NR507 FINAL EXAM – COMPREHENSIVE ADVANCED
PATHOPHYSIOLOGY REVIEW EXAM QUESTIONS
AND CORRECT ANSWERS WITH RATIONALES
GRADED A+ LATEST
Question 1
A patient with chronic kidney disease develops secondary hyperparathyroidism.
Which pathophysiologic mechanism is primarily responsible?
A. Decreased renal excretion of calcium
B. Impaired conversion of vitamin D to its active form
C. Excessive intestinal absorption of phosphate
D. Increased calcitonin secretion
Correct Answer: B
Rationale: Diseased kidneys are unable to convert vitamin D to its active form
(calcitriol), leading to reduced calcium absorption, hypocalcemia, and
compensatory elevation of parathyroid hormone.
Question 2
Which cellular adaptation occurs in response to prolonged hypoxia in myocardial
tissue?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
Correct Answer: C
Rationale: Cardiac myocytes adapt to chronic hypoxia by hypertrophy, increasing
cell size to enhance contractile function, as they are unable to undergo hyperplasia.
,Question 3
The earliest indicator of left-sided heart failure is most likely:
A. Peripheral edema
B. Jugular venous distention
C. Pulmonary congestion
D. Hepatomegaly
Correct Answer: C
Rationale: Left ventricular failure results in increased pulmonary venous pressure,
causing pulmonary congestion and dyspnea before systemic signs develop.
Question 4
Which electrolyte imbalance is most commonly associated with diabetic
ketoacidosis on initial presentation?
A. Hypernatremia
B. Hypokalemia
C. Hyperkalemia
D. Hypocalcemia
Correct Answer: C
Rationale: Despite total body potassium depletion, acidosis and insulin deficiency
cause potassium to shift out of cells, leading to hyperkalemia on presentation.
Question 5
Which mechanism best explains insulin resistance in type 2 diabetes mellitus?
A. Autoimmune destruction of beta cells
B. Reduced insulin secretion from pancreatic alpha cells
C. Downregulation of insulin receptors
D. Increased hepatic gluconeogenesis due to cortisol
,Correct Answer: C
Rationale: Insulin resistance primarily results from decreased sensitivity and
downregulation of insulin receptors in peripheral tissues.
Question 6
A patient with septic shock exhibits hypotension despite adequate fluid
resuscitation. This is primarily due to:
A. Decreased preload
B. Reduced myocardial contractility
C. Systemic vasodilation
D. Increased blood viscosity
Correct Answer: C
Rationale: Septic shock is characterized by widespread vasodilation due to
inflammatory mediators, resulting in distributive shock and persistent hypotension.
Question 7
Which finding is most consistent with syndrome of inappropriate antidiuretic
hormone secretion (SIADH)?
A. Hypernatremia
B. Dehydration
C. Concentrated urine
D. Increased serum osmolality
Correct Answer: C
Rationale: Excess ADH causes water retention, resulting in diluted serum and
inappropriately concentrated urine.
, Question 8
The hallmark pathophysiologic feature of asthma is:
A. Alveolar destruction
B. Irreversible airway obstruction
C. Chronic bronchial dilation
D. Airway hyperresponsiveness
Correct Answer: D
Rationale: Asthma is characterized by reversible airway obstruction due to
inflammation and hyperresponsiveness of bronchial smooth muscle.
Question 9
Which immunoglobulin is primarily responsible for immediate hypersensitivity
reactions?
A. IgA
B. IgE
C. IgG
D. IgM
Correct Answer: B
Rationale: IgE binds to mast cells and basophils, triggering histamine release
during type I hypersensitivity reactions.
Question 10
A decrease in oncotic pressure contributing to edema formation is most commonly
caused by:
A. Increased capillary permeability
B. Venous obstruction
C. Hypoalbuminemia
D. Lymphatic obstruction
PATHOPHYSIOLOGY REVIEW EXAM QUESTIONS
AND CORRECT ANSWERS WITH RATIONALES
GRADED A+ LATEST
Question 1
A patient with chronic kidney disease develops secondary hyperparathyroidism.
Which pathophysiologic mechanism is primarily responsible?
A. Decreased renal excretion of calcium
B. Impaired conversion of vitamin D to its active form
C. Excessive intestinal absorption of phosphate
D. Increased calcitonin secretion
Correct Answer: B
Rationale: Diseased kidneys are unable to convert vitamin D to its active form
(calcitriol), leading to reduced calcium absorption, hypocalcemia, and
compensatory elevation of parathyroid hormone.
Question 2
Which cellular adaptation occurs in response to prolonged hypoxia in myocardial
tissue?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
Correct Answer: C
Rationale: Cardiac myocytes adapt to chronic hypoxia by hypertrophy, increasing
cell size to enhance contractile function, as they are unable to undergo hyperplasia.
,Question 3
The earliest indicator of left-sided heart failure is most likely:
A. Peripheral edema
B. Jugular venous distention
C. Pulmonary congestion
D. Hepatomegaly
Correct Answer: C
Rationale: Left ventricular failure results in increased pulmonary venous pressure,
causing pulmonary congestion and dyspnea before systemic signs develop.
Question 4
Which electrolyte imbalance is most commonly associated with diabetic
ketoacidosis on initial presentation?
A. Hypernatremia
B. Hypokalemia
C. Hyperkalemia
D. Hypocalcemia
Correct Answer: C
Rationale: Despite total body potassium depletion, acidosis and insulin deficiency
cause potassium to shift out of cells, leading to hyperkalemia on presentation.
Question 5
Which mechanism best explains insulin resistance in type 2 diabetes mellitus?
A. Autoimmune destruction of beta cells
B. Reduced insulin secretion from pancreatic alpha cells
C. Downregulation of insulin receptors
D. Increased hepatic gluconeogenesis due to cortisol
,Correct Answer: C
Rationale: Insulin resistance primarily results from decreased sensitivity and
downregulation of insulin receptors in peripheral tissues.
Question 6
A patient with septic shock exhibits hypotension despite adequate fluid
resuscitation. This is primarily due to:
A. Decreased preload
B. Reduced myocardial contractility
C. Systemic vasodilation
D. Increased blood viscosity
Correct Answer: C
Rationale: Septic shock is characterized by widespread vasodilation due to
inflammatory mediators, resulting in distributive shock and persistent hypotension.
Question 7
Which finding is most consistent with syndrome of inappropriate antidiuretic
hormone secretion (SIADH)?
A. Hypernatremia
B. Dehydration
C. Concentrated urine
D. Increased serum osmolality
Correct Answer: C
Rationale: Excess ADH causes water retention, resulting in diluted serum and
inappropriately concentrated urine.
, Question 8
The hallmark pathophysiologic feature of asthma is:
A. Alveolar destruction
B. Irreversible airway obstruction
C. Chronic bronchial dilation
D. Airway hyperresponsiveness
Correct Answer: D
Rationale: Asthma is characterized by reversible airway obstruction due to
inflammation and hyperresponsiveness of bronchial smooth muscle.
Question 9
Which immunoglobulin is primarily responsible for immediate hypersensitivity
reactions?
A. IgA
B. IgE
C. IgG
D. IgM
Correct Answer: B
Rationale: IgE binds to mast cells and basophils, triggering histamine release
during type I hypersensitivity reactions.
Question 10
A decrease in oncotic pressure contributing to edema formation is most commonly
caused by:
A. Increased capillary permeability
B. Venous obstruction
C. Hypoalbuminemia
D. Lymphatic obstruction
