NUR 631 MIDTERM EXAM 2026/2027 |
200 Q&A + RATIONALES | VERIFIED A+
STUDY GUIDE | GCU & D'YOUVILLE
Advanced Physiology & Pathophysiology (GCU Style)
1. What initiates an action potential by changing the resting
membrane potential?
Answer: Sodium gates open, allowing sodium to rush into
the cell.
Rationale: Influx of positive ions causes depolarization.
2. Which necrosis type is linked to pulmonary tuberculosis?
Answer: Caseous necrosis.
Rationale: It is a combination of coagulative and liquefactive
necrosis.
3. What is a primary example of compensatory hyperplasia?
Answer: Liver regeneration.
Rationale: An adaptive mechanism following tissue loss.
4. Edema from low plasma albumin is due to a reduction in
which pressure?
Answer: Plasma oncotic (colloid) pressure.
Rationale: Low albumin causes fluid to leak into the tissues.
5. From whom is an autosomal recessive disease inherited?
Answer: Both parents.
Rationale: Requires two copies of the gene.
6. Which hormones manage calcium and phosphate
balance?
Answer: Parathyroid hormone (PTH), Vitamin D, and
Calcitonin.
Rationale: PTH increases calcium, Vitamin D helps absorption,
and Calcitonin lowers it.
7. What is the recurrence risk for an autosomal dominant
disease in each pregnancy?
, Answer: 50%.
Rationale: Only one dominant allele is required.
8. What chromosome defect causes Prader-Willi
Syndrome?
Answer: Deletion or imprinting defect on chromosome
15.
Rationale: Usually a deletion of the paternal chromosome.
Course Hero +6
Advanced Health Assessment (D’Youville Style)
9. Classify "Mr. M. has a respiratory rate of 32 and a pulse
rate of 120."
Answer: Objective.
Rationale: Observable and measurable exam data.
10. What causes wheezes during auscultation?
Answer: Narrowed air passages.
Rationale: Air passing through constricted airways.
11. How do you differentiate clubbed nails from curved
nails?
Answer: Inspect the nail/base angle.
Rationale: Clubbing shows an angle of 180 degrees or more.
12. What is the diaphragm of the stethoscope used for?
Answer: High-pitched sounds.
Rationale: Used for lung, heart, and bowel sounds.
13. A patient has a genetic condition where they have an extra
X chromosome, resulting in a 47,XXY karyotype. Which
syndrome does this describe?
A. Turner Syndrome
B. Down Syndrome
C. Klinefelter Syndrome
D. Fragile X Syndrome
Answer: C
Rationale: Klinefelter syndrome (47,XXY) affects males and is
characterized by an extra X chromosome, leading to symptoms like
infertility and gynecomastia.
,14. In the process of cellular injury, what is the primary
consequence of a decrease in ATP production?
A. Increased protein synthesis
B. Failure of the Sodium-Potassium (Na+/K+) pump
C. Cellular dehydration
D. Increased pH of the cell
Answer: B
Rationale: ATP is required for the Na+/K+ pump. When ATP fails,
sodium stays inside the cell, pulling water in and causing the cell to
swell (oncosis).
15. Which of the following is an example of Metaplasia?
A. The heart enlarging due to high blood pressure
B. The uterus enlarging during pregnancy
C. Replacement of normal ciliated columnar epithelium with stratified
squamous epithelium in a smoker’s airway
D. A decrease in muscle size due to disuse
Answer: C
Rationale: Metaplasia is the reversible replacement of one mature cell
type by another, often as a response to chronic irritation.
16. A 55-year-old male with a history of smoking is diagnosed
with a form of necrosis in the brain following an ischemic
stroke. Which type of necrosis is most likely?
A. Coagulative
B. Liquefactive
C. Fat
D. Gangrenous
Answer: B
Rationale: Liquefactive necrosis is characteristic of ischemic injury to
the brain because brain cells are rich in digestive hydrolytic enzymes.
17. What is the primary intracellular electrolyte?
A. Sodium
B. Potassium
C. Calcium
D. Chloride
Answer: B
Rationale: Potassium (K+) is the most abundant cation inside the cell,
while Sodium (Na+) is the primary extracellular cation.
, 18. A patient presents with a serum sodium level of 120
mEq/L. Which clinical manifestation is the provider most
concerned about?
A. Hyperactive deep tendon reflexes
B. Cerebral edema and seizures
C. Constipation
D. Tented skin turgor
Answer: B
Rationale: Hyponatremia (Low Na+) causes water to move into cells
via osmosis. In the brain, this leads to cerebral edema, which can cause
confusion, seizures, and coma.
19. Which acid-base imbalance is a patient with chronic
obstructive pulmonary disease (COPD) most at risk for?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Rationale: COPD results in CO2 retention (hypoventilation). High levels
of CO2 lead to increased carbonic acid, resulting in respiratory
acidosis.
20. A patient has the following ABG results: pH 7.52, PaCO2 30
mmHg, HCO3 24 mEq/L. What is the interpretation?
A. Metabolic Alkalosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Compensated Metabolic Acidosis
Answer: C
Rationale: The pH is high (>7.45), indicating alkalosis. The CO2 is low
(<35), explaining the alkalosis, and the HCO3 is normal, indicating no
compensation yet.
21. Which type of cellular adaptation involves a decrease in
cell size?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Dysplasia
Answer: C
200 Q&A + RATIONALES | VERIFIED A+
STUDY GUIDE | GCU & D'YOUVILLE
Advanced Physiology & Pathophysiology (GCU Style)
1. What initiates an action potential by changing the resting
membrane potential?
Answer: Sodium gates open, allowing sodium to rush into
the cell.
Rationale: Influx of positive ions causes depolarization.
2. Which necrosis type is linked to pulmonary tuberculosis?
Answer: Caseous necrosis.
Rationale: It is a combination of coagulative and liquefactive
necrosis.
3. What is a primary example of compensatory hyperplasia?
Answer: Liver regeneration.
Rationale: An adaptive mechanism following tissue loss.
4. Edema from low plasma albumin is due to a reduction in
which pressure?
Answer: Plasma oncotic (colloid) pressure.
Rationale: Low albumin causes fluid to leak into the tissues.
5. From whom is an autosomal recessive disease inherited?
Answer: Both parents.
Rationale: Requires two copies of the gene.
6. Which hormones manage calcium and phosphate
balance?
Answer: Parathyroid hormone (PTH), Vitamin D, and
Calcitonin.
Rationale: PTH increases calcium, Vitamin D helps absorption,
and Calcitonin lowers it.
7. What is the recurrence risk for an autosomal dominant
disease in each pregnancy?
, Answer: 50%.
Rationale: Only one dominant allele is required.
8. What chromosome defect causes Prader-Willi
Syndrome?
Answer: Deletion or imprinting defect on chromosome
15.
Rationale: Usually a deletion of the paternal chromosome.
Course Hero +6
Advanced Health Assessment (D’Youville Style)
9. Classify "Mr. M. has a respiratory rate of 32 and a pulse
rate of 120."
Answer: Objective.
Rationale: Observable and measurable exam data.
10. What causes wheezes during auscultation?
Answer: Narrowed air passages.
Rationale: Air passing through constricted airways.
11. How do you differentiate clubbed nails from curved
nails?
Answer: Inspect the nail/base angle.
Rationale: Clubbing shows an angle of 180 degrees or more.
12. What is the diaphragm of the stethoscope used for?
Answer: High-pitched sounds.
Rationale: Used for lung, heart, and bowel sounds.
13. A patient has a genetic condition where they have an extra
X chromosome, resulting in a 47,XXY karyotype. Which
syndrome does this describe?
A. Turner Syndrome
B. Down Syndrome
C. Klinefelter Syndrome
D. Fragile X Syndrome
Answer: C
Rationale: Klinefelter syndrome (47,XXY) affects males and is
characterized by an extra X chromosome, leading to symptoms like
infertility and gynecomastia.
,14. In the process of cellular injury, what is the primary
consequence of a decrease in ATP production?
A. Increased protein synthesis
B. Failure of the Sodium-Potassium (Na+/K+) pump
C. Cellular dehydration
D. Increased pH of the cell
Answer: B
Rationale: ATP is required for the Na+/K+ pump. When ATP fails,
sodium stays inside the cell, pulling water in and causing the cell to
swell (oncosis).
15. Which of the following is an example of Metaplasia?
A. The heart enlarging due to high blood pressure
B. The uterus enlarging during pregnancy
C. Replacement of normal ciliated columnar epithelium with stratified
squamous epithelium in a smoker’s airway
D. A decrease in muscle size due to disuse
Answer: C
Rationale: Metaplasia is the reversible replacement of one mature cell
type by another, often as a response to chronic irritation.
16. A 55-year-old male with a history of smoking is diagnosed
with a form of necrosis in the brain following an ischemic
stroke. Which type of necrosis is most likely?
A. Coagulative
B. Liquefactive
C. Fat
D. Gangrenous
Answer: B
Rationale: Liquefactive necrosis is characteristic of ischemic injury to
the brain because brain cells are rich in digestive hydrolytic enzymes.
17. What is the primary intracellular electrolyte?
A. Sodium
B. Potassium
C. Calcium
D. Chloride
Answer: B
Rationale: Potassium (K+) is the most abundant cation inside the cell,
while Sodium (Na+) is the primary extracellular cation.
, 18. A patient presents with a serum sodium level of 120
mEq/L. Which clinical manifestation is the provider most
concerned about?
A. Hyperactive deep tendon reflexes
B. Cerebral edema and seizures
C. Constipation
D. Tented skin turgor
Answer: B
Rationale: Hyponatremia (Low Na+) causes water to move into cells
via osmosis. In the brain, this leads to cerebral edema, which can cause
confusion, seizures, and coma.
19. Which acid-base imbalance is a patient with chronic
obstructive pulmonary disease (COPD) most at risk for?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Rationale: COPD results in CO2 retention (hypoventilation). High levels
of CO2 lead to increased carbonic acid, resulting in respiratory
acidosis.
20. A patient has the following ABG results: pH 7.52, PaCO2 30
mmHg, HCO3 24 mEq/L. What is the interpretation?
A. Metabolic Alkalosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Compensated Metabolic Acidosis
Answer: C
Rationale: The pH is high (>7.45), indicating alkalosis. The CO2 is low
(<35), explaining the alkalosis, and the HCO3 is normal, indicating no
compensation yet.
21. Which type of cellular adaptation involves a decrease in
cell size?
A. Hypertrophy
B. Hyperplasia
C. Atrophy
D. Dysplasia
Answer: C
