2026/2027: 200 HIGH-YIELD PRACTICE
QUESTIONS, ANSWERS & RATIONALES |
COMPREHENSIVE STUDY GUIDE |GRADED A+
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1. A patient develops metabolic acidosis after prolonged diarrhea.
Which mechanism best explains the acid-base disturbance?
A. Excessive loss of bicarbonate
B. Excessive retention of bicarbonate
C. Increased removal of hydrogen ions by the lungs
D. Increased production of aldosterone
Answer: A. Excessive loss of bicarbonate
Rationale: Diarrhea can cause substantial gastrointestinal
bicarbonate loss. Reduced bicarbonate decreases the body's buffering
capacity and contributes to metabolic acidosis.
2. Which cellular adaptation occurs when a tissue increases the
size of existing cells in response to increased workload?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: B. Hypertrophy
Rationale: Hypertrophy is an increase in cell size. Hyperplasia
involves an increase in cell number, while atrophy involves decreased
cell size.
,3. Which finding is most characteristic of left-sided heart failure?
A. Pulmonary congestion
B. Peripheral venous obstruction
C. Ascites without pulmonary findings
D. Enlarged liver as the primary manifestation
Answer: A. Pulmonary congestion
Rationale: Left ventricular failure causes blood to back up into the
pulmonary circulation, producing pulmonary congestion, dyspnea,
and potentially pulmonary edema.
4. A patient with chronic obstructive pulmonary disease has
difficulty exhaling air. What pathophysiologic change primarily
contributes to this problem?
A. Increased airway resistance
B. Increased alveolar surface area
C. Increased pulmonary compliance from stronger elastic recoil
D. Increased diffusion capacity
Answer: A. Increased airway resistance
Rationale: COPD involves airflow limitation caused by airway
narrowing, inflammation, mucus production, and/or loss of elastic
recoil, making expiration difficult.
5. Which process is primarily responsible for the swelling
associated with acute inflammation?
A. Decreased vascular permeability
B. Increased vascular permeability
C. Decreased blood flow
D. Reduced movement of plasma proteins
,Answer: B. Increased vascular permeability
Rationale: Acute inflammation increases vascular permeability,
allowing fluid and plasma proteins to move into surrounding tissues
and contribute to edema.
6. Which hormone primarily increases blood glucose during
fasting by stimulating hepatic glucose production?
A. Insulin
B. Glucagon
C. Calcitonin
D. Aldosterone
Answer: B. Glucagon
Rationale: Glucagon is released by pancreatic alpha cells when blood
glucose falls. It promotes hepatic glycogenolysis and
gluconeogenesis, increasing circulating glucose.
7. A patient with severe dehydration develops prerenal acute
kidney injury. What is the primary initiating problem?
A. Reduced renal perfusion
B. Destruction of glomerular basement membranes
C. Urinary tract obstruction
D. Excessive renal blood flow
Answer: A. Reduced renal perfusion
Rationale: Prerenal kidney injury occurs when blood flow to the
kidneys decreases. Severe dehydration can substantially reduce
circulating volume and renal perfusion.
, 8. Which finding is most directly associated with increased
intracranial pressure?
A. Bradycardia with widening pulse pressure
B. Persistent hypotension with tachycardia
C. Increased bowel sounds
D. Increased peripheral edema
Answer: A. Bradycardia with widening pulse pressure
Rationale: Bradycardia and widening pulse pressure can occur as
components of the Cushing response associated with significantly
increased intracranial pressure.
9. What is the principal pathophysiologic problem in type 1
diabetes mellitus?
A. Excessive insulin secretion
B. Autoimmune destruction of pancreatic beta cells
C. Excessive glucagon receptor destruction
D. Increased cellular sensitivity to insulin
Answer: B. Autoimmune destruction of pancreatic beta cells
Rationale: Type 1 diabetes is characterized by destruction of
pancreatic beta cells, resulting in an absolute deficiency of insulin.
10. Which mechanism explains why anemia can cause fatigue and
weakness?
A. Increased oxygen delivery to tissues
B. Reduced oxygen-carrying capacity of blood
C. Increased hemoglobin production
D. Increased tissue oxygen extraction without limitation
Answer: B. Reduced oxygen-carrying capacity of blood