NR507/NR 507 MIDTERM EXAM 2026–2027 | ADVANCED
PATHOPHYSIOLOGY 200 QUESTIONS & VERIFIED ANSWERS 100%
ALREADY GRADED A+
Q1. A 55-year-old man with COPD is confused, SpO₂ 78% on room air, and using
accessory muscles. What is your first action?
A. Apply high-flow O₂ via nonrebreather
B. Insert IV and draw labs
C. Give nebulized albuterol
D. Place patient supine
Answer: A. Apply high-flow O₂ via nonrebreather
Rationale: Correcting hypoxemia takes priority before medications or labs.
Q2. A 45-year-old with chest pain for 20 minutes has BP 88/60, HR 122, and cool,
clammy skin. What should be done first?
A. Administer aspirin
B. Provide high-flow oxygen
C. Begin rapid IV fluids
D. Prepare for thrombolysis
Answer: B. Provide high-flow oxygen
Rationale: Oxygen improves delivery in suspected MI with shock.
Q3. A 70-year-old suddenly develops left arm weakness, slurred speech, and facial
droop. Symptoms started 30 minutes ago. What is your priority?
A. Give aspirin 325 mg
B. Check blood glucose
C. Give IV alteplase
D. Obtain head CT
,Answer: B. Check blood glucose
Rationale: Hypoglycemia must be ruled out as a stroke mimic.
Q4. A patient with cirrhosis presents with hematemesis, HR 130, BP 78/48, and
pale skin. What is the most important first step?
A. Administer lactulose
B. Insert two large-bore IVs and start fluids
C. Give IV proton pump inhibitor
D. Position in Trendelenburg
Answer: B. Insert two large-bore IVs and start fluids
Rationale: Resuscitation is priority in hypovolemic shock from variceal bleeding.
Q5. A 22-year-old has fever, severe headache, neck stiffness, and photophobia. He
is lethargic but arousable. What should be done first?
A. Give IV antibiotics
B. Place patient on droplet isolation
C. Order lumbar puncture
D. Administer IV fluids
Answer: B. Place patient on droplet isolation
Rationale: Suspected meningitis requires immediate isolation before treatment.
Q6. A patient with CKD has pruritus, bone pain, and low calcium. Which hormone
is elevated?
A. Calcitonin
B. Aldosterone
C. Parathyroid hormone
D. Cortisol
Answer: C. Parathyroid hormone
Rationale: CKD reduces vitamin D activation → hypocalcemia → secondary
hyperparathyroidism.
,Q7. A 50-year-old with diabetes is nauseated, confused, and has fruity breath odor.
Labs: pH 7.20, glucose 450 mg/dL. What is the immediate therapy?
A. Give IV insulin and fluids
B. Administer IM glucagon
C. Provide oral carbohydrates
D. Give IV calcium gluconate
Answer: A. Give IV insulin and fluids
Rationale: DKA requires insulin plus fluid resuscitation.
Q8. A patient with COPD suddenly has sharp chest pain, absent breath sounds on
the right, and severe dyspnea. What condition is most likely?
A. Pulmonary embolism
B. Tension pneumothorax
C. Pneumonia
D. Pulmonary edema
Answer: B. Tension pneumothorax
Rationale: Sudden unilateral absent sounds + distress suggest pneumothorax.
Q9. A 68-year-old with hypertension has LV hypertrophy on echocardiogram.
What causes this?
A. Increased preload
B. Increased afterload
C. Decreased venous return
D. Increased cardiac output
Answer: B. Increased afterload
Rationale: Chronic high BP forces LV to thicken against resistance.
Q10. A 35-year-old with asthma is wheezing, RR 32, and using accessory muscles.
He is speaking in single words. What is the priority?
A. Administer nebulized bronchodilator
B. Provide IV steroids
C. Give magnesium sulfate
, D. Obtain chest X-ray
Answer: A. Administer nebulized bronchodilator
Rationale: Rapid reversal of bronchospasm is first priority.
Q11. A 45-year-old with hyperthyroidism develops fever, tachycardia, and
agitation. What is the likely complication?
A. Thyroid storm
B. Myxedema coma
C. Addisonian crisis
D. SIADH
Answer: A. Thyroid storm
Rationale: Life-threatening hyperthyroid crisis presents with fever, tachycardia,
and CNS symptoms.
Q12. A patient with emphysema has a “barrel chest.” What explains this?
A. Loss of surfactant
B. Air trapping and hyperinflation
C. Fibrosis of alveoli
D. Pleural effusion
Answer: B. Air trapping and hyperinflation
Rationale: Destruction of alveoli causes overinflation and chest expansion.
Q13. A 30-year-old with sickle cell disease reports severe limb pain after
dehydration. What is occurring?
A. Hemolytic anemia
B. Splenic rupture
C. Vaso-occlusive crisis
D. DIC
Answer: C. Vaso-occlusive crisis
Rationale: Sickling from hypoxia/dehydration causes vessel occlusion and pain.
PATHOPHYSIOLOGY 200 QUESTIONS & VERIFIED ANSWERS 100%
ALREADY GRADED A+
Q1. A 55-year-old man with COPD is confused, SpO₂ 78% on room air, and using
accessory muscles. What is your first action?
A. Apply high-flow O₂ via nonrebreather
B. Insert IV and draw labs
C. Give nebulized albuterol
D. Place patient supine
Answer: A. Apply high-flow O₂ via nonrebreather
Rationale: Correcting hypoxemia takes priority before medications or labs.
Q2. A 45-year-old with chest pain for 20 minutes has BP 88/60, HR 122, and cool,
clammy skin. What should be done first?
A. Administer aspirin
B. Provide high-flow oxygen
C. Begin rapid IV fluids
D. Prepare for thrombolysis
Answer: B. Provide high-flow oxygen
Rationale: Oxygen improves delivery in suspected MI with shock.
Q3. A 70-year-old suddenly develops left arm weakness, slurred speech, and facial
droop. Symptoms started 30 minutes ago. What is your priority?
A. Give aspirin 325 mg
B. Check blood glucose
C. Give IV alteplase
D. Obtain head CT
,Answer: B. Check blood glucose
Rationale: Hypoglycemia must be ruled out as a stroke mimic.
Q4. A patient with cirrhosis presents with hematemesis, HR 130, BP 78/48, and
pale skin. What is the most important first step?
A. Administer lactulose
B. Insert two large-bore IVs and start fluids
C. Give IV proton pump inhibitor
D. Position in Trendelenburg
Answer: B. Insert two large-bore IVs and start fluids
Rationale: Resuscitation is priority in hypovolemic shock from variceal bleeding.
Q5. A 22-year-old has fever, severe headache, neck stiffness, and photophobia. He
is lethargic but arousable. What should be done first?
A. Give IV antibiotics
B. Place patient on droplet isolation
C. Order lumbar puncture
D. Administer IV fluids
Answer: B. Place patient on droplet isolation
Rationale: Suspected meningitis requires immediate isolation before treatment.
Q6. A patient with CKD has pruritus, bone pain, and low calcium. Which hormone
is elevated?
A. Calcitonin
B. Aldosterone
C. Parathyroid hormone
D. Cortisol
Answer: C. Parathyroid hormone
Rationale: CKD reduces vitamin D activation → hypocalcemia → secondary
hyperparathyroidism.
,Q7. A 50-year-old with diabetes is nauseated, confused, and has fruity breath odor.
Labs: pH 7.20, glucose 450 mg/dL. What is the immediate therapy?
A. Give IV insulin and fluids
B. Administer IM glucagon
C. Provide oral carbohydrates
D. Give IV calcium gluconate
Answer: A. Give IV insulin and fluids
Rationale: DKA requires insulin plus fluid resuscitation.
Q8. A patient with COPD suddenly has sharp chest pain, absent breath sounds on
the right, and severe dyspnea. What condition is most likely?
A. Pulmonary embolism
B. Tension pneumothorax
C. Pneumonia
D. Pulmonary edema
Answer: B. Tension pneumothorax
Rationale: Sudden unilateral absent sounds + distress suggest pneumothorax.
Q9. A 68-year-old with hypertension has LV hypertrophy on echocardiogram.
What causes this?
A. Increased preload
B. Increased afterload
C. Decreased venous return
D. Increased cardiac output
Answer: B. Increased afterload
Rationale: Chronic high BP forces LV to thicken against resistance.
Q10. A 35-year-old with asthma is wheezing, RR 32, and using accessory muscles.
He is speaking in single words. What is the priority?
A. Administer nebulized bronchodilator
B. Provide IV steroids
C. Give magnesium sulfate
, D. Obtain chest X-ray
Answer: A. Administer nebulized bronchodilator
Rationale: Rapid reversal of bronchospasm is first priority.
Q11. A 45-year-old with hyperthyroidism develops fever, tachycardia, and
agitation. What is the likely complication?
A. Thyroid storm
B. Myxedema coma
C. Addisonian crisis
D. SIADH
Answer: A. Thyroid storm
Rationale: Life-threatening hyperthyroid crisis presents with fever, tachycardia,
and CNS symptoms.
Q12. A patient with emphysema has a “barrel chest.” What explains this?
A. Loss of surfactant
B. Air trapping and hyperinflation
C. Fibrosis of alveoli
D. Pleural effusion
Answer: B. Air trapping and hyperinflation
Rationale: Destruction of alveoli causes overinflation and chest expansion.
Q13. A 30-year-old with sickle cell disease reports severe limb pain after
dehydration. What is occurring?
A. Hemolytic anemia
B. Splenic rupture
C. Vaso-occlusive crisis
D. DIC
Answer: C. Vaso-occlusive crisis
Rationale: Sickling from hypoxia/dehydration causes vessel occlusion and pain.
