NR 507/ NR507 Advanced Pathophysiology Guide Actual
Exam 2026/2027 | Complete Exam-Style Questions with
Detailed Rationales | Pass Guaranteed – A+ Graded
Q1: A cell undergoes reversible injury due to hypoxia. Which cellular change is most
characteristic of this stage?
A. Karyolysis
B. Cellular swelling [CORRECT]
C. Coagulative necrosis
D. Apoptotic body formation
Correct Answer: B
Rationale: Correct because cellular swelling (hydropic change) from ATP depletion and Na+/K+
pump failure is the earliest and most reversible manifestation of hypoxic injury.
---
Q2: Which genetic inheritance pattern describes a disorder that manifests only in males and is
transmitted through carrier females?
A. Autosomal dominant
B. Autosomal recessive
C. X-linked recessive [CORRECT]
D. Mitochondrial
Correct Answer: C
Rationale: Correct because X-linked recessive disorders (e.g., hemophilia A, Duchenne
muscular dystrophy) affect males who inherit the mutated X from carrier mothers.
---
Q3: A patient's ABG shows pH 7.28, PaCO2 32 mmHg, HCO3 16 mEq/L. Which acid-base
disorder is present?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis [CORRECT]
D. Metabolic alkalosis
Correct Answer: C
Rationale: Correct because low pH with low HCO3 and compensatory low PaCO2 indicates
metabolic acidosis with respiratory compensation.
,---
Q4: Which immunoglobulin is responsible for immediate hypersensitivity reactions?
A. IgA
B. IgM
C. IgE [CORRECT]
D. IgG
Correct Answer: C
Rationale: Correct because IgE binds mast cells and triggers histamine release in Type I
hypersensitivity reactions such as anaphylaxis and allergic asthma.
---
Q5: A patient with SLE develops a "butterfly rash" and joint pain. Which pathophysiologic
mechanism underlies these manifestations?
A. IgE-mediated mast cell degranulation
B. Immune complex deposition in tissues [CORRECT]
C. T-cell mediated cytotoxicity
D. Complement deficiency
Correct Answer: B
Rationale: Correct because SLE is a Type III hypersensitivity disorder where circulating immune
complexes deposit in skin, joints, and kidneys, causing inflammation.
---
Q6: Which anemia is characterized by macrocytic, normochromic red blood cells with
hypersegmented neutrophils?
A. Iron deficiency anemia
B. Thalassemia
C. Vitamin B12 deficiency anemia [CORRECT]
D. Sickle cell anemia
Correct Answer: C
Rationale: Correct because B12 deficiency impairs DNA synthesis, producing large (macrocytic)
RBCs and hypersegmented neutrophils on peripheral smear.
---
Q7: A patient with DIC presents with oozing from IV sites and petechiae. Which laboratory
finding is expected?
A. Elevated platelet count
B. Decreased D-dimer
, C. Prolonged PT/PTT with low fibrinogen [CORRECT]
D. Elevated fibrinogen
Correct Answer: C
Rationale: Correct because DIC consumes clotting factors and platelets, leading to prolonged
PT/PTT, low fibrinogen, and elevated D-dimer from simultaneous clot formation and breakdown.
---
Q8: In heart failure, which mechanism initially compensates for decreased cardiac output but
eventually worsens the condition?
A. Baroreceptor-mediated bradycardia
B. RAAS activation causing fluid retention [CORRECT]
C. Decreased sympathetic outflow
D. Reduced ADH secretion
Correct Answer: B
Rationale: Correct because RAAS activation increases preload and afterload through
sodium/water retention and vasoconstriction, which initially maintains perfusion but eventually
exacerbates heart failure.
---
Q9: A patient with COPD has a barrel chest and prolonged expiration. Which pathophysiologic
change explains this finding?
A. Increased elastic recoil of the lungs
B. Air trapping due to loss of elastic recoil [CORRECT]
C. Decreased residual volume
D. Thickened pleural membranes
Correct Answer: B
Rationale: Correct because COPD destroys alveolar walls and elastin, causing air trapping,
hyperinflation, and barrel chest deformity.
---
Q10: Which type of hypersensitivity reaction is responsible for anaphylaxis?
A. Type I [CORRECT]
B. Type II
C. Type III
D. Type IV
Correct Answer: A
Exam 2026/2027 | Complete Exam-Style Questions with
Detailed Rationales | Pass Guaranteed – A+ Graded
Q1: A cell undergoes reversible injury due to hypoxia. Which cellular change is most
characteristic of this stage?
A. Karyolysis
B. Cellular swelling [CORRECT]
C. Coagulative necrosis
D. Apoptotic body formation
Correct Answer: B
Rationale: Correct because cellular swelling (hydropic change) from ATP depletion and Na+/K+
pump failure is the earliest and most reversible manifestation of hypoxic injury.
---
Q2: Which genetic inheritance pattern describes a disorder that manifests only in males and is
transmitted through carrier females?
A. Autosomal dominant
B. Autosomal recessive
C. X-linked recessive [CORRECT]
D. Mitochondrial
Correct Answer: C
Rationale: Correct because X-linked recessive disorders (e.g., hemophilia A, Duchenne
muscular dystrophy) affect males who inherit the mutated X from carrier mothers.
---
Q3: A patient's ABG shows pH 7.28, PaCO2 32 mmHg, HCO3 16 mEq/L. Which acid-base
disorder is present?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis [CORRECT]
D. Metabolic alkalosis
Correct Answer: C
Rationale: Correct because low pH with low HCO3 and compensatory low PaCO2 indicates
metabolic acidosis with respiratory compensation.
,---
Q4: Which immunoglobulin is responsible for immediate hypersensitivity reactions?
A. IgA
B. IgM
C. IgE [CORRECT]
D. IgG
Correct Answer: C
Rationale: Correct because IgE binds mast cells and triggers histamine release in Type I
hypersensitivity reactions such as anaphylaxis and allergic asthma.
---
Q5: A patient with SLE develops a "butterfly rash" and joint pain. Which pathophysiologic
mechanism underlies these manifestations?
A. IgE-mediated mast cell degranulation
B. Immune complex deposition in tissues [CORRECT]
C. T-cell mediated cytotoxicity
D. Complement deficiency
Correct Answer: B
Rationale: Correct because SLE is a Type III hypersensitivity disorder where circulating immune
complexes deposit in skin, joints, and kidneys, causing inflammation.
---
Q6: Which anemia is characterized by macrocytic, normochromic red blood cells with
hypersegmented neutrophils?
A. Iron deficiency anemia
B. Thalassemia
C. Vitamin B12 deficiency anemia [CORRECT]
D. Sickle cell anemia
Correct Answer: C
Rationale: Correct because B12 deficiency impairs DNA synthesis, producing large (macrocytic)
RBCs and hypersegmented neutrophils on peripheral smear.
---
Q7: A patient with DIC presents with oozing from IV sites and petechiae. Which laboratory
finding is expected?
A. Elevated platelet count
B. Decreased D-dimer
, C. Prolonged PT/PTT with low fibrinogen [CORRECT]
D. Elevated fibrinogen
Correct Answer: C
Rationale: Correct because DIC consumes clotting factors and platelets, leading to prolonged
PT/PTT, low fibrinogen, and elevated D-dimer from simultaneous clot formation and breakdown.
---
Q8: In heart failure, which mechanism initially compensates for decreased cardiac output but
eventually worsens the condition?
A. Baroreceptor-mediated bradycardia
B. RAAS activation causing fluid retention [CORRECT]
C. Decreased sympathetic outflow
D. Reduced ADH secretion
Correct Answer: B
Rationale: Correct because RAAS activation increases preload and afterload through
sodium/water retention and vasoconstriction, which initially maintains perfusion but eventually
exacerbates heart failure.
---
Q9: A patient with COPD has a barrel chest and prolonged expiration. Which pathophysiologic
change explains this finding?
A. Increased elastic recoil of the lungs
B. Air trapping due to loss of elastic recoil [CORRECT]
C. Decreased residual volume
D. Thickened pleural membranes
Correct Answer: B
Rationale: Correct because COPD destroys alveolar walls and elastin, causing air trapping,
hyperinflation, and barrel chest deformity.
---
Q10: Which type of hypersensitivity reaction is responsible for anaphylaxis?
A. Type I [CORRECT]
B. Type II
C. Type III
D. Type IV
Correct Answer: A
