NURS 6501 – Advanced Pathophysiology Exam
Section 1 (Questions 1–20)
1. Which of the following is the primary mechanism leading to type 1 diabetes mellitus?
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells ✅
C. Increased hepatic glucose production
D. Excessive glucagon secretion
Answer: B
Explanation: Type 1 diabetes is caused by autoimmune destruction of pancreatic beta cells,
leading to absolute insulin deficiency.
Why others are wrong:
A → Insulin resistance is characteristic of type 2 diabetes, not type 1.
C → Increased hepatic glucose contributes to hyperglycemia but is not the primary cause.
D → Excess glucagon may worsen hyperglycemia but is not the initiating factor.
2. A patient presents with hyperventilation and a pH of 7.48. What is the primary
disorder?
A. Metabolic acidosis
B. Respiratory alkalosis ✅
C. Metabolic alkalosis
D. Respiratory acidosis
Answer: B
Explanation: Elevated pH and hyperventilation indicate a primary loss of CO₂, causing
respiratory alkalosis.
Why others are wrong:
A → Metabolic acidosis presents with low pH, not high.
C → Metabolic alkalosis involves increased HCO₃⁻, not hyperventilation.
D → Respiratory acidosis involves hypoventilation and low pH.
3. Which cytokine is most associated with systemic inflammation and fever?
A. Interleukin-10
B. Tumor necrosis factor-alpha (TNF-α) ✅
C. Transforming growth factor-beta
D. Interleukin-4
,Answer: B
Explanation: TNF-α is a pro-inflammatory cytokine that induces fever and acute-phase
responses.
Why others are wrong:
A → IL-10 is anti-inflammatory.
C → TGF-β mainly regulates cell growth and repair.
D → IL-4 is involved in humoral immunity and allergic responses.
4. Which type of shock is characterized by widespread vasodilation and relative
hypovolemia?
A. Cardiogenic shock
B. Hypovolemic shock
C. Distributive shock ✅
D. Obstructive shock
Answer: C
Explanation: Distributive shock (e.g., septic, anaphylactic) involves vasodilation and pooling of
blood, reducing effective circulating volume.
Why others are wrong:
A → Cardiogenic shock is due to heart pump failure.
B → Hypovolemic shock is due to actual loss of blood/fluid.
D → Obstructive shock is due to mechanical obstruction (e.g., PE, tamponade).
5. A patient has fatty liver, hepatomegaly, and insulin resistance. What is the most likely
diagnosis?
A. Hepatitis B
B. Non-alcoholic fatty liver disease (NAFLD) ✅
C. Cirrhosis
D. Hemochromatosis
Answer: B
Explanation: NAFLD is commonly associated with obesity and insulin resistance and presents
with hepatomegaly and steatosis.
Why others are wrong:
A → Hepatitis B causes viral hepatitis, not primarily steatosis.
C → Cirrhosis is late-stage liver fibrosis.
D → Hemochromatosis causes iron overload, not fatty infiltration.
,6. Which electrolyte imbalance is most likely in a patient with Addison’s disease?
A. Hypernatremia
B. Hypokalemia
C. Hyponatremia ✅
D. Hypercalcemia
Answer: C
Explanation: Addison’s disease (adrenal insufficiency) leads to low aldosterone, causing
sodium loss and hyponatremia.
Why others are wrong:
A → Hypernatremia is opposite; sodium is lost, not retained.
B → Hypokalemia is seen with hyperaldosteronism, not Addison’s.
D → Hypercalcemia is not a typical feature of Addison’s.
7. What is the pathophysiologic hallmark of acute respiratory distress syndrome (ARDS)?
A. Bronchospasm
B. Pulmonary edema from increased capillary permeability ✅
C. Pleural effusion
D. Pulmonary embolism
Answer: B
Explanation: ARDS involves increased alveolar-capillary permeability leading to non-
cardiogenic pulmonary edema and hypoxemia.
Why others are wrong:
A → Bronchospasm is typical of asthma, not ARDS.
C → Pleural effusion is fluid in pleural space, not alveolar flooding.
D → Pulmonary embolism is obstruction, not diffuse alveolar damage.
8. Which type of hypersensitivity reaction involves IgE antibodies and mast cell
degranulation?
A. Type I ✅
B. Type II
C. Type III
D. Type IV
Answer: A
Explanation: Type I hypersensitivity is immediate, IgE-mediated, causing histamine release
(e.g., anaphylaxis).
Why others are wrong:
, B → Type II is cytotoxic antibody-mediated.
C → Type III is immune complex-mediated.
D → Type IV is delayed, T-cell mediated.
9. A patient presents with increased thirst, frequent urination, and polyphagia. Lab shows
fasting glucose 190 mg/dL. Which type of diabetes is most likely?
A. Type 1 diabetes ✅
B. Type 2 diabetes
C. Gestational diabetes
D. MODY
Answer: A
Explanation: Acute presentation with polyuria, polydipsia, and polyphagia in a younger patient
usually indicates type 1 diabetes.
Why others are wrong:
B → Type 2 is often gradual and insulin-resistant.
C → Gestational diabetes occurs only in pregnancy.
D → MODY is rare and genetically inherited.
10. Which hormone is primarily responsible for calcium regulation by increasing serum
calcium?
A. Calcitonin
B. Parathyroid hormone (PTH) ✅
C. Vitamin D
D. Aldosterone
Answer: B
Explanation: PTH raises serum calcium by stimulating bone resorption, kidney reabsorption,
and activating vitamin D.
Why others are wrong:
A → Calcitonin lowers serum calcium.
C → Vitamin D helps absorption but is not the primary regulator.
D → Aldosterone regulates sodium, not calcium.
11. In congestive heart failure, which compensatory mechanism initially helps maintain
cardiac output?
A. Decreased sympathetic activity
B. Activation of renin-angiotensin-aldosterone system (RAAS) ✅
Section 1 (Questions 1–20)
1. Which of the following is the primary mechanism leading to type 1 diabetes mellitus?
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells ✅
C. Increased hepatic glucose production
D. Excessive glucagon secretion
Answer: B
Explanation: Type 1 diabetes is caused by autoimmune destruction of pancreatic beta cells,
leading to absolute insulin deficiency.
Why others are wrong:
A → Insulin resistance is characteristic of type 2 diabetes, not type 1.
C → Increased hepatic glucose contributes to hyperglycemia but is not the primary cause.
D → Excess glucagon may worsen hyperglycemia but is not the initiating factor.
2. A patient presents with hyperventilation and a pH of 7.48. What is the primary
disorder?
A. Metabolic acidosis
B. Respiratory alkalosis ✅
C. Metabolic alkalosis
D. Respiratory acidosis
Answer: B
Explanation: Elevated pH and hyperventilation indicate a primary loss of CO₂, causing
respiratory alkalosis.
Why others are wrong:
A → Metabolic acidosis presents with low pH, not high.
C → Metabolic alkalosis involves increased HCO₃⁻, not hyperventilation.
D → Respiratory acidosis involves hypoventilation and low pH.
3. Which cytokine is most associated with systemic inflammation and fever?
A. Interleukin-10
B. Tumor necrosis factor-alpha (TNF-α) ✅
C. Transforming growth factor-beta
D. Interleukin-4
,Answer: B
Explanation: TNF-α is a pro-inflammatory cytokine that induces fever and acute-phase
responses.
Why others are wrong:
A → IL-10 is anti-inflammatory.
C → TGF-β mainly regulates cell growth and repair.
D → IL-4 is involved in humoral immunity and allergic responses.
4. Which type of shock is characterized by widespread vasodilation and relative
hypovolemia?
A. Cardiogenic shock
B. Hypovolemic shock
C. Distributive shock ✅
D. Obstructive shock
Answer: C
Explanation: Distributive shock (e.g., septic, anaphylactic) involves vasodilation and pooling of
blood, reducing effective circulating volume.
Why others are wrong:
A → Cardiogenic shock is due to heart pump failure.
B → Hypovolemic shock is due to actual loss of blood/fluid.
D → Obstructive shock is due to mechanical obstruction (e.g., PE, tamponade).
5. A patient has fatty liver, hepatomegaly, and insulin resistance. What is the most likely
diagnosis?
A. Hepatitis B
B. Non-alcoholic fatty liver disease (NAFLD) ✅
C. Cirrhosis
D. Hemochromatosis
Answer: B
Explanation: NAFLD is commonly associated with obesity and insulin resistance and presents
with hepatomegaly and steatosis.
Why others are wrong:
A → Hepatitis B causes viral hepatitis, not primarily steatosis.
C → Cirrhosis is late-stage liver fibrosis.
D → Hemochromatosis causes iron overload, not fatty infiltration.
,6. Which electrolyte imbalance is most likely in a patient with Addison’s disease?
A. Hypernatremia
B. Hypokalemia
C. Hyponatremia ✅
D. Hypercalcemia
Answer: C
Explanation: Addison’s disease (adrenal insufficiency) leads to low aldosterone, causing
sodium loss and hyponatremia.
Why others are wrong:
A → Hypernatremia is opposite; sodium is lost, not retained.
B → Hypokalemia is seen with hyperaldosteronism, not Addison’s.
D → Hypercalcemia is not a typical feature of Addison’s.
7. What is the pathophysiologic hallmark of acute respiratory distress syndrome (ARDS)?
A. Bronchospasm
B. Pulmonary edema from increased capillary permeability ✅
C. Pleural effusion
D. Pulmonary embolism
Answer: B
Explanation: ARDS involves increased alveolar-capillary permeability leading to non-
cardiogenic pulmonary edema and hypoxemia.
Why others are wrong:
A → Bronchospasm is typical of asthma, not ARDS.
C → Pleural effusion is fluid in pleural space, not alveolar flooding.
D → Pulmonary embolism is obstruction, not diffuse alveolar damage.
8. Which type of hypersensitivity reaction involves IgE antibodies and mast cell
degranulation?
A. Type I ✅
B. Type II
C. Type III
D. Type IV
Answer: A
Explanation: Type I hypersensitivity is immediate, IgE-mediated, causing histamine release
(e.g., anaphylaxis).
Why others are wrong:
, B → Type II is cytotoxic antibody-mediated.
C → Type III is immune complex-mediated.
D → Type IV is delayed, T-cell mediated.
9. A patient presents with increased thirst, frequent urination, and polyphagia. Lab shows
fasting glucose 190 mg/dL. Which type of diabetes is most likely?
A. Type 1 diabetes ✅
B. Type 2 diabetes
C. Gestational diabetes
D. MODY
Answer: A
Explanation: Acute presentation with polyuria, polydipsia, and polyphagia in a younger patient
usually indicates type 1 diabetes.
Why others are wrong:
B → Type 2 is often gradual and insulin-resistant.
C → Gestational diabetes occurs only in pregnancy.
D → MODY is rare and genetically inherited.
10. Which hormone is primarily responsible for calcium regulation by increasing serum
calcium?
A. Calcitonin
B. Parathyroid hormone (PTH) ✅
C. Vitamin D
D. Aldosterone
Answer: B
Explanation: PTH raises serum calcium by stimulating bone resorption, kidney reabsorption,
and activating vitamin D.
Why others are wrong:
A → Calcitonin lowers serum calcium.
C → Vitamin D helps absorption but is not the primary regulator.
D → Aldosterone regulates sodium, not calcium.
11. In congestive heart failure, which compensatory mechanism initially helps maintain
cardiac output?
A. Decreased sympathetic activity
B. Activation of renin-angiotensin-aldosterone system (RAAS) ✅
