ADVANCED PATHOPHYSIOLOGY MIDTERM NUR
6501 WALDEN UNIVERSITY / COMPLETE ACTUAL
EXAM / 150+ QUESTIONS AND CORRECT
DETAILED ANSWERS / 2025/2026
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) Correct Answer Acute
lymphblastic leukemia
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
,ADVANCED PATHOPHYSIOLOGY MIDTERM NUR
6501 WALDEN UNIVERSITY / COMPLETE ACTUAL
EXAM / 150+ QUESTIONS AND CORRECT
DETAILED ANSWERS / 2025/2026
D. Increased fragility of the erythrocyte membrane Correct Answer
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 Correct Answer 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
,ADVANCED PATHOPHYSIOLOGY MIDTERM NUR
6501 WALDEN UNIVERSITY / COMPLETE ACTUAL
EXAM / 150+ QUESTIONS AND CORRECT
DETAILED ANSWERS / 2025/2026
D. Vitamin C deficiency Correct Answer 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 Correct Answer 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 Correct Answer Aggregation of platelets
A 24-year-old presents to the office with fatigue. On physical exam, the NP
notices that she ispale 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 causeof this patient's
anemia?
, ADVANCED PATHOPHYSIOLOGY MIDTERM NUR
6501 WALDEN UNIVERSITY / COMPLETE ACTUAL
EXAM / 150+ QUESTIONS AND CORRECT
DETAILED ANSWERS / 2025/2026
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 Correct Answer 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 Correct Answer Anemia of chronic disease
A 14-year-old male presents with high fever for ten days. Physical
examination reveals scattered petechial hemorrhages but is negative for
enlargement of the liver or spleen or lymph nodes. Bone marrow
examination does not show any abnormal cells. The complete blood count
(CBC) demonstrates a hemoglobin concentration (HgB) of 13.2 g/dL,
hematocrit (Hct) of 38.9%, mean cell volume (MCV) of 93 fL, platelet count of
175,000/microliter, and white blood cell (WBC) count of 1850/microliter, with
the differential count showing 1 segmented neutrophil, 98 lymphocytes, and
1 monocyte per 100 WBCs. What is the most likely cause of these findings?
6501 WALDEN UNIVERSITY / COMPLETE ACTUAL
EXAM / 150+ QUESTIONS AND CORRECT
DETAILED ANSWERS / 2025/2026
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) Correct Answer Acute
lymphblastic leukemia
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
,ADVANCED PATHOPHYSIOLOGY MIDTERM NUR
6501 WALDEN UNIVERSITY / COMPLETE ACTUAL
EXAM / 150+ QUESTIONS AND CORRECT
DETAILED ANSWERS / 2025/2026
D. Increased fragility of the erythrocyte membrane Correct Answer
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 Correct Answer 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
,ADVANCED PATHOPHYSIOLOGY MIDTERM NUR
6501 WALDEN UNIVERSITY / COMPLETE ACTUAL
EXAM / 150+ QUESTIONS AND CORRECT
DETAILED ANSWERS / 2025/2026
D. Vitamin C deficiency Correct Answer 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 Correct Answer 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 Correct Answer Aggregation of platelets
A 24-year-old presents to the office with fatigue. On physical exam, the NP
notices that she ispale 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 causeof this patient's
anemia?
, ADVANCED PATHOPHYSIOLOGY MIDTERM NUR
6501 WALDEN UNIVERSITY / COMPLETE ACTUAL
EXAM / 150+ QUESTIONS AND CORRECT
DETAILED ANSWERS / 2025/2026
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 Correct Answer 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 Correct Answer Anemia of chronic disease
A 14-year-old male presents with high fever for ten days. Physical
examination reveals scattered petechial hemorrhages but is negative for
enlargement of the liver or spleen or lymph nodes. Bone marrow
examination does not show any abnormal cells. The complete blood count
(CBC) demonstrates a hemoglobin concentration (HgB) of 13.2 g/dL,
hematocrit (Hct) of 38.9%, mean cell volume (MCV) of 93 fL, platelet count of
175,000/microliter, and white blood cell (WBC) count of 1850/microliter, with
the differential count showing 1 segmented neutrophil, 98 lymphocytes, and
1 monocyte per 100 WBCs. What is the most likely cause of these findings?
