AGPCNP NURS6202 Advanced Pathophysiology
Midterm Exam Review 2026–2027 Comprehensive
Practice Questions with Verified Answers
1. Which of the following is the primary cause of chronic obstructive pulmonary disease
(COPD)?
A. Genetic predisposition
B. Air pollution
C. Smoking
D. Occupational exposure
Answer: C. Smoking
2. What is the primary pathophysiological mechanism of type 2 diabetes mellitus?
A. Autoimmune destruction of beta cells
B. Insulin resistance
C. Genetic mutations
D. Viral infection
Answer: B. Insulin resistance
3. Which of the following is a common complication of hypertension?
A. Osteoporosis
B. Chronic kidney disease
C. Asthma
D. Rheumatoid arthritis
Answer: B. Chronic kidney disease
4. In heart failure with reduced ejection fraction (HFrEF), the primary pathophysiological
abnormality is:
A. Impaired ventricular filling
B. Reduced cardiac output due to systolic dysfunction
C. Increased ventricular compliance
D. Elevated pulmonary capillary wedge pressure
Answer: B. Reduced cardiac output due to systolic dysfunction
,5. The most common cause of chronic liver disease in the United States is:
A. Hepatitis B
B. Hepatitis C
C. Alcoholic liver disease
D. Nonalcoholic fatty liver disease
Answer: D. Nonalcoholic fatty liver disease
6. Which of the following best describes the pathogenesis of atherosclerosis?
A. Smooth muscle cell proliferation in the intima
B. Deposition of calcium in the media
C. Accumulation of lipid-laden macrophages and fibrous tissue
D. Inflammation of the adventitia
Answer: C. Accumulation of lipid-laden macrophages and fibrous tissue
7. The classic triad of symptoms in Parkinson's disease includes:
A. Tremor, rigidity, and bradykinesia
B. Tremor, ataxia, and dysmetria
C. Rigidity, dystonia, and chorea
D. Bradykinesia, postural instability, and dysphagia
Answer: A. Tremor, rigidity, and bradykinesia
8. Which laboratory finding is most consistent with iron deficiency anemia?
A. Low serum ferritin, high total iron-binding capacity (TIBC)
B. High serum ferritin, low TIBC
C. Low serum iron, low ferritin, low TIBC
D. Normal ferritin, low TIBC
Answer: A. Low serum ferritin, high total iron-binding capacity (TIBC)
9. A patient with type 1 diabetes presents with nausea, vomiting, and fruity breath odor.
Which acid-base disturbance is most likely?
A. Metabolic acidosis with high anion gap
B. Metabolic acidosis with normal anion gap
C. Respiratory acidosis
D. Metabolic alkalosis
Answer: A. Metabolic acidosis with high anion gap
10. The most common cause of hyperthyroidism is:
A. Toxic multinodular goiter
, B. Graves' disease
C. Thyroiditis
D. Thyroid adenoma
Answer: B. Graves' disease
11. Which of the following is a hallmark finding in nephrotic syndrome?
A. Hematuria
B. Proteinuria >3.5 g/day
C. Hypertension
D. Elevated serum creatinine
Answer: B. Proteinuria >3.5 g/day
12. The primary pathophysiological defect in cystic fibrosis involves:
A. Defective chloride transport due to CFTR mutation
B. Impaired surfactant production
C. Excessive mucus secretion from goblet cells
D. Bronchial hyperreactivity
Answer: A. Defective chloride transport due to CFTR mutation
13. Which of the following is most commonly associated with peptic ulcer disease?
A. Helicobacter pylori infection
B. Excessive gastric acid secretion
C. NSAID use
D. Both A and C
Answer: D. Both A and C
14. In acute pancreatitis, the elevation of which enzyme is most specific?
A. Amylase
B. Lipase
C. Trypsin
D. Elastase
Answer: B. Lipase
15. The most common cause of community-acquired pneumonia in adults is:
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Haemophilus influenzae
, D. Legionella pneumophila
Answer: B. Streptococcus pneumoniae
16. Which of the following is a characteristic of malignant hypertension?
A. Diastolic BP > 120 mmHg with papilledema
B. Systolic BP > 180 mmHg with headache
C. Diastolic BP > 110 mmHg with retinal hemorrhages
D. Systolic BP > 200 mmHg with confusion
Answer: A. Diastolic BP > 120 mmHg with papilledema
17. The most common site of osteoporotic fractures is:
A. Hip
B. Spine (vertebral)
C. Wrist (distal radius)
D. Pelvis
Answer: B. Spine (vertebral)
18. In gout, the characteristic joint manifestation is caused by deposition of:
A. Calcium pyrophosphate crystals
B. Monosodium urate crystals
C. Hydroxyapatite crystals
D. Cholesterol crystals
Answer: B. Monosodium urate crystals
19. Which of the following is a classic sign of bacterial meningitis?
A. Kernig's sign
B. Brudzinski's sign
C. Photophobia
D. All of the above
Answer: D. All of the above
20. The most common pathogen causing urinary tract infections in community-dwelling
women is:
A. Klebsiella pneumoniae
B. Proteus mirabilis
C. Escherichia coli
D. Enterococcus faecalis
Answer: C. Escherichia coli
Midterm Exam Review 2026–2027 Comprehensive
Practice Questions with Verified Answers
1. Which of the following is the primary cause of chronic obstructive pulmonary disease
(COPD)?
A. Genetic predisposition
B. Air pollution
C. Smoking
D. Occupational exposure
Answer: C. Smoking
2. What is the primary pathophysiological mechanism of type 2 diabetes mellitus?
A. Autoimmune destruction of beta cells
B. Insulin resistance
C. Genetic mutations
D. Viral infection
Answer: B. Insulin resistance
3. Which of the following is a common complication of hypertension?
A. Osteoporosis
B. Chronic kidney disease
C. Asthma
D. Rheumatoid arthritis
Answer: B. Chronic kidney disease
4. In heart failure with reduced ejection fraction (HFrEF), the primary pathophysiological
abnormality is:
A. Impaired ventricular filling
B. Reduced cardiac output due to systolic dysfunction
C. Increased ventricular compliance
D. Elevated pulmonary capillary wedge pressure
Answer: B. Reduced cardiac output due to systolic dysfunction
,5. The most common cause of chronic liver disease in the United States is:
A. Hepatitis B
B. Hepatitis C
C. Alcoholic liver disease
D. Nonalcoholic fatty liver disease
Answer: D. Nonalcoholic fatty liver disease
6. Which of the following best describes the pathogenesis of atherosclerosis?
A. Smooth muscle cell proliferation in the intima
B. Deposition of calcium in the media
C. Accumulation of lipid-laden macrophages and fibrous tissue
D. Inflammation of the adventitia
Answer: C. Accumulation of lipid-laden macrophages and fibrous tissue
7. The classic triad of symptoms in Parkinson's disease includes:
A. Tremor, rigidity, and bradykinesia
B. Tremor, ataxia, and dysmetria
C. Rigidity, dystonia, and chorea
D. Bradykinesia, postural instability, and dysphagia
Answer: A. Tremor, rigidity, and bradykinesia
8. Which laboratory finding is most consistent with iron deficiency anemia?
A. Low serum ferritin, high total iron-binding capacity (TIBC)
B. High serum ferritin, low TIBC
C. Low serum iron, low ferritin, low TIBC
D. Normal ferritin, low TIBC
Answer: A. Low serum ferritin, high total iron-binding capacity (TIBC)
9. A patient with type 1 diabetes presents with nausea, vomiting, and fruity breath odor.
Which acid-base disturbance is most likely?
A. Metabolic acidosis with high anion gap
B. Metabolic acidosis with normal anion gap
C. Respiratory acidosis
D. Metabolic alkalosis
Answer: A. Metabolic acidosis with high anion gap
10. The most common cause of hyperthyroidism is:
A. Toxic multinodular goiter
, B. Graves' disease
C. Thyroiditis
D. Thyroid adenoma
Answer: B. Graves' disease
11. Which of the following is a hallmark finding in nephrotic syndrome?
A. Hematuria
B. Proteinuria >3.5 g/day
C. Hypertension
D. Elevated serum creatinine
Answer: B. Proteinuria >3.5 g/day
12. The primary pathophysiological defect in cystic fibrosis involves:
A. Defective chloride transport due to CFTR mutation
B. Impaired surfactant production
C. Excessive mucus secretion from goblet cells
D. Bronchial hyperreactivity
Answer: A. Defective chloride transport due to CFTR mutation
13. Which of the following is most commonly associated with peptic ulcer disease?
A. Helicobacter pylori infection
B. Excessive gastric acid secretion
C. NSAID use
D. Both A and C
Answer: D. Both A and C
14. In acute pancreatitis, the elevation of which enzyme is most specific?
A. Amylase
B. Lipase
C. Trypsin
D. Elastase
Answer: B. Lipase
15. The most common cause of community-acquired pneumonia in adults is:
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Haemophilus influenzae
, D. Legionella pneumophila
Answer: B. Streptococcus pneumoniae
16. Which of the following is a characteristic of malignant hypertension?
A. Diastolic BP > 120 mmHg with papilledema
B. Systolic BP > 180 mmHg with headache
C. Diastolic BP > 110 mmHg with retinal hemorrhages
D. Systolic BP > 200 mmHg with confusion
Answer: A. Diastolic BP > 120 mmHg with papilledema
17. The most common site of osteoporotic fractures is:
A. Hip
B. Spine (vertebral)
C. Wrist (distal radius)
D. Pelvis
Answer: B. Spine (vertebral)
18. In gout, the characteristic joint manifestation is caused by deposition of:
A. Calcium pyrophosphate crystals
B. Monosodium urate crystals
C. Hydroxyapatite crystals
D. Cholesterol crystals
Answer: B. Monosodium urate crystals
19. Which of the following is a classic sign of bacterial meningitis?
A. Kernig's sign
B. Brudzinski's sign
C. Photophobia
D. All of the above
Answer: D. All of the above
20. The most common pathogen causing urinary tract infections in community-dwelling
women is:
A. Klebsiella pneumoniae
B. Proteus mirabilis
C. Escherichia coli
D. Enterococcus faecalis
Answer: C. Escherichia coli
