NURS 5315 EXAM 5 – ADVANCED PATHOPHYSIOLOGY
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LATEST UPDATE
EXAM STRUCTURE OVERVIEW
NURS 5315 Advanced Pathophysiology builds on foundational anatomy and physiology
knowledge, focusing on advanced pathophysiologic concepts across the lifespan.
Exam 5 typically covers the following content domains:
• Hematologic System Disorders
• Cardiovascular System Disorders
• Respiratory System Disorders
• Renal System Disorders
• Fluid, Electrolyte, and Acid-Base Disorders
• Gastrointestinal System Disorders
• Endocrine System Disorders
• Immune System Disorders
• Neurologic System Disorders
• Musculoskeletal System Disorders
• Integumentary System Disorders
SECTION 1: HEMATOLOGIC SYSTEM DISORDERS (Questions 1–40)
Question 1
A patient with anemia of chronic disease would most likely present with which
of the following laboratory findings?
A) Elevated serum iron, elevated TIBC, elevated ferritin
B) Low serum iron, low TIBC, elevated ferritin
C) Low serum iron, elevated TIBC, low ferritin
D) Elevated serum iron, low TIBC, low ferritin
[Correct Answer] B
Rationale: Anemia of chronic disease is characterized by low serum iron, low
total iron-binding capacity (TIBC), and elevated ferritin. This pattern reflects
the body's inflammatory response, where iron is sequestered in macrophages and
ferritin is increased as an acute-phase reactant. Iron deficiency anemia (C)
shows low ferritin and elevated TIBC.
1
,Question 2
Which of the following is the most common cause of iron deficiency anemia in
adults?
A) Decreased dietary intake
B) Chronic blood loss
C) Increased iron requirements
D) Impaired iron absorption
[Correct Answer] B
Rationale: Chronic blood loss is the most common cause of iron deficiency anemia
in adults. In premenopausal women, this is typically due to menstrual bleeding;
in older adults, gastrointestinal bleeding is the most frequent cause. While
decreased dietary intake and impaired absorption can cause iron deficiency,
they are less common than chronic blood loss in adults.
Question 3
A patient with pernicious anemia has a deficiency of which of the following?
A) Folic acid
B) Vitamin B12
C) Iron
D) Vitamin B6
[Correct Answer] B
Rationale: Pernicious anemia is caused by a deficiency of intrinsic factor,
which is required for the absorption of vitamin B12 in the terminal ileum. This
leads to vitamin B12 deficiency and impaired DNA synthesis in rapidly dividing
cells, particularly affecting red blood cell production in the bone marrow.
Question 4
Which of the following laboratory findings is characteristic of pernicious
anemia?
A) Microcytic, hypochromic red blood cells
B) Normocytic, normochromic red blood cells
C) Macrocytic, normochromic red blood cells with hypersegmented neutrophils
D) Microcytic, normochromic red blood cells
2
,[Correct Answer] C
Rationale: Pernicious anemia is a megaloblastic anemia characterized by
macrocytic
(normochromic) red blood cells and hypersegmented neutrophils. The
macrocytosis
results from impaired DNA synthesis, which causes a maturation defect in the
nucleus while cytoplasmic development continues normally.
Question 5
What is the most common cause of vitamin B12 deficiency?
A) Pernicious anemia
B) Gastrectomy
C) Malabsorption syndromes
D) Inadequate dietary intake
[Correct Answer] A
Rationale: Pernicious anemia is the most common cause of vitamin B12 deficiency
in adults. It is an autoimmune condition in which antibodies attack parietal
cells or intrinsic factor, leading to impaired B12 absorption. Strict vegans
may also develop B12 deficiency from inadequate dietary intake, but this is
less common.
Question 6
A patient with folate deficiency would most likely have which of the following
causes?
A) Autoimmune destruction of parietal cells
B) Dietary deficiency and malabsorption
C) Chronic blood loss
D) Bone marrow failure
[Correct Answer] B
Rationale: Folate deficiency is most commonly caused by inadequate dietary
intake (especially in alcoholics) and malabsorption syndromes. Unlike vitamin
B12 deficiency, it is not caused by autoimmune destruction. Folate is found in
leafy green vegetables, fruits, and fortified grains.
3
, Question 7
Which of the following is a key distinguishing feature between vitamin B12
deficiency and folate deficiency?
A) Macrocytic anemia
B) Hypersegmented neutrophils
C) Neurologic symptoms
D) Elevated homocysteine levels
[Correct Answer] C
Rationale: Neurologic symptoms (subacute combined degeneration of the spinal
cord, peripheral neuropathy, and cognitive changes) are a distinguishing
feature of vitamin B12 deficiency that do not occur in folate deficiency.
Both deficiencies cause macrocytic anemia, hypersegmented neutrophils, and
elevated homocysteine levels.
Question 8
Sickle cell anemia is caused by which type of genetic mutation?
A) Deletion of one or more genes
B) Point mutation in the beta-globin gene
C) Gene duplication
D) Chromosomal translocation
[Correct Answer] B
Rationale: Sickle cell anemia is caused by a single point mutation in the
beta-globin gene on chromosome 11, where adenine is substituted for thymine,
resulting in glutamic acid being replaced by valine at position 6 of the
beta-globin chain. This substitution causes hemoglobin S to polymerize under
low oxygen conditions.
Question 9
The pathophysiology of sickle cell crisis involves which of the following
mechanisms?
A) Increased red blood cell production
B) Polymerization of hemoglobin S under hypoxic conditions
C) Decreased red blood cell destruction
4
UTA 2026 ACTUAL EXAM TEST BANK COMPLETE 300-QUESTION
BANK WITH VERIFIED ANSWERS & DETAILED RATIONALES|
LATEST UPDATE
EXAM STRUCTURE OVERVIEW
NURS 5315 Advanced Pathophysiology builds on foundational anatomy and physiology
knowledge, focusing on advanced pathophysiologic concepts across the lifespan.
Exam 5 typically covers the following content domains:
• Hematologic System Disorders
• Cardiovascular System Disorders
• Respiratory System Disorders
• Renal System Disorders
• Fluid, Electrolyte, and Acid-Base Disorders
• Gastrointestinal System Disorders
• Endocrine System Disorders
• Immune System Disorders
• Neurologic System Disorders
• Musculoskeletal System Disorders
• Integumentary System Disorders
SECTION 1: HEMATOLOGIC SYSTEM DISORDERS (Questions 1–40)
Question 1
A patient with anemia of chronic disease would most likely present with which
of the following laboratory findings?
A) Elevated serum iron, elevated TIBC, elevated ferritin
B) Low serum iron, low TIBC, elevated ferritin
C) Low serum iron, elevated TIBC, low ferritin
D) Elevated serum iron, low TIBC, low ferritin
[Correct Answer] B
Rationale: Anemia of chronic disease is characterized by low serum iron, low
total iron-binding capacity (TIBC), and elevated ferritin. This pattern reflects
the body's inflammatory response, where iron is sequestered in macrophages and
ferritin is increased as an acute-phase reactant. Iron deficiency anemia (C)
shows low ferritin and elevated TIBC.
1
,Question 2
Which of the following is the most common cause of iron deficiency anemia in
adults?
A) Decreased dietary intake
B) Chronic blood loss
C) Increased iron requirements
D) Impaired iron absorption
[Correct Answer] B
Rationale: Chronic blood loss is the most common cause of iron deficiency anemia
in adults. In premenopausal women, this is typically due to menstrual bleeding;
in older adults, gastrointestinal bleeding is the most frequent cause. While
decreased dietary intake and impaired absorption can cause iron deficiency,
they are less common than chronic blood loss in adults.
Question 3
A patient with pernicious anemia has a deficiency of which of the following?
A) Folic acid
B) Vitamin B12
C) Iron
D) Vitamin B6
[Correct Answer] B
Rationale: Pernicious anemia is caused by a deficiency of intrinsic factor,
which is required for the absorption of vitamin B12 in the terminal ileum. This
leads to vitamin B12 deficiency and impaired DNA synthesis in rapidly dividing
cells, particularly affecting red blood cell production in the bone marrow.
Question 4
Which of the following laboratory findings is characteristic of pernicious
anemia?
A) Microcytic, hypochromic red blood cells
B) Normocytic, normochromic red blood cells
C) Macrocytic, normochromic red blood cells with hypersegmented neutrophils
D) Microcytic, normochromic red blood cells
2
,[Correct Answer] C
Rationale: Pernicious anemia is a megaloblastic anemia characterized by
macrocytic
(normochromic) red blood cells and hypersegmented neutrophils. The
macrocytosis
results from impaired DNA synthesis, which causes a maturation defect in the
nucleus while cytoplasmic development continues normally.
Question 5
What is the most common cause of vitamin B12 deficiency?
A) Pernicious anemia
B) Gastrectomy
C) Malabsorption syndromes
D) Inadequate dietary intake
[Correct Answer] A
Rationale: Pernicious anemia is the most common cause of vitamin B12 deficiency
in adults. It is an autoimmune condition in which antibodies attack parietal
cells or intrinsic factor, leading to impaired B12 absorption. Strict vegans
may also develop B12 deficiency from inadequate dietary intake, but this is
less common.
Question 6
A patient with folate deficiency would most likely have which of the following
causes?
A) Autoimmune destruction of parietal cells
B) Dietary deficiency and malabsorption
C) Chronic blood loss
D) Bone marrow failure
[Correct Answer] B
Rationale: Folate deficiency is most commonly caused by inadequate dietary
intake (especially in alcoholics) and malabsorption syndromes. Unlike vitamin
B12 deficiency, it is not caused by autoimmune destruction. Folate is found in
leafy green vegetables, fruits, and fortified grains.
3
, Question 7
Which of the following is a key distinguishing feature between vitamin B12
deficiency and folate deficiency?
A) Macrocytic anemia
B) Hypersegmented neutrophils
C) Neurologic symptoms
D) Elevated homocysteine levels
[Correct Answer] C
Rationale: Neurologic symptoms (subacute combined degeneration of the spinal
cord, peripheral neuropathy, and cognitive changes) are a distinguishing
feature of vitamin B12 deficiency that do not occur in folate deficiency.
Both deficiencies cause macrocytic anemia, hypersegmented neutrophils, and
elevated homocysteine levels.
Question 8
Sickle cell anemia is caused by which type of genetic mutation?
A) Deletion of one or more genes
B) Point mutation in the beta-globin gene
C) Gene duplication
D) Chromosomal translocation
[Correct Answer] B
Rationale: Sickle cell anemia is caused by a single point mutation in the
beta-globin gene on chromosome 11, where adenine is substituted for thymine,
resulting in glutamic acid being replaced by valine at position 6 of the
beta-globin chain. This substitution causes hemoglobin S to polymerize under
low oxygen conditions.
Question 9
The pathophysiology of sickle cell crisis involves which of the following
mechanisms?
A) Increased red blood cell production
B) Polymerization of hemoglobin S under hypoxic conditions
C) Decreased red blood cell destruction
4
