1
NURS 6501 2025 Midterm Actual
Exam – Advanced Pathophysiology |
Graded A | Verified Questions and
Expert Answers
1. What is the primary mechanism of cellular injury in hypoxia?
A. Increased ATP production
B. Failure of the sodium-potassium pump
C. Enhanced mitochondrial function
D. Decreased reactive oxygen species
Correct Answer: B. Failure of the sodium-potassium pump
Rationale: Hypoxia impairs ATP production via oxidative phosphorylation, leading to
failure of the sodium-potassium pump, causing cellular swelling and injury due to ion
imbalances.
2. Which type of hypersensitivity reaction is associated with contact dermatitis?
A. Type I
B. Type II
C. Type III
D. Type IV
Correct Answer: D. Type IV
Rationale: Contact dermatitis is a Type IV (delayed) hypersensitivity reaction mediated
by T-cells, occurring hours to days after exposure to allergens like poison ivy.
3. What is the hallmark of apoptosis?
A. Cellular swelling
B. Nuclear fragmentation
C. Membrane rupture
D. Inflammatory response
Correct Answer: B. Nuclear fragmentation
Rationale: Apoptosis involves programmed cell death with nuclear fragmentation and
chromatin condensation, without inflammation, unlike necrosis.
4. Which electrolyte imbalance is most likely to cause ventricular arrhythmias?
A. Hypercalcemia
B. Hypokalemia
C. Hyponatremia
D. Hypermagnesemia
Correct Answer: B. Hypokalemia
Rationale: Hypokalemia alters cardiac repolarization, increasing the risk of ventricular
arrhythmias like torsades de pointes.
, 2
5. What is the primary pathophysiological mechanism of type 1 diabetes mellitus?
A. Insulin resistance
B. Autoimmune beta-cell destruction
C. Excessive glucagon secretion
D. Impaired glucose uptake
Correct Answer: B. Autoimmune beta-cell destruction
Rationale: Type 1 diabetes results from autoimmune destruction of pancreatic beta cells,
leading to absolute insulin deficiency.
6. Which characteristic differentiates benign tumors from malignant tumors?
A. Metastasis
B. Rapid growth
C. Encapsulation
D. Anaplasia
Correct Answer: C. Encapsulation
Rationale: Benign tumors are encapsulated and non-invasive, while malignant tumors
metastasize and exhibit anaplasia.
7. What is the primary cause of edema in nephrotic syndrome?
A. Increased hydrostatic pressure
B. Decreased oncotic pressure
C. Lymphatic obstruction
D. Sodium retention
Correct Answer: B. Decreased oncotic pressure
Rationale: Nephrotic syndrome causes proteinuria, reducing plasma albumin and oncotic
pressure, leading to fluid leakage into interstitial spaces.
8. Which inflammatory mediator is primarily responsible for inducing fever?
A. Histamine
B. Prostaglandin E2
C. Bradykinin
D. Leukotriene
Correct Answer: B. Prostaglandin E2
Rationale: Prostaglandin E2 acts on the hypothalamus to raise the body’s temperature set
point, causing fever.
9. What is the primary pathophysiological feature of Parkinson’s disease?
A. Loss of dopamine-producing neurons
B. Amyloid plaque formation
C. Demyelination of neurons
D. Excessive glutamate release
Correct Answer: A. Loss of dopamine-producing neurons
Rationale: Parkinson’s disease involves degeneration of dopaminergic neurons in the
substantia nigra, causing motor symptoms like tremors.
10. Which condition is caused by autoantibodies against thyroid-stimulating hormone
receptors?
A. Hashimoto’s thyroiditis
B. Graves’ disease
C. Myxedema
D. Thyroid cancer
, 3
Correct Answer: B. Graves’ disease
Rationale: Graves’ disease results from autoantibodies stimulating TSH receptors,
leading to hyperthyroidism.
11. What is the primary mechanism of injury in ischemic stroke?
A. Hemorrhagic rupture
B. Oxygen deprivation
C. Excitotoxicity
D. Vasospasm
Correct Answer: B. Oxygen deprivation
Rationale: Ischemic stroke results from blocked blood flow, causing neuronal death due
to lack of oxygen and ATP.
12. Which cell type predominates in chronic inflammation?
A. Neutrophils
B. Mononuclear cells
C. Eosinophils
D. Basophils
Correct Answer: B. Mononuclear cells
Rationale: Chronic inflammation is characterized by lymphocytes and macrophages,
unlike acute inflammation, which involves neutrophils.
13. What is the primary cause of respiratory acidosis?
A. Hyperventilation
B. Hypoventilation
C. Metabolic alkalosis
D. Renal compensation
Correct Answer: B. Hypoventilation
Rationale: Hypoventilation causes CO2 retention, increasing carbonic acid and lowering
blood pH.
14. Which condition is associated with a positive antinuclear antibody (ANA) test?
A. Rheumatoid arthritis
B. Systemic lupus erythematosus
C. Osteoarthritis
D. Gout
Correct Answer: B. Systemic lupus erythematosus
Rationale: A positive ANA test is highly sensitive for SLE, an autoimmune disease
affecting multiple organs.
15. What is the primary pathophysiological mechanism of congestive heart failure?
A. Increased cardiac output
B. Decreased myocardial contractility
C. Peripheral vasodilation
D. Reduced preload
Correct Answer: B. Decreased myocardial contractility
Rationale: Heart failure results from impaired myocardial contractility, reducing cardiac
output and causing fluid backup.
16. Which type of shock is caused by massive histamine release?
A. Hypovolemic
B. Cardiogenic
NURS 6501 2025 Midterm Actual
Exam – Advanced Pathophysiology |
Graded A | Verified Questions and
Expert Answers
1. What is the primary mechanism of cellular injury in hypoxia?
A. Increased ATP production
B. Failure of the sodium-potassium pump
C. Enhanced mitochondrial function
D. Decreased reactive oxygen species
Correct Answer: B. Failure of the sodium-potassium pump
Rationale: Hypoxia impairs ATP production via oxidative phosphorylation, leading to
failure of the sodium-potassium pump, causing cellular swelling and injury due to ion
imbalances.
2. Which type of hypersensitivity reaction is associated with contact dermatitis?
A. Type I
B. Type II
C. Type III
D. Type IV
Correct Answer: D. Type IV
Rationale: Contact dermatitis is a Type IV (delayed) hypersensitivity reaction mediated
by T-cells, occurring hours to days after exposure to allergens like poison ivy.
3. What is the hallmark of apoptosis?
A. Cellular swelling
B. Nuclear fragmentation
C. Membrane rupture
D. Inflammatory response
Correct Answer: B. Nuclear fragmentation
Rationale: Apoptosis involves programmed cell death with nuclear fragmentation and
chromatin condensation, without inflammation, unlike necrosis.
4. Which electrolyte imbalance is most likely to cause ventricular arrhythmias?
A. Hypercalcemia
B. Hypokalemia
C. Hyponatremia
D. Hypermagnesemia
Correct Answer: B. Hypokalemia
Rationale: Hypokalemia alters cardiac repolarization, increasing the risk of ventricular
arrhythmias like torsades de pointes.
, 2
5. What is the primary pathophysiological mechanism of type 1 diabetes mellitus?
A. Insulin resistance
B. Autoimmune beta-cell destruction
C. Excessive glucagon secretion
D. Impaired glucose uptake
Correct Answer: B. Autoimmune beta-cell destruction
Rationale: Type 1 diabetes results from autoimmune destruction of pancreatic beta cells,
leading to absolute insulin deficiency.
6. Which characteristic differentiates benign tumors from malignant tumors?
A. Metastasis
B. Rapid growth
C. Encapsulation
D. Anaplasia
Correct Answer: C. Encapsulation
Rationale: Benign tumors are encapsulated and non-invasive, while malignant tumors
metastasize and exhibit anaplasia.
7. What is the primary cause of edema in nephrotic syndrome?
A. Increased hydrostatic pressure
B. Decreased oncotic pressure
C. Lymphatic obstruction
D. Sodium retention
Correct Answer: B. Decreased oncotic pressure
Rationale: Nephrotic syndrome causes proteinuria, reducing plasma albumin and oncotic
pressure, leading to fluid leakage into interstitial spaces.
8. Which inflammatory mediator is primarily responsible for inducing fever?
A. Histamine
B. Prostaglandin E2
C. Bradykinin
D. Leukotriene
Correct Answer: B. Prostaglandin E2
Rationale: Prostaglandin E2 acts on the hypothalamus to raise the body’s temperature set
point, causing fever.
9. What is the primary pathophysiological feature of Parkinson’s disease?
A. Loss of dopamine-producing neurons
B. Amyloid plaque formation
C. Demyelination of neurons
D. Excessive glutamate release
Correct Answer: A. Loss of dopamine-producing neurons
Rationale: Parkinson’s disease involves degeneration of dopaminergic neurons in the
substantia nigra, causing motor symptoms like tremors.
10. Which condition is caused by autoantibodies against thyroid-stimulating hormone
receptors?
A. Hashimoto’s thyroiditis
B. Graves’ disease
C. Myxedema
D. Thyroid cancer
, 3
Correct Answer: B. Graves’ disease
Rationale: Graves’ disease results from autoantibodies stimulating TSH receptors,
leading to hyperthyroidism.
11. What is the primary mechanism of injury in ischemic stroke?
A. Hemorrhagic rupture
B. Oxygen deprivation
C. Excitotoxicity
D. Vasospasm
Correct Answer: B. Oxygen deprivation
Rationale: Ischemic stroke results from blocked blood flow, causing neuronal death due
to lack of oxygen and ATP.
12. Which cell type predominates in chronic inflammation?
A. Neutrophils
B. Mononuclear cells
C. Eosinophils
D. Basophils
Correct Answer: B. Mononuclear cells
Rationale: Chronic inflammation is characterized by lymphocytes and macrophages,
unlike acute inflammation, which involves neutrophils.
13. What is the primary cause of respiratory acidosis?
A. Hyperventilation
B. Hypoventilation
C. Metabolic alkalosis
D. Renal compensation
Correct Answer: B. Hypoventilation
Rationale: Hypoventilation causes CO2 retention, increasing carbonic acid and lowering
blood pH.
14. Which condition is associated with a positive antinuclear antibody (ANA) test?
A. Rheumatoid arthritis
B. Systemic lupus erythematosus
C. Osteoarthritis
D. Gout
Correct Answer: B. Systemic lupus erythematosus
Rationale: A positive ANA test is highly sensitive for SLE, an autoimmune disease
affecting multiple organs.
15. What is the primary pathophysiological mechanism of congestive heart failure?
A. Increased cardiac output
B. Decreased myocardial contractility
C. Peripheral vasodilation
D. Reduced preload
Correct Answer: B. Decreased myocardial contractility
Rationale: Heart failure results from impaired myocardial contractility, reducing cardiac
output and causing fluid backup.
16. Which type of shock is caused by massive histamine release?
A. Hypovolemic
B. Cardiogenic
