NSG 5140 – Advanced Pathophysiology Midterm Exam
Review 150-Question Practice Exam with Correct Answers
& Rationales
South College – 2026Edition
1. Which of the following best describes the pathophysiology of type 1
diabetes mellitus?
A) Insulin resistance in peripheral tissues
B) Autoimmune destruction of pancreatic beta cells
C) Excess glucagon secretion
D) Impaired renal glucose reabsorption
Rationale: 👀*** Type 1 diabetes results from autoimmune destruction of beta
cells, leading to absolute insulin deficiency.
2. A patient with chronic heart failure presents with peripheral edema.
Which mechanism is primarily responsible?
A) Increased cardiac output
B) Decreased ADH secretion
C) Increased hydrostatic pressure in capillaries
D) Decreased renin-angiotensin-aldosterone activation
Rationale: 👀*** Elevated hydrostatic pressure in venous capillaries causes
fluid to leak into tissues, producing edema.
3. Which electrolyte abnormality is most likely in a patient with diabetic
ketoacidosis (DKA)?
A) Hypercalcemia
,B) Hypernatremia
C) Hyperkalemia
D) Hypokalemia
Rationale: 👀*** Despite total body potassium depletion, serum potassium is
often elevated due to acidosis and insulin deficiency.
4. Which of the following best describes the pathophysiology of Graves’
disease?
A) Destruction of thyroid tissue
B) Autoantibodies stimulate TSH receptors
C) Pituitary adenoma secreting TSH
D) Iodine deficiency
Rationale: 👀*** Graves’ disease is caused by autoantibodies that stimulate
thyroid hormone production.
5. A patient presents with jaundice, dark urine, and elevated indirect
bilirubin. What is the most likely mechanism?
A) Obstruction of bile ducts
B) Hemolysis causing unconjugated hyperbilirubinemia
C) Hepatocellular injury causing direct bilirubin elevation
D) Impaired enterohepatic circulation
Rationale: 👀*** Hemolysis increases unconjugated bilirubin in the serum
before hepatic conjugation.
6. In chronic obstructive pulmonary disease (COPD), which of the
following changes occurs?
A) Decreased residual volume
,B) Decreased total lung capacity
C) Increased functional residual capacity
D) Decreased airway resistance
Rationale: 👀*** Air trapping in COPD increases functional residual capacity
due to loss of elastic recoil.
7. A 55-year-old patient with hypertension develops left ventricular
hypertrophy. This is an example of:
A) Atrophy
B) Hyperplasia
C) Physiologic adaptation to increased afterload
D) Apoptosis
Rationale: 👀*** LVH results from increased myocardial workload leading to
hypertrophy (cell enlargement).
8. Which of the following is the hallmark of nephrotic syndrome?
A) Hematuria
B) Hypertension
C) Proteinuria >3.5 g/day
D) Azotemia
Rationale: 👀*** Massive proteinuria, hypoalbuminemia, and edema are the
hallmarks of nephrotic syndrome.
9. A patient presents with hypoxemia and normal PaCO₂. Which type of
respiratory failure is this?
A) Type I (hypoxemic) respiratory failure
B) Type II (hypercapnic) respiratory failure
, C) Type III (perioperative) respiratory failure
D) Type IV (shock-related) respiratory failure
Rationale: 👀*** Type I respiratory failure is characterized by low oxygen with
normal or low CO₂.
10. In patients with chronic liver disease, which pathophysiologic
mechanism leads to ascites?
A) Increased plasma oncotic pressure
B) Increased renal sodium excretion
C) Portal hypertension and hypoalbuminemia
D) Increased hepatic bile production
Rationale: 👀*** Portal hypertension increases hydrostatic pressure, and
hypoalbuminemia decreases oncotic pressure, leading to fluid accumulation.
11. Which of the following best describes the pathophysiology of
atherosclerosis?
A) Hypercoagulability leading to thrombi
B) Infection-induced endothelial damage
C) Endothelial injury with lipid deposition and inflammation
D) Autoimmune destruction of arteries
Rationale: 👀*** Atherosclerosis develops from endothelial dysfunction, lipid
accumulation, and chronic inflammation.
12. Which hormone is primarily responsible for calcium regulation by
increasing serum calcium levels?
A) Calcitonin
B) Parathyroid hormone (PTH)
Review 150-Question Practice Exam with Correct Answers
& Rationales
South College – 2026Edition
1. Which of the following best describes the pathophysiology of type 1
diabetes mellitus?
A) Insulin resistance in peripheral tissues
B) Autoimmune destruction of pancreatic beta cells
C) Excess glucagon secretion
D) Impaired renal glucose reabsorption
Rationale: 👀*** Type 1 diabetes results from autoimmune destruction of beta
cells, leading to absolute insulin deficiency.
2. A patient with chronic heart failure presents with peripheral edema.
Which mechanism is primarily responsible?
A) Increased cardiac output
B) Decreased ADH secretion
C) Increased hydrostatic pressure in capillaries
D) Decreased renin-angiotensin-aldosterone activation
Rationale: 👀*** Elevated hydrostatic pressure in venous capillaries causes
fluid to leak into tissues, producing edema.
3. Which electrolyte abnormality is most likely in a patient with diabetic
ketoacidosis (DKA)?
A) Hypercalcemia
,B) Hypernatremia
C) Hyperkalemia
D) Hypokalemia
Rationale: 👀*** Despite total body potassium depletion, serum potassium is
often elevated due to acidosis and insulin deficiency.
4. Which of the following best describes the pathophysiology of Graves’
disease?
A) Destruction of thyroid tissue
B) Autoantibodies stimulate TSH receptors
C) Pituitary adenoma secreting TSH
D) Iodine deficiency
Rationale: 👀*** Graves’ disease is caused by autoantibodies that stimulate
thyroid hormone production.
5. A patient presents with jaundice, dark urine, and elevated indirect
bilirubin. What is the most likely mechanism?
A) Obstruction of bile ducts
B) Hemolysis causing unconjugated hyperbilirubinemia
C) Hepatocellular injury causing direct bilirubin elevation
D) Impaired enterohepatic circulation
Rationale: 👀*** Hemolysis increases unconjugated bilirubin in the serum
before hepatic conjugation.
6. In chronic obstructive pulmonary disease (COPD), which of the
following changes occurs?
A) Decreased residual volume
,B) Decreased total lung capacity
C) Increased functional residual capacity
D) Decreased airway resistance
Rationale: 👀*** Air trapping in COPD increases functional residual capacity
due to loss of elastic recoil.
7. A 55-year-old patient with hypertension develops left ventricular
hypertrophy. This is an example of:
A) Atrophy
B) Hyperplasia
C) Physiologic adaptation to increased afterload
D) Apoptosis
Rationale: 👀*** LVH results from increased myocardial workload leading to
hypertrophy (cell enlargement).
8. Which of the following is the hallmark of nephrotic syndrome?
A) Hematuria
B) Hypertension
C) Proteinuria >3.5 g/day
D) Azotemia
Rationale: 👀*** Massive proteinuria, hypoalbuminemia, and edema are the
hallmarks of nephrotic syndrome.
9. A patient presents with hypoxemia and normal PaCO₂. Which type of
respiratory failure is this?
A) Type I (hypoxemic) respiratory failure
B) Type II (hypercapnic) respiratory failure
, C) Type III (perioperative) respiratory failure
D) Type IV (shock-related) respiratory failure
Rationale: 👀*** Type I respiratory failure is characterized by low oxygen with
normal or low CO₂.
10. In patients with chronic liver disease, which pathophysiologic
mechanism leads to ascites?
A) Increased plasma oncotic pressure
B) Increased renal sodium excretion
C) Portal hypertension and hypoalbuminemia
D) Increased hepatic bile production
Rationale: 👀*** Portal hypertension increases hydrostatic pressure, and
hypoalbuminemia decreases oncotic pressure, leading to fluid accumulation.
11. Which of the following best describes the pathophysiology of
atherosclerosis?
A) Hypercoagulability leading to thrombi
B) Infection-induced endothelial damage
C) Endothelial injury with lipid deposition and inflammation
D) Autoimmune destruction of arteries
Rationale: 👀*** Atherosclerosis develops from endothelial dysfunction, lipid
accumulation, and chronic inflammation.
12. Which hormone is primarily responsible for calcium regulation by
increasing serum calcium levels?
A) Calcitonin
B) Parathyroid hormone (PTH)
