NSG 530 Exam 1 Actual Exam V3 | NSG 530 Advanced
Pathophysiology (NSG530 Exam 1) | Wilkes University
1. A 55-year-old male smoker undergoes a biopsy of the bronchial mucosa, which reveals a
change from ciliated columnar epithelium to stratified squamous epithelium. Which cellular
adaptation is most likely represented here?
A. Atrophy
B. Metaplasia
C. Hyperplasia
D. Dysplasia
Answer: B
Rationale: Metaplasia is the reversible replacement of one mature cell type by another
adult cell type, often as an adaptive response to chronic irritation. In the respiratory tract
of smokers, fragile ciliated columnar cells are replaced by tougher stratified squamous
cells. Although these new cells are more resilient to smoke, the loss of cilia impairs the
protective clearage of mucus.
2. During an ischemic event, the failure of the sodium-potassium (Na+/K+) pump leads to
which primary cellular consequence?
A. Intracellular dehydration
B. Cellular swelling and burst risk
C. Increased intracellular potassium
D. Decreased osmotic pressure
Answer: B
Rationale: Ischemia causes a decrease in ATP production, which is required to power the
Na+/K+ pump. When the pump fails, sodium accumulates inside the cell, creating an
osmotic gradient that pulls water into the cytoplasm. This results in acute cellular swelling,
also known as oncosis, which can eventually lead to membrane rupture.
3. A patient is diagnosed with an autosomal dominant disorder. If one parent is heterozygous
for the trait and the other is unaffected, what is the probability that their child will inherit the
disease?
A. 25%
B. 100%
C. 75%
,D. 50%
Answer: D
Rationale: In autosomal dominant inheritance, only one copy of the mutated gene is
necessary for the disease to manifest. A heterozygous parent has a 50% chance of passing
the dominant allele to each offspring. Because the other parent is unaffected (homozygous
recessive), the Punnett square yields a 1:1 ratio of affected to unaffected children.
4. Which process involves the programmed suicide of a cell without initiating an
inflammatory response in the surrounding tissue?
A. Necrosis
B. Apoptosis
C. Autophagy
D. Pyreptosis
Answer: B
Rationale: Apoptosis is a distinct, highly regulated process of cell death that occurs under
both physiological and pathological conditions. Unlike necrosis, which involves cell
swelling and membrane rupture, apoptosis leads to cell shrinkage and the formation of
apoptotic bodies. These bodies are quickly engulfed by phagocytes, preventing the release
of intracellular contents that would otherwise trigger inflammation.
5. A patient presents with a serum potassium level of 6.8 mEq/L. Which electrocardiogram
(ECG) change is most characteristic of this electrolyte imbalance?
A. Prominent U waves
B. Peaked T waves
C. ST-segment depression
D. Prolonged QT interval
Answer: B
Rationale: Hyperkalemia, defined as elevated serum potassium, significantly affects the
resting membrane potential of cardiac myocytes. Peaked T waves are often the earliest ECG
sign of hyperkalemia, reflecting accelerated repolarization. As levels rise further, the QRS
complex may widen and the P wave may disappear, eventually leading to a sine-wave
pattern and cardiac arrest.
6. A 40-year-old female presents with muscle spasms and a positive Chvostek sign. Which
electrolyte abnormality should the nurse practitioner suspect?
A. Hypermagnesemia
B. Hypocalcemia
, C. Hypernatremia
D. Hypokalemia
Answer: B
Rationale: The Chvostek sign, elicited by tapping the facial nerve, indicates increased
neuromuscular irritability. Hypocalcemia lowers the threshold for nerve excitation, leading
to spontaneous firing of motor nerves. This can manifest as muscle twitching, cramping,
and in severe cases, tetany or seizures.
7. What is the primary mechanism of edema in a patient with end-stage liver disease and low
serum albumin?
A. Increased capillary hydrostatic pressure
B. Lymphatic obstruction
C. Increased capillary permeability
D. Decreased capillary oncotic pressure
Answer: D
Rationale: Albumin is the primary protein responsible for maintaining plasma oncotic
pressure, which keeps fluid within the vascular space. In liver failure, albumin synthesis is
impaired, leading to a drop in oncotic pressure. Consequently, fluid moves from the
capillaries into the interstitial space, resulting in widespread edema and ascites.
8. An arterial blood gas (ABG) shows: pH 7.31, PaCO2 52 mmHg, and HCO3 26 mEq/L. How
would the nurse practitioner interpret these results?
A. Metabolic acidosis
B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Answer: B
Rationale: The pH is below 7.35, indicating acidosis. The PaCO2 is elevated (above 45
mmHg), which suggests a respiratory cause for the low pH. Since the bicarbonate is within
or near the normal range, this indicates an acute or partially compensated respiratory
acidosis, likely due to hypoventilation.
9. Which immunoglobulin is the first to be produced during the primary immune response to
an antigen?
A. IgG
B. IgA
Pathophysiology (NSG530 Exam 1) | Wilkes University
1. A 55-year-old male smoker undergoes a biopsy of the bronchial mucosa, which reveals a
change from ciliated columnar epithelium to stratified squamous epithelium. Which cellular
adaptation is most likely represented here?
A. Atrophy
B. Metaplasia
C. Hyperplasia
D. Dysplasia
Answer: B
Rationale: Metaplasia is the reversible replacement of one mature cell type by another
adult cell type, often as an adaptive response to chronic irritation. In the respiratory tract
of smokers, fragile ciliated columnar cells are replaced by tougher stratified squamous
cells. Although these new cells are more resilient to smoke, the loss of cilia impairs the
protective clearage of mucus.
2. During an ischemic event, the failure of the sodium-potassium (Na+/K+) pump leads to
which primary cellular consequence?
A. Intracellular dehydration
B. Cellular swelling and burst risk
C. Increased intracellular potassium
D. Decreased osmotic pressure
Answer: B
Rationale: Ischemia causes a decrease in ATP production, which is required to power the
Na+/K+ pump. When the pump fails, sodium accumulates inside the cell, creating an
osmotic gradient that pulls water into the cytoplasm. This results in acute cellular swelling,
also known as oncosis, which can eventually lead to membrane rupture.
3. A patient is diagnosed with an autosomal dominant disorder. If one parent is heterozygous
for the trait and the other is unaffected, what is the probability that their child will inherit the
disease?
A. 25%
B. 100%
C. 75%
,D. 50%
Answer: D
Rationale: In autosomal dominant inheritance, only one copy of the mutated gene is
necessary for the disease to manifest. A heterozygous parent has a 50% chance of passing
the dominant allele to each offspring. Because the other parent is unaffected (homozygous
recessive), the Punnett square yields a 1:1 ratio of affected to unaffected children.
4. Which process involves the programmed suicide of a cell without initiating an
inflammatory response in the surrounding tissue?
A. Necrosis
B. Apoptosis
C. Autophagy
D. Pyreptosis
Answer: B
Rationale: Apoptosis is a distinct, highly regulated process of cell death that occurs under
both physiological and pathological conditions. Unlike necrosis, which involves cell
swelling and membrane rupture, apoptosis leads to cell shrinkage and the formation of
apoptotic bodies. These bodies are quickly engulfed by phagocytes, preventing the release
of intracellular contents that would otherwise trigger inflammation.
5. A patient presents with a serum potassium level of 6.8 mEq/L. Which electrocardiogram
(ECG) change is most characteristic of this electrolyte imbalance?
A. Prominent U waves
B. Peaked T waves
C. ST-segment depression
D. Prolonged QT interval
Answer: B
Rationale: Hyperkalemia, defined as elevated serum potassium, significantly affects the
resting membrane potential of cardiac myocytes. Peaked T waves are often the earliest ECG
sign of hyperkalemia, reflecting accelerated repolarization. As levels rise further, the QRS
complex may widen and the P wave may disappear, eventually leading to a sine-wave
pattern and cardiac arrest.
6. A 40-year-old female presents with muscle spasms and a positive Chvostek sign. Which
electrolyte abnormality should the nurse practitioner suspect?
A. Hypermagnesemia
B. Hypocalcemia
, C. Hypernatremia
D. Hypokalemia
Answer: B
Rationale: The Chvostek sign, elicited by tapping the facial nerve, indicates increased
neuromuscular irritability. Hypocalcemia lowers the threshold for nerve excitation, leading
to spontaneous firing of motor nerves. This can manifest as muscle twitching, cramping,
and in severe cases, tetany or seizures.
7. What is the primary mechanism of edema in a patient with end-stage liver disease and low
serum albumin?
A. Increased capillary hydrostatic pressure
B. Lymphatic obstruction
C. Increased capillary permeability
D. Decreased capillary oncotic pressure
Answer: D
Rationale: Albumin is the primary protein responsible for maintaining plasma oncotic
pressure, which keeps fluid within the vascular space. In liver failure, albumin synthesis is
impaired, leading to a drop in oncotic pressure. Consequently, fluid moves from the
capillaries into the interstitial space, resulting in widespread edema and ascites.
8. An arterial blood gas (ABG) shows: pH 7.31, PaCO2 52 mmHg, and HCO3 26 mEq/L. How
would the nurse practitioner interpret these results?
A. Metabolic acidosis
B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Answer: B
Rationale: The pH is below 7.35, indicating acidosis. The PaCO2 is elevated (above 45
mmHg), which suggests a respiratory cause for the low pH. Since the bicarbonate is within
or near the normal range, this indicates an acute or partially compensated respiratory
acidosis, likely due to hypoventilation.
9. Which immunoglobulin is the first to be produced during the primary immune response to
an antigen?
A. IgG
B. IgA
