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NUR2063 ESSENTIALS OF PATHOPHYSIOLOGY FINAL Original Exam
Questions with Answers and Rationales
1. A patient with chronic hypertension develops left
ventricular thickening. This is an example of which cellular
adaptation?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Answer: B) Hypertrophy
Rationale: Hypertrophy is an increase in cell size, not number. In
chronic hypertension, the left ventricle pumps against higher
pressure, causing cardiac muscle cells to enlarge. Hyperplasia is
an increase in cell number; atrophy is a decrease in size;
metaplasia is a reversible change from one mature cell type to
another.
2. Which of the following is the first vascular response in acute
inflammation?
A) Vasodilation
B) Vasoconstriction
C) Increased capillary permeability
D) Leukocyte migration
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Answer: B) Vasoconstriction
Rationale: The immediate, transient response to injury is brief
arteriolar vasoconstriction, followed by vasodilation and
increased permeability. This initial constriction helps limit blood
loss, then inflammatory mediators cause the classic signs.
3. A patient presents with muscle weakness, cardiac
arrhythmias, and peaked T waves on ECG. Which electrolyte
imbalance is most likely?
A) Hypokalemia
B) Hyperkalemia
C) Hyponatremia
D) Hypocalcemia
Answer: B) Hyperkalemia
Rationale: Hyperkalemia causes peaked T waves, muscle
weakness, and can lead to fatal arrhythmias. Hypokalemia
causes flattened T waves and U waves; hyponatremia causes
neuro symptoms; hypocalcemia causes tetany and Chvostek’s
sign.
4. A patient with chronic obstructive pulmonary disease
(COPD) has an arterial blood gas showing pH 7.32, PaCO₂ 60
mmHg, HCO₃⁻ 30 mEq/L. This is interpreted as:
A) Metabolic acidosis
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B) Metabolic alkalosis
C) Respiratory acidosis with partial compensation
D) Respiratory alkalosis with partial compensation
Answer: C) Respiratory acidosis with partial compensation
Rationale: High PaCO₂ indicates respiratory acidosis
(hypoventilation). The pH is low (acidosis), and HCO₃⁻ is
elevated (30) as the kidneys attempt to compensate. If fully
compensated, pH would be near normal; here it is still acidotic,
so partial compensation.
5. Which immunoglobulin is primarily involved in Type I
hypersensitivity reactions?
A) IgA
B) IgG
C) IgM
D) IgE
Answer: D) IgE
Rationale: Type I hypersensitivity (e.g., anaphylaxis, allergic
rhinitis) is mediated by IgE antibodies bound to mast cells and
basophils, causing degranulation and release of histamine.
6. A patient with left-sided heart failure would most likely
exhibit which clinical finding?
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A) Peripheral edema
B) Jugular vein distention
C) Pulmonary crackles and dyspnea
D) Hepatomegaly
Answer: C) Pulmonary crackles and dyspnea
Rationale: Left heart failure causes blood to back up into the
lungs, leading to pulmonary congestion, crackles, and dyspnea.
Right heart failure causes systemic congestion (peripheral
edema, JVD, hepatomegaly).
7. The primary pathophysiologic mechanism of asthma is:
A) Destruction of alveolar walls
B) Chronic bronchial inflammation and hyperresponsiveness
C) Accumulation of thick mucus in the pancreas
D) Fibrosis of lung tissue
Answer: B) Chronic bronchial inflammation and
hyperresponsiveness
Rationale: Asthma is characterized by reversible airway
obstruction due to inflammation, bronchoconstriction, and
mucus production. Destruction of alveolar walls occurs in
emphysema; fibrosis in pulmonary fibrosis; thick mucus in cystic
fibrosis.
NUR2063 ESSENTIALS OF PATHOPHYSIOLOGY FINAL Original Exam
Questions with Answers and Rationales
1. A patient with chronic hypertension develops left
ventricular thickening. This is an example of which cellular
adaptation?
A) Hyperplasia
B) Hypertrophy
C) Atrophy
D) Metaplasia
Answer: B) Hypertrophy
Rationale: Hypertrophy is an increase in cell size, not number. In
chronic hypertension, the left ventricle pumps against higher
pressure, causing cardiac muscle cells to enlarge. Hyperplasia is
an increase in cell number; atrophy is a decrease in size;
metaplasia is a reversible change from one mature cell type to
another.
2. Which of the following is the first vascular response in acute
inflammation?
A) Vasodilation
B) Vasoconstriction
C) Increased capillary permeability
D) Leukocyte migration
,https://www.stuvia.com/user/performance
Answer: B) Vasoconstriction
Rationale: The immediate, transient response to injury is brief
arteriolar vasoconstriction, followed by vasodilation and
increased permeability. This initial constriction helps limit blood
loss, then inflammatory mediators cause the classic signs.
3. A patient presents with muscle weakness, cardiac
arrhythmias, and peaked T waves on ECG. Which electrolyte
imbalance is most likely?
A) Hypokalemia
B) Hyperkalemia
C) Hyponatremia
D) Hypocalcemia
Answer: B) Hyperkalemia
Rationale: Hyperkalemia causes peaked T waves, muscle
weakness, and can lead to fatal arrhythmias. Hypokalemia
causes flattened T waves and U waves; hyponatremia causes
neuro symptoms; hypocalcemia causes tetany and Chvostek’s
sign.
4. A patient with chronic obstructive pulmonary disease
(COPD) has an arterial blood gas showing pH 7.32, PaCO₂ 60
mmHg, HCO₃⁻ 30 mEq/L. This is interpreted as:
A) Metabolic acidosis
,https://www.stuvia.com/user/performance
B) Metabolic alkalosis
C) Respiratory acidosis with partial compensation
D) Respiratory alkalosis with partial compensation
Answer: C) Respiratory acidosis with partial compensation
Rationale: High PaCO₂ indicates respiratory acidosis
(hypoventilation). The pH is low (acidosis), and HCO₃⁻ is
elevated (30) as the kidneys attempt to compensate. If fully
compensated, pH would be near normal; here it is still acidotic,
so partial compensation.
5. Which immunoglobulin is primarily involved in Type I
hypersensitivity reactions?
A) IgA
B) IgG
C) IgM
D) IgE
Answer: D) IgE
Rationale: Type I hypersensitivity (e.g., anaphylaxis, allergic
rhinitis) is mediated by IgE antibodies bound to mast cells and
basophils, causing degranulation and release of histamine.
6. A patient with left-sided heart failure would most likely
exhibit which clinical finding?
, https://www.stuvia.com/user/performance
A) Peripheral edema
B) Jugular vein distention
C) Pulmonary crackles and dyspnea
D) Hepatomegaly
Answer: C) Pulmonary crackles and dyspnea
Rationale: Left heart failure causes blood to back up into the
lungs, leading to pulmonary congestion, crackles, and dyspnea.
Right heart failure causes systemic congestion (peripheral
edema, JVD, hepatomegaly).
7. The primary pathophysiologic mechanism of asthma is:
A) Destruction of alveolar walls
B) Chronic bronchial inflammation and hyperresponsiveness
C) Accumulation of thick mucus in the pancreas
D) Fibrosis of lung tissue
Answer: B) Chronic bronchial inflammation and
hyperresponsiveness
Rationale: Asthma is characterized by reversible airway
obstruction due to inflammation, bronchoconstriction, and
mucus production. Destruction of alveolar walls occurs in
emphysema; fibrosis in pulmonary fibrosis; thick mucus in cystic
fibrosis.
