NURS 6501 ADVANCED PATHOPHYSIOLOGY FINAL AND MIDTERM EXAM QUESTIONS WITH 100% VERIFIED ANSWERS AND DETAILED RATIONALES

NURS 6501 ADVANCED PATHOPHYSIOLOGY FINAL AND MIDTERM EXAM QUESTIONS WITH 100% VERIFIED ANSWERS AND DETAILED RATIONALES 1. A patient with chronic kidney disease (CKD) has anemia. Which pathophysiologic mechanism is the primary cause of this anemia? A) Decreased iron absorption from the gastrointestinal tract B) Increased destruction of red blood cells in the spleen C) Decreased production of erythropoietin by the kidneys D) Vitamin B12 deficiency due to poor dietary intake Correct Answer: C Rationale: The kidneys produce erythropoietin (EPO), which stimulates red blood cell production in the bone marrow. In CKD, the damaged kidneys cannot produce enough EPO, leading to anemia. ________________________________________ 2. A patient with a history of heart failure is prescribed an ACE inhibitor. What is the primary mechanism of action of this drug class? A) Blocking beta-adrenergic receptors in the heart B) Inhibiting the conversion of angiotensin I to angiotensin II C) Blocking calcium channels in vascular smooth muscle D) Increasing the excretion of sodium and water in the kidneys Correct Answer: B Rationale: ACE inhibitors work by blocking the angiotensin-converting enzyme, which prevents the conversion of angiotensin I to the potent vasoconstrictor angiotensin II. This leads to vasodilation and decreased aldosterone secretion. ________________________________________ 3. A 5-year-old male presents with a webbed neck, short stature, and a shield-shaped chest. Which karyotype would confirm the suspected diagnosis? A) 47, XXY B) 45, X C) 47, XXX D) 47, XYY Correct Answer: B Rationale: Turner syndrome is characterized by a 45, X karyotype (monosomy X). Clinical features include short stature, webbed neck, shield chest, and ovarian dysgenesis. ________________________________________ 4. A patient with a history of gout is experiencing an acute flare-up in his great toe. Which pathophysiologic process is most likely responsible for this condition? A) Deposition of calcium pyrophosphate crystals in the joint B) Accumulation of uric acid crystals in the joint space C) Autoimmune destruction of the synovial membrane D) Degenerative changes in the articular cartilage Correct Answer: B Rationale: Gout is caused by the deposition of monosodium urate crystals in joints and tissues due to hyperuricemia. This triggers an intense inflammatory response, leading to acute pain and swelling. ________________________________________ 5. A nurse is teaching a patient about the Na⁺/K⁺-ATPase pump. Which statement accurately describes its function? A) It pumps 3 sodium ions out of the cell and 2 potassium ions into the cell, using ATP B) It pumps 2 sodium ions out of the cell and 3 potassium ions into the cell, using ATP C) It allows sodium and potassium to freely diffuse across the cell membrane D) It exchanges sodium for potassium only during an action potential Correct Answer: A Rationale: The Na⁺/K⁺-ATPase pump actively transports 3 sodium ions out of the cell and 2 potassium ions into the cell against their concentration gradients, utilizing energy from ATP hydrolysis to maintain the resting membrane potential. ________________________________________ 6. A 65-year-old male with a history of smoking presents with hemoptysis and weight loss. A biopsy reveals small cell lung cancer. Which genetic mutation is most commonly associated with this type of cancer? A) BRCA1 B) APC C) p53 D) HER2 Correct Answer: C Rationale: p53 is a tumor suppressor gene. Mutations in p53 are very common in many cancers, including small cell lung cancer. Loss of p53 function allows cells with DNA damage to continue dividing. ________________________________________ 7. A patient with Hashimoto's thyroiditis is likely to have which of the following laboratory findings? A) Elevated T3 and T4, decreased TSH B) Decreased T3 and T4, elevated TSH C) Elevated T3 and T4, elevated TSH D) Decreased T3 and T4, decreased TSH Correct Answer: B Rationale: Hashimoto's thyroiditis is an autoimmune disease that destroys the thyroid gland, leading to hypothyroidism. This results in low levels of thyroid hormones (T3 and T4) and a compensatory increase in TSH from the pituitary gland. ________________________________________ 8. A patient diagnosed with Crohn's disease is experiencing abdominal pain and diarrhea. Which area of the gastrointestinal tract is most characteristically affected? A) The entire colon B) The terminal ileum and colon, with skip lesions C) The rectum and sigmoid colon D) The stomach and duodenum Correct Answer: B Rationale: Crohn's disease is a type of inflammatory bowel disease that can affect any part of the GI tract but most commonly involves the terminal ileum and colon. It is characterized by transmural inflammation and skip lesions (areas of normal tissue between affected areas). ________________________________________ 9. A patient's arterial blood gas (ABG) results show a pH of 7.32, PaCO₂ of 50 mmHg, and HCO₃⁻ of 24 mEq/L. Which condition do these results indicate? A) Metabolic acidosis B) Metabolic alkalosis C) Respiratory acidosis D) Respiratory alkalosis Correct Answer: C Rationale: This ABG shows acidemia (pH 7.35) with an elevated PaCO₂ ( 45 mmHg). The HCO₃⁻ is normal, indicating that the primary problem is respiratory acidosis (retention of CO₂) without metabolic compensation yet. ________________________________________ 10. Which of the following is a characteristic feature of osteoarthritis, as opposed to rheumatoid arthritis?