NUR 6501 Advanced Pathophysiology Midterm Exam –
Walden University – 2025-2026 Verified Questions & Detailed
Answers (150+ Qs)
A |4-year-old |child |appears |listless |for |the |last |week. |He |complains |of |pain |when |he |is |picked |up |by |
his |mother, |and |he |is |irritable |when |touching |his |arms |or |legs. |Several |large |ecchymotic |lesions |have |
appeared |on |his |right |thigh |and |left |shoulder. |A |complete |blood |count |reveals |a |HgB=10.2, |
Hct=30.5%, |MCV=96fL, |platelet |count |of |45,000/ML, |and |WBC |count |of |13,990/ML. |Examination |of |
the |peripheral |blood |smear |reveals |numerous |blasts. |The |blasts |lack |peroxidase-positive |granules |but |
do |contain |periodic |acid-Schiff |(PAS)-positive |aggregates |and |stain |positively |for |TdT. |Flow |cytometry |
shows |the |phenotype |of |blasts |to |be |CD19+, |CD3-, |and |sIg-. |What |is |the |most |likely |diagnosis?
A. |Acute |lymphoblastic |leukemia |(ALL)
B. |Chronic |lymphocytic |leukemia |(CLL)
C. |Acute |myelogenous |leukemia |(AML)
D. |Chronic |myelogenous |leukemia |(CML) |- |answersAcute |lymphblastic |leukemia
A |3-year-old |child |of |Italian |ancestry |presents |with |failure |to |thrive. |Physical |examination |indicates |
hepatosplenomegaly. |His |hemoglobin |concentration |is |6 |g/dL, |and |the |peripheral |blood |smear |reveals
|severely |hypochromic |microcytic |red |cells. |Total |serum |iron |level |is |normal. |The |reticulocyte |count |is |
10%. |Hemoglobin |electrophoresis |shows |very |little |hemoglobin |A. |A |radiograph |of |the |skull |shows |
maxillofacial |deformities. |What |is |the |principle |cause |of |anemia |and |other |abnormalities |in |this |
patient?
A. |Reduced |synthesis |of |hemoglobin |F
B. |Reduced |red |blood |cell |survival |from |imbalance |in |the |production |of |alpha |and |beta |globin |chains
C. |Relative |deficiency |of |vitamin |B12
D. |Increased |fragility |of |the |erythrocyte |membrane |- |answersReduced |synthesis |of |hemoglobin |F
A |68-year-old |previously |healthy |female |has |been |feeling |increasingly |tired |and |weak |for |several |
months. |She |states |that |she |has |had |black, |tarry |stools |for |several |weeks. |She |is |found |to |be |anemic |
with |a |hemoglobin |concentration |of |9.3g/dL. |The |peripheral |blood |smear |reveals |microcytic |and |
hypochromic |blood |cells. |Which |of |the |following |conditions |should |be |suspected |as |the |most |likely |of |
her |condition |as |indicated |by |the |peripheral |blood |smear?
A. |Aplastic |anemia
,B. |Beta |thalassemia
C. |Gastrointestinal |blood |loss
D. |Pernicious |anemia |- |answersGastrointestinal |blood |loss
A |76-year-old |female |notices |that |small, |pinpoint |to |blotchy |areas |of |superficial |hemorrhage |have |
appeared |on |her |gums |and |on |the |skin |of |her |arms |and |legs |over |several |weeks. |She |is |found |to |have
|a |normal |prothrombin |time(PT) |and |partial |thromboplastin |time |(PTT). |Her |CBC |shows |hemoglobin |
concentration |of |12.7 |g/dL, |hematocrit |of |37.2%. |MCV |of |80 |fL/red |cell, |platelet |count |of
|276,000/microliter, |and |WBC |of |5600/microliter. |Her |template |bleeding |time |is |3 |minutes. |Her |
fibrinogen |level |is |normal, |and |there |are |no |fibrin |split |products |detectable. |Which |of |the |following |
conditions |best |explain |these |findings?
A. |Chronic |renal |failure
B. |Macronodular |cirrhosis
C. |Vitamin |B12 |deficiency
D. |Vitamin |C |deficiency |- |answersVitamin |C |deficiency
A |young |adult |patient |has |just |been |diagnosed |with |Von |Willebrand |disease. |Which |of |the |following |
statements |should |you |make |to |advise |the |patient |of |potential |consequences |of |this |disease?
A. |You |may |need |an |allogeneic |bone |marrow |transplant
B. |You |may |have |excessive |bleeding |following |tooth |extraction
C. |A |splenectomy |may |be |necessary |to |control |the |disease
D. |Expect |increasing |difficulties |with |joint |mobility |- |answersYou |may |have |excessive |bleeding |
following |tooth |extraction
Low |dose |aspirin |is |commonly |used |to |reduce |the |risk |of |arterial |thrombosis |in |patients |who |have |
suffered |a |myocardial |infarction. |Which |one |of |the |following |steps |in |homeostasis |is |inhibited |by |
aspirin?
A. |Synthesis |of |von |Willebrand |factor
B. |Aggregation |of |platelets
C. |Activation |of |factor |Xa
D. |Synthesis |of |antithrombin |III |- |answersAggregation |of |platelets
A |24-year-old |presents |to |the |office |with |fatigue. |On |physical |exam, |the |NP |notices |that |she |ispale |
with |the |following |vital |signs: |HR |112, |BP |98/64, |resp |20, |O2 |sats |99%. |Her |CBC |shows: |WBC6,000, |
,Hemoglobin |9.6, |Hematocrit |30.2, |MCV |is |decreased |at |76. |What |is |the |mostly |likely |causeof |this |
patient's |anemia?
A. |Iron |deficiency |anemia |caused |by |menstruation
B. |Beta |Thalassemia |of |genetic |origin
C. |Pernicious |anemia |caused |by |dietary |deficiency
D. |Folate |deficiency |caused |by |alcoholism |- |answersIron |deficiency |anemia |caused |by |menstruation
A |65-year-old |female |presents |to |your |office |complaining |of |fatigue. |She |has |a |long |of |rheumatoid |
arthritis. |A |CBC |reveals |the |following: |Hgb=11.6 |g/dL, |Hct=34.8%, |MCV=87 |fL/red |cell, |platelet |count |
of |268,000/microliter, |and |WBC |count |of |6800/microliter. |The |serum |haptoglobin |level |is |normal, |and
|the |serum |iron |concentration |is |20 |micrograms/dL. |The |total |iron |binding |capacity |is |195 |
micrograms/dL, |and |the |percent |saturation |is |10.2. |The |serum |ferritin |concentration |is |317 |ng/mL. |No
|fibrin |split |products |are |detected. |The |reticulocyte |concentration |is |1.1%. |What |is |the |most |likely |
diagnosis?
A. |Beta- |thalassemia |major
B. |Anemia |of |chronic |disease |
C. |Acute |blood |loss |anemia
D. |Iron |deficiency |anemia |- |answersAnemia |of |chronic |disease
A |14-year-old |male |presents |with |high |fever |for |ten |days. |Physical |examination |reveals |scattered |
petechial |hemorrhages |but |is |negative |for |enlargement |of |the |liver |or |spleen |or |lymph |nodes. |Bone |
marrow |examination |does |not |show |any |abnormal |cells. |The |complete |blood |count |(CBC) |
demonstrates |a |hemoglobin |concentration |(HgB) |of |13.2 |g/dL, |hematocrit |(Hct) |of |38.9%, |mean |cell |
volume |(MCV) |of |93 |fL, |platelet |count |of |175,000/microliter, |and |white |blood |cell |(WBC) |count |of |
1850/microliter, |with |the |differential |count |showing |1 |segmented |neutrophil, |98 |lymphocytes, |and |1 |
monocyte |per |100 |WBCs. |What |is |the |most |likely |cause |of |these |findings?
A. |Overwhelming |bacterial |infection
B. |Acute |lymphocytic |(or |lymphoblastic) |leukemia
C. |Acute |myeloid |leukemia
D. |Aplastic |anemia |- |answersOverwhelming |bacterial |infection
A |31-year-old |male |has |a |history |of |chronic |anemia |and |painful |crises |with |joint |and |abdominal |pain. |
A |head |computed |tomography |(CT) |scan |reveals |several |small |remote |infarctions. |During |one |of |these
, acute |crises, |he |is |admitted |with |severe |dyspnea. |A |CBC |is |performed. |Which |of |the |following |
|
morphologic |findings |for |RBCs |is |most |likely |to |be |seen |on |the |peripheral |blood |smear?
A. |Tear |drop |cells
B. |Schistocytes
C. |Sickle |cells
D. |Spherocytes |- |answersSickle |cells
A |50-year-old |male |has |a |blood |pressure |of |160/95 |mm |Hg. |If |this |condition |remains |untreated |for |
years, |which |of |the |following |cardiovascular |alterations |will |be |seen |on |a |transthoracic |
echocardiogram |and |ECG?
A. |Left |Ventricular |Hypertrophy
B. |Left |Ventricular |Atrophy
C. |Left |Atrial |Atrophy
D. |Right |Ventricular |Hypertrophy |- |answersLeft |ventricular |hypertrophy
A |65-year-old |male |with |longstanding |uncontrolled |HTN |presents |to |the |office |for |evaluation |of |
syncope. |His |vital |signs |are |temperature=98.3, |Pulse=85, |RR=17, |BP=165/85. |Physical |examination |
reveals |a |fourth |heart |sound |and |a |4/6 |crescendo-decrescendo |murmur |heard |at |the |right |upper |
sternal |border |with |radiation |to |the |carotid |arteries. |His |ECG |reveals |enlarged |QRS |waves, |consistent |
with |left |ventricular |hypertrophy. |What |is |the |most |likely |cause |of |his |syncopal |episodes?
A. |Mitral |regurgitation
B. |Mitral |Stenosis
C. |Aortic |regurgitation
D. |Aortic |stenosis |- |answersAortic |stenosis
A |63-year-old |female |presents |to |the |emergency |room |with |sudden |onset |of |severe |chest |and |back |
pain. |She |describes |the |pain |as |sharp |and |different |from |her |anginal |pain. |Her |past |medical |history |is |
positive |for |HTN |X |20 |years. |VS: |HR |105, |BP |160/105, |RR |17. |On |physical |examination, |the |NP |notices |
that |her |pedal |and |radial |pulses |are |not |equal. |What |is |the |most |likely |cause |of |her |chest |pain?
A. |Unstable |angina
B. |Aortic |dissection
Walden University – 2025-2026 Verified Questions & Detailed
Answers (150+ Qs)
A |4-year-old |child |appears |listless |for |the |last |week. |He |complains |of |pain |when |he |is |picked |up |by |
his |mother, |and |he |is |irritable |when |touching |his |arms |or |legs. |Several |large |ecchymotic |lesions |have |
appeared |on |his |right |thigh |and |left |shoulder. |A |complete |blood |count |reveals |a |HgB=10.2, |
Hct=30.5%, |MCV=96fL, |platelet |count |of |45,000/ML, |and |WBC |count |of |13,990/ML. |Examination |of |
the |peripheral |blood |smear |reveals |numerous |blasts. |The |blasts |lack |peroxidase-positive |granules |but |
do |contain |periodic |acid-Schiff |(PAS)-positive |aggregates |and |stain |positively |for |TdT. |Flow |cytometry |
shows |the |phenotype |of |blasts |to |be |CD19+, |CD3-, |and |sIg-. |What |is |the |most |likely |diagnosis?
A. |Acute |lymphoblastic |leukemia |(ALL)
B. |Chronic |lymphocytic |leukemia |(CLL)
C. |Acute |myelogenous |leukemia |(AML)
D. |Chronic |myelogenous |leukemia |(CML) |- |answersAcute |lymphblastic |leukemia
A |3-year-old |child |of |Italian |ancestry |presents |with |failure |to |thrive. |Physical |examination |indicates |
hepatosplenomegaly. |His |hemoglobin |concentration |is |6 |g/dL, |and |the |peripheral |blood |smear |reveals
|severely |hypochromic |microcytic |red |cells. |Total |serum |iron |level |is |normal. |The |reticulocyte |count |is |
10%. |Hemoglobin |electrophoresis |shows |very |little |hemoglobin |A. |A |radiograph |of |the |skull |shows |
maxillofacial |deformities. |What |is |the |principle |cause |of |anemia |and |other |abnormalities |in |this |
patient?
A. |Reduced |synthesis |of |hemoglobin |F
B. |Reduced |red |blood |cell |survival |from |imbalance |in |the |production |of |alpha |and |beta |globin |chains
C. |Relative |deficiency |of |vitamin |B12
D. |Increased |fragility |of |the |erythrocyte |membrane |- |answersReduced |synthesis |of |hemoglobin |F
A |68-year-old |previously |healthy |female |has |been |feeling |increasingly |tired |and |weak |for |several |
months. |She |states |that |she |has |had |black, |tarry |stools |for |several |weeks. |She |is |found |to |be |anemic |
with |a |hemoglobin |concentration |of |9.3g/dL. |The |peripheral |blood |smear |reveals |microcytic |and |
hypochromic |blood |cells. |Which |of |the |following |conditions |should |be |suspected |as |the |most |likely |of |
her |condition |as |indicated |by |the |peripheral |blood |smear?
A. |Aplastic |anemia
,B. |Beta |thalassemia
C. |Gastrointestinal |blood |loss
D. |Pernicious |anemia |- |answersGastrointestinal |blood |loss
A |76-year-old |female |notices |that |small, |pinpoint |to |blotchy |areas |of |superficial |hemorrhage |have |
appeared |on |her |gums |and |on |the |skin |of |her |arms |and |legs |over |several |weeks. |She |is |found |to |have
|a |normal |prothrombin |time(PT) |and |partial |thromboplastin |time |(PTT). |Her |CBC |shows |hemoglobin |
concentration |of |12.7 |g/dL, |hematocrit |of |37.2%. |MCV |of |80 |fL/red |cell, |platelet |count |of
|276,000/microliter, |and |WBC |of |5600/microliter. |Her |template |bleeding |time |is |3 |minutes. |Her |
fibrinogen |level |is |normal, |and |there |are |no |fibrin |split |products |detectable. |Which |of |the |following |
conditions |best |explain |these |findings?
A. |Chronic |renal |failure
B. |Macronodular |cirrhosis
C. |Vitamin |B12 |deficiency
D. |Vitamin |C |deficiency |- |answersVitamin |C |deficiency
A |young |adult |patient |has |just |been |diagnosed |with |Von |Willebrand |disease. |Which |of |the |following |
statements |should |you |make |to |advise |the |patient |of |potential |consequences |of |this |disease?
A. |You |may |need |an |allogeneic |bone |marrow |transplant
B. |You |may |have |excessive |bleeding |following |tooth |extraction
C. |A |splenectomy |may |be |necessary |to |control |the |disease
D. |Expect |increasing |difficulties |with |joint |mobility |- |answersYou |may |have |excessive |bleeding |
following |tooth |extraction
Low |dose |aspirin |is |commonly |used |to |reduce |the |risk |of |arterial |thrombosis |in |patients |who |have |
suffered |a |myocardial |infarction. |Which |one |of |the |following |steps |in |homeostasis |is |inhibited |by |
aspirin?
A. |Synthesis |of |von |Willebrand |factor
B. |Aggregation |of |platelets
C. |Activation |of |factor |Xa
D. |Synthesis |of |antithrombin |III |- |answersAggregation |of |platelets
A |24-year-old |presents |to |the |office |with |fatigue. |On |physical |exam, |the |NP |notices |that |she |ispale |
with |the |following |vital |signs: |HR |112, |BP |98/64, |resp |20, |O2 |sats |99%. |Her |CBC |shows: |WBC6,000, |
,Hemoglobin |9.6, |Hematocrit |30.2, |MCV |is |decreased |at |76. |What |is |the |mostly |likely |causeof |this |
patient's |anemia?
A. |Iron |deficiency |anemia |caused |by |menstruation
B. |Beta |Thalassemia |of |genetic |origin
C. |Pernicious |anemia |caused |by |dietary |deficiency
D. |Folate |deficiency |caused |by |alcoholism |- |answersIron |deficiency |anemia |caused |by |menstruation
A |65-year-old |female |presents |to |your |office |complaining |of |fatigue. |She |has |a |long |of |rheumatoid |
arthritis. |A |CBC |reveals |the |following: |Hgb=11.6 |g/dL, |Hct=34.8%, |MCV=87 |fL/red |cell, |platelet |count |
of |268,000/microliter, |and |WBC |count |of |6800/microliter. |The |serum |haptoglobin |level |is |normal, |and
|the |serum |iron |concentration |is |20 |micrograms/dL. |The |total |iron |binding |capacity |is |195 |
micrograms/dL, |and |the |percent |saturation |is |10.2. |The |serum |ferritin |concentration |is |317 |ng/mL. |No
|fibrin |split |products |are |detected. |The |reticulocyte |concentration |is |1.1%. |What |is |the |most |likely |
diagnosis?
A. |Beta- |thalassemia |major
B. |Anemia |of |chronic |disease |
C. |Acute |blood |loss |anemia
D. |Iron |deficiency |anemia |- |answersAnemia |of |chronic |disease
A |14-year-old |male |presents |with |high |fever |for |ten |days. |Physical |examination |reveals |scattered |
petechial |hemorrhages |but |is |negative |for |enlargement |of |the |liver |or |spleen |or |lymph |nodes. |Bone |
marrow |examination |does |not |show |any |abnormal |cells. |The |complete |blood |count |(CBC) |
demonstrates |a |hemoglobin |concentration |(HgB) |of |13.2 |g/dL, |hematocrit |(Hct) |of |38.9%, |mean |cell |
volume |(MCV) |of |93 |fL, |platelet |count |of |175,000/microliter, |and |white |blood |cell |(WBC) |count |of |
1850/microliter, |with |the |differential |count |showing |1 |segmented |neutrophil, |98 |lymphocytes, |and |1 |
monocyte |per |100 |WBCs. |What |is |the |most |likely |cause |of |these |findings?
A. |Overwhelming |bacterial |infection
B. |Acute |lymphocytic |(or |lymphoblastic) |leukemia
C. |Acute |myeloid |leukemia
D. |Aplastic |anemia |- |answersOverwhelming |bacterial |infection
A |31-year-old |male |has |a |history |of |chronic |anemia |and |painful |crises |with |joint |and |abdominal |pain. |
A |head |computed |tomography |(CT) |scan |reveals |several |small |remote |infarctions. |During |one |of |these
, acute |crises, |he |is |admitted |with |severe |dyspnea. |A |CBC |is |performed. |Which |of |the |following |
|
morphologic |findings |for |RBCs |is |most |likely |to |be |seen |on |the |peripheral |blood |smear?
A. |Tear |drop |cells
B. |Schistocytes
C. |Sickle |cells
D. |Spherocytes |- |answersSickle |cells
A |50-year-old |male |has |a |blood |pressure |of |160/95 |mm |Hg. |If |this |condition |remains |untreated |for |
years, |which |of |the |following |cardiovascular |alterations |will |be |seen |on |a |transthoracic |
echocardiogram |and |ECG?
A. |Left |Ventricular |Hypertrophy
B. |Left |Ventricular |Atrophy
C. |Left |Atrial |Atrophy
D. |Right |Ventricular |Hypertrophy |- |answersLeft |ventricular |hypertrophy
A |65-year-old |male |with |longstanding |uncontrolled |HTN |presents |to |the |office |for |evaluation |of |
syncope. |His |vital |signs |are |temperature=98.3, |Pulse=85, |RR=17, |BP=165/85. |Physical |examination |
reveals |a |fourth |heart |sound |and |a |4/6 |crescendo-decrescendo |murmur |heard |at |the |right |upper |
sternal |border |with |radiation |to |the |carotid |arteries. |His |ECG |reveals |enlarged |QRS |waves, |consistent |
with |left |ventricular |hypertrophy. |What |is |the |most |likely |cause |of |his |syncopal |episodes?
A. |Mitral |regurgitation
B. |Mitral |Stenosis
C. |Aortic |regurgitation
D. |Aortic |stenosis |- |answersAortic |stenosis
A |63-year-old |female |presents |to |the |emergency |room |with |sudden |onset |of |severe |chest |and |back |
pain. |She |describes |the |pain |as |sharp |and |different |from |her |anginal |pain. |Her |past |medical |history |is |
positive |for |HTN |X |20 |years. |VS: |HR |105, |BP |160/105, |RR |17. |On |physical |examination, |the |NP |notices |
that |her |pedal |and |radial |pulses |are |not |equal. |What |is |the |most |likely |cause |of |her |chest |pain?
A. |Unstable |angina
B. |Aortic |dissection
