NSG5140 WEEK 5 MIDTERM EXAM DUE 30TH SEPTEMBER COMPLETE
ACTUAL EXAM QUESTIONS 1- 50 SCREENSHOTS NSG 5140 ADVANCED
PATHOPHYSIOLOGY NSG5140 ONLINE EXAM REQUIRES RESPONDUS
LOCKDOWN BROWSER + WEBCAM EXAM QUESTIONS AND ANSWERS
| 100% PASS GUARANTEED | GRADED A
CORE DOMAINS
Cellular Adaptation, Injury, and Death
Inflammation and Tissue Repair
Genetics and Genetic Disorders
Immune System Disorders and Hypersensitivity
Fluid, Electrolyte, and Acid-Base Balance
Hematologic Pathophysiology
Cardiovascular Pathophysiology
Pulmonary Pathophysiology
Renal and Urologic Pathophysiology
Endocrine and Metabolic Pathophysiology
INTRODUCTION
This comprehensive examination assesses the advanced pathophysiology knowledge and clinical
reasoning skills required of the graduate nursing student. It evaluates foundational mechanisms
of cellular adaptation, injury, inflammation, immunity, genetics, and system-based
pathophysiology across the lifespan. The examination employs multiple-choice and case-based
questions to simulate realistic clinical encounters. Emphasis is placed on critical thinking,
integration of pathophysiologic mechanisms with clinical presentation, and the application of
evidence-based diagnostic reasoning. This assessment prepares candidates for the rigor of
advanced practice nursing certification and real-world clinical practice.
SECTION ONE: QUESTIONS 1–50
1. A 58-year-old male with a 40-pack-year smoking history undergoes a lung biopsy that
reveals replacement of normal ciliated columnar epithelium with stratified squamous
epithelium. Which cellular adaptation is present?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
, C. Metaplasia
RATIONALE: Metaplasia is the reversible replacement of one differentiated cell type with
another in response to chronic irritation. In smokers, ciliated columnar epithelium is replaced by
stratified squamous epithelium, which is more resistant to injury but loses mucus clearance
function.
2. A 62-year-old female with long-standing hypertension develops left ventricular wall
thickening. Which cellular adaptation is primarily responsible for this finding?
A. Hyperplasia of cardiac muscle cells
B. Hypertrophy of cardiac muscle cells
C. Metaplasia of cardiac tissue
D. Dysplasia of the myocardium
B. Hypertrophy of cardiac muscle cells
RATIONALE: Hypertension increases the workload on the left ventricle, leading to
hypertrophy—an increase in cell size without an increase in cell number. Cardiac muscle cells
are terminally differentiated and cannot undergo hyperplasia.
3. A 45-year-old male with chronic alcohol use disorder presents with confusion, ataxia, and
ophthalmoplegia. Which vitamin deficiency is responsible for this condition?
A. Vitamin B12
B. Thiamine (B1)
C. Folate
D. Vitamin C
B. Thiamine (B1)
RATIONALE: Wernicke encephalopathy is caused by thiamine deficiency, common in chronic
alcohol use. The classic triad is confusion, ataxia, and ophthalmoplegia. It is a medical
emergency requiring immediate thiamine replacement.
4. A 28-year-old female with systemic lupus erythematosus has a kidney biopsy showing
immune complex deposition in the glomerular basement membrane. Which type of
hypersensitivity reaction is primarily responsible?
A. Type I hypersensitivity
B. Type II hypersensitivity
C. Type III hypersensitivity
D. Type IV hypersensitivity
, C. Type III hypersensitivity
RATIONALE: Type III hypersensitivity involves deposition of antigen-antibody immune
complexes in tissues, leading to complement activation and inflammation. Lupus nephritis is a
classic example of this mechanism.
5. A 32-year-old male sustains a deep laceration. Which cell type is primarily responsible for
synthesizing collagen and forming the scar matrix during wound healing?
A. Neutrophils
B. Macrophages
C. Fibroblasts
D. Endothelial cells
C. Fibroblasts
RATIONALE: Fibroblasts migrate into the wound and synthesize type III collagen, which is
later remodeled to type I collagen. They are the principal cells responsible for scar formation.
6. A child is diagnosed with X-linked agammaglobulinemia. Which pathophysiologic
mechanism best explains the increased susceptibility to bacterial infections?
A. Defective T-cell mediated immunity
B. Failure of B-cell maturation and antibody production
C. Impaired phagocyte oxidative burst
D. Complement deficiency
B. Failure of B-cell maturation and antibody production
RATIONALE: X-linked agammaglobulinemia results from a mutation in Bruton tyrosine kinase
(BTK), causing failure of pre-B cells to mature into B cells. This leads to absent or markedly
reduced immunoglobulins and recurrent bacterial infections.
7. A 52-year-old male with diabetic ketoacidosis has a blood glucose of 480 mg/dL and an
arterial pH of 7.20. Which compensatory mechanism is expected?
A. Hyperventilation to decrease PaCO2
B. Hypoventilation to increase PaCO2
C. Increased renal bicarbonate excretion
D. Increased renal hydrogen ion excretion
A. Hyperventilation to decrease PaCO2
RATIONALE: Metabolic acidosis triggers respiratory compensation via hyperventilation
(Kussmaul respirations) to blow off CO2 and raise pH. Renal compensation occurs over days, not
acutely.
ACTUAL EXAM QUESTIONS 1- 50 SCREENSHOTS NSG 5140 ADVANCED
PATHOPHYSIOLOGY NSG5140 ONLINE EXAM REQUIRES RESPONDUS
LOCKDOWN BROWSER + WEBCAM EXAM QUESTIONS AND ANSWERS
| 100% PASS GUARANTEED | GRADED A
CORE DOMAINS
Cellular Adaptation, Injury, and Death
Inflammation and Tissue Repair
Genetics and Genetic Disorders
Immune System Disorders and Hypersensitivity
Fluid, Electrolyte, and Acid-Base Balance
Hematologic Pathophysiology
Cardiovascular Pathophysiology
Pulmonary Pathophysiology
Renal and Urologic Pathophysiology
Endocrine and Metabolic Pathophysiology
INTRODUCTION
This comprehensive examination assesses the advanced pathophysiology knowledge and clinical
reasoning skills required of the graduate nursing student. It evaluates foundational mechanisms
of cellular adaptation, injury, inflammation, immunity, genetics, and system-based
pathophysiology across the lifespan. The examination employs multiple-choice and case-based
questions to simulate realistic clinical encounters. Emphasis is placed on critical thinking,
integration of pathophysiologic mechanisms with clinical presentation, and the application of
evidence-based diagnostic reasoning. This assessment prepares candidates for the rigor of
advanced practice nursing certification and real-world clinical practice.
SECTION ONE: QUESTIONS 1–50
1. A 58-year-old male with a 40-pack-year smoking history undergoes a lung biopsy that
reveals replacement of normal ciliated columnar epithelium with stratified squamous
epithelium. Which cellular adaptation is present?
A. Hyperplasia
B. Hypertrophy
C. Metaplasia
D. Dysplasia
, C. Metaplasia
RATIONALE: Metaplasia is the reversible replacement of one differentiated cell type with
another in response to chronic irritation. In smokers, ciliated columnar epithelium is replaced by
stratified squamous epithelium, which is more resistant to injury but loses mucus clearance
function.
2. A 62-year-old female with long-standing hypertension develops left ventricular wall
thickening. Which cellular adaptation is primarily responsible for this finding?
A. Hyperplasia of cardiac muscle cells
B. Hypertrophy of cardiac muscle cells
C. Metaplasia of cardiac tissue
D. Dysplasia of the myocardium
B. Hypertrophy of cardiac muscle cells
RATIONALE: Hypertension increases the workload on the left ventricle, leading to
hypertrophy—an increase in cell size without an increase in cell number. Cardiac muscle cells
are terminally differentiated and cannot undergo hyperplasia.
3. A 45-year-old male with chronic alcohol use disorder presents with confusion, ataxia, and
ophthalmoplegia. Which vitamin deficiency is responsible for this condition?
A. Vitamin B12
B. Thiamine (B1)
C. Folate
D. Vitamin C
B. Thiamine (B1)
RATIONALE: Wernicke encephalopathy is caused by thiamine deficiency, common in chronic
alcohol use. The classic triad is confusion, ataxia, and ophthalmoplegia. It is a medical
emergency requiring immediate thiamine replacement.
4. A 28-year-old female with systemic lupus erythematosus has a kidney biopsy showing
immune complex deposition in the glomerular basement membrane. Which type of
hypersensitivity reaction is primarily responsible?
A. Type I hypersensitivity
B. Type II hypersensitivity
C. Type III hypersensitivity
D. Type IV hypersensitivity
, C. Type III hypersensitivity
RATIONALE: Type III hypersensitivity involves deposition of antigen-antibody immune
complexes in tissues, leading to complement activation and inflammation. Lupus nephritis is a
classic example of this mechanism.
5. A 32-year-old male sustains a deep laceration. Which cell type is primarily responsible for
synthesizing collagen and forming the scar matrix during wound healing?
A. Neutrophils
B. Macrophages
C. Fibroblasts
D. Endothelial cells
C. Fibroblasts
RATIONALE: Fibroblasts migrate into the wound and synthesize type III collagen, which is
later remodeled to type I collagen. They are the principal cells responsible for scar formation.
6. A child is diagnosed with X-linked agammaglobulinemia. Which pathophysiologic
mechanism best explains the increased susceptibility to bacterial infections?
A. Defective T-cell mediated immunity
B. Failure of B-cell maturation and antibody production
C. Impaired phagocyte oxidative burst
D. Complement deficiency
B. Failure of B-cell maturation and antibody production
RATIONALE: X-linked agammaglobulinemia results from a mutation in Bruton tyrosine kinase
(BTK), causing failure of pre-B cells to mature into B cells. This leads to absent or markedly
reduced immunoglobulins and recurrent bacterial infections.
7. A 52-year-old male with diabetic ketoacidosis has a blood glucose of 480 mg/dL and an
arterial pH of 7.20. Which compensatory mechanism is expected?
A. Hyperventilation to decrease PaCO2
B. Hypoventilation to increase PaCO2
C. Increased renal bicarbonate excretion
D. Increased renal hydrogen ion excretion
A. Hyperventilation to decrease PaCO2
RATIONALE: Metabolic acidosis triggers respiratory compensation via hyperventilation
(Kussmaul respirations) to blow off CO2 and raise pH. Renal compensation occurs over days, not
acutely.
