1
Midterm Exam – NR507 / NR
507 Advanced
Pathophysiology (Latest 2025
/ 2026): Verified Answers –
Chamberlain
Question 1: What is the most abundant class of
plasma protein?
• A. Globulin
• B. Albumin
• C. Clotting factors
• D. Complement proteins
Rationale: Albumin constitutes approximately 60% of total plasma
protein (about 4 g/dL) and maintains oncotic pressure, preventing
edema; clinically, low levels in liver disease lead to ascites via reduced
vascular colloid osmotic pressure.
Question 2: Carcinoma in situ is characterized by
which changes?
• A. Cells have broken through the local basement membrane
• B. Cells have invaded immediate surrounding tissue
• C. Cells remain localized in the glandular or squamous cells
• D. Cellular and tissue alterations indicate dysplasia
, 2
Rationale: Carcinoma in situ (CIS) represents preinvasive malignancy
confined to the epithelium without basement membrane breach, allowing
early detection via screening; progression to invasive cancer involves
stromal invasion, as in cervical CIS detected by Pap smear.
Question 3: Which laboratory test is considered
adequate for an accurate and reliable diagnosis of
gonococcal urethritis in a symptomatic man?
• A. Ligase chain reaction (LCR)
• B. Gram-stain technique
• C. Polymerase chain reaction (PCR)
• D. DNA testing
Rationale: Gram-stain reveals gram-negative diplococci within
neutrophils, confirming Neisseria gonorrhoeae; this rapid method guides
empiric therapy in acute urethritis, preventing complications like
disseminated infection.
Question 4: The Papanicolaou (Pap) test is used
to screen for which cancer?
• A. Ovarian
• B. Uterine
• C. Cervical
• D. Vaginal
Rationale: Pap smear detects dysplastic changes from HPV-induced
cervical intraepithelial neoplasia; early identification reduces invasive
squamous cell carcinoma risk through colposcopy and excision.
Question 5: Causes of hyperkalemia include:
• A. Hyperparathyroidism and malnutrition
, 3
• B. Vomiting and diarrhea
• C. Renal failure and Addison disease
• D. Hyperaldosteronism and Cushing disease
Rationale: Renal failure impairs K+ excretion, while Addison's
mineralocorticoid deficiency reduces aldosterone-mediated renal K+
secretion; clinically, ECG changes like peaked T-waves necessitate
urgent stabilization to prevent arrhythmias.
Question 6: What is the major concern regarding
the treatment of gonococci infections?
• A. Changes in virulence
• B. Changes in pathogenicity
• C. Mutations into different strains
• D. Development of antibiotic resistance
Rationale: Resistance in N. gonorrhoeae (e.g., to cephalosporins) arises
via beta-lactamase production and efflux pumps, complicating CDC-
recommended dual therapy (ceftriaxone + azithromycin) and risking
untreated pelvic inflammatory disease.
Question 7: Hypersensitivity is best defined as
a(an):
• A. Disturbance in the immunologic tolerance of self-antigens
• B. Immunologic reaction of one person to the tissue of another
person
• C. Altered immunologic response to an antigen that results in
disease
• D. Undetectable immune response in the presence of antigens
Rationale: Hypersensitivity involves exaggerated immune responses
(types I-IV) causing tissue damage, e.g., anaphylaxis in type I;
Midterm Exam – NR507 / NR
507 Advanced
Pathophysiology (Latest 2025
/ 2026): Verified Answers –
Chamberlain
Question 1: What is the most abundant class of
plasma protein?
• A. Globulin
• B. Albumin
• C. Clotting factors
• D. Complement proteins
Rationale: Albumin constitutes approximately 60% of total plasma
protein (about 4 g/dL) and maintains oncotic pressure, preventing
edema; clinically, low levels in liver disease lead to ascites via reduced
vascular colloid osmotic pressure.
Question 2: Carcinoma in situ is characterized by
which changes?
• A. Cells have broken through the local basement membrane
• B. Cells have invaded immediate surrounding tissue
• C. Cells remain localized in the glandular or squamous cells
• D. Cellular and tissue alterations indicate dysplasia
, 2
Rationale: Carcinoma in situ (CIS) represents preinvasive malignancy
confined to the epithelium without basement membrane breach, allowing
early detection via screening; progression to invasive cancer involves
stromal invasion, as in cervical CIS detected by Pap smear.
Question 3: Which laboratory test is considered
adequate for an accurate and reliable diagnosis of
gonococcal urethritis in a symptomatic man?
• A. Ligase chain reaction (LCR)
• B. Gram-stain technique
• C. Polymerase chain reaction (PCR)
• D. DNA testing
Rationale: Gram-stain reveals gram-negative diplococci within
neutrophils, confirming Neisseria gonorrhoeae; this rapid method guides
empiric therapy in acute urethritis, preventing complications like
disseminated infection.
Question 4: The Papanicolaou (Pap) test is used
to screen for which cancer?
• A. Ovarian
• B. Uterine
• C. Cervical
• D. Vaginal
Rationale: Pap smear detects dysplastic changes from HPV-induced
cervical intraepithelial neoplasia; early identification reduces invasive
squamous cell carcinoma risk through colposcopy and excision.
Question 5: Causes of hyperkalemia include:
• A. Hyperparathyroidism and malnutrition
, 3
• B. Vomiting and diarrhea
• C. Renal failure and Addison disease
• D. Hyperaldosteronism and Cushing disease
Rationale: Renal failure impairs K+ excretion, while Addison's
mineralocorticoid deficiency reduces aldosterone-mediated renal K+
secretion; clinically, ECG changes like peaked T-waves necessitate
urgent stabilization to prevent arrhythmias.
Question 6: What is the major concern regarding
the treatment of gonococci infections?
• A. Changes in virulence
• B. Changes in pathogenicity
• C. Mutations into different strains
• D. Development of antibiotic resistance
Rationale: Resistance in N. gonorrhoeae (e.g., to cephalosporins) arises
via beta-lactamase production and efflux pumps, complicating CDC-
recommended dual therapy (ceftriaxone + azithromycin) and risking
untreated pelvic inflammatory disease.
Question 7: Hypersensitivity is best defined as
a(an):
• A. Disturbance in the immunologic tolerance of self-antigens
• B. Immunologic reaction of one person to the tissue of another
person
• C. Altered immunologic response to an antigen that results in
disease
• D. Undetectable immune response in the presence of antigens
Rationale: Hypersensitivity involves exaggerated immune responses
(types I-IV) causing tissue damage, e.g., anaphylaxis in type I;
