Advanced Pathophysiology OA Exam
– WGU D115 – Western Governors
University –2025/2026 –Qns with Ans
EXAM
Q1. What directly causes ovulation during the menstrual cycle?
A) Gradual decrease in estrogen levels.
B) Sudden increase of LH.
C) Sharp rise in progesterone levels.
D) Gradual increase in estrogen levels.
Rationale: Ovulation generally occurs 1-2 hours before the final progesterone surge, or
about 12-36 hours after the onset of the FSH and LH surge .
Q2. Which is a symptom of syndrome of inappropriate antidiuretic hormone
(SIADH)?
A) Hypernatremia
B) Hyponatremia
C) Hyperkalemia
D) Hypokalemia
Rationale: A low sodium level or hyponatremia is a major complication of SIADH and is
responsible for many of the symptoms of SIADH .
Q3. A woman has sustained a traumatic brain injury. She is able to follow simple
commands and can manipulate objects. Which term describes this state?
A) Coma
B) Persistent vegetative state
C) Minimally conscious
D) Locked-in syndrome
, Rationale: When responses to the environment are seen, the patient is said to be in a
minimally conscious state .
Q4. Age and the admission of the Glasgow Coma Scale (GCS) are important
diagnostic factors in TBI. Which GCS score describes a severe TBI?
A) 13-15
B) 12-13
C) 9-12
D) 3-8
Rationale: The GCS is scored between 3 and 15, 3 being the worst and 15 the best .
Q5. Which term describes recurrent, intrusive thoughts or impulses?
A) Hallucinations
B) Compulsions
C) Obsessions
D) Delusions
Rationale: Obsessions are recurrent and persistent thoughts, impulses, or images that
cause distressing emotions such as anxiety or disgust .
Q6. In the most commonly seen form of Turner Syndrome, how is the X
chromosome affected?
A) Each cell has only one X chromosome.
B) Some cells have two X chromosomes, while the other cells have only one.
C) Each cell has two X chromosomes, but part of the chromosome is missing.
D) Each cell has an extra X chromosome.
Rationale: 45% of persons with Turner Syndrome have monosomy X, meaning there is
only one copy of the X chromosome in each cell .
Q7. The FNP is assessing a newborn who is demonstrating a high-pitched cry,
microcephaly, hypertelorism, hypotonia, and a low birth weight. The FNP would
suspect which of the following genetic conditions?
A) Down syndrome
B) Cri du chat
C) Edwards syndrome
, D) Patau syndrome
Rationale: The clinical symptoms of cri du chat syndrome usually include a high-pitched
cat-like cry, mental retardation, delayed development, distinctive facial features, small
head size (microcephaly), widely-spaced eyes (hypertelorism), low birth weight and weak
muscle tone (hypotonia) in infancy .
Q8. What is the most common indication for genetic counseling?
A) maternal age
B) drug exposure during the first trimester
C) Increased maternal alpha-fetoprotein
D) history of previous still birth
Rationale: The largest group of women who benefit from genetic counseling are those
over the age of 35 .
Q9. When explaining the types of adaptive immunity, the FNP student is aware
that:
A) Adaptive immunity is a cell-mediated immune response which is carried out by
T cells and B cells.
B) Adaptive immunity is a nonspecific response that provides immediate defense against
infection.
C) Adaptive immunity includes physical barriers like the skin and mucous membranes.
D) Adaptive immunity is the first line of defense and does not have memory.
Rationale: There are two types of adaptive immunity responses: the cell-mediated
immune response, which is carried out by T cells, and the humoral immune response,
which is controlled by activated B cells and antibodies .
Q10. The FNP understands that a potential complication of tonsillar infections,
which is characterized by severe sore throat, difficulty swallowing, odynophagia,
trismus, and a "hot potato" voice; accompanied by fever, chills and malaise is
indicative of:
A) Retropharyngeal abscess
B) Epiglottitis
C) Peritonsillar cellulitis
D) Peritonsillar abscess
, Rationale: Peritonsillar abscess is characterized by severe sore throat, pain or difficulty
swallowing, jaw muscle spasms, and a hot potato voice .
Q11. A young adult woman presents with anxiety, tremors, heart palpitations,
intolerance to heat, fatigue, unexplained weight loss, and increased appetite. After
laboratory evaluation of thyroid hormone levels, the nurse practitioner diagnoses
hyperthyroidism. What is the most frequent underlying cause of this condition in
this population?
A) Thyroid malignancy
B) Graves’ disease
C) Pituitary gland tumor
D) Thyroid inflammation following pregnancy
Rationale: Graves’ disease is an autoimmune disorder, also referred to as diffuse toxic
goiter, and is the leading cause of hyperthyroidism among young adult women.
Autoantibodies stimulate the thyroid gland, resulting in excessive hormone production .
Q12. Which of the following characteristics applies to type 2 diabetes mellitus?
A) Major risk factors are heredity and obesity
B) Pear-shaped body type is commonly found
C) Exogenous insulin is needed for control of the disease
D) Physical activity increases insulin resistance
Rationale: Risk factors of type 2 DM include increasing age, obesity, race, and genetics .
13. A patient with chronic liver disease presents with confusion, asterixis, and
elevated serum ammonia. What is the most likely diagnosis?
A) Hepatic encephalopathy
B) Wernicke’s encephalopathy
C) Alzheimer’s disease
D) Stroke
– WGU D115 – Western Governors
University –2025/2026 –Qns with Ans
EXAM
Q1. What directly causes ovulation during the menstrual cycle?
A) Gradual decrease in estrogen levels.
B) Sudden increase of LH.
C) Sharp rise in progesterone levels.
D) Gradual increase in estrogen levels.
Rationale: Ovulation generally occurs 1-2 hours before the final progesterone surge, or
about 12-36 hours after the onset of the FSH and LH surge .
Q2. Which is a symptom of syndrome of inappropriate antidiuretic hormone
(SIADH)?
A) Hypernatremia
B) Hyponatremia
C) Hyperkalemia
D) Hypokalemia
Rationale: A low sodium level or hyponatremia is a major complication of SIADH and is
responsible for many of the symptoms of SIADH .
Q3. A woman has sustained a traumatic brain injury. She is able to follow simple
commands and can manipulate objects. Which term describes this state?
A) Coma
B) Persistent vegetative state
C) Minimally conscious
D) Locked-in syndrome
, Rationale: When responses to the environment are seen, the patient is said to be in a
minimally conscious state .
Q4. Age and the admission of the Glasgow Coma Scale (GCS) are important
diagnostic factors in TBI. Which GCS score describes a severe TBI?
A) 13-15
B) 12-13
C) 9-12
D) 3-8
Rationale: The GCS is scored between 3 and 15, 3 being the worst and 15 the best .
Q5. Which term describes recurrent, intrusive thoughts or impulses?
A) Hallucinations
B) Compulsions
C) Obsessions
D) Delusions
Rationale: Obsessions are recurrent and persistent thoughts, impulses, or images that
cause distressing emotions such as anxiety or disgust .
Q6. In the most commonly seen form of Turner Syndrome, how is the X
chromosome affected?
A) Each cell has only one X chromosome.
B) Some cells have two X chromosomes, while the other cells have only one.
C) Each cell has two X chromosomes, but part of the chromosome is missing.
D) Each cell has an extra X chromosome.
Rationale: 45% of persons with Turner Syndrome have monosomy X, meaning there is
only one copy of the X chromosome in each cell .
Q7. The FNP is assessing a newborn who is demonstrating a high-pitched cry,
microcephaly, hypertelorism, hypotonia, and a low birth weight. The FNP would
suspect which of the following genetic conditions?
A) Down syndrome
B) Cri du chat
C) Edwards syndrome
, D) Patau syndrome
Rationale: The clinical symptoms of cri du chat syndrome usually include a high-pitched
cat-like cry, mental retardation, delayed development, distinctive facial features, small
head size (microcephaly), widely-spaced eyes (hypertelorism), low birth weight and weak
muscle tone (hypotonia) in infancy .
Q8. What is the most common indication for genetic counseling?
A) maternal age
B) drug exposure during the first trimester
C) Increased maternal alpha-fetoprotein
D) history of previous still birth
Rationale: The largest group of women who benefit from genetic counseling are those
over the age of 35 .
Q9. When explaining the types of adaptive immunity, the FNP student is aware
that:
A) Adaptive immunity is a cell-mediated immune response which is carried out by
T cells and B cells.
B) Adaptive immunity is a nonspecific response that provides immediate defense against
infection.
C) Adaptive immunity includes physical barriers like the skin and mucous membranes.
D) Adaptive immunity is the first line of defense and does not have memory.
Rationale: There are two types of adaptive immunity responses: the cell-mediated
immune response, which is carried out by T cells, and the humoral immune response,
which is controlled by activated B cells and antibodies .
Q10. The FNP understands that a potential complication of tonsillar infections,
which is characterized by severe sore throat, difficulty swallowing, odynophagia,
trismus, and a "hot potato" voice; accompanied by fever, chills and malaise is
indicative of:
A) Retropharyngeal abscess
B) Epiglottitis
C) Peritonsillar cellulitis
D) Peritonsillar abscess
, Rationale: Peritonsillar abscess is characterized by severe sore throat, pain or difficulty
swallowing, jaw muscle spasms, and a hot potato voice .
Q11. A young adult woman presents with anxiety, tremors, heart palpitations,
intolerance to heat, fatigue, unexplained weight loss, and increased appetite. After
laboratory evaluation of thyroid hormone levels, the nurse practitioner diagnoses
hyperthyroidism. What is the most frequent underlying cause of this condition in
this population?
A) Thyroid malignancy
B) Graves’ disease
C) Pituitary gland tumor
D) Thyroid inflammation following pregnancy
Rationale: Graves’ disease is an autoimmune disorder, also referred to as diffuse toxic
goiter, and is the leading cause of hyperthyroidism among young adult women.
Autoantibodies stimulate the thyroid gland, resulting in excessive hormone production .
Q12. Which of the following characteristics applies to type 2 diabetes mellitus?
A) Major risk factors are heredity and obesity
B) Pear-shaped body type is commonly found
C) Exogenous insulin is needed for control of the disease
D) Physical activity increases insulin resistance
Rationale: Risk factors of type 2 DM include increasing age, obesity, race, and genetics .
13. A patient with chronic liver disease presents with confusion, asterixis, and
elevated serum ammonia. What is the most likely diagnosis?
A) Hepatic encephalopathy
B) Wernicke’s encephalopathy
C) Alzheimer’s disease
D) Stroke
