NURS 5315 Exam 2 UTA 2026 |
NURS 5315 Advanced
Pathophysiology Latest
Updated Exam
1. A 58-year-old male with a long-standing history of hypertension presents
with progressive left ventricular hypertrophy noted on echocardiogram. The
nurse practitioner understands that the most likely pathophysiological
explanation for this compensatory mechanism is which of the following?
• A. Decreased myocardial oxygen demand due to reduced afterload
• B. Increased cardiac muscle mass in response to chronic pressure
overload
• C. Fibrotic replacement of myocardial cells causing ventricular dilation
• D. Reduced sympathetic nervous system activation leading to cardiac
remodeling
Rationale: Chronic hypertension increases afterload, forcing the left ventricle to
work harder. Over time, myocardial cells enlarge to compensate for increased
workload, resulting in left ventricular hypertrophy .
2. A patient with poorly controlled type 2 diabetes mellitus develops diabetic
nephropathy. Which mechanism is primarily responsible for glomerular
damage in this condition?
, • A. Autoimmune destruction of renal tubules
• B. Increased ketone production causing tubular necrosis
• C. Persistent hyperglycemia leading to microvascular injury
• D. Acute vasodilation of renal arteries causing hyperfiltration
Rationale: Chronic hyperglycemia damages glomerular capillaries through
advanced glycation end products and microvascular inflammation, leading to
diabetic nephropathy .
3. A nurse practitioner evaluates a patient with chronic obstructive
pulmonary disease (COPD) who demonstrates barrel chest formation and
prolonged expiration. Which underlying pathophysiological process best
explains these findings?
• A. Restrictive lung expansion from pleural fibrosis
• B. Air trapping due to destruction of alveolar elastic tissue
• C. Increased pulmonary compliance caused by fluid accumulation
• D. Bronchial hyperreactivity leading to episodic bronchoconstriction
Rationale: In emphysema, destruction of alveolar walls reduces elastic recoil,
causing air trapping and hyperinflation, which contributes to barrel chest
appearance .
4. A 35-year-old female develops Graves disease and reports heat intolerance,
weight loss, and palpitations. Which physiological effect is directly caused by
elevated thyroid hormone levels?
• A. Reduced basal metabolic rate
, • B. Increased sympathetic nervous system sensitivity
• C. Suppression of catecholamine receptors
• D. Decreased cardiac output and oxygen consumption
Rationale: Excess thyroid hormone increases beta-adrenergic receptor sensitivity,
leading to tachycardia, palpitations, anxiety, and heat intolerance .
5. A patient with systemic lupus erythematosus develops glomerulonephritis.
Which immunological mechanism is primarily responsible for tissue damage?
• A. Direct bacterial invasion of nephrons
• B. Immune complex deposition within glomeruli
• C. Excess erythropoietin production
• D. Histamine release from mast cells only
Rationale: Lupus nephritis results from immune complexes depositing in
glomeruli, triggering inflammation and tissue injury .
6. A patient diagnosed with syndrome of inappropriate antidiuretic hormone
secretion (SIADH) is at highest risk for which electrolyte imbalance?
• A. Hypernatremia
• B. Hyperkalemia
• C. Hyponatremia
• D. Hypercalcemia
Rationale: Excess ADH causes water retention, diluting serum sodium
concentrations and leading to hyponatremia .
, 7. A patient with acute pancreatitis reports severe epigastric pain radiating to
the back. Which pathophysiological process causes pancreatic tissue
destruction?
• A. Premature activation of digestive enzymes within the pancreas
• B. Reduced pancreatic enzyme production
• C. Autoimmune destruction of insulin-producing cells
• D. Chronic bacterial infection of pancreatic ducts
Rationale: Activated pancreatic enzymes digest pancreatic tissue, causing
inflammation and necrosis .
8. A patient with heart failure presents with pulmonary edema. Which
mechanism contributes most directly to fluid accumulation in the lungs?
• A. Decreased pulmonary capillary hydrostatic pressure
• B. Elevated left ventricular end-diastolic pressure
• C. Increased plasma oncotic pressure
• D. Reduced sodium and water retention
Rationale: Left-sided heart failure increases pulmonary venous pressure, forcing
fluid into alveolar spaces .
NURS 5315 Advanced
Pathophysiology Latest
Updated Exam
1. A 58-year-old male with a long-standing history of hypertension presents
with progressive left ventricular hypertrophy noted on echocardiogram. The
nurse practitioner understands that the most likely pathophysiological
explanation for this compensatory mechanism is which of the following?
• A. Decreased myocardial oxygen demand due to reduced afterload
• B. Increased cardiac muscle mass in response to chronic pressure
overload
• C. Fibrotic replacement of myocardial cells causing ventricular dilation
• D. Reduced sympathetic nervous system activation leading to cardiac
remodeling
Rationale: Chronic hypertension increases afterload, forcing the left ventricle to
work harder. Over time, myocardial cells enlarge to compensate for increased
workload, resulting in left ventricular hypertrophy .
2. A patient with poorly controlled type 2 diabetes mellitus develops diabetic
nephropathy. Which mechanism is primarily responsible for glomerular
damage in this condition?
, • A. Autoimmune destruction of renal tubules
• B. Increased ketone production causing tubular necrosis
• C. Persistent hyperglycemia leading to microvascular injury
• D. Acute vasodilation of renal arteries causing hyperfiltration
Rationale: Chronic hyperglycemia damages glomerular capillaries through
advanced glycation end products and microvascular inflammation, leading to
diabetic nephropathy .
3. A nurse practitioner evaluates a patient with chronic obstructive
pulmonary disease (COPD) who demonstrates barrel chest formation and
prolonged expiration. Which underlying pathophysiological process best
explains these findings?
• A. Restrictive lung expansion from pleural fibrosis
• B. Air trapping due to destruction of alveolar elastic tissue
• C. Increased pulmonary compliance caused by fluid accumulation
• D. Bronchial hyperreactivity leading to episodic bronchoconstriction
Rationale: In emphysema, destruction of alveolar walls reduces elastic recoil,
causing air trapping and hyperinflation, which contributes to barrel chest
appearance .
4. A 35-year-old female develops Graves disease and reports heat intolerance,
weight loss, and palpitations. Which physiological effect is directly caused by
elevated thyroid hormone levels?
• A. Reduced basal metabolic rate
, • B. Increased sympathetic nervous system sensitivity
• C. Suppression of catecholamine receptors
• D. Decreased cardiac output and oxygen consumption
Rationale: Excess thyroid hormone increases beta-adrenergic receptor sensitivity,
leading to tachycardia, palpitations, anxiety, and heat intolerance .
5. A patient with systemic lupus erythematosus develops glomerulonephritis.
Which immunological mechanism is primarily responsible for tissue damage?
• A. Direct bacterial invasion of nephrons
• B. Immune complex deposition within glomeruli
• C. Excess erythropoietin production
• D. Histamine release from mast cells only
Rationale: Lupus nephritis results from immune complexes depositing in
glomeruli, triggering inflammation and tissue injury .
6. A patient diagnosed with syndrome of inappropriate antidiuretic hormone
secretion (SIADH) is at highest risk for which electrolyte imbalance?
• A. Hypernatremia
• B. Hyperkalemia
• C. Hyponatremia
• D. Hypercalcemia
Rationale: Excess ADH causes water retention, diluting serum sodium
concentrations and leading to hyponatremia .
, 7. A patient with acute pancreatitis reports severe epigastric pain radiating to
the back. Which pathophysiological process causes pancreatic tissue
destruction?
• A. Premature activation of digestive enzymes within the pancreas
• B. Reduced pancreatic enzyme production
• C. Autoimmune destruction of insulin-producing cells
• D. Chronic bacterial infection of pancreatic ducts
Rationale: Activated pancreatic enzymes digest pancreatic tissue, causing
inflammation and necrosis .
8. A patient with heart failure presents with pulmonary edema. Which
mechanism contributes most directly to fluid accumulation in the lungs?
• A. Decreased pulmonary capillary hydrostatic pressure
• B. Elevated left ventricular end-diastolic pressure
• C. Increased plasma oncotic pressure
• D. Reduced sodium and water retention
Rationale: Left-sided heart failure increases pulmonary venous pressure, forcing
fluid into alveolar spaces .
