NSG 5140 ADVANCED PATHOPHYSIOLOGY WEEK 5 MIDTERM
EXAM | 200 Practice Questions & Detailed Answers |
Respondus LockDown Browser + Webcam | A+ Graded
1. Which of the following is the primary mechanism of cellular injury in hypoxic conditions?
A. DNA mutation
B. ATP depletion leading to loss of ion homeostasis
C. Free radical formation
D. Protein misfolding
Correct Answer: B. Hypoxia impairs oxidative phosphorylation, leading to decreased ATP production.
The Na⁺/K⁺ ATPase pump requires ATP to maintain ion gradients; failure of this pump causes
intracellular sodium accumulation, water influx, and cellular swelling. This is the hallmark of hypoxic
cellular injury.
2. A patient with heart failure develops peripheral edema. Which hemodynamic force is primarily
increased in this condition?
A. Plasma oncotic pressure
B. Capillary hydrostatic pressure
C. Interstitial oncotic pressure
D. Lymphatic drainage
Correct Answer: B. Heart failure increases venous pressure, which raises capillary hydrostatic pressure.
This forces fluid out of the capillaries into the interstitial space, leading to peripheral edema.
,3. Which of the following best describes the pathophysiology of Type 1 Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells
C. Impaired glucose uptake due to receptor downregulation
D. Increased hepatic glucose production
Correct Answer: B. Type 1 Diabetes Mellitus is characterized by autoimmune destruction of pancreatic
beta cells, leading to absolute insulin deficiency.
4. A patient with severe sepsis is demonstrating signs of distributive shock. Which primary
hemodynamic alteration would you expect to observe?
A. Elevated systemic vascular resistance (SVR) and decreased cardiac output
B. Elevated pulmonary capillary wedge pressure (PCWP) and increased mixed venous oxygen saturation
C. Decreased systemic vascular resistance (SVR) and increased cardiac output
D. Decreased cardiac output and elevated central venous pressure (CVP)
Correct Answer: C. Distributive shock, such as septic shock, is characterized by profound vasodilation
leading to low SVR. The body initially compensates by increasing cardiac output.
5. What is the hallmark of reversible cellular injury?
A. Nuclear pyknosis
B. Cellular swelling and fatty change
,C. Karyolysis
D. Apoptotic body formation
Correct Answer: B. Cellular swelling (hydropic change) and fatty change are hallmark features of
reversible cellular injury. Nuclear changes such as pyknosis, karyolysis, and karyorrhexis indicate
irreversible injury and cell death.
6. Which intracellular organelle is known as the "powerhouse" of the cell due to its role in oxidative
phosphorylation?
A. Ribosome
B. Golgi apparatus
C. Mitochondria
D. Endoplasmic reticulum
Correct Answer: C. Mitochondria are responsible for oxidative phosphorylation and ATP production
through the electron transport chain.
7. A 68yearold patient with chronic heart failure presents with increased dyspnea and peripheral edema.
Assessment reveals a BNP of 900 pg/mL. Which mechanism best explains the physiologic response to
elevated BNP?
A. Systemic vasoconstriction to maintain organ perfusion
B. Inhibition of the reninangiotensinaldosterone system
C. Activation of sympathetic nervous system outflow
D. Renal retention of sodium and water to expand volume
, Correct Answer: B. BNP is released in response to ventricular stretch and functions to antagonize the
RAAS, promote natriuresis, and induce vasodilation.
8. Which type of hypersensitivity reaction is associated with a bee sting allergic response?
A. Type I
B. Type II
C. Type III
D. Type IV
Correct Answer: A. Type I hypersensitivity reactions are immediate allergic responses mediated by IgE
and mast cell degranulation. Bee sting reactions are classic examples of Type I hypersensitivity.
9. A patient is diagnosed with WiskottAldrich syndrome. Which assessment findings should the nurse
monitor for?
A. Increased IgM and bleeding
B. Decreased IgM and bleeding
C. Increased IgG and thrombosis
D. Decreased IgA and infection
Correct Answer: B. WiskottAldrich syndrome is characterized by decreased IgM, thrombocytopenia
(bleeding), and eczema.
EXAM | 200 Practice Questions & Detailed Answers |
Respondus LockDown Browser + Webcam | A+ Graded
1. Which of the following is the primary mechanism of cellular injury in hypoxic conditions?
A. DNA mutation
B. ATP depletion leading to loss of ion homeostasis
C. Free radical formation
D. Protein misfolding
Correct Answer: B. Hypoxia impairs oxidative phosphorylation, leading to decreased ATP production.
The Na⁺/K⁺ ATPase pump requires ATP to maintain ion gradients; failure of this pump causes
intracellular sodium accumulation, water influx, and cellular swelling. This is the hallmark of hypoxic
cellular injury.
2. A patient with heart failure develops peripheral edema. Which hemodynamic force is primarily
increased in this condition?
A. Plasma oncotic pressure
B. Capillary hydrostatic pressure
C. Interstitial oncotic pressure
D. Lymphatic drainage
Correct Answer: B. Heart failure increases venous pressure, which raises capillary hydrostatic pressure.
This forces fluid out of the capillaries into the interstitial space, leading to peripheral edema.
,3. Which of the following best describes the pathophysiology of Type 1 Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells
C. Impaired glucose uptake due to receptor downregulation
D. Increased hepatic glucose production
Correct Answer: B. Type 1 Diabetes Mellitus is characterized by autoimmune destruction of pancreatic
beta cells, leading to absolute insulin deficiency.
4. A patient with severe sepsis is demonstrating signs of distributive shock. Which primary
hemodynamic alteration would you expect to observe?
A. Elevated systemic vascular resistance (SVR) and decreased cardiac output
B. Elevated pulmonary capillary wedge pressure (PCWP) and increased mixed venous oxygen saturation
C. Decreased systemic vascular resistance (SVR) and increased cardiac output
D. Decreased cardiac output and elevated central venous pressure (CVP)
Correct Answer: C. Distributive shock, such as septic shock, is characterized by profound vasodilation
leading to low SVR. The body initially compensates by increasing cardiac output.
5. What is the hallmark of reversible cellular injury?
A. Nuclear pyknosis
B. Cellular swelling and fatty change
,C. Karyolysis
D. Apoptotic body formation
Correct Answer: B. Cellular swelling (hydropic change) and fatty change are hallmark features of
reversible cellular injury. Nuclear changes such as pyknosis, karyolysis, and karyorrhexis indicate
irreversible injury and cell death.
6. Which intracellular organelle is known as the "powerhouse" of the cell due to its role in oxidative
phosphorylation?
A. Ribosome
B. Golgi apparatus
C. Mitochondria
D. Endoplasmic reticulum
Correct Answer: C. Mitochondria are responsible for oxidative phosphorylation and ATP production
through the electron transport chain.
7. A 68yearold patient with chronic heart failure presents with increased dyspnea and peripheral edema.
Assessment reveals a BNP of 900 pg/mL. Which mechanism best explains the physiologic response to
elevated BNP?
A. Systemic vasoconstriction to maintain organ perfusion
B. Inhibition of the reninangiotensinaldosterone system
C. Activation of sympathetic nervous system outflow
D. Renal retention of sodium and water to expand volume
, Correct Answer: B. BNP is released in response to ventricular stretch and functions to antagonize the
RAAS, promote natriuresis, and induce vasodilation.
8. Which type of hypersensitivity reaction is associated with a bee sting allergic response?
A. Type I
B. Type II
C. Type III
D. Type IV
Correct Answer: A. Type I hypersensitivity reactions are immediate allergic responses mediated by IgE
and mast cell degranulation. Bee sting reactions are classic examples of Type I hypersensitivity.
9. A patient is diagnosed with WiskottAldrich syndrome. Which assessment findings should the nurse
monitor for?
A. Increased IgM and bleeding
B. Decreased IgM and bleeding
C. Increased IgG and thrombosis
D. Decreased IgA and infection
Correct Answer: B. WiskottAldrich syndrome is characterized by decreased IgM, thrombocytopenia
(bleeding), and eczema.
