NURS 5315 Exam 2 V2 | NURS 5315
Advanced Pathophysiology | Actual Q&A
with Rationale (NURS5315 Exam 2) | The
University of Texas at Arlington
1. A patient presents with dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. Which
pathophysiological process is primarily responsible for these symptoms?
A. Direct alveolar-capillary membrane damage from an infectious agent
B. Systemic venous congestion leading to peripheral edema
C. Decreased oncotic pressure due to hepatic failure
D. Increased pulmonary capillary hydrostatic pressure due to left-sided heart failure
Answer: D
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation,
which increases the hydrostatic pressure within the pulmonary capillaries. This pressure
forces fluid into the alveolar spaces, resulting in pulmonary edema and the clinical
symptoms of dyspnea and orthopnea. These findings are distinct from right-sided failure,
which typically presents with systemic venous congestion.
2. Which of the following describes the characteristic cellular change found in pernicious
anemia?
A. Macrocytic, normochromic red blood cells
,B. Normocytic, normochromic red blood cells
C. Microcytic, hypochromic red blood cells
D. Small, spherical red blood cells lacking central pallor
Answer: A
Rationale: Pernicious anemia is a type of megaloblastic anemia caused by a deficiency in
Vitamin B12, often due to a lack of intrinsic factor. The absence of B12 impairs DNA
synthesis in RBC precursors, leading to the production of large, immature macrocytes.
These cells are typically normochromic because hemoglobin synthesis remains relatively
unaffected despite the size change.
3. In the pathogenesis of atherosclerosis, which cell type is responsible for the formation of
foam cells after ingesting oxidized LDL?
A. Neutrophils
B. Macrophages
C. Endothelial cells
D. Smooth muscle cells
Answer: B
Rationale: The process begins when macrophages migrate into the tunica intima and
phagocytize oxidized low-density lipoproteins (LDL). Once these macrophages become
engorged with lipids, they are referred to as foam cells, which aggregate to form fatty
, streaks. This is a critical early step in the development of atherosclerotic plaques in the
arterial wall.
4. Which mechanism is the primary cause of hypertension in patients with renal artery
stenosis?
A. Increased sympathetic nervous system activity
B. Direct stimulation of alpha-receptors by norepinephrine
C. Activation of the renin-angiotensin-aldosterone system (RAAS)
D. Loss of sodium-wasting capabilities in the distal tubule
Answer: C
Rationale: Renal artery stenosis reduces blood flow to the kidneys, which is perceived by
the juxtaglomerular apparatus as systemic hypotension. In response, the kidneys secrete
renin, which eventually leads to the production of Angiotensin II and Aldosterone. This
results in systemic vasoconstriction and sodium retention, significantly elevating blood
pressure.
5. A 65-year-old patient is diagnosed with Chronic Obstructive Pulmonary Disease (COPD)
characterized by chronic bronchitis. What is the hallmark pathological change in this
condition?
A. Destruction of alveolar walls and loss of elastic recoil
B. Hypertrophy of mucus-secreting glands in the bronchial wall
C. Permanent dilation of the bronchi due to chronic infection
Advanced Pathophysiology | Actual Q&A
with Rationale (NURS5315 Exam 2) | The
University of Texas at Arlington
1. A patient presents with dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. Which
pathophysiological process is primarily responsible for these symptoms?
A. Direct alveolar-capillary membrane damage from an infectious agent
B. Systemic venous congestion leading to peripheral edema
C. Decreased oncotic pressure due to hepatic failure
D. Increased pulmonary capillary hydrostatic pressure due to left-sided heart failure
Answer: D
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation,
which increases the hydrostatic pressure within the pulmonary capillaries. This pressure
forces fluid into the alveolar spaces, resulting in pulmonary edema and the clinical
symptoms of dyspnea and orthopnea. These findings are distinct from right-sided failure,
which typically presents with systemic venous congestion.
2. Which of the following describes the characteristic cellular change found in pernicious
anemia?
A. Macrocytic, normochromic red blood cells
,B. Normocytic, normochromic red blood cells
C. Microcytic, hypochromic red blood cells
D. Small, spherical red blood cells lacking central pallor
Answer: A
Rationale: Pernicious anemia is a type of megaloblastic anemia caused by a deficiency in
Vitamin B12, often due to a lack of intrinsic factor. The absence of B12 impairs DNA
synthesis in RBC precursors, leading to the production of large, immature macrocytes.
These cells are typically normochromic because hemoglobin synthesis remains relatively
unaffected despite the size change.
3. In the pathogenesis of atherosclerosis, which cell type is responsible for the formation of
foam cells after ingesting oxidized LDL?
A. Neutrophils
B. Macrophages
C. Endothelial cells
D. Smooth muscle cells
Answer: B
Rationale: The process begins when macrophages migrate into the tunica intima and
phagocytize oxidized low-density lipoproteins (LDL). Once these macrophages become
engorged with lipids, they are referred to as foam cells, which aggregate to form fatty
, streaks. This is a critical early step in the development of atherosclerotic plaques in the
arterial wall.
4. Which mechanism is the primary cause of hypertension in patients with renal artery
stenosis?
A. Increased sympathetic nervous system activity
B. Direct stimulation of alpha-receptors by norepinephrine
C. Activation of the renin-angiotensin-aldosterone system (RAAS)
D. Loss of sodium-wasting capabilities in the distal tubule
Answer: C
Rationale: Renal artery stenosis reduces blood flow to the kidneys, which is perceived by
the juxtaglomerular apparatus as systemic hypotension. In response, the kidneys secrete
renin, which eventually leads to the production of Angiotensin II and Aldosterone. This
results in systemic vasoconstriction and sodium retention, significantly elevating blood
pressure.
5. A 65-year-old patient is diagnosed with Chronic Obstructive Pulmonary Disease (COPD)
characterized by chronic bronchitis. What is the hallmark pathological change in this
condition?
A. Destruction of alveolar walls and loss of elastic recoil
B. Hypertrophy of mucus-secreting glands in the bronchial wall
C. Permanent dilation of the bronchi due to chronic infection
