaCO₂
Answer: B. Decreased pH and decreased bicarbonate concentration
Rationale: Metabolic acidosis is characterized by reduced bicarbonate levels, resulting in
decreased blood pH. Respiratory compensation typically occurs through hyperventilation to
lower PaCO₂.
4. Which electrolyte imbalance most commonly produces peaked T waves on an
electrocardiogram?
A. Hypokalemia
B. Hyponatremia
C. Hypocalcemia
D. Hyperkalemia
Answer: D. Hyperkalemia
Rationale: Hyperkalemia accelerates ventricular repolarization, producing tall, peaked T
waves. Severe hyperkalemia can progress to widened QRS complexes, ventricular
arrhythmias, and cardiac arrest.
5. A patient develops generalized edema due to nephrotic syndrome. Which mechanism is
primarily responsible?
A. Increased plasma oncotic pressure
B. Increased lymphatic drainage
C. Hypoalbuminemia resulting in decreased plasma oncotic pressure
D. Reduced capillary permeability
Answer: C. Hypoalbuminemia resulting in decreased plasma oncotic pressure
Rationale: Massive urinary protein loss lowers serum albumin concentration, reducing plasma
oncotic pressure and allowing fluid to move from the intravascular compartment into the
interstitial space.
6. Which hormone directly increases water reabsorption within the collecting ducts of the
kidneys?
A. Aldosterone
B. Renin
, C. Atrial natriuretic peptide
D. Antidiuretic hormone (ADH)
Answer: D. Antidiuretic hormone (ADH)
Rationale: ADH binds to V2 receptors in the collecting ducts, promoting insertion of
aquaporin-2 water channels into the luminal membrane and increasing water reabsorption.
7. Which acid-base disturbance is expected in a patient with severe diabetic ketoacidosis?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Answer: C. Metabolic acidosis
Rationale: Insulin deficiency leads to increased lipolysis and ketone body production.
Accumulation of ketoacids lowers blood pH and bicarbonate concentration, resulting in
metabolic acidosis.
8. A patient with chronic kidney disease develops normocytic anemia primarily because of
decreased production of:
A. Iron
B. Vitamin B12
C. Folate
D. Erythropoietin
Answer: D. Erythropoietin
Rationale: Diseased kidneys produce inadequate erythropoietin, reducing bone marrow
stimulation and resulting in normocytic, normochromic anemia.
9. Which mechanism contributes most to pulmonary edema in acute left ventricular failure?
A. Decreased pulmonary hydrostatic pressure
B. Increased plasma oncotic pressure
C. Elevated pulmonary capillary hydrostatic pressure
D. Reduced pulmonary blood flow
Answer: C. Elevated pulmonary capillary hydrostatic pressure
PATHOPHYSIOLOGY -COMPREHENSIVE FINAL EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS
LATEST 2026-2027 (VERIFIED ANSWERS) ALREADY
GRADED A+
1. A patient develops cellular swelling shortly after an acute myocardial infarction. Which
pathophysiologic event is primarily responsible for this reversible injury?
A. Increased ATP production
B. Failure of the sodium-potassium ATPase pump due to ATP depletion
C. Increased protein synthesis
D. Excess collagen deposition
Answer: B. Failure of the sodium-potassium ATPase pump due to ATP depletion
Rationale: Ischemia rapidly decreases ATP production. Without adequate ATP, the sodium-
potassium ATPase pump fails, causing intracellular sodium and water accumulation, resulting
in cellular swelling (hydropic change), one of the earliest reversible manifestations of cell
injury.
2. Which adaptation occurs when skeletal muscle enlarges following resistance training?
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Hypertrophy
Answer: D. Hypertrophy
Rationale: Hypertrophy is an increase in cell size due to increased synthesis of structural
proteins and organelles. Skeletal muscle responds to increased workload primarily through
hypertrophy rather than hyperplasia.
3. Which laboratory finding is most consistent with metabolic acidosis?
,A. Elevated pH with elevated bicarbonate
B. Decreased pH and decreased bicarbonate concentration
C. Elevated pH with decreased PaCO₂
D. Elevated bicarbonate with elevated PaCO₂
Answer: B. Decreased pH and decreased bicarbonate concentration
Rationale: Metabolic acidosis is characterized by reduced bicarbonate levels, resulting in
decreased blood pH. Respiratory compensation typically occurs through hyperventilation to
lower PaCO₂.
4. Which electrolyte imbalance most commonly produces peaked T waves on an
electrocardiogram?
A. Hypokalemia
B. Hyponatremia
C. Hypocalcemia
D. Hyperkalemia
Answer: D. Hyperkalemia
Rationale: Hyperkalemia accelerates ventricular repolarization, producing tall, peaked T
waves. Severe hyperkalemia can progress to widened QRS complexes, ventricular
arrhythmias, and cardiac arrest.
5. A patient develops generalized edema due to nephrotic syndrome. Which mechanism is
primarily responsible?
A. Increased plasma oncotic pressure
B. Increased lymphatic drainage
C. Hypoalbuminemia resulting in decreased plasma oncotic pressure
D. Reduced capillary permeability
Answer: C. Hypoalbuminemia resulting in decreased plasma oncotic pressure
Rationale: Massive urinary protein loss lowers serum albumin concentration, reducing plasma
oncotic pressure and allowing fluid to move from the intravascular compartment into the
interstitial space.
6. Which hormone directly increases water reabsorption within the collecting ducts of the
kidneys?
A. Aldosterone
B. Renin
, C. Atrial natriuretic peptide
D. Antidiuretic hormone (ADH)
Answer: D. Antidiuretic hormone (ADH)
Rationale: ADH binds to V2 receptors in the collecting ducts, promoting insertion of
aquaporin-2 water channels into the luminal membrane and increasing water reabsorption.
7. Which acid-base disturbance is expected in a patient with severe diabetic ketoacidosis?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Answer: C. Metabolic acidosis
Rationale: Insulin deficiency leads to increased lipolysis and ketone body production.
Accumulation of ketoacids lowers blood pH and bicarbonate concentration, resulting in
metabolic acidosis.
8. A patient with chronic kidney disease develops normocytic anemia primarily because of
decreased production of:
A. Iron
B. Vitamin B12
C. Folate
D. Erythropoietin
Answer: D. Erythropoietin
Rationale: Diseased kidneys produce inadequate erythropoietin, reducing bone marrow
stimulation and resulting in normocytic, normochromic anemia.
9. Which mechanism contributes most to pulmonary edema in acute left ventricular failure?
A. Decreased pulmonary hydrostatic pressure
B. Increased plasma oncotic pressure
C. Elevated pulmonary capillary hydrostatic pressure
D. Reduced pulmonary blood flow
Answer: C. Elevated pulmonary capillary hydrostatic pressure
