ADVANCED PATHOPHYSIOLOGY
MIDTERM NUR 6501 WALDEN
UNIVERSITY / COMPLETE ACTUAL
EXAM / QUESTIONS AND CORRECT
DETAILED ANSWERS / 2025/2026
A b4-year-old bchild bappears blistless bfor bthe blast bweek. bHe bcomplains bof bpain bwhen
bhe bis bpicked bup bby bhis bmother, band bhe bis birritable bwhen btouching bhis barms bor
blegs. bSeveral blarge becchymotic blesions bhave bappeared bon bhis bright bthigh band bleft
bshoulder. bA bcomplete bblood bcount breveals ba bHgB=10.2, bHct=30.5%, bMCV=96fL,
bplatelet bcount bof b45,000/ML, band bWBC bcount bof b13,990/ML. bExamination bof bthe
bperipheral bblood bsmear breveals bnumerous bblasts. bThe bblasts black bperoxidase-
positive bgranules bbut bdo bcontain bperiodic bacid-Schiff b(PAS)-positive baggregates
band bstain bpositively bfor bTdT. bFlow bcytometry bshows bthe bphenotype bof bblasts bto
bbe bCD19+, bCD3-, band bsIg-. bWhat bis bthe bmost blikely bdiagnosis?
A. bAcute blymphoblastic bleukemia b(ALL)
B. bChronic blymphocytic bleukemia b(CLL)
C. bAcute bmyelogenous bleukemia b(AML)
D. bChronic bmyelogenous bleukemia b(CML) b- bcorrect banswer✔✔Acute blymphblastic
bleukemia
A b3-year-old bchild bof bItalian bancestry bpresents bwith bfailure bto bthrive. bPhysical
bexamination bindicates bhepatosplenomegaly. bHis bhemoglobin bconcentration bis b6
bg/dL, band bthe bperipheral bblood bsmear breveals bseverely bhypochromic bmicrocytic
bred bcells. bTotal bserum biron blevel bis bnormal. bThe breticulocyte bcount bis b10%.
bHemoglobin belectrophoresis bshows bvery blittle bhemoglobin bA. bA bradiograph bof bthe
bskull bshows bmaxillofacial bdeformities. bWhat bis bthe bprinciple bcause bof banemia band
bother babnormalities bin bthis bpatient?
A. bReduced bsynthesis bof bhemoglobin bF
,B. bReduced bred bblood bcell bsurvival bfrom bimbalance bin bthe bproduction bof balpha
band bbeta bglobin bchains
C. bRelative bdeficiency bof bvitamin bB12
D. bIncreased bfragility bof bthe berythrocyte bmembrane b- bcorrect banswer✔✔Reduced
bsynthesis bof bhemoglobin bF
A b68-year-old bpreviously bhealthy bfemale bhas bbeen bfeeling bincreasingly btired band
bweak bfor bseveral bmonths. bShe bstates bthat bshe bhas bhad bblack, btarry bstools bfor
bseveral bweeks. bShe bis bfound bto bbe banemic bwith ba bhemoglobin bconcentration bof
b9.3g/dL. bThe bperipheral bblood bsmear breveals bmicrocytic band bhypochromic bblood
bcells. bWhich bof bthe bfollowing bconditions bshould bbe bsuspected bas bthe bmost blikely
bof bher bcondition bas bindicated bby bthe bperipheral bblood bsmear?
A. bAplastic banemia
B. bBeta bthalassemia
C. bGastrointestinal bblood bloss
D. bPernicious banemia b- bcorrect banswer✔✔Gastrointestinal bblood bloss
A b76-year-old bfemale bnotices bthat bsmall, bpinpoint bto bblotchy bareas bof bsuperficial
bhemorrhage bhave bappeared bon bher bgums band bon bthe bskin bof bher barms band blegs
bover bseveral bweeks. bShe bis bfound bto bhave ba bnormal bprothrombin btime(PT) band
bpartial bthromboplastin btime b(PTT). bHer bCBC bshows bhemoglobin bconcentration bof
b12.7 bg/dL, bhematocrit bof b37.2%. bMCV bof b80 bfL/red bcell, bplatelet bcount bof
b276,000/microliter, band bWBC bof b5600/microliter. bHer btemplate bbleeding btime bis b3
bminutes. bHer bfibrinogen blevel bis bnormal, band bthere bare bno bfibrin bsplit bproducts
bdetectable. bWhich bof bthe bfollowing bconditions bbest bexplain bthese bfindings?
A. bChronic brenal bfailure
B. bMacronodular bcirrhosis
C. bVitamin bB12 bdeficiency
D. bVitamin bC bdeficiency b- bcorrect banswer✔✔Vitamin bC bdeficiency
A byoung badult bpatient bhas bjust bbeen bdiagnosed bwith bVon bWillebrand bdisease.
bWhich bof bthe bfollowing bstatements bshould byou bmake bto badvise bthe bpatient bof
bpotential bconsequences bof bthis bdisease?
A. bYou bmay bneed ban ballogeneic bbone bmarrow btransplant
B. bYou bmay bhave bexcessive bbleeding bfollowing btooth bextraction
C. bA bsplenectomy bmay bbe bnecessary bto bcontrol bthe bdisease
D. bExpect bincreasing bdifficulties bwith bjoint bmobility b- bcorrect banswer✔✔You bmay
bhave bexcessive bbleeding bfollowing btooth bextraction
Low bdose baspirin bis bcommonly bused bto breduce bthe brisk bof barterial bthrombosis bin
bpatients bwho bhave bsuffered ba bmyocardial binfarction. bWhich bone bof bthe bfollowing
bsteps bin bhomeostasis bis binhibited bby baspirin?
, A. bSynthesis bof bvon bWillebrand bfactor
B. bAggregation bof bplatelets
C. bActivation bof bfactor bXa
D. bSynthesis bof bantithrombin bIII b- bcorrect banswer✔✔Aggregation bof bplatelets
A b24-year-old bpresents bto bthe boffice bwith bfatigue. bOn bphysical bexam, bthe bNP
bnotices bthat bshe bispale bwith bthe bfollowing bvital bsigns: bHR b112, bBP b98/64, bresp
b20, bO2 bsats b99%. bHer bCBC bshows: bWBC6,000, bHemoglobin b9.6, bHematocrit
b30.2, bMCV bis bdecreased bat b76. bWhat bis bthe bmostly blikely bcauseof bthis bpatient's
banemia?
A. bIron bdeficiency banemia bcaused bby bmenstruation
B. bBeta bThalassemia bof bgenetic borigin
C. bPernicious banemia bcaused bby bdietary bdeficiency
D. bFolate bdeficiency bcaused bby balcoholism b- bcorrect banswer✔✔Iron bdeficiency
banemia bcaused bby bmenstruation
A b65-year-old bfemale bpresents bto byour boffice bcomplaining bof bfatigue. bShe bhas ba
blong bof brheumatoid barthritis. bA bCBC breveals bthe bfollowing: bHgb=11.6 bg/dL,
bHct=34.8%, bMCV=87 bfL/red bcell, bplatelet bcount bof b268,000/microliter, band bWBC
bcount bof b6800/microliter. bThe bserum bhaptoglobin blevel bis bnormal, band bthe bserum
biron bconcentration bis b20 bmicrograms/dL. bThe btotal biron bbinding bcapacity bis b195
bmicrograms/dL, band bthe bpercent bsaturation bis b10.2. bThe bserum bferritin
bconcentration bis b317 bng/mL. bNo bfibrin bsplit bproducts bare bdetected. bThe
breticulocyte bconcentration bis b1.1%. bWhat bis bthe bmost blikely bdiagnosis?
A. bBeta- bthalassemia bmajor
B. bAnemia bof bchronic bdisease b
C. bAcute bblood bloss banemia
D. bIron bdeficiency banemia b- bcorrect banswer✔✔Anemia bof bchronic bdisease
A b14-year-old bmale bpresents bwith bhigh bfever bfor bten bdays. bPhysical bexamination
breveals bscattered bpetechial bhemorrhages bbut bis bnegative bfor benlargement bof bthe
bliver bor bspleen bor blymph bnodes. bBone bmarrow bexamination bdoes bnot bshow bany
babnormal bcells. bThe bcomplete bblood bcount b(CBC) bdemonstrates ba bhemoglobin
bconcentration b(HgB) bof b13.2 bg/dL, bhematocrit b(Hct) bof b38.9%, bmean bcell bvolume
b(MCV) bof b93 bfL, bplatelet bcount bof b175,000/microliter, band bwhite bblood bcell b(WBC)
bcount bof b1850/microliter, bwith bthe bdifferential bcount bshowing b1 bsegmented
bneutrophil, b98 blymphocytes, band b1 bmonocyte bper b100 bWBCs. bWhat bis bthe bmost
blikely bcause bof bthese bfindings?
A. bOverwhelming bbacterial binfection
B. bAcute blymphocytic b(or blymphoblastic) bleukemia
C. bAcute bmyeloid bleukemia
D. bAplastic banemia b- bcorrect banswer✔✔Overwhelming bbacterial binfection
MIDTERM NUR 6501 WALDEN
UNIVERSITY / COMPLETE ACTUAL
EXAM / QUESTIONS AND CORRECT
DETAILED ANSWERS / 2025/2026
A b4-year-old bchild bappears blistless bfor bthe blast bweek. bHe bcomplains bof bpain bwhen
bhe bis bpicked bup bby bhis bmother, band bhe bis birritable bwhen btouching bhis barms bor
blegs. bSeveral blarge becchymotic blesions bhave bappeared bon bhis bright bthigh band bleft
bshoulder. bA bcomplete bblood bcount breveals ba bHgB=10.2, bHct=30.5%, bMCV=96fL,
bplatelet bcount bof b45,000/ML, band bWBC bcount bof b13,990/ML. bExamination bof bthe
bperipheral bblood bsmear breveals bnumerous bblasts. bThe bblasts black bperoxidase-
positive bgranules bbut bdo bcontain bperiodic bacid-Schiff b(PAS)-positive baggregates
band bstain bpositively bfor bTdT. bFlow bcytometry bshows bthe bphenotype bof bblasts bto
bbe bCD19+, bCD3-, band bsIg-. bWhat bis bthe bmost blikely bdiagnosis?
A. bAcute blymphoblastic bleukemia b(ALL)
B. bChronic blymphocytic bleukemia b(CLL)
C. bAcute bmyelogenous bleukemia b(AML)
D. bChronic bmyelogenous bleukemia b(CML) b- bcorrect banswer✔✔Acute blymphblastic
bleukemia
A b3-year-old bchild bof bItalian bancestry bpresents bwith bfailure bto bthrive. bPhysical
bexamination bindicates bhepatosplenomegaly. bHis bhemoglobin bconcentration bis b6
bg/dL, band bthe bperipheral bblood bsmear breveals bseverely bhypochromic bmicrocytic
bred bcells. bTotal bserum biron blevel bis bnormal. bThe breticulocyte bcount bis b10%.
bHemoglobin belectrophoresis bshows bvery blittle bhemoglobin bA. bA bradiograph bof bthe
bskull bshows bmaxillofacial bdeformities. bWhat bis bthe bprinciple bcause bof banemia band
bother babnormalities bin bthis bpatient?
A. bReduced bsynthesis bof bhemoglobin bF
,B. bReduced bred bblood bcell bsurvival bfrom bimbalance bin bthe bproduction bof balpha
band bbeta bglobin bchains
C. bRelative bdeficiency bof bvitamin bB12
D. bIncreased bfragility bof bthe berythrocyte bmembrane b- bcorrect banswer✔✔Reduced
bsynthesis bof bhemoglobin bF
A b68-year-old bpreviously bhealthy bfemale bhas bbeen bfeeling bincreasingly btired band
bweak bfor bseveral bmonths. bShe bstates bthat bshe bhas bhad bblack, btarry bstools bfor
bseveral bweeks. bShe bis bfound bto bbe banemic bwith ba bhemoglobin bconcentration bof
b9.3g/dL. bThe bperipheral bblood bsmear breveals bmicrocytic band bhypochromic bblood
bcells. bWhich bof bthe bfollowing bconditions bshould bbe bsuspected bas bthe bmost blikely
bof bher bcondition bas bindicated bby bthe bperipheral bblood bsmear?
A. bAplastic banemia
B. bBeta bthalassemia
C. bGastrointestinal bblood bloss
D. bPernicious banemia b- bcorrect banswer✔✔Gastrointestinal bblood bloss
A b76-year-old bfemale bnotices bthat bsmall, bpinpoint bto bblotchy bareas bof bsuperficial
bhemorrhage bhave bappeared bon bher bgums band bon bthe bskin bof bher barms band blegs
bover bseveral bweeks. bShe bis bfound bto bhave ba bnormal bprothrombin btime(PT) band
bpartial bthromboplastin btime b(PTT). bHer bCBC bshows bhemoglobin bconcentration bof
b12.7 bg/dL, bhematocrit bof b37.2%. bMCV bof b80 bfL/red bcell, bplatelet bcount bof
b276,000/microliter, band bWBC bof b5600/microliter. bHer btemplate bbleeding btime bis b3
bminutes. bHer bfibrinogen blevel bis bnormal, band bthere bare bno bfibrin bsplit bproducts
bdetectable. bWhich bof bthe bfollowing bconditions bbest bexplain bthese bfindings?
A. bChronic brenal bfailure
B. bMacronodular bcirrhosis
C. bVitamin bB12 bdeficiency
D. bVitamin bC bdeficiency b- bcorrect banswer✔✔Vitamin bC bdeficiency
A byoung badult bpatient bhas bjust bbeen bdiagnosed bwith bVon bWillebrand bdisease.
bWhich bof bthe bfollowing bstatements bshould byou bmake bto badvise bthe bpatient bof
bpotential bconsequences bof bthis bdisease?
A. bYou bmay bneed ban ballogeneic bbone bmarrow btransplant
B. bYou bmay bhave bexcessive bbleeding bfollowing btooth bextraction
C. bA bsplenectomy bmay bbe bnecessary bto bcontrol bthe bdisease
D. bExpect bincreasing bdifficulties bwith bjoint bmobility b- bcorrect banswer✔✔You bmay
bhave bexcessive bbleeding bfollowing btooth bextraction
Low bdose baspirin bis bcommonly bused bto breduce bthe brisk bof barterial bthrombosis bin
bpatients bwho bhave bsuffered ba bmyocardial binfarction. bWhich bone bof bthe bfollowing
bsteps bin bhomeostasis bis binhibited bby baspirin?
, A. bSynthesis bof bvon bWillebrand bfactor
B. bAggregation bof bplatelets
C. bActivation bof bfactor bXa
D. bSynthesis bof bantithrombin bIII b- bcorrect banswer✔✔Aggregation bof bplatelets
A b24-year-old bpresents bto bthe boffice bwith bfatigue. bOn bphysical bexam, bthe bNP
bnotices bthat bshe bispale bwith bthe bfollowing bvital bsigns: bHR b112, bBP b98/64, bresp
b20, bO2 bsats b99%. bHer bCBC bshows: bWBC6,000, bHemoglobin b9.6, bHematocrit
b30.2, bMCV bis bdecreased bat b76. bWhat bis bthe bmostly blikely bcauseof bthis bpatient's
banemia?
A. bIron bdeficiency banemia bcaused bby bmenstruation
B. bBeta bThalassemia bof bgenetic borigin
C. bPernicious banemia bcaused bby bdietary bdeficiency
D. bFolate bdeficiency bcaused bby balcoholism b- bcorrect banswer✔✔Iron bdeficiency
banemia bcaused bby bmenstruation
A b65-year-old bfemale bpresents bto byour boffice bcomplaining bof bfatigue. bShe bhas ba
blong bof brheumatoid barthritis. bA bCBC breveals bthe bfollowing: bHgb=11.6 bg/dL,
bHct=34.8%, bMCV=87 bfL/red bcell, bplatelet bcount bof b268,000/microliter, band bWBC
bcount bof b6800/microliter. bThe bserum bhaptoglobin blevel bis bnormal, band bthe bserum
biron bconcentration bis b20 bmicrograms/dL. bThe btotal biron bbinding bcapacity bis b195
bmicrograms/dL, band bthe bpercent bsaturation bis b10.2. bThe bserum bferritin
bconcentration bis b317 bng/mL. bNo bfibrin bsplit bproducts bare bdetected. bThe
breticulocyte bconcentration bis b1.1%. bWhat bis bthe bmost blikely bdiagnosis?
A. bBeta- bthalassemia bmajor
B. bAnemia bof bchronic bdisease b
C. bAcute bblood bloss banemia
D. bIron bdeficiency banemia b- bcorrect banswer✔✔Anemia bof bchronic bdisease
A b14-year-old bmale bpresents bwith bhigh bfever bfor bten bdays. bPhysical bexamination
breveals bscattered bpetechial bhemorrhages bbut bis bnegative bfor benlargement bof bthe
bliver bor bspleen bor blymph bnodes. bBone bmarrow bexamination bdoes bnot bshow bany
babnormal bcells. bThe bcomplete bblood bcount b(CBC) bdemonstrates ba bhemoglobin
bconcentration b(HgB) bof b13.2 bg/dL, bhematocrit b(Hct) bof b38.9%, bmean bcell bvolume
b(MCV) bof b93 bfL, bplatelet bcount bof b175,000/microliter, band bwhite bblood bcell b(WBC)
bcount bof b1850/microliter, bwith bthe bdifferential bcount bshowing b1 bsegmented
bneutrophil, b98 blymphocytes, band b1 bmonocyte bper b100 bWBCs. bWhat bis bthe bmost
blikely bcause bof bthese bfindings?
A. bOverwhelming bbacterial binfection
B. bAcute blymphocytic b(or blymphoblastic) bleukemia
C. bAcute bmyeloid bleukemia
D. bAplastic banemia b- bcorrect banswer✔✔Overwhelming bbacterial binfection
