NURS 5315 UTA Advanced Pathophysiology Exam 3 – Latest
Updated 2025–2026| Fully Solved | 75 Questions
1. In an advanced pathophysiology case involving prolonged tissue hypoxia and early reversible
cellular injury, which explanation is most accurate?
A. ATP depletion
B. nuclear fragmentation
C. lysosomal membrane rupture
D. irreversible plasma membrane disruption
Answer: A. ATP depletion
Rationale: Hypoxia first reduces oxidative phosphorylation and ATP production. ATP-dependent ion
pumps then fail, causing cellular swelling before irreversible membrane and nuclear injury occurs.
2. A clinician is linking the patient's findings to chronic systemic hypertension causing increased left
ventricular wall thickness. Which mechanism provides the best explanation?
A. myocyte hypertrophy
B. dysplasia
C. squamous metaplasia
D. myocyte hyperplasia
Answer: A. myocyte hypertrophy
Rationale: Adult cardiac myocytes have little capacity for division, so chronic pressure overload enlarges
existing cells, producing hypertrophy.
3. Which mechanism would most appropriately connect the clinical presentation with controlled
removal of damaged cells without a major inflammatory response?
A. liquefactive necrosis
B. gangrenous necrosis
C. coagulative necrosis
D. apoptosis
Answer: D. apoptosis
Rationale: Apoptosis is programmed cell death with membrane integrity largely preserved and cellular
fragments removed without the marked inflammation typical of necrosis.
4. In an advanced pathophysiology case involving replacement of bronchial ciliated columnar
epithelium by stratified squamous epithelium in a smoker, which explanation is most accurate?
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, A. anaplasia
B. hyperplasia
C. hypertrophy
D. metaplasia
Answer: D. metaplasia
Rationale: Metaplasia is a reversible substitution of one mature cell type for another that is more resistant
to chronic stress.
5. A clinician is linking the patient's findings to generalized edema in severe hypoalbuminemia.
Which mechanism provides the best explanation?
A. decreased plasma oncotic pressure
B. decreased capillary hydrostatic pressure
C. increased lymphatic drainage
D. increased plasma oncotic pressure
Answer: A. decreased plasma oncotic pressure
Rationale: Low serum albumin reduces the osmotic force that retains water in the vascular space,
promoting interstitial fluid accumulation.
6. Which mechanism would most appropriately connect the clinical presentation with neurologic
deterioration in severe acute hyponatremia?
A. increased serum osmolality
B. water movement into brain cells causing cerebral edema
C. osmotic water movement out of neurons
D. intracellular dehydration
Answer: B. water movement into brain cells causing cerebral edema
Rationale: Low extracellular sodium lowers serum osmolality, so water enters brain cells and can cause
cerebral edema, seizures, or herniation.
7. In an advanced pathophysiology case involving ECG changes associated with clinically important
hyperkalemia, which explanation is most accurate?
A. isolated prolonged QT interval
B. prominent U waves
C. tall peaked T waves
D. diffuse ST elevation
Answer: C. tall peaked T waves
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, Rationale: Hyperkalemia alters myocardial membrane depolarization and commonly produces peaked T
waves before more severe conduction abnormalities develop.
8. A clinician is linking the patient's findings to persistent vomiting with elevated serum
bicarbonate. Which mechanism provides the best explanation?
A. respiratory alkalosis with renal acid retention
B. metabolic alkalosis with compensatory hypoventilation
C. metabolic acidosis with hyperventilation
D. respiratory acidosis with bicarbonate loss
Answer: B. metabolic alkalosis with compensatory hypoventilation
Rationale: Loss of gastric hydrogen ions produces metabolic alkalosis; respiratory compensation retains
carbon dioxide through hypoventilation.
9. Which mechanism would most appropriately connect the clinical presentation with diabetic
ketoacidosis?
A. normal-anion-gap metabolic alkalosis
B. primary respiratory acidosis
C. high-anion-gap metabolic acidosis
D. primary respiratory alkalosis
Answer: C. high-anion-gap metabolic acidosis
Rationale: Accumulation of ketoacids consumes bicarbonate, producing a high-anion-gap metabolic
acidosis with compensatory hyperventilation.
10. In an advanced pathophysiology case involving activation of the renin-angiotensin-aldosterone
system after reduced renal perfusion, which explanation is most accurate?
A. reduced sympathetic activity
B. suppression of thirst and aldosterone
C. natriuresis and vasodilation
D. sodium retention and vasoconstriction
Answer: D. sodium retention and vasoconstriction
Rationale: Angiotensin II causes vasoconstriction and stimulates aldosterone, which increases renal
sodium and water retention.
11. A clinician is linking the patient's findings to first major leukocyte response in acute bacterial
inflammation. Which mechanism provides the best explanation?
A. plasma-cell predominance
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Updated 2025–2026| Fully Solved | 75 Questions
1. In an advanced pathophysiology case involving prolonged tissue hypoxia and early reversible
cellular injury, which explanation is most accurate?
A. ATP depletion
B. nuclear fragmentation
C. lysosomal membrane rupture
D. irreversible plasma membrane disruption
Answer: A. ATP depletion
Rationale: Hypoxia first reduces oxidative phosphorylation and ATP production. ATP-dependent ion
pumps then fail, causing cellular swelling before irreversible membrane and nuclear injury occurs.
2. A clinician is linking the patient's findings to chronic systemic hypertension causing increased left
ventricular wall thickness. Which mechanism provides the best explanation?
A. myocyte hypertrophy
B. dysplasia
C. squamous metaplasia
D. myocyte hyperplasia
Answer: A. myocyte hypertrophy
Rationale: Adult cardiac myocytes have little capacity for division, so chronic pressure overload enlarges
existing cells, producing hypertrophy.
3. Which mechanism would most appropriately connect the clinical presentation with controlled
removal of damaged cells without a major inflammatory response?
A. liquefactive necrosis
B. gangrenous necrosis
C. coagulative necrosis
D. apoptosis
Answer: D. apoptosis
Rationale: Apoptosis is programmed cell death with membrane integrity largely preserved and cellular
fragments removed without the marked inflammation typical of necrosis.
4. In an advanced pathophysiology case involving replacement of bronchial ciliated columnar
epithelium by stratified squamous epithelium in a smoker, which explanation is most accurate?
Page 1
, A. anaplasia
B. hyperplasia
C. hypertrophy
D. metaplasia
Answer: D. metaplasia
Rationale: Metaplasia is a reversible substitution of one mature cell type for another that is more resistant
to chronic stress.
5. A clinician is linking the patient's findings to generalized edema in severe hypoalbuminemia.
Which mechanism provides the best explanation?
A. decreased plasma oncotic pressure
B. decreased capillary hydrostatic pressure
C. increased lymphatic drainage
D. increased plasma oncotic pressure
Answer: A. decreased plasma oncotic pressure
Rationale: Low serum albumin reduces the osmotic force that retains water in the vascular space,
promoting interstitial fluid accumulation.
6. Which mechanism would most appropriately connect the clinical presentation with neurologic
deterioration in severe acute hyponatremia?
A. increased serum osmolality
B. water movement into brain cells causing cerebral edema
C. osmotic water movement out of neurons
D. intracellular dehydration
Answer: B. water movement into brain cells causing cerebral edema
Rationale: Low extracellular sodium lowers serum osmolality, so water enters brain cells and can cause
cerebral edema, seizures, or herniation.
7. In an advanced pathophysiology case involving ECG changes associated with clinically important
hyperkalemia, which explanation is most accurate?
A. isolated prolonged QT interval
B. prominent U waves
C. tall peaked T waves
D. diffuse ST elevation
Answer: C. tall peaked T waves
Page 2
, Rationale: Hyperkalemia alters myocardial membrane depolarization and commonly produces peaked T
waves before more severe conduction abnormalities develop.
8. A clinician is linking the patient's findings to persistent vomiting with elevated serum
bicarbonate. Which mechanism provides the best explanation?
A. respiratory alkalosis with renal acid retention
B. metabolic alkalosis with compensatory hypoventilation
C. metabolic acidosis with hyperventilation
D. respiratory acidosis with bicarbonate loss
Answer: B. metabolic alkalosis with compensatory hypoventilation
Rationale: Loss of gastric hydrogen ions produces metabolic alkalosis; respiratory compensation retains
carbon dioxide through hypoventilation.
9. Which mechanism would most appropriately connect the clinical presentation with diabetic
ketoacidosis?
A. normal-anion-gap metabolic alkalosis
B. primary respiratory acidosis
C. high-anion-gap metabolic acidosis
D. primary respiratory alkalosis
Answer: C. high-anion-gap metabolic acidosis
Rationale: Accumulation of ketoacids consumes bicarbonate, producing a high-anion-gap metabolic
acidosis with compensatory hyperventilation.
10. In an advanced pathophysiology case involving activation of the renin-angiotensin-aldosterone
system after reduced renal perfusion, which explanation is most accurate?
A. reduced sympathetic activity
B. suppression of thirst and aldosterone
C. natriuresis and vasodilation
D. sodium retention and vasoconstriction
Answer: D. sodium retention and vasoconstriction
Rationale: Angiotensin II causes vasoconstriction and stimulates aldosterone, which increases renal
sodium and water retention.
11. A clinician is linking the patient's findings to first major leukocyte response in acute bacterial
inflammation. Which mechanism provides the best explanation?
A. plasma-cell predominance
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