EXAM 1
Advanced Pathophysiology
Actual Questions with Verified Answers
Wilkes University
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➢100 Exam Questions w/ Answers
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,Table of Contents
NSG 530 Exam 1 ........................................................................ 2
NSG 530 Exam 1 Study Guide ............................................42
NSG 530 Exam 1
1. A 45-year-old patient presents with chronic fatigue. Laboratory studies reveal
decreased ATP production. The nurse practitioner understands that ATP is
primarily generated in which cellular organelle through aerobic respiration?
A. Nucleus
B. Mitochondria
C. Ribosomes
D. Golgi apparatus
Correct Answer: B
Rationale: Mitochondria are the 'power plants' of the cell, generating ATP through
aerobic respiration where glucose and oxygen combine. The nucleus contains DNA and
controls cell activity; ribosomes synthesize proteins; the Golgi apparatus processes and
packages proteins and lipids.
2. A nursing student is reviewing cell structure. Which statement correctly
describes the function of the nucleus?
A. It synthesizes proteins for cellular function
, B. It contains all DNA and controls cell activity
C. It generates ATP through aerobic respiration
D. It breaks down toxins to protect the cell
Correct Answer: B
Rationale: The nucleus contains all of the cell's DNA and controls cell activity. Protein
synthesis occurs at ribosomes, ATP generation occurs in mitochondria, and toxin
breakdown occurs in peroxisomes.
3. A patient with liver disease has impaired drug metabolism. The nurse
understands that drug detoxification primarily occurs in which cellular structure?
A. Rough endoplasmic reticulum
B. Smooth endoplasmic reticulum
C. Lysosomes
D. Peroxisomes
Correct Answer: B
Rationale: The smooth endoplasmic reticulum synthesizes lipids and participates in
drug detoxification. The rough ER is involved in protein production, lysosomes break
down cell products, and peroxisomes break down toxins.
4. A 62-year-old patient with chronic obstructive pulmonary disease (COPD) has
impaired ciliary function in the respiratory tract. The nurse recognizes that cilia
primarily function to:
A. Generate ATP for cellular energy
B. Move substances along and act as a filter
C. Synthesize proteins for tissue repair
D. Break down foreign bodies in the alveoli
Correct Answer: B
Rationale: Cilia help move substances along surfaces and act as filters, such as in the
respiratory tract where they help clear mucus and debris. ATP generation occurs in
,mitochondria, protein synthesis at ribosomes, and foreign body breakdown in
lysosomes.
CASE: A 28-year-old male patient is diagnosed with infertility. Semen analysis
reveals immotile sperm. The nurse practitioner understands that the structural
defect most likely involves which cellular component?
5. Which cellular component is most likely defective?
A. Cilia
B. Flagellum
C. Microvilli
D. Lysosomes
Correct Answer: B
Rationale: The flagellum is only found in sperm and helps the sperm move forward.
Cilia are found in respiratory and other tracts; microvilli increase surface area for
absorption; lysosomes break down cellular waste.
6. A patient receiving intravenous fluids develops peripheral edema. The nurse
understands that this fluid shift is best explained by which transport mechanism?
A. Active transport requiring ATP
B. Diffusion of solutes from high to low concentration
C. Osmosis of water across a semipermeable membrane
D. Facilitated diffusion using carrier molecules
Correct Answer: C
Rationale: Osmosis is the movement of water or another solvent across a cellular
membrane from an area of low solute concentration to an area of high solute
concentration. In IV fluid administration, increased hydrostatic pressure or altered
osmotic gradients can cause water movement into interstitial spaces, resulting in edema.
7. A nurse is caring for a patient with hyponatremia. The sodium-potassium pump
is critical for maintaining electrolyte balance. Which statement best describes this
pump's function?
, A. It moves sodium and potassium down their concentration gradients
B. It helps re-establish proper Na+ and K+ concentrations inside and outside the cell
using ATP
C. It allows passive diffusion of both ions across the membrane
D. It breaks down ATP to release energy for cellular metabolism
Correct Answer: B
Rationale: The sodium-potassium pump is an example of active transport that uses ATP
to move sodium out of the cell and potassium into the cell against their concentration
gradients, helping re-establish proper concentrations. This maintains the resting
membrane potential essential for nerve and muscle function.
8. A patient with diabetes mellitus has elevated blood glucose. The nurse
understands that glucose enters most cells through which transport mechanism?
A. Simple diffusion across the lipid bilayer
B. Facilitated diffusion using carrier molecules
C. Active transport requiring ATP hydrolysis
D. Endocytosis of glucose molecules
Correct Answer: B
Rationale: Glucose is too large to pass through the lipid bilayer by simple diffusion. It
enters most cells via facilitated diffusion using glucose transporters (GLUT proteins),
which are carrier molecules that assist movement without requiring ATP. Active transport
is used for ions like Na+ and K+.
9. A macrophage engulfs a bacterial pathogen. This cellular process is best
described as:
A. Exocytosis
B. Phagocytosis, a form of endocytosis
C. Pinocytosis
D. Facilitated diffusion
Correct Answer: B
,Rationale: Phagocytosis ('cell eating') is a form of endocytosis involving the engulfing of
solid particles such as bacteria. Exocytosis releases materials from cells; pinocytosis
involves fluid uptake; facilitated diffusion moves substances across membranes using
carriers.
10. A patient with mitochondrial myopathy has muscle weakness and fatigue. The
pathophysiology is most directly related to impaired:
A. Protein synthesis
B. ATP production through aerobic respiration
C. Lipid metabolism in the smooth ER
D. DNA replication in the nucleus
Correct Answer: B
Rationale: Mitochondrial myopathy results from defects in mitochondrial function,
impairing ATP production through aerobic respiration. The mitochondria combine
glucose and oxygen to form ATP, which provides cellular energy. Impaired ATP
production directly causes muscle weakness and fatigue.
11. During strenuous exercise, a patient experiences muscle pain and fatigue. The
nurse understands that anaerobic respiration produces which byproduct?
A. Carbon dioxide and water
B. Lactic acid
C. Urea
D. Ketone bodies
Correct Answer: B
Rationale: Anaerobic respiration involves glycolysis, breaking glucose into pyruvate and
producing only 2 ATP molecules. The byproduct is lactic acid, which can cause muscle
pain, fatigue, metabolic acidosis, and in severe cases, kidney or respiratory failure.
Aerobic respiration produces CO2 and water.
CASE: A 55-year-old marathon runner collapses during a race and is brought to
the emergency department. Laboratory studies reveal severe metabolic acidosis
and elevated lactic acid levels.
,12. Which complication is the patient MOST at risk for developing?
A. Respiratory alkalosis
B. Kidney failure
C. Hyperglycemia
D. Thrombocytosis
Correct Answer: B
Rationale: Excessive lactic acid buildup from anaerobic respiration can lead to
metabolic acidosis, kidney failure, respiratory failure, and death. The acidic environment
damages renal tubules and impairs kidney function. Respiratory alkalosis would result
from hyperventilation, not lactic acidosis.
13. A nurse is reviewing the cytoplasm's composition with a student. The
cytoplasm contains all of the following EXCEPT:
A. Water and electrolytes
B. Suspended proteins and neutral fats
C. Glycogen, the stored form of glucose
D. DNA in its double-helix structure
Correct Answer: D
Rationale: The cytoplasm contains water, electrolytes, suspended proteins, neutral fats,
and glycogen (stored glucose). DNA in its double-helix structure is located within the
nucleus, not freely in the cytoplasm. The cytoplasm is the site of metabolic activity and
supports organelles.
14. The Golgi apparatus is often referred to as the 'UPS of the cell' because it:
A. Generates energy packages for cellular transport
B. Processes and packages proteins and lipids for distribution
C. Breaks down cellular waste products for recycling
D. Synthesizes new proteins from amino acids
Correct Answer: B
,Rationale: The Golgi apparatus processes and packages proteins and lipids, similar to
how UPS packages and ships items. Energy generation occurs in mitochondria; waste
breakdown in lysosomes; protein synthesis at ribosomes.
15. A patient with a genetic disorder has impaired protein synthesis. The nurse
understands that proteins are synthesized at which cellular structure?
A. Mitochondria
B. Ribosomes
C. Lysosomes
D. Peroxisomes
Correct Answer: B
Rationale: Ribosomes are the cellular structures responsible for protein synthesis. They
may be free in the cytoplasm or attached to the rough endoplasmic reticulum.
Mitochondria produce ATP, lysosomes break down waste, and peroxisomes detoxify
harmful substances.
16. A cell's semipermeable membrane allows it to maintain proper shape and
control transport. Which molecules can freely pass through this membrane?
A. Large proteins and polysaccharides
B. Fats and small molecules like oxygen
C. Ions such as sodium and potassium
D. Glucose and amino acids
Correct Answer: B
Rationale: The cell membrane has a phospholipid bilayer and protein receptors. Only
fats (lipid-soluble substances) and small molecules like oxygen can pass freely through
the lipid bilayer. Large proteins, ions, glucose, and amino acids require transport
mechanisms.
17. A patient with chronic alcohol use has liver damage. The nurse understands
that the smooth endoplasmic reticulum is involved in all of the following EXCEPT:
A. Lipid synthesis
, B. Drug detoxification
C. Protein production
D. Steroid hormone synthesis
Correct Answer: C
Rationale: The smooth endoplasmic reticulum synthesizes lipids, participates in drug
detoxification, and produces steroid hormones. Protein production is the function of the
rough endoplasmic reticulum, which has ribosomes attached to its surface.
18. A nurse is teaching a patient about cellular energy. Which two molecules must
combine to form ATP?
A. Carbon dioxide and water
B. Oxygen and glucose
C. Nitrogen and hydrogen
D. Sodium and potassium
Correct Answer: B
Rationale: Oxygen and glucose combine in the mitochondria to form ATP through
aerobic respiration. When we ingest food (glucose) and breathe in oxygen, the
mitochondria create ATP packets that provide cellular energy. CO2 and water are
byproducts, not reactants.
19. A patient with peroxisomal disorder has accumulated toxins in cells. The
nurse understands that peroxisomes primarily function to:
A. Synthesize proteins for cellular repair
B. Break down toxins to protect the cell
C. Package proteins for cellular export
D. Store glycogen for energy reserves
Correct Answer: B
Rationale: Peroxisomes break down toxins in cells to protect them from oxidative
damage. Protein synthesis occurs at ribosomes, packaging at the Golgi apparatus, and
glycogen storage in the cytoplasm.