NUR 631 Advanced Physiology &
Pathophysiology Midterm 2026/2027 –
Practice Questions & Answers with Detailed
Rationales Guaranteed Pass (GRADED A+)
1. Which cellular adaptation occurs when a tissue increases
in cell size in response to increased workload?
A. Hyperplasia
B. Atrophy
C. Hypertrophy
D. Metaplasia
Rationale: Hypertrophy is an increase in individual cell size,
commonly occurring in tissues such as skeletal and cardiac
muscle when workload increases.
2. Which mechanism is primarily responsible for
maintaining the resting membrane potential of most cells?
A. Calcium influx
B. Potassium permeability and the sodium-potassium pump
C. Chloride secretion
D. Increased intracellular sodium
Rationale: The resting membrane potential is largely
determined by potassium concentration gradients and selective
membrane permeability, with the Na⁺/K⁺ ATPase maintaining
the underlying ion gradients.
,3. A patient develops metabolic acidosis. Which respiratory
response would normally occur?
A. Decreased respiratory rate
B. Hypoventilation
C. Increased ventilation
D. Complete respiratory suppression
Rationale: Increased ventilation removes carbon dioxide,
reducing carbonic acid and helping compensate for metabolic
acidosis.
4. Which finding is most characteristic of left-sided heart
failure?
A. Peripheral edema only
B. Hepatomegaly
C. Ascites
D. Pulmonary congestion
Rationale: Left ventricular dysfunction causes blood to back up
into the pulmonary circulation, producing pulmonary
congestion and potentially pulmonary edema.
5. What is the primary stimulus for aldosterone secretion?
A. Increased serum calcium
B. Angiotensin II and increased potassium concentration
,C. Decreased serum sodium alone
D. Increased atrial natriuretic peptide
Rationale: Aldosterone secretion is stimulated mainly by
angiotensin II and elevated plasma potassium. It promotes
sodium reabsorption and potassium excretion in the distal
nephron.
6. Which hormone increases blood glucose during fasting?
A. Insulin
B. Glucagon
C. Somatostatin
D. Calcitonin
Rationale: Glucagon promotes hepatic glycogenolysis and
gluconeogenesis, increasing blood glucose during fasting.
7. Which mechanism contributes most directly to insulin
resistance in type 2 diabetes mellitus?
A. Excessive insulin receptor sensitivity
B. Complete absence of glucagon
C. Impaired cellular response to insulin
D. Increased glucose uptake by skeletal muscle
Rationale: Insulin resistance occurs when target tissues respond
inadequately to insulin, reducing glucose uptake and
contributing to hyperglycemia.
, 8. A patient with chronic kidney disease develops normocytic
anemia. What is the primary pathophysiologic mechanism?
A. Excess iron absorption
B. Increased erythrocyte production
C. Decreased erythropoietin production
D. Increased folate synthesis
Rationale: Diseased kidneys produce less erythropoietin,
reducing bone marrow stimulation and resulting in decreased
red blood cell production.
9. Which acid-base abnormality is expected with prolonged
vomiting?
A. Respiratory acidosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Rationale: Prolonged vomiting causes loss of gastric
hydrochloric acid, increasing serum bicarbonate relative to
hydrogen ions and producing metabolic alkalosis.
10. Which electrolyte abnormality is most likely to cause
muscle weakness and cardiac dysrhythmias when severe?
Pathophysiology Midterm 2026/2027 –
Practice Questions & Answers with Detailed
Rationales Guaranteed Pass (GRADED A+)
1. Which cellular adaptation occurs when a tissue increases
in cell size in response to increased workload?
A. Hyperplasia
B. Atrophy
C. Hypertrophy
D. Metaplasia
Rationale: Hypertrophy is an increase in individual cell size,
commonly occurring in tissues such as skeletal and cardiac
muscle when workload increases.
2. Which mechanism is primarily responsible for
maintaining the resting membrane potential of most cells?
A. Calcium influx
B. Potassium permeability and the sodium-potassium pump
C. Chloride secretion
D. Increased intracellular sodium
Rationale: The resting membrane potential is largely
determined by potassium concentration gradients and selective
membrane permeability, with the Na⁺/K⁺ ATPase maintaining
the underlying ion gradients.
,3. A patient develops metabolic acidosis. Which respiratory
response would normally occur?
A. Decreased respiratory rate
B. Hypoventilation
C. Increased ventilation
D. Complete respiratory suppression
Rationale: Increased ventilation removes carbon dioxide,
reducing carbonic acid and helping compensate for metabolic
acidosis.
4. Which finding is most characteristic of left-sided heart
failure?
A. Peripheral edema only
B. Hepatomegaly
C. Ascites
D. Pulmonary congestion
Rationale: Left ventricular dysfunction causes blood to back up
into the pulmonary circulation, producing pulmonary
congestion and potentially pulmonary edema.
5. What is the primary stimulus for aldosterone secretion?
A. Increased serum calcium
B. Angiotensin II and increased potassium concentration
,C. Decreased serum sodium alone
D. Increased atrial natriuretic peptide
Rationale: Aldosterone secretion is stimulated mainly by
angiotensin II and elevated plasma potassium. It promotes
sodium reabsorption and potassium excretion in the distal
nephron.
6. Which hormone increases blood glucose during fasting?
A. Insulin
B. Glucagon
C. Somatostatin
D. Calcitonin
Rationale: Glucagon promotes hepatic glycogenolysis and
gluconeogenesis, increasing blood glucose during fasting.
7. Which mechanism contributes most directly to insulin
resistance in type 2 diabetes mellitus?
A. Excessive insulin receptor sensitivity
B. Complete absence of glucagon
C. Impaired cellular response to insulin
D. Increased glucose uptake by skeletal muscle
Rationale: Insulin resistance occurs when target tissues respond
inadequately to insulin, reducing glucose uptake and
contributing to hyperglycemia.
, 8. A patient with chronic kidney disease develops normocytic
anemia. What is the primary pathophysiologic mechanism?
A. Excess iron absorption
B. Increased erythrocyte production
C. Decreased erythropoietin production
D. Increased folate synthesis
Rationale: Diseased kidneys produce less erythropoietin,
reducing bone marrow stimulation and resulting in decreased
red blood cell production.
9. Which acid-base abnormality is expected with prolonged
vomiting?
A. Respiratory acidosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Rationale: Prolonged vomiting causes loss of gastric
hydrochloric acid, increasing serum bicarbonate relative to
hydrogen ions and producing metabolic alkalosis.
10. Which electrolyte abnormality is most likely to cause
muscle weakness and cardiac dysrhythmias when severe?
