NR 507 ADVANCED PATHOPHYSIOLOGY: COMPREHENSIVE 100-QUESTION MIDTERM REVIEW WITH RATIONALES – CHAMBERLAIN COLLEGE OF NURSING ||ALREADY GRADED A+ || MOST RECENT || NEWEST!!

NR 507 ADVANCED PATHOPHYSIOLOGY:
COMPREHENSIVE 100-QUESTION
MIDTERM REVIEW WITH RATIONALES –
CHAMBERLAIN COLLEGE OF NURSING
||ALREADY GRADED A+ || MOST RECENT ||
NEWEST!!
Question 1
A 58-year-old male with a history of hypertension presents with left-sided heart
failure. Which compensatory mechanism at the cellular level is primarily responsible
for the increased thickness of his left ventricular wall?
A. Hyperplasia
B. Metaplasia
C. Dysplasia
D. Hypertrophy

Rationale: The correct answer is D. Hypertrophy is an increase in the size of
individual cells in response to increased workload. Cardiac myocytes are terminally
differentiated and cannot divide (hyperplasia), so they enlarge to compensate for the
chronic pressure overload from hypertension.




Question 2
A patient with chronic gastroesophageal reflux disease (GERD) develops Barrett's
esophagus. This cellular adaptation is best described as:
A. Dysplasia
B. Hyperplasia
C. Atrophy
D. Metaplasia

Rationale: The correct answer is D. Metaplasia is the reversible replacement of one
differentiated cell type with another. In Barrett's esophagus, the normal stratified
squamous epithelium is replaced by intestinal columnar epithelium to better
withstand the chronic acid exposure.

,Question 3
A pathologist examining a section of myocardial tissue from a patient who suffered a
heart attack notes preserved cellular outlines but loss of the nuclei. This type of
necrosis is characteristic of:
A. Coagulative necrosis
B. Liquefactive necrosis
C. Caseous necrosis
D. Fat necrosis

Rationale: The correct answer is A. Coagulative necrosis is the hallmark of ischemic
injury in solid organs like the heart, kidneys, and spleen. The cell architecture is
preserved for several days, but the nuclei undergo karyolysis.




Question 4
A 45-year-old female presents with fatigue and pallor. Lab results show low serum
ferritin, low hemoglobin, and microcytic, hypochromic red blood cells. What is the
most likely underlying pathophysiologic mechanism?
A. Failure of the bone marrow to produce cells
B. Autoimmune destruction of RBCs
C. Vitamin B12 deficiency
D. Insufficient iron supply for heme synthesis

Rationale: The correct answer is D. Iron deficiency anemia is characterized by low
ferritin and microcytic/hypochromic cells. Without adequate iron, protoporphyrin
cannot combine with iron to form heme, leading to small, pale RBCs.




Question 5
A patient is diagnosed with pernicious anemia. Which lab finding would confirm this
diagnosis?
A. Elevated folic acid
B. Low serum iron
C. Elevated MCV with low ferritin
D. Low vitamin B12 with positive anti-intrinsic factor antibodies

Rationale: The correct answer is D. Pernicious anemia is caused by an autoimmune
destruction of gastric parietal cells or intrinsic factor, leading to B12 malabsorption.
Low B12 and anti-intrinsic factor antibodies confirm the diagnosis.

,Question 6
A patient with type 1 diabetes mellitus develops diabetic ketoacidosis (DKA). The
primary pathophysiologic cause of this condition is:
A. Excessive carbohydrate intake
B. Increased peripheral glucose uptake
C. Insulin resistance at the receptor site
D. Absolute insulin deficiency leading to increased lipolysis and ketogenesis

Rationale: The correct answer is D. In type 1 diabetes, absolute insulin deficiency
allows unopposed glucagon action, which stimulates lipolysis in adipose tissue. Free
fatty acids are shunted to the liver to form ketone bodies, causing metabolic acidosis.




Question 7
Which laboratory finding is most consistent with a diagnosis of primary
hypothyroidism?
A. Low TSH, elevated free T4
B. Low TSH, low free T4
C. Elevated TSH, elevated free T4
D. Elevated TSH, low free T4

Rationale: The correct answer is D. In primary hypothyroidism, the thyroid gland
itself fails to produce T4, so the pituitary secretes more TSH to compensate. This
results in an elevated TSH with a low free T4.




Question 8
A patient presents with heat intolerance, tachycardia, exophthalmos, and a diffuse
goiter. These signs are most consistent with:
A. Hashimoto thyroiditis
B. Graves disease
C. Myxedema coma
D. De Quervain thyroiditis

Rationale: The correct answer is B. Graves disease is an autoimmune hyperthyroid
condition caused by TSH receptor-stimulating antibodies. The antibodies mimic TSH,
causing unregulated thyroid hormone production, goiter, and exophthalmos.

, Question 9
A 6-month-old infant is brought to the ED with stridor, drooling, and respiratory
distress. The mother states the child has not received routine immunizations. Which
type of hypersensitivity reaction is causing this acute airway compromise?
A. Type II
B. Type III
C. Type IV
D. Type I

Rationale: The correct answer is D. The infant is presenting with acute epiglottitis or
laryngeal edema due to anaphylaxis (likely from a food or insect sting). Type I
hypersensitivity is IgE-mediated and involves mast cell degranulation, leading to
rapid bronchospasm and edema.




Question 10
A patient with Systemic Lupus Erythematosus (SLE) develops glomerulonephritis due
to immune complex deposition in the renal basement membrane. This is an example
of which hypersensitivity reaction?
A. Type I
B. Type II
C. Type IV
D. Type III

Rationale: The correct answer is D. Type III hypersensitivity is mediated by soluble
immune complexes (antigen-antibody) that deposit in tissues (like the renal
glomeruli or joints), activating the complement cascade and leading to inflammation
and tissue damage.




Question 11
Contact dermatitis caused by poison ivy is a classic example of which type of
hypersensitivity?
A. Type I
B. Type II
C. Type III
D. Type IV