1|Page
NSG 530 EXAM 3 ADVANCED
PATHOPHYSIOLOGY ACTUAL EXAM |
150 QUESTIONS AND CORRECT
DETAILED ANSWERS | LATEST 2026-2027
VERSION |RATED A +
1. A 65-year-old patient presents with progressive dyspnea
and fatigue. Echocardiogram reveals a reduced ejection
fraction. Which pathophysiologic mechanism primarily
explains the patient’s symptoms?
A. Increased preload
B. Decreased myocardial contractility
C. Pulmonary vasoconstriction
D. Systemic vasodilation
Rationale: Heart failure with reduced ejection fraction results
from impaired myocardial contractility, leading to decreased
cardiac output and symptoms such as dyspnea and fatigue.
2. A patient with chronic kidney disease develops
hyperkalemia. Which cellular mechanism is primarily
responsible for the associated cardiac arrhythmias?
A. Enhanced sodium influx
B. Decreased calcium release from the sarcoplasmic
reticulum
,2|Page
C. Altered resting membrane potential due to increased
extracellular potassium
D. Increased ATPase activity
Rationale: Elevated extracellular potassium reduces the
resting membrane potential, making cardiac cells more
excitable and predisposing to arrhythmias.
3. A patient develops acute respiratory distress syndrome
(ARDS) after sepsis. Which pathophysiologic change is
characteristic of ARDS?
A. Obstructive airway inflammation
B. Diffuse alveolar damage with increased capillary
permeability
C. Pulmonary arterial hypertension
D. Pleural effusion
Rationale: ARDS involves diffuse alveolar-capillary injury,
leading to non-cardiogenic pulmonary edema and impaired
gas exchange.
4. Which cytokine is most closely associated with systemic
inflammation in sepsis?
A. Interleukin-4
B. Tumor necrosis factor-alpha (TNF-α)
C. Interferon-gamma
D. Interleukin-10
Rationale: TNF-α is a key pro-inflammatory mediator that
triggers the systemic inflammatory response in sepsis.
5. A patient presents with polyuria, polydipsia, and weight
loss. Laboratory results reveal hyperglycemia. Which
,3|Page
mechanism primarily underlies these findings?
A. Increased insulin sensitivity
B. Excess renal glucose reabsorption
C. Insulin deficiency leading to impaired glucose uptake
D. Excess glucagon suppression
Rationale: In type 1 diabetes mellitus, insulin deficiency
prevents glucose uptake into cells, causing hyperglycemia,
osmotic diuresis, and weight loss.
6. A patient develops a deep vein thrombosis (DVT) after
surgery. Which Virchow’s triad component is most relevant
here?
A. Hyperdynamic circulation
B. Endothelial repair
C. Venous stasis
D. Hypocoagulability
Rationale: Post-surgical immobility contributes to venous
stasis, one of the three components of Virchow’s triad
predisposing to DVT.
7. A 45-year-old patient with chronic alcohol use presents
with epigastric pain radiating to the back. Serum amylase
and lipase are elevated. What is the primary mechanism of
tissue injury?
A. Autoimmune inflammation
B. Obstruction of bile ducts
C. Premature activation of pancreatic enzymes causing
autodigestion
D. Viral cytotoxicity
, 4|Page
Rationale: Acute pancreatitis often results from premature
activation of digestive enzymes within the pancreas, causing
tissue autodigestion.
8. A patient with hypothyroidism exhibits bradycardia,
fatigue, and weight gain. Which hormone alteration is most
responsible?
A. Increased T3
B. Increased T4
C. Decreased thyroid hormone leading to reduced
metabolic rate
D. Increased TSH receptor activity
Rationale: Low thyroid hormone reduces basal metabolic rate,
leading to fatigue, weight gain, and slowed heart rate.
9. A patient presents with jaundice, dark urine, and elevated
AST/ALT. Hepatitis B surface antigen is positive. Which
pathophysiologic process is occurring?
A. Biliary obstruction
B. Hepatocellular injury and inflammation
C. Hemolysis
D. Cirrhosis-induced portal hypertension
Rationale: Viral hepatitis causes direct hepatocyte injury,
leading to enzyme elevation and clinical jaundice.
10. A 60-year-old patient with hypertension develops left
ventricular hypertrophy. Which cellular process
predominates in this adaptation?
A. Myocyte hyperplasia
B. Myocyte hypertrophy
NSG 530 EXAM 3 ADVANCED
PATHOPHYSIOLOGY ACTUAL EXAM |
150 QUESTIONS AND CORRECT
DETAILED ANSWERS | LATEST 2026-2027
VERSION |RATED A +
1. A 65-year-old patient presents with progressive dyspnea
and fatigue. Echocardiogram reveals a reduced ejection
fraction. Which pathophysiologic mechanism primarily
explains the patient’s symptoms?
A. Increased preload
B. Decreased myocardial contractility
C. Pulmonary vasoconstriction
D. Systemic vasodilation
Rationale: Heart failure with reduced ejection fraction results
from impaired myocardial contractility, leading to decreased
cardiac output and symptoms such as dyspnea and fatigue.
2. A patient with chronic kidney disease develops
hyperkalemia. Which cellular mechanism is primarily
responsible for the associated cardiac arrhythmias?
A. Enhanced sodium influx
B. Decreased calcium release from the sarcoplasmic
reticulum
,2|Page
C. Altered resting membrane potential due to increased
extracellular potassium
D. Increased ATPase activity
Rationale: Elevated extracellular potassium reduces the
resting membrane potential, making cardiac cells more
excitable and predisposing to arrhythmias.
3. A patient develops acute respiratory distress syndrome
(ARDS) after sepsis. Which pathophysiologic change is
characteristic of ARDS?
A. Obstructive airway inflammation
B. Diffuse alveolar damage with increased capillary
permeability
C. Pulmonary arterial hypertension
D. Pleural effusion
Rationale: ARDS involves diffuse alveolar-capillary injury,
leading to non-cardiogenic pulmonary edema and impaired
gas exchange.
4. Which cytokine is most closely associated with systemic
inflammation in sepsis?
A. Interleukin-4
B. Tumor necrosis factor-alpha (TNF-α)
C. Interferon-gamma
D. Interleukin-10
Rationale: TNF-α is a key pro-inflammatory mediator that
triggers the systemic inflammatory response in sepsis.
5. A patient presents with polyuria, polydipsia, and weight
loss. Laboratory results reveal hyperglycemia. Which
,3|Page
mechanism primarily underlies these findings?
A. Increased insulin sensitivity
B. Excess renal glucose reabsorption
C. Insulin deficiency leading to impaired glucose uptake
D. Excess glucagon suppression
Rationale: In type 1 diabetes mellitus, insulin deficiency
prevents glucose uptake into cells, causing hyperglycemia,
osmotic diuresis, and weight loss.
6. A patient develops a deep vein thrombosis (DVT) after
surgery. Which Virchow’s triad component is most relevant
here?
A. Hyperdynamic circulation
B. Endothelial repair
C. Venous stasis
D. Hypocoagulability
Rationale: Post-surgical immobility contributes to venous
stasis, one of the three components of Virchow’s triad
predisposing to DVT.
7. A 45-year-old patient with chronic alcohol use presents
with epigastric pain radiating to the back. Serum amylase
and lipase are elevated. What is the primary mechanism of
tissue injury?
A. Autoimmune inflammation
B. Obstruction of bile ducts
C. Premature activation of pancreatic enzymes causing
autodigestion
D. Viral cytotoxicity
, 4|Page
Rationale: Acute pancreatitis often results from premature
activation of digestive enzymes within the pancreas, causing
tissue autodigestion.
8. A patient with hypothyroidism exhibits bradycardia,
fatigue, and weight gain. Which hormone alteration is most
responsible?
A. Increased T3
B. Increased T4
C. Decreased thyroid hormone leading to reduced
metabolic rate
D. Increased TSH receptor activity
Rationale: Low thyroid hormone reduces basal metabolic rate,
leading to fatigue, weight gain, and slowed heart rate.
9. A patient presents with jaundice, dark urine, and elevated
AST/ALT. Hepatitis B surface antigen is positive. Which
pathophysiologic process is occurring?
A. Biliary obstruction
B. Hepatocellular injury and inflammation
C. Hemolysis
D. Cirrhosis-induced portal hypertension
Rationale: Viral hepatitis causes direct hepatocyte injury,
leading to enzyme elevation and clinical jaundice.
10. A 60-year-old patient with hypertension develops left
ventricular hypertrophy. Which cellular process
predominates in this adaptation?
A. Myocyte hyperplasia
B. Myocyte hypertrophy
