NURS 6501N ADVANCED PATHOPHYSIOLOGY MIDTERM EXAM REVIEW | WALDEN UNIVERSITY | 2025/2026 EDITION | 150+ VERIFIED QUESTIONS WITH CORRECT, DETAILED ANSWERS AND EXPLANATIONS

NURS 6501N ADVANCED PATHOPHYSIOLOGY MIDTERM EXAM REVIEW | WALDEN UNIVERSITY | 2025/2026 EDITION | 150+ VERIFIED QUESTIONS WITH CORRECT, DETAILED ANSWERS AND EXPLANATIONS A 4-year-old child appears listless for the last week. He complains of pain when he is picked up by his mother, and he is irritable when touching his arms or legs. Several large ecchymotic lesions have appeared on his right thigh and left shoulder. A complete blood count reveals a HgB=10.2, Hct=30.5%, MCV=96fL, platelet count of 45,000/ML, and WBC count of 13,990/ML. Examination of the peripheral blood smear reveals numerous blasts. The blasts lack peroxidase-positive granules but do contain periodic acid-Schiff (PAS)-positive aggregates and stain positively for TdT. Flow cytometry shows the phenotype of blasts to be CD19+, CD3-, and sIg-. What is the most likely diagnosis? A. Acute lymphoblastic leukemia (ALL) B. Chronic lymphocytic leukemia (CLL) C. Acute myelogenous leukemia (AML) D. Chronic myelogenous leukemia (CML) Acute lymphoblastic leukemia A 55-year-old male had a fasting blood glucose level of 160 mg/dL 1 month ago. Today, his fasting glucose level is 140 mg/dL. He has a history of HTN that is controlled with an ACE inhibitor. He has no other medical problems. He is 5'11" and weighs 215 lbs. His father had DM, but the family history is otherwise noncontributory. This patient is asymptomatic, and his physical examination is unremarkable. What is the most likely diagnosis? A. Maturity Onset Diabetes of the Young (MODY) B. Addison's disease C. Type 2 Diabetes D. Cushing's syndrome C. type 2 diabetes A 13-year-old male has been drinking large quantities of fluids and has an insatiable appetite, even for a teenager. However, he is losing weight and has become more tired and listless over the past month. A complete blood count is normal, but he is found to have a fasting serum glucose of 175 mg/dL. A diagnosis of type 1 diabetes is made. What is the probable inheritance pattern of his underlying disease? A. Autosomal dominant B. Multi-factorial C. X-linked recessive D. Autosomal recessive B. Multifactorial Ms. Jackson, a 45 y/o female, complains of fatigue, weight gain, lack of concentration, and swelling for almost one year. The Nurse Practitioner thinks the patient could have hypothyroidism based on her clinical presentation. Which lab values would help to confirm Ms. Jackson's diagnosis of hypothyroidism? A. Increased TSH and decreased free T4 B. Increased TSH and increased T3 C. Decreased TSH and increased total T4 D. Decreased TSH and decreased free T4 A. increased TSH and decreased free t4 Mr. Mann, age 50, presents to the Emergency Department with his wife for complaints of palpitations, feeling of panic with shakiness, headache, nausea for the past two hours. Upon arrival BP is 210/105. His medical history is significant for GERD and HTN. He takes Prilosec OTC daily and lisinopril 10mg daily. He has no known medication allergies. His family history includes HTN and cardiovascular disease in father, osteoporosis, anxiety, and HTN in mother, and breast cancer in only sister. His wife states the patient did this a couple of weeks ago on two different occasions, but the symptoms went away in just one or two minutes. His physical exam reveals mild diaphoresis, epigastric tenderness, and generalized trembling. What diagnosis does this patient's presentation most closely represent? A. Myxedema Coma B. Addison's Disease C. Thyrotoxicosis D. Pheochromocytoma D. pheochromocytoma A 72-year-old male is brought to the ED in a coma. He was delivered to the ED from a nursing home and was reported by the nursing home staff to have had a seizure that lasted less than 1 minute. He was subsequently confused and soon thereafter entered a comatose state. His medical history is significant for Type II DM requiring insulin, HTN, and mild CHF. In the ED, the patient is very lethargic and responds only to painful stimuli. His vital signs are stable. The list of differential diagnoses that can cause seizure and coma. What is the most important diagnostic study to do immediately? A. Serum toxicology B. CT head without contrast C. CT head with contrast D. Serum glucose D. serum glucose A 2-year-old child who recently immigrated to the United States has failure to thrive. The child is short, with course facial features, a protruding tongue, and an umbilical hernia. Profound mental retardation is apparent as the child matures. These findings are best explained by a lack of: A. Somatostatin B. Cortisol C. Thyroxine (T4) D. Norepinephrine C. thyroxine A 3-year-old child of Italian ancestry presents with failure to thrive. Physical examination indicates hepatosplenomegaly. His hemoglobin concentration is 6 g/dL, and the peripheral blood smear reveals severely hypochromic microcytic red cells. Total serum iron level is normal. The reticulocyte count is 10%. Hemoglobin electrophoresis shows very little hemoglobin A. A radiograph of the skull shows maxillofacial deformities. What is the principle cause of anemia and other abnormalities in this patient? A. Reduced synthesis of hemoglobin F B. Reduced red blood cell survival from imbalance in the production of alpha and beta globin chains C. Relative deficiency of vitamin B12 D. Increased fragility of the erythrocyte membrane Reduced synthesis of hemoglobin F A 68-year-old previously healthy female has been feeling increasingly tired and weak for several months. She states that she has had black, tarry stools for several weeks. She is found to be anemic with a hemoglobin concentration of 9.3g/dL. The peripheral blood smear reveals microcytic and hypochromic blood cells. Which of the following conditions should be suspected as the most likely of her condition as indicated by the peripheral blood smear? A. Aplastic anemia B. Beta thalassemia C. Gastrointestinal blood loss D. Pernicious anemia Gastrointestinal blood loss A 76-year-old female notices that small, pinpoint to blotchy areas of superficial hemorrhage have appeared on her gums and on the skin of her arms and legs over several weeks. She is found to have a normal prothrombin time (PT) and partial thromboplastin time (PTT). Her CBC shows hemoglobin concentration of 12.7 g/dL, hematocrit of 37.2%. MCV of 80 fL/red cell, platelet count of 276,000/microliter, and WBC of 5600/microliter. Her template bleeding time is 3 minutes. Her fibrinogen level is normal, and there are no fibrin split products detectable. Which of the following conditions best explain these findings? A. Chronic renal failure B. Macronodular cirrhosis C. Vitamin B12 deficiency D. Vitamin C deficiency Vitamin C deficiency A young adult patient has just been diagnosed with Von Willebrand disease. Which of the following statements should you make to advise the patient of potential consequences of this disease? A. You may need an allogeneic bone marrow transplant B. You may have excessive bleeding following tooth extraction C. A splenectomy may be necessary to control the disease D. Expect increasing difficulties with joint mobility You may have excessive bleeding following tooth extraction Low dose aspirin is commonly used to reduce the risk of arterial thrombosis in patients who have suffered a myocardial infarction. Which one of the following steps in homeostasis is inhibited by aspirin? A. Synthesis of von Willebrand factor B. Aggregation of platelets C. Activation of factor Xa D. Synthesis of antithrombin III Aggregation of platelets A 24-year-old presents to the office with fatigue. On physical exam, the NP notices that she is pale with the following vital signs: HR 112, BP 98/64, resp 20, O2 sats 99%. Her CBC shows: WBC6,000, Hemoglobin 9.6, Hematocrit 30.2, MCV is decreased at 76. What is the mostly likely cause of this patient's anemia? A. Iron deficiency anemia caused by menstruation B. Beta Thalassemia of genetic origin C. Pernicious anemia caused by dietary deficiency D. Folate deficiency caused by alcoholism Iron deficiency anemia caused by menstruation A 65-year-old female presents to your office complaining of fatigue. She has a long of rheumatoid arthritis. A CBC reveals the following: Hgb=11.6 g/dL, Hct=34.8%, MCV=87 Fl/red cell, platelet count of 268,000/microliter, and WBC count of 6800/microliter. The serum haptoglobin level is normal, and the serum iron concentration is 20 micrograms/dL. The total iron binding capacity is 195 micrograms/dL, and the percent saturation is 10.2. The serum ferritin concentration is 317 ng/mL. No fibrin split products are detected. The reticulocyte concentration is 1.1%. What is the most likely diagnosis? A. Beta- thalassemia major B. Anemia of chronic disease C. Acute blood loss anemia D. Iron deficiency anemia Anemia of chronic disease A 36-year-old female presents to the clinic with a history of fatigue for the past few months. She admits to mild constipation that is not troublesome for her. She reports a 5 lb weight gain over the past 6 months, which she attributes to living a more sedentary life due to her fatigue. Her thyroid does not seem enlarged, although her face is slightly puffy. The remainder of her exam is unremarkable. The nurse practitioner orders thyroid function studies, which show an elevated Thyroid Stimulating Hormone (TSH). What is the most likely diagnosis? A. Grave's disease B. Addison's disease C. Hyperthyroidism D. Hypothyroidism Hypothyroidism Mrs. Patterson, a 62-year-old female, presents to the clinic to review lab results. Her only complaint is fatigue. Which two laboratory results would lead the Nurse Practitioner to suspect primary hyperparathyroidism? A. Hypercalcemia and hypophosphatemia B. Elevated Vitamin D level and Hypocalcemia C. Hypocalcemia and Hypophosphatemia D. Hyperkalemia and hypophosphatemia A. Hypercalcemia and hypophosphatemia