WALDEN UNIVERSITY
Master of Science in Nursing (MSN) Program
NURS 6501 Advanced Pathophysiology
Academic Year: 2026/2027
Midterm Examination – Comprehensive Question
Bank
NCLEX-style · 146 questions
Q1
Which blood test measures the percentage of red blood cells in the blood?
A. Hematocrit (Hct)
B. Hemoglobin (Hgb)
C. White blood cell count
D. Platelet count
correct Answer: A. Hematocrit (Hct)
Rationale:
Hematocrit (Hct) measures the percentage of red blood cells (RBCs) in the total blood volume.
Hemoglobin measures the oxygen-carrying protein within RBCs. White blood cell count and
platelet count measure different blood components.
, Q2
A patient with chronic inflammatory disease presents with anemia. Which type of anemia is
most associated with chronic inflammatory conditions?
A. Anemia of chronic disease
B. Iron deficiency anemia
C. Pernicious anemia
D. Aplastic anemia
correct Answer: A. Anemia of chronic disease
Rationale:
Anemia of chronic disease is associated with chronic inflammatory conditions such as rheumatoid
arthritis, infections, and malignancies. It is characterized by low serum iron, low total iron binding
capacity (TIBC), and normal to elevated ferritin due to increased hepcidin levels that sequester
iron.
Q3
What condition is characterized by the failure of bone marrow to produce blood cells?
A. Aplastic anemia
B. Sickle cell anemia
C. Beta-thalassemia major
D. Iron deficiency anemia
correct Answer: A. Aplastic anemia
Rationale:
Aplastic anemia is a condition where the bone marrow fails to produce sufficient blood cells,
including erythrocytes, leukocytes, and thrombocytes. This can be caused by autoimmune
destruction of stem cells, exposure to toxins, or viral infections. Sickle cell anemia, beta-
thalassemia, and iron deficiency anemia involve specific red blood cell abnormalities rather than
bone marrow failure.
, Q4
In sickle cell disease, what triggers red blood cells to become abnormally shaped and cause
hemolysis?
A. Hypoxemia, acidosis, dehydration, and low temperature
B. Hyperoxia and alkalosis
C. High glucose levels
D. Excessive iron intake
correct Answer: A. Hypoxemia, acidosis, dehydration, and low temperature
Rationale:
Sickle cell disease involves a genetic mutation in hemoglobin causing RBCs to sickle (become
crescent-shaped) under conditions of low oxygen (hypoxemia), acidosis, dehydration, and low
temperature. This sickling leads to hemolysis, vaso-occlusion, and tissue ischemia. The
pathophysiology involves chronic hemolysis and microvascular occlusions.
Q5
What is the most common anemia and nutritional disorder globally?
A. Iron deficiency anemia
B. Pernicious anemia
C. Folate deficiency anemia
D. Aplastic anemia
correct Answer: A. Iron deficiency anemia
Rationale:
Iron deficiency anemia is the most common anemia and nutritional disorder worldwide. It is
characterized by microcytic, hypochromic RBCs due to insufficient iron stores. Causes include
dietary deficiency, chronic blood loss, and increased iron requirements during growth or
pregnancy. Clinical manifestations include fatigue, pallor, glossitis, and angular stomatitis.
, Q6
Which laboratory finding is characteristic of iron deficiency anemia?
A. Low ferritin, low serum iron, high TIBC
B. High ferritin, low serum iron, low TIBC
C. Low ferritin, high serum iron, low TIBC
D. High ferritin, high serum iron, high TIBC
correct Answer: A. Low ferritin, low serum iron, high TIBC
Rationale:
Iron deficiency anemia is characterized by low serum ferritin (reflecting depleted iron stores), low
serum iron, and high total iron binding capacity (TIBC) (reflecting increased transferrin to bind
available iron). The percent saturation is also low. This pattern distinguishes it from anemia of
chronic disease where ferritin is normal to elevated.
Q7
What type of anemia is caused by vitamin B12 deficiency due to intrinsic factor absence?
A. Pernicious anemia
B. Folate deficiency anemia
C. Iron deficiency anemia
D. Aplastic anemia
correct Answer: A. Pernicious anemia
Rationale:
Pernicious anemia is a macrocytic anemia caused by vitamin B12 deficiency due to the absence of
intrinsic factor, which is necessary for B12 absorption in the ileum. This is often due to
autoimmune destruction of gastric parietal cells. It leads to megaloblastic anemia and
neurological symptoms.
Master of Science in Nursing (MSN) Program
NURS 6501 Advanced Pathophysiology
Academic Year: 2026/2027
Midterm Examination – Comprehensive Question
Bank
NCLEX-style · 146 questions
Q1
Which blood test measures the percentage of red blood cells in the blood?
A. Hematocrit (Hct)
B. Hemoglobin (Hgb)
C. White blood cell count
D. Platelet count
correct Answer: A. Hematocrit (Hct)
Rationale:
Hematocrit (Hct) measures the percentage of red blood cells (RBCs) in the total blood volume.
Hemoglobin measures the oxygen-carrying protein within RBCs. White blood cell count and
platelet count measure different blood components.
, Q2
A patient with chronic inflammatory disease presents with anemia. Which type of anemia is
most associated with chronic inflammatory conditions?
A. Anemia of chronic disease
B. Iron deficiency anemia
C. Pernicious anemia
D. Aplastic anemia
correct Answer: A. Anemia of chronic disease
Rationale:
Anemia of chronic disease is associated with chronic inflammatory conditions such as rheumatoid
arthritis, infections, and malignancies. It is characterized by low serum iron, low total iron binding
capacity (TIBC), and normal to elevated ferritin due to increased hepcidin levels that sequester
iron.
Q3
What condition is characterized by the failure of bone marrow to produce blood cells?
A. Aplastic anemia
B. Sickle cell anemia
C. Beta-thalassemia major
D. Iron deficiency anemia
correct Answer: A. Aplastic anemia
Rationale:
Aplastic anemia is a condition where the bone marrow fails to produce sufficient blood cells,
including erythrocytes, leukocytes, and thrombocytes. This can be caused by autoimmune
destruction of stem cells, exposure to toxins, or viral infections. Sickle cell anemia, beta-
thalassemia, and iron deficiency anemia involve specific red blood cell abnormalities rather than
bone marrow failure.
, Q4
In sickle cell disease, what triggers red blood cells to become abnormally shaped and cause
hemolysis?
A. Hypoxemia, acidosis, dehydration, and low temperature
B. Hyperoxia and alkalosis
C. High glucose levels
D. Excessive iron intake
correct Answer: A. Hypoxemia, acidosis, dehydration, and low temperature
Rationale:
Sickle cell disease involves a genetic mutation in hemoglobin causing RBCs to sickle (become
crescent-shaped) under conditions of low oxygen (hypoxemia), acidosis, dehydration, and low
temperature. This sickling leads to hemolysis, vaso-occlusion, and tissue ischemia. The
pathophysiology involves chronic hemolysis and microvascular occlusions.
Q5
What is the most common anemia and nutritional disorder globally?
A. Iron deficiency anemia
B. Pernicious anemia
C. Folate deficiency anemia
D. Aplastic anemia
correct Answer: A. Iron deficiency anemia
Rationale:
Iron deficiency anemia is the most common anemia and nutritional disorder worldwide. It is
characterized by microcytic, hypochromic RBCs due to insufficient iron stores. Causes include
dietary deficiency, chronic blood loss, and increased iron requirements during growth or
pregnancy. Clinical manifestations include fatigue, pallor, glossitis, and angular stomatitis.
, Q6
Which laboratory finding is characteristic of iron deficiency anemia?
A. Low ferritin, low serum iron, high TIBC
B. High ferritin, low serum iron, low TIBC
C. Low ferritin, high serum iron, low TIBC
D. High ferritin, high serum iron, high TIBC
correct Answer: A. Low ferritin, low serum iron, high TIBC
Rationale:
Iron deficiency anemia is characterized by low serum ferritin (reflecting depleted iron stores), low
serum iron, and high total iron binding capacity (TIBC) (reflecting increased transferrin to bind
available iron). The percent saturation is also low. This pattern distinguishes it from anemia of
chronic disease where ferritin is normal to elevated.
Q7
What type of anemia is caused by vitamin B12 deficiency due to intrinsic factor absence?
A. Pernicious anemia
B. Folate deficiency anemia
C. Iron deficiency anemia
D. Aplastic anemia
correct Answer: A. Pernicious anemia
Rationale:
Pernicious anemia is a macrocytic anemia caused by vitamin B12 deficiency due to the absence of
intrinsic factor, which is necessary for B12 absorption in the ileum. This is often due to
autoimmune destruction of gastric parietal cells. It leads to megaloblastic anemia and
neurological symptoms.
